The Canadian Perinatal Mental Health Collaborative has been compiling a list of mental health resources to help during Covid-19 / coronavirus. Please check here for the latest updates: https://cpmhc.ca/resources-during-covid-19/
👉 From the World Health Organization: All pregnant women, including those with confirmed or suspected COVID-19 infections, have the right to high quality care before, during and after childbirth. This includes antenatal, newborn, postnatal, intrapartum and mental health care.
A safe and positive childbirth experience includes:
💙 Being treated with respect and dignity; 💚 Having a companion of choice present during delivery; 💙 Clear communication by maternity staff; 💚 Appropriate pain relief strategies: 💙 Mobility in labour where possible, and birth position of choice.
If COVID-19 is suspected or confirmed, health workers should take all appropriate precautions to reduce risks of infection to themselves and others, including hand hygiene, and appropriate use of protective clothing like gloves, gown and medical mask.
👉 Postpartum Support International has created additional online support groups during this difficult time. They are free and open to the public. Participants need to create a Support Group Central account and register for the group of their choice.
Though we are extremely disappointed that there is no mention of Perinatal Mental Health Care — at all — in the 2021 Canadian federal budget unveiled April 19th, we are hopeful that the government’s promise of $20 million over 5 years to support a new National Institute for Women’s Health Research will include perinatal mental health research.
We are also encouraged to see the government supporting other long called for national strategies such as a National Autism Strategy, Strategic Research on Pediatrician Cancer, and National Universal Pharmacare.
Let’s hope we don’t have to wait too much longer for a National Perinatal Mental Health Strategy
The following is an article by the Canadian Perinatal Mental Health Collaborative as part of their #thisismystory campaign shedding a light on the need for improved perinatal mental health care in Canada.
Carleigh Weldon of Windsor, Ontario, was nicknamed, ‘the baby whisperer’ growing up.
“I always knew I wanted to be a mom,” Carleigh told us. “I have a huge extended family and lots of cousins. I knew motherhood was going to be a challenge and even though I had heard that it would be one of the hardest things in life, I also felt it would be one of the most rewarding.”
Carleigh met her husband Scott in a Pilates teacher training course in 2010 and the two were married in 2014. They have two children, a boy and a girl.
In 2005, Carleigh was involved in a tragic bus accident while traveling with her hockey team in New York. Sadly, her coach, his 13-year-old son, her friend’s mom and the truck driver were killed.
“My teammates and I all survived but suffered from multiple injuries,” said Carleigh. “I had a head injury and sprained my wrist but I was one of the lucky ones.”
Carleigh suffered from post-traumatic stress disorder following the accident. Due to her history of mental illness, Carleigh was screened for perinatal mental illness during each pregnancy.
“Both pregnancies were great,” recalls Carleigh.
“The week after my son was born was pure bliss. My husband and I said it was one of the best moments of our life.”
Unfortunately, Carleigh began to struggle with breastfeeding which she believes triggered postpartum depression.
“I had painful vasospasm, a severe, sudden constriction and narrowing of a blood vessel in the nipple that is extremely painful,” said Carleigh. “My nipples would go completely white because there was no blood flow even though my son’s latch looked good.”
When it was time for her six week checkup with her obstetrician, he asked Carleigh if she had any questions.
“I mentioned that I was sad, perhaps more than I should have been,” says Carleigh. “He didn’t seem concerned and just mentioned medication if I ‘needed a little something to help’. My checkup was about a minute long and I remember thinking, ‘I waited six weeks for that!?’ I felt alone as I was no longer considered his patient after the birth of my son. I went and got help on my own and talked to the same psychologist that helped me after the bus accident. I’ve been depressed before so I know the signs, I just have never taken medication for it. Not that there is anything wrong with taking medication, I just thought it was odd that that was my OB’s first and only suggestion.”
After their daughter was born, Carleigh and Scott were told their baby may have Epidermolysis bullosa, a rare condition where her skin could fall off. Carleigh began panicking. She was given the number of a social worker to call who deals with postpartum depression but the number was wrong.
“The hospital should be ashamed that they gave that out,” said Carleigh.
After Carleigh and Scott visited a dermatologist, they were told that their daughter was indeed suffering from a rare disorder, but not the one mentioned to them in the hospital. Their daughter was actually suffering from Focal Dermal Hypoplasia or Goltz Syndrome causing the hair, teeth, nails, and glands to develop and function abnormally.
Carleigh’s mental health began to deteriorate.
“We had specialist after specialist appointment,” said Carleigh. “I felt like I was living a nightmare. I don’t think I slept for three weeks straight and I became obsessed with researching her disorder. I was manic and would repeat the same thing over and over again. I thought this was my fault, that I had to give her up for adoption. I became very paranoid. I had suicidal thoughts and I was hallucinating, I would wake up in cold sweats. I couldn’t even remember how to do simple everyday things like laundry. People had to tell me what to do, when to eat and when to get dressed. I cried every day and I was so confused because people were congratulating me but consoling me at the same time. I never wanted to be left alone.”
Carleigh knew she needed help but she struggled to get it.
“It’s almost like our healthcare system warns you about postpartum depression but if you actually have it, they don’t know what to do with you,” said Carleigh. “And let me tell you, no one knew what to do with me.”
Trying to navigate the health care system was especially very frustrating and time consuming so Carleigh had to take matters into her own hands. Her friends, family and coworkers came over to help in shifts so she was never left alone. But Carleigh needed medical help. She went to the emergency room a total of three times to try and find it.
“The psychiatrist I was finally referred to, was not a good fit,” recalls Carleigh. “I agreed to start taking an antidepressant and to follow up with him in a week. Things didn’t improve and during my appointment, he asked if I would love my son any less if something bad happened to him. That’s definitely not what I needed. I needed someone to acknowledge that something bad happened to my daughter and how I was feeling was okay. He increased my medication but the way the pharmacist worded it, I was taking too much, too soon. My medication wasn’t being monitored closely enough or being monitored by anyone really.”
Carleigh’s brother and sister-in-law began desperately asking around for a good psychologist for Carleigh to try. One of their coworkers heard about Carleigh’s story so she told her husband who is a psychiatrist at another local hospital. He couldn’t stop thinking about Carleigh and he wanted to help.
“He was the one to finally diagnose me with postpartum depression/borderline psychosis,” said Carleigh. “My family tried everything they could to keep me at home with my babies but eventually I admitted myself to the hospital. I was angry and I just felt so hopeless. I really couldn’t see the light at the end of the tunnel.”
Carleigh was hospitalized for five weeks. She was in the psychiatric ward for one full week which she says was awful.
“I remember it was a Thursday evening and beginning of a long weekend. I only had one therapy session because doctors don’t work on weekends or holidays. So I was there more for my medication to be monitored,” says Carleigh.
“I was then able to move to a long term care facility where my psychiatrist worked. After a week or so there, I was able to come and go as I pleased. I just had to sleep there in order to have my daily therapy sessions. This was more suitable for my needs and my boss made up a weekly schedule for me so everyday I was doing some sort of self care activity. This really helped to bring me back to myself and that’s how my healing journey began.”
It took three months for Carleigh to begin feeling better.
“I remember I cried the hardest I had since my daughter was born and I finally grieved the loss of what I thought our life was going to be,” said Carleigh. “The pressure released from my head and I could finally think clearly. My daughter also started to thrive at three months of age. She went from drinking a bottle in 1.5 hours to four minutes.”
Carleigh would like our elected officials to know that parents need more help than what the system currently provides.
“Women deserve to be treated better,” said Carleigh. “There is definitely more awareness about postpartum depression but when a woman actually has a maternal mental illness, I feel like nobody knows what to do with them. If a woman needs to be hospitalized for a maternal mental illness, I don’t see how separating her from her new baby is beneficial in any way. We need programs in place, we need structure, we need a plan and we need to help the family as a whole.”
Carleigh also feels like there is still a lot of stigma when it comes to postpartum depression.
“I felt like I had to justify why I was feeling the way that I was,” said Carleigh. “I have been told by other moms that they wouldn’t even know where to begin to ask for help. It shouldn’t be that difficult. It would have also been nice if my high-risk obstetrician called and asked how I was doing after I missed my six-week checkup. I want to share my story so this doesn’t happen to someone else ever again.”
If you would like to tell your story and contribute to the #thisismystory CPMHC campaign, please email us at firstname.lastname@example.org.
Needless to say, we at the Canadian Perinatal Mental Health Collaborative are overjoyed that Ms Bhutila Karpoche, Parkdale-High Park MPP and Ontario NDP critic for mental health and addictions, has tabled a bill calling for the provincial government to review maternal mental health in Ontario and develop and implement an action plan. “The Bill requires the Minister of Health to conduct a comprehensive review of maternal mental health in Ontario and prepare a Provincial Framework and Action Plan on the issue. The Bill requires the Minister to report to the Assembly periodically about the progress of the review and to table the Provincial Framework and Action Plan in the Assembly.” – Legislative Assembly of Ontario We support her 100% and will be doing everything we can to make sure this bill passes. The CPMHC had a chance to briefly chat with Ms Karpoche in December shortly after she rose in the legislature with her newborn baby to talk about maternal mental health. This was our lovely conversation with her: CPMHC: Congratulations on your baby! When was he born? Is this your first child? Ms Karpoche: Thank you! My newborn is three months old, and he is my second child. My first child – his proud big sister — is four years old. CPMHC: What prompted you to rise in the legislature and speak on behalf of moms and the importance of maternal mental health? Have you ever experienced a maternal mental health issue/illness? Ms Karpoche: As a mother, I know first hand the postpartum stresses we experience. Being the mother of newborn while serving as an elected member of the Ontario legislature gave me a unique opportunity to shine a light on this important issue, which is too often overlooked. I am fortunate to have this platform and wanted to give maternal mental health the attention it needs. CPMHC: Advocates are calling for universal perinatal mental health screening and better access to treatment. Do you agree and will you be working to improve perinatal mental health care in Ontario? Ms Karpoche: New moms and moms-to-be shouldn’t have to struggle in silence with mental health issues. Screening could help women and their health care providers identify these concerns sooner, and we need to make sure treatment is readily available when this happens. The Ontario NDP supports better access to perinatal mental health screening and treatment, and I am committed to leading the way as a new mom and the party’s critic for mental health. CPMHC: Do you agree with NDP federal party leader, Mr. Jagmeet Singh that Canada requires a national perinatal mental health strategy? Ms Karpoche: I was so happy to see Jagmeet express his support for a national perinatal mental health strategy. Being a new mom can be an incredibly joyful time, but it can also be an incredibly isolating and stressful time. Too many new moms who are suffering from poor mental health continue to fall through the cracks, and a national strategy could help create a safety net. Thank you for your support Ms Karpoche! We look forward to supporting you every step of the way! So what happens now? The first reading of the bill was carried on February 25th. No word yet on when the bill will go to committee. Following that, the bill will move on to second reading and if it passes, will go to committee once again, then third reading and hopefully Royal Assent. Ms Karpoche’s bill also proposes declaring the first Wednesday of May, Maternal Mental Health Day in Ontario. Of course we support that too and are working diligently across Canada to have cities and provinces and the country in declaring May 2-10th, World Maternal Mental Health Week. Our amazing volunteers are planning awareness walks across the country and we hope to have Ms Karpoche speak at our walk in Toronto on May 2nd. Stay tuned for more details and if you would like to organize a walk in your community, please email us at email@example.com Read more about Bill 176, Maternal Mental Health Act, 2020:https://www.ontariondp.ca/news/ndp-mpp-tables-bill-establish-maternal-mental-health-strategy-ontario
The following is an article by the Canadian Perinatal Mental Health Collaborative as part of their #thisismystory campaign shedding a light on the need for improved perinatal mental health care in Canada.
Health care professional and mom of three, Kiersta Hazlett of Moonstone, Ontario is deeply saddened at the lack of resources for families experiencing a perinatal mental illness.
“We desperately need a coordinated strategy so that women and men are screened universally during their prenatal appointments and routinely in the postnatal period by trained providers who know the signs of mental illness and who are trained to act.” Kiersta told us.
“We then need resources and treatments that are accessible to everyone to refer them to that they don’t have to wait for. We need to remove as many barriers to accessing assessments and treatment as possible. We need to continue to work at eliminating stigmas related to mental illness, especially in the places where people access their health and illness care.”
Growing up, Kiersta was told she was great with other people’s kids.
“I enjoyed babysitting and caring for younger kids,” Kiersta told us. “It felt like a natural thing to do, and that I would naturally be good at parenting if this was what it was like for me. So making the decision to become pregnant was easy for me.”
Kiersta had been married to her then husband for just over a year when she became pregnant very easily at the age of 27. At the time, she was working full time as a public health nurse in the area of reproductive health. She taught prenatal classes and provided support in the community to pregnant and new mothers.
“I taught others how to breastfeed,” said Kiersta. “I educated families on the signs and symptoms of postpartum depression. I felt then that I was in a pretty good position to welcome a child into my family because I felt so confident that I knew what I was doing and what to expect.”
Because of her profession, Kiersta felt she had a good grasp on perinatal mental illness. She knew that it occurred often, that it was at times difficult to pinpoint the causes but that women with certain risk factors were more likely to develop it.
“I can say now that I certainly had some of the risk factors, but I found it difficult to recognize and accept that the symptoms of anxiety and then eventually depression, were actually happening to me,” said Kiersta. “Looking back on my first pregnancy, I can see just how firmly anxiety had taken hold. Prior to that I felt my mental health was stable and there was no remarkable period of time that I felt I was really struggling. Pregnancy certainly amplified any feelings of anxiety that I had.”
Kiersta was hyper vigilant about everything during pregnancy. She was worried about bacteria in her food or on cooking utensils and would beat herself up when she ate something on the list of foods to avoid during pregnancy. She obsessively counted fetal movements and was scared of going too far from home for too long for fear of something happening to her and that she wouldn’t be able to get to a hospital in time.
“I even stopped exercising because after a yoga class early on in my pregnancy I started spotting,” said Kiersta. “I was fine, and the baby was fine, and I knew that the spotting could be normal and that it likely wasn’t caused by exercise, but I couldn’t let myself take the chance so I just stopped. I started to lose pieces of myself for fear I’d inadvertently hurt my baby, lose my pregnancy or give birth to a baby who was sick or deformed because of something I could have avoided during pregnancy. Those thoughts were all consuming. I lost so much sleep and obsessed about things all day long.”
Kiersta was not screened for perinatal mental illness by either her family doctor or her obstetrician during pregnancy.
“I was never asked how I was doing mentally or emotionally,” said Kiersta. “Both of my care providers knew what my nursing job was and felt confident that I would be fine. I really believe they just felt that I would speak up if something was off. But I was so embarrassed to admit that I was struggling. And I wasn’t even sure it was abnormal at the time.”
After being induced at 42 weeks, the baby’s heart rate began getting dangerously low so Kiersta had to have an emergency C-section. During the first few days and weeks after her baby was born, Kiersta said she felt so foreign to herself.
“It was so hard to try and recover from major abdominal surgery while learning how to breastfeed and care for a baby,” said Kiersta “I remember not wanting anyone to come visit me in the hospital but not having a say. Family from my then husband’s side kept showing up and I wasn’t able to rest. I felt like I had absolutely no control over how my labour went, and now I felt like no one was listening to me when I was asking for space and time to recover and be with my baby.”
Just 12 hours after being discharged, Kiersta returned to the hospital because her baby became significantly dehydrated. Mother and baby remained hospitalized for a following 48 hours.
“This was really when my anxiety went through the roof,” Kiersta said. “I felt like I was living in a state of constant worry but also felt foggy and sluggish. I took myself off all pain medications very quickly because the side effects were not helping with my mental clarity.”
At five months postpartum, Kiersta told her family doctor she wasn’t doing well. By this time, she was severely depressed and not sleeping. She became totally isolated at home, she wouldn’t eat, and she would sit all day in the dark without any lights or sound on because she felt it was too much for her to handle.
“I would lay in bed with my baby, only getting up to feed and change her or to use the washroom,” recalled Kiersta. “I often made excuses about getting together with friends, which was conflicting for me because that was really the only thing that improved my mood was being with them. I hid my true thoughts and feelings with my friends, but I was able to let a bit out. Venting about how heavy my load felt was helpful, but I was always scared to be fully honest with them.”
It took a lot to tell her husband how she was really feeling. This was because she felt like everyone thought she was just being lazy or dramatic. Kiersta was told by a member of her husband’s family who found her crying in the bathroom of a restaurant while changing her baby’s diaper to “get over it”, that she wasn’t the first person this has happened to.
“I was so overwhelmed with being made to attend this event with the baby that I just couldn’t cope any longer,” said Kiersta. “I was in pain and exhausted but that didn’t matter. I had to be there because it was an important celebration for another family member. On an average day, my husband would become frustrated with me and told me to get out of bed because we had things to do. I was still expected to maintain our household and try to get meals ready but I couldn’t do it. When I tried explaining how it felt impossible to even get my teeth brushed he said, “what do you actually have to do every day?” He didn’t get it, he didn’t want to get it. And instead of looking elsewhere for help, I felt defeated, like there was something wrong with me.”
Kiersta felt guilty like maybe she was somehow taking advantage of the situation, that if she was tougher, perhaps she would have been able to handle it all.
“It was definitely driving my husband and I apart,” said Kiersta. “He didn’t understand and he didn’t care to try to help me. He thought I was just giving up. When he told me he wanted to go on a trip with his friend I was at my lowest point. I felt I needed to fully disclose what was happening to me inside so he could realize how horrible I felt. I told him I wanted to leave and never come back, I told him I wanted to die. He told me I was overreacting and being selfish. What about what he wanted? What about his needs?”
Kiersta’s then husband went on his trip while she moved in with her parents for a week. It felt impossible for Kiersta to leave her home, but she did it because she was afraid for her baby if she didn’t. Through all of it, she only wanted her baby to be well.
“I was starting to have intrusive thoughts about throwing her into traffic outside of our home,” said Kiersta. “I would walk past our knife block at home and I pictured myself grabbing a knife and stabbing her with it. I was so scared of myself. I never wanted to do anything that would risk hurting her. It was during this time that I stayed with my parents that they really saw how I was doing.”
After telling her mother about the intrusive thoughts, Kiersta was surprised to hear her mother respond that she too had them after giving birth to Hazlett.
“My mom came with my to that first appointment,” said Kiersta. “My doctor prescribed me an antidepressant that is also used to treat generalized anxiety disorder. I began taking it that day. Once I started taking those first steps I felt like I started to regain control. Because I was familiar with our healthcare system, I felt confident eventually reaching out to a therapist and have accessed counselling here and there over the past ten years.”
Though she started feeling better once the medication took effect, Kiersta feels she should have been more closely monitored during the initial phase after her diagnosis. She only went back to see her doctor once after four weeks to assess her symptoms once she began treatment.
“It took me almost five months after starting my medication to climb fully out of the depression,” said Kiersta. “But even after that, I still struggled functioning to my full abilities at work when I returned. I had a hard time managing work and life. I felt stressed a lot of the time. The anxiety still remained but I slowly built up my toolkit.”
Kiersta’s second and third pregnancies were completely different. She chose to receive care from midwives and was screened for perinatal mental illness early and often during her pregnancies.
“I felt better supported and understood,” said Kiersta. “I felt like I could be open with what my first pregnancy was like.”
In the postpartum period after her second baby, Abriana was born, when she became sleep deprived and started to feel symptoms of depression, she was able to get support from her parents.
“With my third baby, Lochlan, I have my awesome partner Matt to lean on,” said Hazlett. “It made a world of difference for me.” Hazlett said she’s currently the happiest she’s ever been and has a partner that supports her, but she still becomes easily overwhelmed and stressed at times and has to actively work at managing her anxiety.
“I have been able to come off treatment for periods of time, and I do end up coping, but all it takes is a stressful event like needing to return to work after my maternity leave or even just every day stressors to trigger some of my anxiety symptoms which usually show up like irritability, worry, chest tightness and difficulty sleeping,” said Hazlett. “I find now that it is just best to stay on my medication versus risking relapse. I’m better for everyone when I’m stable and well. I’m the person and the parent I want to be instead of someone I don’t recognize and don’t like. For me, protecting my sleep and carving out space for me to be alone and quiet each day help keep my symptoms at bay as well.”
Hazlett encourages those currently struggling to find one person you trust that you know will help and support you through this, and lean on them to help you get started with treatment.
“People who truly love you won’t see you as a burden,” Hazlett said. “They will recognize you aren’t well and will help you get what you deserve. People struggling with mental illness aren’t able to fully advocate for themselves like they would if they weren’t having symptoms. They need a champion.”
Hazlett also wants moms and dads suffering to know that recovery is possible and that if you have been trying for a while to get better and one method doesn’t seem to work, try another medication or another therapy.
“Keep searching for a counsellor that feels like they are the right fit if you aren’t satisfied with the support you have now,” said Hazlett. “This isn’t a ‘one size fits all’ plan for recovery. We need options because we are all so different. Put everything you can into yourself to get better. Unfortunately, this isn’t something that can be done for us. We need to do the hard work of climbing out of the well. This is possible if there are enough good options to help us climb up.”
If you would like to tell your story and contribute to the #thisismystory CPMHC campaign, please email us at firstname.lastname@example.org.
After Ivana Poku became a mom, she was astonished and shocked by the reality of motherhood.
“It was nothing like I had expected,” Poku told us. “I remember I could not wait to meet my twin boys and experience this immediate rush of love people were talking about. However, when that moment came, I felt nothing. I was glad they were ok. I was glad to have them, but there was no rush of love, no pure happiness, no fireworks. Immediately, I felt like a complete failure. And it didn’t get better from there.”
Poku went on to develop postpartum depression, a perinatal mental illness up to 20 per cent of women suffer from as well as 10 per cent of men. Perinatal mental illness can include depression, anxiety, obsessive-compulsive disorder, bipolar disorder, and psychosis and it can happen any time during pregnancy and up to a year postpartum. Left untreated, it can develop into chronic mental illness.
“The boys were born six weeks early so they had to stay at the special care and baby unit,” Poku told us. “Since I wanted to breastfeed, we stayed with them in this tiny hospital room, which didn’t add to my well-being either.”
Spending all day in a confined space with two screaming babies was hard for Poku as she struggled to breastfeed her newborn twins.
“After I became a mom, I felt so lonely, confused and lost,” Poku told us. “There was so much I needed to hear and no one told me. So much I needed to get and no one gave to me. I had so many questions no one seemed to have answers to or I felt ashamed to ask.”
After her ordeal, Poku decided to share her experience and offer advice to new moms in a book she wrote titled, “Motherhood: The Unspoken”. The book reveals the unspoken truths about motherhood people don’t talk about and postpartum depression. The purpose of the book is to show what motherhood is really about, especially in the early stages, to break the stigma, and to help new moms reduce the risks of postpartum depression. It contains ten real motherhood stories and reveals what these moms went through as new mothers and how things were different from what they had previously imagined.
“It is a book I needed so badly myself after becoming a mom,” Poku told us. “Sadly, most new moms feel lost and lonely and often suffer in silence.”
There is no universal screening for perinatal mental illness in the U.S. or Canada and access to treatment is difficult. While the cause of perinatal mental illness is still unknown, many researchers point to a combination of hormonal fluctuations and environmental stress such as lack of sleep, isolation, and feeling overwhelmed with parenthood.
Poku found it difficult to speak to her doctor or any other health professional. She felt ashamed of herself and worried that if she confessed how she felt, her children would be taken away.
“However, when I got to the point when I felt the urge to hurt my child,” Poku explained to us, “I immediately sought professional help and started taking antidepressants.”
Not a health professional herself, Poku says though she doesn’t offer medical advice in her book, she wrote about what helped her based purely on her own personal experience.
“What I highlight the most in the book is the importance of talking and not keeping the emotions inside,” Poku told us. “Talking is the key.”
Sarah Cunningham of Oshawa, Ontario, wanted children for as long as she could remember.
“I have always loved and worked with children,” Cunningham told us. “My husband and I wanted to get pregnant immediately after getting married.”
Cunningham and her husband, Kyle, tried to become pregnant for more than six months. Although Cunning felt in her gut that something wasn’t right, she was brushed off and told to keep trying. Once she finally got the referrals and testing she pushed for, she was diagnosed with polycystic ovary syndrome (PCOS) and referred to a fertility clinic.Over 1.4 million Canadian women may have PCOS, emphasis on the word “may” because, just like perinatal mental illness, though it’s common, and in the case of PCOS, one of the most common endocrine disorders for women, it’s not properly diagnosed or managed in Canada.
Cunningham became pregnant after three months of fertility treatment.
“My pregnancy was amazing,” Cunningham said. “I was one of those ‘unicorns’ that other moms hated – no morning sickness, nothing. Aside from the usual aches and pains, I loved every moment of being pregnant, and assumed I would love motherhood just as much.”
Though she had planned a drug free, vaginal birth, after 24 hours of labour, Cunningham delivered her daughter, Leah, via C-section. The entire experience left her feeling out of control and she was both mentally and physically distressed.
“Immediately following the birth, I was physically in pain from having an unplanned C-section, and emotionally, I was all over the place,” Cunningham described. “I couldn’t stop crying but this was chalked up to the ‘baby blues’. When I realized how unhappy I was feeling, I was plagued with guilt. This baby was everything I had ever wanted. Why wasn’t I happier? I felt that if I was suffering from postpartum depression, it somehow made me ungrateful.”
Breastfeeding also proved difficult.
“We were sent home after two nights in the hospital and told not to worry, that my milk would come in,” Cunningham said. “Unfortunately, days later, we were readmitted to the hospital because our daughter was dehydrated and had to stay overnight. She had all kinds of blood taken and had to be supplemented with formula which made me feel like a failure.”
Cunningham doesn’t understand why she wasn’t screened for perinatal mental illness during pregnancy or postpartum.
“I went through infertility, had a traumatic birth experience, a colicky baby, and sleep deprivation that likely put me at a higher risk,” Cunningham explained. “I think something else that put me largely at risk for postpartum depression was the loss of my own mother when I was young. I had no idea how intensely the grief would return after becoming a mother myself and how much I would need her there for it all, especially after having such a bad experience.”
At her six-week postpartum check-up, Cunningham’s obstetrician (OB) did ask her how she was feeling. Cunningham replied that she was crying almost all the time, that she didn’t feel herself and that she felt anxious at times too. After explaining how she felt, the OB in turn replied to Cunningham, “But it’s not postpartum depression, right?”
Cunningham got the impression that the OB was trying to tell her what she felt was normal, so she stopped asking for help. It wasn’t until three months later, when she was four months postpartum, that she ended up making an urgent appointment to see her family doctor. Cunningham was desperate for help. She told her family doctor she was feeling rage, hopelessness, and exhaustion, all of which were “severely” uncharacteristic of her. Cunningham told her family doctor she couldn’t go on feeling the way she did. The doctor placed her on a four month wait list to see a general psychiatrist.
“I was crushed,” recalled Cunningham. “This was by far the most frustrating part of the journey for me. I couldn’t wait four months. The only way that I finally got the help I needed was by seeking out private therapy on my own, with a psychologist specializing in maternal mental health. This was both costly and time-consuming but well worth it. I also asked for a referral to the Women’s College Hospital Reproductive Life Stages Program, which I finally started after another long wait.”
Cunningham was officially diagnosed with postpartum depression, nine months after first seeking help but was discharged with no follow up plan from the Reproductive Life Stages program only three months after starting it due to the fact that the program doesn’t treat women past one year postpartum.
The psychiatrist from the program did offer to continue seeing Cunningham slightly longer than the year mark but Cunningham declined as she was going back to work and could no longer commute from Oshawa to Toronto to attend the appointments.
“It took a lot of advocating for myself before I received any help,” Cunningham said. “Once I started therapy and medication it was a huge game changer. I wish I had started them sooner. I am lucky to have a wonderfully supportive husband, but the illness definitely put stress on both of us and our relationship as we were completely blindsided by it.”
Cunningham wants parents to know that perinatal mental illness is common, treatable, that you deserve to get help, and that needing help doesn’t make you a bad mom.
“I thought motherhood would be the happiest time of my life,” said Cunningham. “This was something I had wanted so badly for so long, I thought it would be perfect. I had heard of postpartum depression before, but didn’t consider it would happen to me. I had no idea how common it was.”
As far as a message for our elected leaders, Cunningham wants them to know that perinatal mental health needs to be a priority.
“So many moms are slipping through the cracks,” said Cunningham. “Every health professional who sees babies should be educated about perinatal mental illness and the signs and symptoms. It’s absurd, and sad, that moms and dads are not routinely screened for perinatal mental illness, and that only one postpartum check-up is scheduled.”If you would like to tell your story and contribute to the #thisismystory CPMHC campaign, please email us at email@example.com.
Nicole Devlin, of Calgary, Alberta, knew she wanted to be a mom when she met her husband, Kelly.
“I could envision us having children together and it made me feel even more confident and excited at the possibility,” Devlin told us. “After we got married, we knew it was time to start planning a family. We enjoyed our honeymoon and a couple of other trips as husband and wife and then we got down to business.”
But the journey to becoming pregnant wasn’t an easy one.
“I had those friends where you just looked at them and they got pregnant,” said Devlin. “It took us almost eight months to conceive our son. I know that doesn’t seem very long, but when you’re trying, it feels like an eternity, especially when others around you keep getting pregnant.”
Devlin was excited at the thought of being a mom.
“I thought it was going to be beautiful, blissful and full of rainbows,” said Devlin. “That I was going to love this little human so much and that being a mom was going to be the most amazing thing ever. It was going to be the best day of my life when I gave birth.”
Though she had heard of postpartum depression, Devlin said she didn’t know much about it.
“Sure, they brushed upon the subject in our prenatal classes but just as quickly as it was presented, the subject quickly left my head,” said Devlin. “I was never concerned about postpartum depression or any of the perinatal mood disorders at all. My family had some mental health issues but again, I hardly knew anything about it nor did I ever think that would happen to me.”
Devlin loved being pregnant and the pregnancy itself went well.
“I was happy, ate very healthy, loved my bump and loved pregnancy all around,” said Devlin. “I did not suffer any anxiety or depression while pregnant.”
Labour was a different story. It wasn’t anything like Devlin expected it would be. After testing positive for Strep B, she had to go to the hospital when her water broke at 38 weeks.
“Off to the hospital I went to get IV antibiotics,” said Devlin. “This was at three am. I was feeling nothing in terms of contractions. Next came the induction, something I never wanted but the risk for infection was increasing the longer my labour was delayed. The contractions started quite quickly after that and escalated. I told myself I did not want drugs as this was part of my birth plan. I at least wanted to hold onto that since my plan was already going out the window.”
Finally, after the most painful contractions and finding out she was only five centimetres dilated, Devlin decided to get an epidural.
“But before the epidural set in, the nurse left to get the doctor. Something wasn’t right,” said Devlin. “The baby’s heart rate was going up and down. The doctor returned and began turning me and pushing the baby to try to turn him. It wasn’t helping.”
While still feeling her contractions, Devlin was told she would need to have an emergency c-section. Within minutes, there was a team of six in the hospital room and a short time later, Devlin’s son, Brady, was born.
“It was over quickly and there was my baby boy,” said Devlin. “I don’t even remember that moment. It was like an out of body experience and here I thought I would have the emotional tears and my baby in my arms. Looking back, I think at the very moment I had my son, I had postpartum depression. Physically, I felt sore, awful, not expecting to have major surgery and have to stay in the hospital for three nights with my newborn. Mentally, I just felt no connection, no overwhelming love for this little human. Yes, I answered to people that he was amazing, beautiful, and that I loved him so much but I didn’t feel it. I didn’t give it much thought though. I thought I was just so exhausted from 15 hours of labour followed by surgery.”
Devlin and Brady
At home, Devlin continued to feel apathetic towards Brady and breastfeeding wasn’t coming easily. At two months postpartum, anxiety set in.
“It would start when my husband left for work and got worse to the point where I couldn’t even get out of bed in the morning due to the heavy feeling of anxiety,” said Devlin. “I couldn’t eat and when I did, I would just get sick. It got so bad that I would wake up in the morning in a full state of anxiety and instantly get sick.”
After speaking with her family doctor, Devlin was diagnosed with postpartum anxiety, depression and OCD and put on medication.
“I had never felt more alone, disconnected, anxious, depressed and just downright awful in my whole entire life,” said Devlin. “I literally thought I was going crazy, that I was crazy. I felt like an unfit mother that I couldn’t even get up in the morning to take care of my baby because I was in a state of fear for no reason. I couldn’t describe how awful this felt. I felt lost. I felt my husband was a better parent, that it was so easy for him, and what a burden it was to have a wife who had gone crazy making him have to care for me and the baby.”
One night, Devlin went to the emergency room at South Health Campus was admitted to the mental health unit. They ran some tests, she talked to some nurses, and her husband was sent to pick her up.
“I remember crying to them I didn’t want to go home. I didn’t want to be around my baby, but they sent me home,” said Devlin. “I went and saw my family doctor again. She said she couldn’t help me anymore when I told her about how I was feeling and how I didn’t want to be around my baby. So my husband and I went home, I had a shower and I started thinking – what kind of mother am I? Do my husband and my son really need this? My husband is taking such good care of our son, why do I need to be here? Some scary stuff… so I went downstairs and told my husband I can’t be here, I am too anxious and worried I am going back to the emergency room.”
Devlin was once again admitted to the mental health ward but this time, was made to stay.
“They took my phone and everything but my hospital gown,” said Devlin. “I was terrified. I was allowed to call my husband and my mom. The nurses were not sympathetic at all. There were people in the hallway walking around screaming. My husband came to get me.”
Devlin was put on a six-week waitlist to see a psychologist. She couldn’t wait that long and began to see someone privately. When her name came up on the waitlist, the psychologist she was sent to looked to be going, in his twenties.
“I looked at him and said no disrespect but there is no way you have any idea how I feel nor can you help me,” said Devlin. “I went back to my doctor’s office and asked for a new doctor.”
Turns out, Devlin’s new doctor finally helped her begin to feel better. She listened to her and prescribed a different medication which worked much better.
“Life changing is all I have to say. Was I cured? No. Was I 100 per cent better? No. but I could get out of bed, I could eat, and I could take care of my son.”
Once Devlin reacted positively to her new medication, she was able to benefit from therapy. She also joined a support group at the Families Matter Society.
“The postpartum depression support group was amazing,” said Devlin. “They offered a safe space for women childcare to boot while you navigated through your perinatal mental illness.”
Though she finally received help, Devlin is still suffering from postpartum depression and anxiety three years later.
“I did go off my medication when my son was 11 months old and I was feeling great to be honest,” said Devlin. “But then as the challenges of motherhood weighed more on me as well as the return to work, I felt myself going down that dark hole again of anxiety and depression so I called my doctor right away and we decided I didn’t give my brain or self enough time to heal so back on my medication I went.”
Devlin said she was in such a hurry to be “normal again” she didn’t see that she was still struggling.
“I am still on medication today, and I am actually learning to help myself more and more through therapy, journaling and through working on my physical health,” said Devlin. “I am even fully trained to help support moms and families going through their own postpartum journeys which is itself so healing to know I can take my lived experience and help someone else.”
Devlin’s advice to parents is to educate themselves on perinatal mental illness, even if you don’t think you are at risk for it.
“Don’t be ashamed and don’t feel you’re a bad parent,” said Devlin. “I know this is easier said than done but I wish someone had said this to me because I could have ended my suffering a lot faster if I had accepted this could did happen. Remember that you are NOT alone. You are NOT a bad mom. You are NOT going crazy. Ask for HELP, talk to a friend, a doctor, and your spouse. And if you have survived postpartum depression, you are a warrior and amazing. Pass your wisdom along and help a mom who is suffering.”
As for a message to our elected leaders, Devlin would like to tell them that we need more programs, facilities, education, and resources for perinatal health.
“Make going to get help a lot more accessible and an easier process,” said Devlin. “Don’t make a mom go through the emergency room to end up in a psychiatric ward. Have a ward in the hospital for moms that are having breakdowns from perinatal mental illness a quiet, calm space to get the help they need. Educate moms leaving the hospital more. Give them the resources and information. The only resources and information I was given at the hospital was breastfeeding being shoved down my throat and some pamphlets on where to go if it wasn’t going right. Have the nurse that visits you at home screen mom and give her tools to identify any perinatal mood disorders. There is so much focus on the newborn and the moms are being forgotten. We too are being born as new moms and we need support and help too. WE NEED A NATIONAL PERINATAL MENTAL HEALTH STRATEGY. Too many moms are suffering with some even losing their lives over this. We are all in this together. We can change the system!”
If you would like to tell your story and contribute to the #thisismystory CPMHC campaign, please email us at firstname.lastname@example.org.
The following is an article by the Canadian Perinatal Mental Health Collaborative as part of their #thisismystory campaign.
Sandra Jessop and her husband Tim of Sault Ste. Marie, Ontario, both wanted their kids to be close in age. So a little over a year after their daughter Madison was born, Jessop became pregnant with their second child, Austin.
“We wanted them to grow up close with one another,” Jessop told us. “So our kids are just under 24 months apart.”
Both pregnancies were problem-free but Jessop worried about labour.
“I felt confident in my ability to take on the responsibilities in caring for a newborn,” Jessop said. “But I was more concerned with the possibility of complications during the delivery process. Otherwise, I looked forward to growing closer with my husband and sharing this new chapter of our lives together.”
While Jessop’s first labour went well, her second didn’t go as smoothly.
“The biggest difference between the births was the size of the babies,” said Jessop. “My son was eight pounds, eight ounces with an above average head circumference. I definitely experienced more pain and needed more sutures.”
Jessop was discharged from the hospital that same day. In the weeks following Austin’s birth, Jessop says she was tired but still confident in her abilities as a second-time mom.
“I felt somewhat assured that I knew a bit more of what to expect with a newborn,” said Jessop. “About three to four weeks postpartum I was still healing but my baby was doing great. Austin was sleeping and nursing well. The only difficulty I had was discomfort with sitting and bending. Mentally, I felt great.”
Jessop didn’t have a history of mental illness and perinatal mental illness wasn’t on her mind at all. She was not screened for a perinatal mental illness during pregnancy or postpartum but says her midwife would often ask her how she was feeling.
“I feel very naive in saying this but I did not actually know very much at all about perinatal mental illness,” said Jessop. “It was not even a concern for me at the time, or through either pregnancy. I felt good and everything felt pretty normal.”
That all changed three months postpartum with Austin when Jessop began to notice a shift in her moods.
“I felt unusually stressed,” said Jessop. “Normally feeling confident in my role as a mother of two, I woke up feeling guilty, worried and anxious about different things. I never thought much about it but that soon led to me not getting enough sleep at night and striving to be super mom.”
Jessop began waking up and cleaning the house before her kids got out of bed. She planned and executed to-do lists and thought she had it all together yet wondered why she felt so anxious about going out to meet a friend for a walk, something she previously enjoyed doing.
“I started feeling like a shell of myself and I was becoming very distracted, guilty, anxious and I avoided going out,” recalled Jessop. “One day, I decided to keep my daughter home from daycare (due to guilt about sending her to daycare), but I became even more distracted and paranoid and wasn’t at all myself. It was at that moment I knew something was not right. I was not ok.”
At first, Jessop tried dealing with her symptoms on her own but they were getting worse and more than she could handle. Jessop began hearing voices and having hallucinations. Her mind was constantly racing. She was exhausted yet she couldn’t sleep.
“I honestly carried on through the initial stages of my anxiety and dismissed it thinking I would feel better. With enough sleep, water, and vitamins, I thought I would be ok,” Jessop told us. “But I went from feeling confident and amazing to crumbling into pieces. I don’t think even my husband knew anything was wrong until my words started making no sense and I wasn’t able to understand what was going on.”
Tim reached out to Jessop’s midwife and who insisted she go straight to the emergency room for help and that’s exactly what Jessop did.
“I was put into the Sault Area Hospital mental health ward for three to four weeks,” said Jessop. “I’m not sure I was ever officially diagnosed, but I was being treated by a psychiatrist who explained what I went through was postpartum psychosis. I was monitored by nurses and staff at the hospital but never felt like there was any support for specifically what I was dealing with.”
Postpartum psychosis is considered rare, affecting one to two women in 1000. Women can also have psychotic symptoms with postpartum bipolar disorder and in fact 21 to 54 per cent of women with postpartum depression have a diagnosis of bipolar disorder.
Postpartum psychosis and psychosis symptoms requires immediate attention. Postpartum Support International has a Postpartum Psychosis Coordinator that can provide assistance to women and families who are not in an emergency situation. (Contact Michele Davidson, at 703-298-3247, at email@example.com.)
“My hallucinations were seeing and hearing a person in my house who was not actually there. I was also convinced that I was being watched/followed to see how I was parenting,” explained Jessop. “During my stay at the hospital I vividly remember having panic attacks through the night because I would wake up hearing gun shots and was convinced that I was going to become a victim. I never felt safe or comfortable in the hospital environment especially due to the police presence in the addictions/mental ward but eventually with time the paranoid thoughts passed.”
Jessop’s postpartum psychosis symptoms lasted two weeks. Following her hospital stay, Jessop continued to deal with depression and anxiety. With medication, it took her a full year to recover.
“If I could give any piece of advice to another mom or dad about perinatal mental illness, it’s to be open and honest about how you are feeling and if you are not feeling yourself,” Jessop said. “I deeply regret not making myself a priority and taking the steps to take care of myself when I first started struggling with my sleep and noticing signs of anxiety. But I didn’t know any different because I never knew these were signs and symptoms of mental illness. I didn’t actually know about postpartum psychosis until it happened to me and I wish I had talked more openly to my husband about how I was feeling. I wish I would have spoken to my family doctor or midwife as soon as I started feeling a bit anxious and struggling with my sleep.”
Jessop wants our elected officials in Canada to know that postpartum mental illness is serious and that if left untreated, could result in a terrible tragedy.
“Women need to feel supported. Information needs to be shared and the stigma around mental illness needs to come to an end,” said Jessop. “Help needs to become a priority and services need to be available for mothers and fathers who may be struggling with their mental health.”
Jessop would also like to see Canada open mother and baby units for those who are deeply suffering, who need the healthcare support so that they do not need to be separated from their child in recovery which she says only causes more anxiety and fear, along with disconnection and isolation. Unlike other countries such as the U.K., Australia, and the U.S., Canada does not have mother and baby units to treat perinatal mental illness.
“I have personally never felt so alone and depressed as I was during hospitalization,” Jessop recalled. “It was by far the worst experience I have ever had to go through and I strongly believe my experience in recovery would have been so much better with my baby by my side and my daughter being able to visit. A year-and-a-half later and I am still reflecting on the precious time I missed with my kids during hospitalization. We all have rights and every mother who is suffering should never have to be separated from her baby for any length of time. If recovery is the goal in mind there should be nurses and doctors encouraging more time to bond and care for their babies. That kind of support needs to be available to mothers and families who are struggling with mental illness.”
If you would like to tell your story and contribute to the #thisismystory CPMHC campaign, please email us at firstname.lastname@example.org
Due to a request for confidentiality, names in this article have been changed.