I was pregnant with my fourth child. I walked into my midwife’s office determined to discuss what happened during my third pregnancy. I sat on the couch and faced her, smiling. “Hi,” I said. We started the normal conversation of an initial prenatal appointment. Nowhere in that conversation could I fit the sentences, “I just want to let you know that during my last pregnancy I felt insane. I felt like I was a danger to myself and others, but I don’t know why.”
I like to pretend that I would have said something during my last pregnancy had it turned out like my 3rd, but I know I’m lying to myself. Every appointment I thought, “Next time. Next time I’ll tell her.” I was paranoid that I would find myself plunged into the abyss of prenatal depression again, but I still wasn’t able to talk about what had happened. In fact, I wouldn’t start talking about it until after I gave birth to my last child.
I wrote an article describing my experience with prenatal depression. Over four years later and I can finally write out the honest, ugly truth.
It was the scariest time of my life.
I felt isolated, alone, terrified. Even now, I am working through processing what I went through. Though I wanted to spread awareness of what I went through, I partly wrote the article as a way to heal. I am a writer and putting words to paper is how I organize my thoughts, how I deal with traumas. Sharing my writing is how I shine a light on issues. The response to my article “We Don’t Talk about Prenatal Depression and It Almost Killed Me” (originally published in The Shadow) has been incredible. Many women have contacted me in an act of solidarity or in surprise that they hadn’t heard about this, but had gone through the same experiences.
This is the promised follow-up article on how to identify and handle prenatal depression. As with everything, I dislike highlighting an issue without at least offering resources or suggestions.
Reaching Out for Help
I didn’t tell my fiancée about what I experienced until after our second child was born (my fourth). Yes, he was there during the pregnancy in question, but he missed every sign. How? He was never warned, he was never educated on what symptoms could cross over to abnormal.
We decided that my two nieces could visit while I was heavy in the pregnancy. That would give my sister a break and my oldest two friends to hang out within the summertime. I had my reservations but wasn’t sure how to articulate them. It’ll be fine, though, I thought, because I’ll have help.
In the end, I didn’t have help. My fiancée was given ample opportunities for overtime. We knew that another baby meant extra expenses. How could he say no? How could I protest?
One day, I gathered all the courage I could. We had plans to have another baby after this one. It would be a total of four children. I was caring for four children. My two sons and two nieces. If I couldn’t care for all four for a few weeks, how could I care for four children that were my own?
*Let’s not even dive into the sexism that exists in those questions…that’s an entire other article on its own.
I thought, He’s going to ask how we can have four children if I can’t even take care of 4 preteens. But I brought it up regardless. I sat him at the table. “This is so much,” I told him. “Sometimes I can’t do this. The kids are so much by myself.”
He frowned. “But…I thought you wanted four kids. How are you going to handle four?”
And that was it.
I don’t remember the rest of the conversation. I completely disassociated. It was my one chance; I was shot down. I had jumped and no one caught me. My nieces were only slated to visit for a few weeks and they were picked up at the end of the month, but the fear, the anxiety, the depression, and the fear remained.
My fiancée failed me, but he was set up to fail. He didn’t hear my underlying tone, assumed that I would be the primary caregiver even if he didn’t “mean” it that way, and wasn’t picking up on any of the red flags. Since the birth of our son, I’ve disclosed what I experienced. As I talk, I see him wilt. As he understands, he asks, “What should I have done? What can I do in the future?” I know that sometimes he feels bad about being so close to me and missing everything, but I don’t blame him at all. He was told pregnant people are emotional; thus, when I exhibited mood swings, severe or mild, he brushed it under the category of normal moodiness. When I was reluctant to go out, he brushed it under the category of lower back pain and swollen feet. He kept the house neat when I was too tired to clean and figured I was nesting when I obsessively scrubbed everything. He rubbed my back and legs and feet, cooked meals whenever he could, and went on walks with me.
By all accounts, he was supportive.
My midwife also missed any signs I may have exhibited during my prenatal appointments. Most healthcare providers don’t screen for depression or anxiety prenatally. In fact, most times, people don’t get screened for depression until the 6-week postpartum visit.
I’m based in the US and can only speak on the American experience; however, from the response my previous article received on social media, it is clear that this is not unique to this country. In the US, mental health resources are scarce and (a lot of times) cost-prohibitive. The Covid-19 pandemic has only increased the need for mental health providers and increased barriers to seeking care. This is especially true for pregnancies carried during the pandemic or other highly stressful times.
We’re failing the pregnant members of our society. We’re failing their partners.
What Do We Do?
Don’t Wait for the Depressed Person to Reach Out.
“Let me know if you need anything!” is usually meant with good intentions. “I’m here to talk if you need me.” is usually meant with sincerity. But when someone is drowning, it is not their job to flag down the lifeguard.
It is important to understand that when depression and anxiety hits hard, it’s difficult to reach out. I think that if I had been okay enough to say hey, “I’m struggling here.” I wouldn’t have felt as terrified. The reason I felt alone was because no one saw what was happening and I was unable to speak. The reason I was terrified was because I knew I was a danger to myself, but I was too far under the water to do anything but struggle to breathe.
Do Initiate Completely a Small (or Big) Task for Them.
When my family caught Covid-19, my fiancée’s mother asked us if we need groceries. He told her we were okay, that we didn’t want to bother her with an extra trip out of her way. What did she do? She went to the store, bought us some staples, and left it on our porch anyway.
Apply this to the pregnant people and partners that are in your life. Many times, especially if depression or anxiety is flaring, guilt and fear prevents people from asking for help.
Pick up some groceries and spare them a trip.
Drop off a cooked meal.
When you go over to their house and you see a chore (e.g. dishes) that needs done, do it rather than offering or asking.
Hold space for them and allow them to vent, if needed.
If they have smaller children, drop by to watch them while they take a shower or nap.
Any small gesture will be appreciated…but don’t wait for them to reach out to you.
Don’t Ask Open Ended Questions.
When someone is depressed, even small talk is tiring. Mundane tasks can be crushing. The energy expendedOpen-Endeddoing simple tasks can wear on the soul. Asking general and open-ended questions typically lead to one-word answers.
How are you? I’m good.
Doing ok? Yeah.
Need anything? Nah.
Do Ask Yes / No Questions or Those That Require Specific Answers.
In a country that uses “How are you?” as a greeting and not a question, it’s difficult to answer open-ended questions honestly. However, asking questions that require a yes or no answer will provide better insights. And if you’re asking these questions, be prepared to provide the solution.
When is the last time you drank some water? Here’s a bottle / cup of water.
Did you shower today? Okay, I’ll watch the kids while you take your time.
Have you napped today? Okay, I can mind the kids while you lie down. If you don’t feel tired or can’t sleep, that’s okay. Take an hour to rest, read, or relax.
When is the last time you ate something? Here is a snack / meal.
Bring Up Concerns at Prenatal Appointments.
If you’re concerned about your partner (or friend) and you attend a prenatal visit, please bring up the concerns to the provider. Even if you’re unsure of what the specific concerns are, try to explain the symptoms. Are they crying everyday? Are they more anxious than usual? Withdrawn? Do you notice that they are beginning to worry about their own health or health of the pregnancy? Are you worried they are bonding correctly? Is it a vague worry?
What I Wish Healthcare Providers Would Do
I would love to see this conversation being initiated at an early prenatal appointment. Bring this topic up to both the pregnant person and their partner. Let them know that this is a possibility. Discuss warning signs and when to mention something. Discuss when to call 911.
I would like to see routine prenatal screening for both depression and anxiety. This allows the conversation to be ongoing and checks on them at various points in the pregnancy.
Awareness of perinatal (and postpartum) mood disorders is increasing, but just barely. It’s not uncommon to find providers who think that any depression symptom during pregnancy is simply a normal mood swing. Those who are brave enough to seek treatment sometimes find it difficult to find a provider, let alone one who believes them.
We’re failing the pregnant members of our society and we need to do better.
For videos surrounding mental health and parenting, check out my YouTube channel.
In cases of emergency — Call 911
Call the toll-free National Suicide Prevention Lifeline (Lifeline) at 1–800–273-TALK (8255), 24 hours a day, 7 days a week. The deaf and hard of hearing can contact the Lifeline via TTY at 1–800–799–4889. All calls are confidential. Contact the Crisis Text Line 24 hours a day, 7 days a week, by texting HELLO to 741741.