Maternal Mental Health Myth Busting Part 1

I remember when I was pregnant with my first child, I was terrified of getting postpartum psychosis. There was no basis for this worry but I had heard about some horrific event in the news and I didn’t want that to be my experience. I had no idea how rare it was - less than 3 people in 1000 births. Nor did I know that certain populations had a higher risk, like those with pre-existing bipolar disorders (1 in 4). Heck, I didn't even know that “PPP” was shorthand for Postpartum Psychosis. I didn’t know because no one talks about it. Stigma is real.

I know now that it is up to us to break this stigma and talk about what it is, what it looks like and that we can prevent it. (Yes, you don’t just have to wait and see if it happens to you.)

Myth #1 | Postpartum Mood Disorders only happen after the baby is born - in the postpartum period. Couldn’t be further from the truth. In fact, 1 in 4 birthing people experience depression DURING pregnancy. This is why Postpartum Mood Disorders are more accurately called Perinatal Mood Disorders. Shifting to use this more inclusive term also includes and validates people who experience infertility or loss. Preconception, pregnancy, birth and postpartum is full of so many unknowns and so much of it feels out of our control. In the “Beyond the Birth” workshop, I always highlight the fact that with a growing baby inside, our ability to take a deep breath becomes limited. So then ask yourself, what do I know about shallow breathing and emotional health for any human? Shallow breaths = More stress and / or anxiety. That’s why people suggest, “take a deep breath” to regain calm. Deep, slow breathing especially with a longer exhale than inhale cues our autonomic nervous system to relax. Another important distinction that is left in the shadows in our culture. Those who experience pregnancy loss are in fact at greater risk for experiencing Perinatal Mood Disorders, yet we invalidate their often difficult emotional journey when their pregnancy doesn’t result in a live birth. That’s a whole other topic for another blog post….

Myth #2 | Postpartum Mood Disorders only show up as Depression, Anxiety or (in rare cases) Psychosis. Cue the loud, obnoxious buzzer. Wrong. Oh, so wrong. There is a whole spectrum of expressions. Have you heard of:

-Postpartum Rage?

-Postpartum PTSD?

-Perinatal Obsessive, Compulsive, Disorder (OCD)?

If you’re at all like I was, I experienced many of these and heard other parenting friends talk about their symptoms yet NONE of us realized that what we were experiencing fell under the umbrella of a Perinatal Mood Disorder. Gosh, I was reading the other day about “Maternal Gatekeeping” which is a dynamic when the mom controls and diminishes the dad’s ability to directly engage with the baby. For me, this came in the form of frustration because he diapered her “wrong” or swaddled her “wrong” or didn’t soothe her as quickly as I felt I could. I had no idea (nor did my partner) that that was a sign that I was experiencing a Perinatal Mood Disorder. We just suffered through it and thought that was normal. Little did we know that with informed support - like a peer coach, support group or therapist, it would have gotten better.

Myth #3 | Any licensed therapist has been trained to treat Perinatal Mood Disorders. Did you know that most mental health provider college or graduate school curriculum does not contain any modules on Perinatal Mental Health. How is this possible? When you think about it, if you’re a therapist who treats women, it is almost a certainty that at some point in your career you will be working with someone who will experience, is experiencing or has experienced pregnancy. And as referenced above, 1 in 4 of those will experience Perinatal Mood Disorders. We understand that if a pregnant person experiences pregnancy complications, they are referred from their OB-GYN (or midwife) to a Maternal-Fetal Medicine (MFM) doctor, yet we are still working to raise awareness that the same is true for our mental health during pregnancy. If you have mental-health related complications in pregnancy, a Perinatal Mental Health Certified (PMH-C) mental health provider is the one with additional training for this population and is best positioned to provide informed and effective care. If you love your therapist and want to work with them through pregnancy, great! Encourage them to get certified or at least get connected with someone who holds their PMH-C.

If you know me at all, I get very passionate about this information. This is part of why I became a Perinatal Mental Health Peer Supporter (a person with lived experience who can bring hope and resources to others while they’re going through it) and why I volunteer with and now am the Board Chairwoman of Postpartum Support International (PSI) - AZ Chapter. It’s my mission to never have to hear another person say, “Gosh, PSI has so many amazing, free resources. I wish I had known about these when I was going through my thing.”

Now you know the truth and no longer have to live in the shroud of misinformation about these three aspects of Perinatal Mental Health. For now, I’ll leave you with the PSI mantra: “You are not alone. You are not to blame. Help is available. You will get better.”

Keep an eye out for Part 2 of this article because we have more myths to bust! If you don’t have time to spare or just don’t want to wait, register for the “Beyond the Birth” workshop where you can learn all of these myths and what you can do to prevent experiencing perinatal mood disorders during your pregnancy and postpartum!