“Are you breastfeeding, hon?” The blond nurse smiled at me, nodding as if she expected me to say yes. She was the third hospital worker to ask me that question in the past hour, and my irritation had gone from simmering to a rolling boil.
I was less than a month postpartum. For the second time in two weeks, I lay on a hospital bed, having a red-hot and throbbing abscess the size of a robin’s egg drained from my left breast. The location of these abscesses made the lancing particularly painful, and the abscesses (I’d actually go on to develop a third one in another week) were close enough to my nipple to make me uncomfortable attempting to breastfeed my newborn daughter. Combined with my milk production problems resulting from a post-childbirth hemorrhage, I certainly was not nursing.
But I wanted to. I was supposed to. What else were my breasts for if not feeding my child? I was already feeling defensive about formula-feeding my baby, so having to admit to these health care professionals over and over that no, I wasn’t nursing my child pushed me over the edge. Tears spilled out of my eyes, and I screamed at the nurse, “No! I’m not breastfeeding! Will everyone quit asking me that?”
Startled, her eyes opened wide. She leaned in and said in a low voice, “Would you like to talk to the on-call psychologist?” I whispered back hoarsely that I would. Clearly I could use some help.
The on-call psychologist spent the better part of an hour perched delicately on a chair across the room, asking questions about my health, my childbirth experience, my family history. She avoided eye contact and took copious notes, filling pages with loopy handwriting and check marks. I had high expectations for the “resources” she promised to match me up with, resources that would save me from the psychological sinkhole that had been breaking up the ground beneath my feet for weeks. When she left my hospital room, I breathed in a shaky sigh of relief. Finally, I thought. Some help.
The “resources” turned out to be the contact information for one mental health facility, printed from a page of online search results. The single sheet of paper was handed to me by a random hospital assistant who wasn’t sure what she was giving me or why and who could only shrug her shoulders when I told her that facility didn’t even accept my insurance. The long intake procedure had been nothing more than an emotionally draining waste of time.
A couple of weeks later, during a follow-up visit at my birth center, my midwife noted that my signs of depression were worsening, and she recommended medication. At a previous appointment a few weeks prior, she’d noticed my “flat affect” and lack of meaningful interaction with my baby, and gently suggested medication. Fearing the side effects, I’d declined. But at this point, I knew something was wrong. I went ahead and accepted the prescription — a month’s supply to get me through until I could find a psychiatrist to manage the medication. Problem solved.
Except for the fact that it was nearly impossible to find a psychiatrist.
I wish I’d logged all the hours I spent researching and calling around, trying to find a psychiatrist who was nearby, accepted my insurance and was taking new patients. Most of the voicemail messages I left were never returned. And the phone numbers I pulled from my insurance website were out-of-date or for inpatient facilities, which wasn’t what I needed. When I finally found a psychiatric nurse accepting new patients, I had to wait nearly two months for my first appointment. And I was lucky to find her at all.
Alarmed by the many articles and essays I’d read on postpartum depression and anxiety, I took the initiative two months before my due date to find a therapist in the event that I needed someone to talk to while adjusting to motherhood. Heavily pregnant, I scheduled a consultation and had a great rapport with the therapist. But here’s the kicker: In those heady first months after my baby was born, I never called her to set up an appointment. I didn’t even remember I had a therapist. The murk in my brain was that thick.
Next week, my beautiful baby will be 5 months old. I’ve got health care practitioners lined up and a plan in place, but I’m not completely out of the woods yet; rather, I’m lingering around the edges, supported by my husband and a few good friends. It’s not something I talk about often, but I’m ready to open up: to encourage women to consider a plan of action in the event that sleep deprivation, hormones and brain chemistry turn their brains into a sloppy, toxic soup.
The weeks and days after giving birth isn’t an ideal time for a crash course in navigating mental health support.
Expectant mothers are prepared for pregnancy, labor and childbirth. But what can we do to help new mothers prepare for the emotional and mental health challenges that may also come with their new bundle of joy?
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