It was a Friday afternoon in April when I stopped by the doctor’s office for my weekly antenatal visit, only to find out that I would be delivering my baby on Monday morning. <Insert mental breakdown here>
She wasn’t due for another week, but she was awkwardly positioned. While there was a 50/50 chance that she would turn during labour, it also posed a risk for a problematic delivery hence the decision for a planned C-section.
Okay just breathe, we just need to repack a few things and prep ourselves for a C-section.
We also need to contact the medical aid... as I made a mental note of all the things I needed to do, trying to calm myself in the process – all the while managing the disappointment of not having a natural birth.
What I wasn’t expecting (or maybe I was, who am I kidding, I wasn’t) was the doctor’s parting words: “Oh, and your husband will only be able to be present for the birth, but he will have to leave after 2 hours and won’t be able to visit until you are discharged.”
At that point, I knew I was not going to be okay. I cried the entire weekend. I continued to cry (at least twice a day) every day for 6 months after that, and every other day for the 3 months that followed. My little one is one-year old now, and there are still days when I cry. Even now, I carry my postpartum depression with me.
The Silent Complication
Postpartum depression, post-natal depression, perinatal depression, whatever you prefer to call it, affects an estimated 1 in 7 women. According to the Post-Natal Depression Support Association of South Africa (PNDSA), up to 30% of new mothers in South Africa (an estimated minimum of 50 000 mothers per year) are clinically ill with depression or anxiety disorders.
Okay, so if that is the case, why aren’t we talking about this more? I was fortunate enough to be able to attend antenatal classes with my husband before the arrival of our baby and even in those classes, the subject was only touched on briefly. We received a handout, ran through it in the last few minutes of class, and that was it.
When people speak so little about something, you naturally assume it doesn’t happen very often or that it won’t happen to you, but the reality is that it happens. Very often. And it happened (and is still happening) to me.
According to the South African Depression and Anxiety Group (SADAG), a recent study carried out by a PPD Support Group showed that depression can begin before a baby is born. Fifty percent of women in the study were depressed during pregnancy and in none of the cases was it picked up.
“Despite the considerable number of cases, the condition generally remains undiagnosed and untreated, leaving mothers to drag themselves through each day without any end in sight! The condition is generally glossed over in childbirth preparation classes and pregnancy guidebooks, and is not routinely screened for in post-partum check-ups. During the check-ups, the focus is very much on the mother’s physical health rather than her emotional wellbeing.”
This was my reality. As my pregnancy progressed and the time drew nearer for me to have my baby, I started to experience intense anxiety and sadness for what I can only imagine was the fear of the unknown that lay ahead of me. I would have regular crying episodes (that no one was aware of) and, in all honesty, chalked it up to “hormones”. I was pregnant, after all.
So how does someone with a degree in psychology, who works in the media and is passionate about mental health not see the signs? Because, in my opinion, as a community we haven’t been taught to recognise the signs. Talking about mental health especially as it relates to motherhood carries a heavy stigma.
Thinking back to my teenage years, I was privy to one or two conversations about people who have had postpartum depression or the “baby blues” (which is a different thing by the way), and the conclusion is always the same: “crazy”, “weak” or “being dramatic”. I mean, what is wrong with you? You should be happy, right?
When this is the narrative that you have about something that is one of the most common complications of pregnancy, how will you be able to identify when you need help?
A Loss of Identity
At 14:01 on 6 April 2020, my beautiful baby arrived earthside and the first thing I thought as she announced her arrival with a little cry was (and I kid you not) “Oh shit, this just got real.” And boy, oh boy, did it ever!
What is postpartum depression like? For me, I was overcome with inexplicable sadness. I was overwhelmed and overcome with fear and anxiety about everything for the future. I was wrought with doubt about my ability to be a good parent and overwhelmed by the scale of this lifetime responsibility.
Those first few weeks were so rough emotionally. I was in awe at what we had created but absolutely, positively defeated. Our baby had colic and we had no idea how to help her. We tried every remedy and all we could do was hang in there until she was over it, but God, it was so hard.
The constant crying, the not knowing what to do as a first-time parent. The self-doubt, the fear that you would do something wrong. The constant worrying about her safety, that she wasn’t too warm or too cold, the constant checking to make sure she was breathing. My husband and I literally slept all over our house just trying to find something that would work for our family.
There were some very dark days and while I never thought about harming myself or my baby, I did wish that I could just disappear. Those thoughts were immediately countered by feelings of bone-crushing guilt. Someone once joked with me that when a woman goes to have a baby, they take the baby out, and replace it with guilt. Truer words have never been spoken.
I struggled with a loss of identity. Who am I? What does it mean to be a mother? Am I doing it right? What does ‘right’ even mean? My life will never be the same again. What if my baby doesn’t like me? The dialogue in my head was exhausting. I was in the worst shape of my life mentally, physically and emotionally.
Nothing had gone “according to plan”, which I doubt would have made any difference because postpartum depression is not something you can control. My rational psychology textbook mind had all the answers and knew exactly what was going on and what I should do, but my emotional mind was in the driver’s seat taking me on the ride of my life.
Over time, my shower and afternoon nap breakdowns became too much, and I picked up the phone and called a psychologist because it was clear: I needed help. The sad thing is that even after receiving my diagnosis I did not feel comfortable telling those closest to me what was going on, purely out of fear of judgment. And not because they are uncaring, judgmental people but because honestly, they have no idea what it really means because no one took the time to explain it to them.
The last thing anyone wants to look like is weak especially at such an “exciting” time in your life, but the reality is that parenthood will break you. It will shake your very foundations as you look at your life, your belief systems and everything you stand for as a person. It will have you asking questions like: “Is this the example I want to set for my child.” It brings you face to face with yourself in a way that you could not imagine, and perhaps that was a contributing factor to the position I found myself in.
If I could end this piece off in anyway it would be to appeal to anyone and everyone working in related fields of healthcare to make a bigger deal about postpartum depression. We are so far off from breaking the stigma associated with mental health as it relates to parenthood (PD affects dads, too!). If you are someone who is dealing with or dealt with postpartum depression, please share your story with others because you don’t know who needs to hear it.
I am eternally grateful to a friend of mine who shared her struggle with postpartum depression. Had it not been for her “bench warming tale” (inside joke!) I would honestly have believed I was “crazy”, “weak” or “being dramatic”. I might have even thought I could go at it alone and may never have sought help. How wrong I would have been.
In the end, with the right support system and the right help, there is light at the end of the tunnel. You don’t have to succumb to something you have no control over just because you are fearful of the stigma associated with it. The people around you may not understand, but perhaps this is your chance to educate them.
Put on your own oxygen mask first before helping others. Get the help you need so that you can be the healthy, happy mommy your baby needs. The person you deserve to be. Self-care saves lives.
Need help or just more information about PD?
Author: Liesl Frankson