By: Catherine Pearson | 10/28/2020
"It's not just right after giving birth. A new study shows that for a significant number of moms, symptoms persist for years."
"When Jane gave birth to her baby 10 years ago, she very quickly began experiencing significant postpartum depression. It felt as though her brain had been abruptly “rewired,” and her symptoms grew worse over time.
“It felt like there was this thing in me that took root and grew,” said Jane, 47, who asked to use only her first name for this story. “Especially feeling suicidal. Those thoughts had a life of their own.”
As the months passed after giving birth, Jane found herself making clearer and clearer plans for how she’d take her own life. She recalls at one point, when her son was 3, nearly pointing out an overpass from which she could easily jump while strolling with her toddler and husband — then immediately recoiling. Not from the thought itself, but from the fact that she had almost casually given her “secret” away.
When her son turned 4, Jane finally recognized her own need to get help and got a prescription for Prozac. Practically overnight, her thoughts of suicide disappeared. And despite the fact that it was years after she had given birth, the roots of her depression felt obvious.
“For me, it could not be more clear that what I had was postpartum depression,” said Jane, who often worried she’d sound “crazy” if she opened up about what she was experiencing — particularly because she adored her son. “It felt almost like my brain was rewired during pregnancy.”
New research published in the journal Pediatrics this week supports what parents like Jane, as well as mental health professionals who specialize in the issue, have long known: that “postpartum” depression is not just something that strikes in the weeks and months immediately following childbirth. It can last for years and grow worse with time.
In the study, which tracked 5,000 mothers in New York over time, one-quarter of the women experienced elevated depression symptoms at some point in the three years after giving birth.
Of course, up to 80% of new moms experience some version of the so-called “baby blues” in the first few weeks after delivery. They may feel sad, anxious and cry a lot. Their moods may shift rapidly as their hormones fluctuate and they learn to care for a vulnerable new infant on extremely little sleep.
Postpartum depression may be more severe (though not always) and lasts longer, often appearing weeks after giving birth but sometimes not for a full year — or, as this new research suggests, even longer. It builds on a recent scientific review that found up to 50% of moms with postpartum depression struggle beyond the first year.
Expanding our collective understanding of how long postpartum depression can persist is important largely because of screening.
The American College of Obstetricians and Gynecologists — which sets the guidelines OB-GYNs and other women’s health providers often use — recommends at least one screening for postpartum depression using an official tool or questionnaire. The American Academy of Pediatrics recommends pediatricians screen for mental health issues in patients at various points in the first six months after they’ve given birth.
But that timeline may not do enough to catch those who are struggling, particularly because many patients with postpartum depression are reluctant to speak about what they’re experiencing out of a sense that their symptoms somehow mean they are bad parents.
That is why the authors of the new study clearly state that screening within the first year after giving birth is insufficient and that pediatricians should consider assessing patients for at least the first two years after they have a baby.
“We know that if a PMAD [perinatal mood and anxiety disorder] is untreated, it can continue. The symptoms can become worse, and many women can ride them right into a subsequent pregnancy,” echoed Paige Bellenbaum, chief external relations officer for The Motherhood Center, a mental health clinic based in New York City.
Even so, Bellenbaum believes far too few pediatricians, OB-GYNs and midwives meet even the current bare minimum recommendations for screening patients for depression and anxiety — to say nothing of assessing how they’re doing years down the road."
Ted-Ed Animations| October 1, 2020| Lesson by TED-Ed, directed by Roxane Campoy and Charlotte Cambon.
"Discover how pregnancy changes every organ in the body— from the heart, to the brain and kidneys— and what we still don’t know about it. -- Muscles and joints shift and jostle. The heart’s pounding rhythm speeds up. Blood roars through arteries and veins. Over the course of a pregnancy, every organ in the body changes. Initiated by a range of hormones, these changes begin as soon as a pregnancy begins. Explore what we know— and don’t know— about pregnancy's effects on the body and brain."
"Every family is unique in its own ways, and parents are navigating the pandemic the best way they know how. We want to shine a light on our co-parenting parents and single parents who are experiencing their own set of distinctive challenges during the pandemic and provide resources to ease the burdens they may be experiencing."
The webinar will be held on November 24, 2020 from 9:00-10:00 PM (Eastern Time) via Zoom.
By Tara Haelle| August 16, 2020
"It was the end of the world as we knew it, and I felt fine. That’s almost exactly what I told my psychiatrist at my March 16 appointment, a few days after our children’s school district extended spring break because of the coronavirus. I said the same at my April 27 appointment, several weeks after our state’s stay-at-home order.
Yes, it was exhausting having a kindergartener and fourth grader doing impromptu distance learning while I was barely keeping up with work. And it was frustrating to be stuck home nonstop, scrambling to get in grocery delivery orders before slots filled up, and tracking down toilet paper. But I was still doing well because I thrive in high-stress emergency situations. It’s exhilarating for my ADHD brain. As just one example, when my husband and I were stranded in Peru during an 8.0-magnitude earthquake that killed thousands, we walked around with a first aid kit helping who we could and tracking down water and food. Then I went out with my camera to document the devastation as a photojournalist and interview Peruvians in my broken Spanish for my hometown paper.
Now we were in a pandemic, and I’m a science journalist who has written about infectious disease and medical research for nearly a decade. I was on fire, cranking out stories, explaining epidemiological concepts in my social networks, trying to help everyone around me make sense of the frightening circumstances of a pandemic and the anxiety surrounding the virus.
I knew it wouldn’t last. It never does. But even knowing I would eventually crash, I didn’t appreciate how hard the crash would be, or how long it would last, or how hard it would be to try to get back up over and over again, or what getting up even looked like.
In those early months, I, along with most of the rest of the country, was using “surge capacity” to operate, as Ann Masten, PhD, a psychologist and professor of child development at the University of Minnesota, calls it. Surge capacity is a collection of adaptive systems — mental and physical — that humans draw on for short-term survival in acutely stressful situations, such as natural disasters. But natural disasters occur over a short period, even if recovery is long. Pandemics are different — the disaster itself stretches out indefinitely.
“The pandemic has demonstrated both what we can do with surge capacity and the limits of surge capacity,” says Masten. When it’s depleted, it has to be renewed. But what happens when you struggle to renew it because the emergency phase has now become chronic?"
By Cassie Shortsleeve| July 14, 2020
"Six weeks after I gave birth to my first daughter, I found myself in my OB/GYN’s office for my postpartum checkup. After a quick conversation and a physical exam, my doctor told me that I was “cleared.” I could resume all regular pre-pregnancy activity.
I went home, fed my baby and went on a run — and had to stop after a half-mile. My pelvic floor felt like it was going to give out and — although once an avid runner — I felt clumsy. That night, I lay awake, milk-stained and sweaty. Nothing about me felt “cleared.”
Despite the fact that in 2018, the American College of Obstetricians and Gynecologists recommended that, to optimize women’s health, postpartum care should become more of a rolling process rather than a single encounter, for many new moms, the six-week postpartum appointment remains the only touch point with the health-care system that birthed her baby.
If Latin America has la cuarentena — a 40-day period when women take care of a new mom while she rests — and the ancient Indian medical system of ayurveda teaches us that we must nurture women for 42 days postpartum for the health of her next 42 years, the United States, traditionally, has this: one lone appointment that, in many senses, gives a message of closure to the fragile and monumental postpartum period.
"The four- to six-week time frame has historically been thought to be enough time for women to be able to go back to do more physically demanding jobs, like farming, without having any serious medical issues,” explains Heather Irobunda, a board-certified OB/GYN in New York. Your uterus has usually shrunk back to a pre-pregnancy size, lacerations have healed, soreness from birth has resolved.
But physical changes persist for longer — probably six months or so, says Kecia Gaither, director of perinatal services at NYC Health+Hospitals/Lincoln. Around then, pelvic floor and abdominal musculature tone returns, changes in hair normalize, and the menstrual cycle might become more regular (if it’s returned).
Some research even suggests women wait 12 months to conceive again. But how long does it take for the body to recover? It depends on where you look.
The Centers for Disease Control and Prevention, for one, says that a “pregnancy-related” death is a death of a woman while pregnant or within one year of the end of pregnancy, but “maternal mortality” is defined by the World Health Organization as the death of a woman while pregnant or within 42 days of the end of pregnancy.
The Diagnostic and Statistical Manual of Mental Disorders, often called the “bible” of psychiatric health conditions, defines postpartum depression as depression “with postpartum onset: defined as within four weeks of delivering a child.” But, says Cindy-Lee Dennis, a professor at the University of Toronto who studies the postpartum period, “it’s fairly standard in the research literature to consider postpartum depression up to one year postpartum.” (Take a landmark 2013 study published in JAMA Psychiatry of 10,000 mothers: It found that 1 in 7 women develop PPD within the first year postpartum.)
Birdie Gunyon Meyer, a registered nurse and director of certification for Postpartum Support International, a nonprofit group that lobbied to extend the period following delivery in the definition of PPD, says: “I don’t think anybody really believes that the postpartum period is over at four or so weeks, but we give that impression when you come in for your four- or six-week checkup."
The truth is, the adjustment to parenthood takes time. It takes more than a couple of weeks and more than a couple of months. Researchers say Year 1 is critical for children and parents alike. “For the child, the brain is growing rapidly and the experiences that happen and the neurological pathways that are developed stay with the child for a lifetime,” says Dennis."
"Do you ever feel like you’re not doing enough as a parent? Like you might be totally screwing this up and maybe even making things worse for your kids? We’re right there with you. Parenting was already hard, and now we're navigating a pandemic on top of it.
In this webinar, we’ll talk about the self-doubt, anxiety, and uncertainty that has come with pandemic parenting. We’ll also share what the research says about “good enough’ parenting, especially in times of crisis. We’ll be joined by guest, Dr. Sharon Lamb, psychologist and author of The Not Good Enough Mother. Agata Freedle will serve as moderator to guide our conversation and pose questions that you submit.
Join us on Zoom at 9 p.m. Eastern Time for this free webinar."
By: Catherine Pearson| July 14, 2020
"We're facing a year without precedent in modern parenthood. So why do we feel...so detached?"
"When the pandemic first hit New York City in March, abruptly closing my boys’ school and daycare, I was a wreck.
I was terrified of my kids getting sick. I was so anxious sitting in bed at night, listening to sirens scream past my window down the Brooklyn-Queens Expressway, I’d lose my breath. Then sometimes, I’d have moments of delirious happiness: My family was safe and hanging out together at, like, 11 a.m. on a Tuesday. We never do that! It was emotional and logistical chaos all day, every day.
Now, months into this mess, I move through my days feeling basically ... nothing. When I see friends and family (from a safe distance, outdoors, usually wearing a mask) and they ask how I’m doing, I say something like: “We’re good! We’ve kept our jobs, and no one’s been sick. Also, I’m dead inside.”
This is only a partial joke.
The everyday stresses parents are facing now are arguably worse than they were when the virus first emerged. Where I live in New York City, public schools recently announced they’ll likely open for in-person learning between one and three days a week — as though those are remotely similar. I have no idea if my husband and I are sending our older son in. I have zero idea what we’re doing for childcare for our younger kiddo, because I do not see a solution that feels relatively safe and is one we can actually afford. I have no idea how we are going to get through the fall or winter or any part of next year.
But I’m not freaking out; I’m numb.
And I’m not alone.
“After being on high alert for so long, it’s entirely understandable that numbness would set in. No one can sustain a state of emergency for any length of time. We weren’t built that way,” said Olivia Bergeron, who runs Mommy Groove Therapy & Parent Coaching in New York City. “Fight or flight is supposed to be a temporary state to ensure survival, not a permanent way of living.”
"Our struggle is not an emotional concern. We are not burned out. We are being crushed by an economy that has bafflingly declared working parents inessential."
By: Deb Perelman
"Last week, I received an email from my children’s principal, sharing some of the first details about plans to reopen New York City schools this fall. The message explained that the city’s Department of Education, following federal guidelines, will require each student to have 65 square feet of classroom space. Not everyone will be allowed in the building at once. The upshot is that my children will be able to physically attend school one out of every three weeks.At the same time, many adults — at least the lucky ones that have held onto their jobs — are supposed to be back at work as the economy reopens. What is confusing to me is that these two plans are moving forward apace without any consideration of the working parents who will be ground up in the gears when they collide.
Let me say the quiet part loud: In the Covid-19 economy, you’re allowed only a kid or a job.
Why isn’t anyone talking about this? Why are we not hearing a primal scream so deafening that no plodding policy can be implemented without addressing the people buried by it? Why am I, a food blogger best known for such hits as the All-Butter Really Flaky Pie Dough and The ‘I Want Chocolate Cake’ Cake, sounding the alarm on this? I think it’s because when you’re home schooling all day, and not performing the work you were hired to do until the wee hours of the morning, and do it on repeat for 106 days (not that anyone is counting), you might be a bit too fried to funnel your rage effectively.
For months, I’ve been muttering about this — in group texts, in secret Facebook groups for moms, in masked encounters when I bump into a parent friend on the street. We all ask one another why we aren’t making more noise. The consensus is that everyone agrees this is a catastrophe, but we are too bone-tired to raise our voices above a groan, let alone scream through a megaphone. Every single person confesses burnout, despair, feeling like they are losing their minds, knowing in their guts that this is untenable.
It should be obvious, but a nonnegotiable precondition of “getting back to normal” is that families need a normal to return to as well. But as soon as you express this, the conversation quickly gets clouded with tangential and irrelevant arguments that would get you kicked off any school debate team.
“But we don’t even know if it’s safe to send kids back to school,” is absolutely correct, but it’s not the central issue here. The sadder flip side — the friend who told me that if their school reopens, her children are going back whether it’s safe or not because she cannot afford to not work — edges closer.
Why do you want teachers to get sick?” isn’t my agenda either, but it’s hard to imagine that a system in which each child will spend two weeks out of every three being handed off among various caretakers only to reconvene in a classroom, infinitely increasing the number of potential virus-carrying interactions, protects a teacher more than a consistent pod of students week in and out with minimized external interactions.
“You shouldn’t have had kids if you can’t take care of them,” is comically troll-like, but has come up so often, one might wonder if you’re supposed to educate your children at night. Or perhaps you should have been paying for some all-age day care backup that sat empty while kids were at school in case the school you were paying taxes to keep open and that requires, by law, that your child attend abruptly closed for the year."
By: Mikaela Kiner
"Pre-pandemic, being a mom meant figuring out the tricky balance between parenting, home, career and self. What that meant in practice was that women in heterosexual relationships took on about two-thirds of domestic responsibilities.
The global coronavirus pandemic has resulted in dramatic shifts for everyone, especially for families, with parents working from home, school and day care closures and a general loss of stability and support. Now moms are homeschooling older kids, caring for little ones, feeding their families three meals a day, and sanitizing everything, all while trying to keep everyone healthy and keep up with their day jobs.
While many partners have stepped up to take on more responsibilities at home during the pandemic, the workload balance has not shifted enough (despite nearly half of men claiming they do "all" the homeschooling, a claim that most women disagree with).
Women are legitimately concerned that they will become the default caregivers and take on most or all of the household chores, leaving little or no time for their careers or their own well-being.
Here's how to keep that from happening by coming to an agreement with your partner about sharing the workload at home.
1. Have the hard conversation.
Many people avoid hard conversations out of a fear that things will become adversarial. But now more than ever, we need to talk about roles and expectations. Remember that your partner also wants what's best for you and the family. View this conversation as a collaborative conflict, one where the two of you are working together toward a win-win solution.
Phrase to try: "Let's sit down for half an hour this evening and review both of our to-do lists," or "Can we find a time in the next day or two to go over everything we're both trying to get done?"
2. Start with your goals in mind.Your goal is to come up with a plan that works for both of you. The focus is you both teaming up against the problem.
Phrase to try: "I'd like to talk about how we can both find a good balance between work and helping the kids," or, "So much has changed. Let's talk about how we're going to make this work for us both."
3. Share your hopes + fears.
Tell your partner what you're worried about, and what's been most challenging. Be honest about your experience and what you're afraid of. You'll notice there are no assumptions, personal attacks, shaming or blaming, which is important. My friend Melissa Strawn was in the middle of launching a business when the virus hit. Her husband works full-time and they're raising five boys. Melissa suggests, "Communicate openly and honestly about what's working and not working. Sometimes, I am just looking to feel validated given how much I actually juggle with five kids and a startup. Other times, I need him to just #getitdone."
Phrase to try: "I'm concerned that I've taken on all of the homeschooling and I don't have time to do my work," or, "I realize I'm trying to cook, clean and watch the baby. When I sit down to focus on my job, I'm already exhausted."
By Al Donato| 4/15/2020 6:48pm EDT
"If you’re an exhausted parent at home right now, you have a friend in Elmo’s dad, Louie. In the latest pandemic programming from “Sesame Street,” the children’s series has released a PSA for parents starring the famous Muppet’s father.
In the PSA, Louie reveals that, like many kids cooped up at home, Elmo won’t leave his parents alone.
“It is wonderful to spend so much time with our children, but it can also be a bit ...” the older Muppet pauses, before letting out the world’s most relatable sigh. “Overwhelming.”