May 10th, 2021
”It takes a village to raise a child”
In March 2020, I became a mom for the 1st time.
My pregnancy had been healthy, I had read all the books, sat in the front row for the baby classes (and took notes and asked questions), and I had the baby's room fully prepared months before she was due.
I had done everything “perfectly.” I was ready to be SuperMom.
When we went into the hospital the news was swirling about a “coronavirus," but I had barely paid attention, my focus was on this soon-to-be-born baby.
A few hours after we arrived the hospital staff told me that my mom would not be able to come to the delivery due to precautions for ”the virus” and that my friends could not come to visit after I had her in the hospital.
I was disappointed & sad, things were not going as I had planned them. I tried to keep calm and focus on our baby. She arrived happy, healthy, and beautiful, 32 hours later.
The day after I had her, I got a phone call from my friend “People are clearing the shelves in the grocery store, there’s no toilet paper, there are no supplies, do you need formula? Formula is running out of stock." A wave of panic swept over me, I responded “Yes, please get me formula, as much as you can!"
During the rest of our stay, while watching the news on our phones and talking to friends about what was going on in the world, I felt waves of panic & anxiety, amidst my love and joy for my baby.
When we brought her home my head was swirling, I had done everything perfectly, I was so ready to love and take care of my baby, but no one taught me how to keep her safe in a pandemic. What if I get COVID-19? What if my husband gets COVID-19? What if my baby gets COVID-19?
The next 3 weeks were spent in daytime bliss with my daughter and nighttime dread, after the baby went to sleep, I felt intense anxiety about COVID-19 and the future as a mom in a pandemic.
I tell this story to shed light on Maternal Mental Health during Maternal Mental Health Month.
I was lucky, I had no predisposition to Postpartum Depression. My support system is strong (some of my best friends are therapists), and within 3 weeks the anxiety started to lift and become much more manageable.
The pandemic unfortunately did not lift, but we had learned this was our new normal and our little family was coping.
A recent study stated that 1 out of every 7 women experiences postpartum depression in the 1st year after childbirth. In an article called “PostPartum Anxiety” by Sharon Mazel,it is stated that 10-15% of new moms will experience postpartum anxiety.
These terms both refer to a clinical level of depression or anxiety not to be confused with the more common “baby blues” which affects 70-80% of new moms.
In the DSM-V perinatal depression and perinatal generalized anxiety are defined as…….
Surprise! They aren’t defined, because neither of those terms is an actual diagnosis in the DSM-V, we have a specifier “with perinatal onset” for Major Depressive Disorder & Generalized Anxiety Disorder meaning, we are seeing new moms present with the criteria of either of those diagnoses during or after pregnancy.
I do not treat postpartum depression and anxiety in my own work as a therapist however I know our field has an endless number of resources/treatments.
We have research that shows using a combination of SSRIs and Cognitive Behavioral Therapy can be highly effective in the treatment of postpartum depression/anxiety.
Our field even has a certification for therapists in perinatal mental health and Clarity Clinic has therapists and psychiatrists who dedicate their careers to working with women experiencing postpartum depression/anxiety.
So, why isn’t it a stand-alone diagnosis in the DSM-V if it is so prevalent? Although the DSM is used by most of the entire world as the authority on psychiatric diagnosis, it is written and published by the American Psychiatric Association. Perhaps a better question is, do we prioritize Maternal Mental Health in the U.S.?
Let’s take a look at some of the factors that affect Maternal Mental Health.
Predisposition - Women who have struggled with mental illness prior to pregnancy are at a higher risk for developing perinatal or postpartum depression/anxiety. Often, women who have postpartum depression/anxiety will show signs of perinatal depression or anxiety (during pregnancy).
Support - Having support from family, friends and mental health practitioners is especially important not only postpartum but throughout motherhood.
Financial Stress -The US is the only developed western country that does not offer universal health care, the cost of having a baby in the US can put some families into debt.
According to Business Insider, in Illinois, this is the average cost of having a baby:
The stress of the cost of delivery coupled with the pressures of going back to work can leave mothers in a situation where they must choose between staying home to take care of their child and going back to work for financial stability.
Even those mothers who are lucky enough to not have to worry about the cost of delivery are still faced with the challenge of career vs motherhood. This balance can be difficult and often results in sacrifices in one area of a mother’s life.
I know more than a few mothers who have chosen to stay home after having a baby due to the costs of childcare. Finding that financially it makes more sense for mom to stay home and take care of the child vs going back to work and paying someone else to watch the child.
Figure: Average Rates Of Childcare In The U.S.
Source: Care.com
While this might make good financial sense for the family it does not consider how leaving a career may affect the mom’s mental health, her autonomy, and sense of worth.
At the start of the pandemic, with no childcare safely available and needing to get back to work, I was lucky to have a job that allowed for me to have the flexibility and to have my own mother providing the childcare.
Most new moms do not have a boss who is a Psychologist (and has devoted her life to promoting mental wellness) and a parent who can provide free childcare.
The US is the only Westernized country in the world that does not guarantee paid maternity leave. In the US companies are only required to allow for 12 weeks of FMLA (family medical leave act), after that if a mother decides to take more (unpaid) leave, she would be at risk of losing her job.
Most companies do offer paid maternity leave, but they are not required to do so.
Even with having an amazing employer who cared about the balance between being a mom and a therapist I still struggled with the choice to decrease my availability for clients to spend more time with my baby. I wanted to do it all.
Figure: Amount Of Paid Leave Mandated By Other Countries Around The World.
Source: Pew Research Center.
The concerns and pressures on Maternal Mental Health go way beyond the “postpartum” time. While we may have a whole month dedicated to Maternal Mental Health, societal pressures and expectations may not really lend to moms having the balance they need in their lives.
We have even come up with cute terms to minimize the negative effects these expectations and lack of support can have on a mother’s mental health.
I often hear the term “Mom Brain” when referring to a mom who is struggling to remember tasks for the day, or when a mom is not following through on something.
“Mom Brain” is likely the result of a lack of sleep affecting the mother’s memory consolidation. A long-term lack of sleep can result in, physical issues like hypertension and a weakened immune system, and psychological issues like long-term memory loss, anxiety, and depression. Doesn’t sound so cute now, right?
Another term often used is “Mom Guilt” which often comes up when a mother must make the choice between herself or time with her children. Although we as moms may have coined this term, it does not make it any less minimizing.
The choice for self-care, time with friends, or a career can often be coupled with agonizing guilt, shame, and fear of making the wrong choice.
In honor of Maternal Mental Health Month, the next time you use the term “it takes a village to raise a child”, don’t forget that there’s a SuperMom who also needs support from that village.
Clarity Clinic offers a range of treatments for postpartum and perinatal anxiety and depression. We have psychiatrists and therapists who are trained in and specialize in these treatment areas. To learn more about how we can support your mental health, call Clarity Clinic at (312) 815-9660 or schedule an appointment today.
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