Postpartum depression is the most horribly ironic illness known to womankind. Here you are, supposed to be on top of the world, and the best moment of your life is made a wretched hell by rampant hormones at war with your brain. If depression is a b-word, then postpartum depression is a c-word, and postpartum psychosis -- a separate, severe, life-threatening illness – well, there’s just no word bad enough.
The Perinatal Psychiatry Inpatient Unit opened on August 15 at the University of North Carolina in Chapel Hill. The first of its kind, it’s a place that specializes in the unique struggles of postpartum mood disorders. When a woman feels that she is in danger of hurting herself or her child, she now has someplace to check in where the medical professionals know what is happening to her, and how to stop it.
To which I say: Great. And it took how long?!
Doctors have known about postpartum mood disorders for hundreds of years, and 29 countries – including Canada, the UK, Australia and Italy, but not including the U.S. – have a special legal distinction for women who kill their babies, so that if a woman is convicted of infanticide, she is given treatment for mental illness. In a comprehensive 2004 article published in the American Journal of Psychiatry, Margaret G. Spinelli, M.D. outlined the history of postpartum mental illnesses and called them “predictable, identifiable, treatable, and, therefore, preventable.” The differences between baby blues, postpartum depression, and postpartum psychosis should be required reading for any mom-to-be.
Spinelli's 2002 textbook, Infanticide: Psychosocial and Legal Perspectives on Mothers Who Kill ($83 at Amazon), came out almost at the same time as the Andrea Yates case – in 2001. After suffering repeatedly from post-partum psychosis and being warned not to have any more kids, Yates drowned all five of her children in a bathtub, including her 6-month-old baby. Her husband, Rusty Yates, now says he ignored obvious signs that she needed more help than he could give, and that he bungled the whole deal. Yeah. No kidding. Yates' case brought national attention to the plight of the mentally ill and those that can be harmed if they aren't treated properly; a life sentence was eventually overturned, and Yates now resides in a mental hospital.
Despite the attention, the stigma against women who suffer from postpartum depression or psychosis continues. Tom Cruise famously mocked Brooke Shields for speaking out about her struggle with PPD and her decision to take antidepressants. Many women are afraid to get help because their support system – their families, even their husbands, who are supposed to have their backs no matter what – minimize their pain and fear. The worse the illness gets, the more the woman thinks that if she treats it, she’ll lose her kids and be treated like a criminal.
And she’s often right. The woman in a recent radio story about the clinic described how she told her midwife she was having thoughts of hurting herself and her baby, and was placed in a nightmarish psychiatric facility in the “same ward that houses schizophrenics, drug addicts, and dementia patients.” Her doctors didn’t understand how PPD is different from other mental illnesses, and their treatment of her didn’t take her recent childbirth into account — though she was allowed to pump, at least.
The new unit, in contrast, offers time with the baby and the woman’s partner, lactation consultation and new-baby care, in addition to the same psychiatric assessments and cautions that a regular mental-health facility would provide. The hospital already has a well-regarded center for women’s mood disorders, so the right professionals were in place already.
But this doesn’t change the stigma, and it doesn’t change the legal system, and I think there are only five beds in this facility. Of course, there are clinics and professionals that specialize in postpartum mood disorders – they can be found at Postpartum Support International. But this one little overnight clinic had better be just the beginning of a slew of similar places. One is just not enough.
Do you think we should have had an in-patient clinic for women suffering from postpartum mental illnesses a long time ago?
Image via WomensMoodDisorders.org