The Horrifying Way the U.S. Treats Moms With Postpartum Depression
By Annamarie Houlis
Recently, new mom Jessica Porten had her first obstetrician appointment since giving birth four months prior — they kept canceling her appointments.
She waited for over an hour with her daughter, Kira, until a nurse practitioner finally called her in. When she let the nurse know she was experiencing postpartum depression that was “manifesting in fits of anger” but assured her she’d never hurt herself of her baby — she only wanted to discuss her medication options — the nurse rushed through her pelvic exam, barely spoke of any medication, left the room to "talk to the doctor" about her PPD and instead called the police.
“The cops can clearly see I’m of sound mind... so they allow me to drive to the ER with Kira in my car while one cop drives in front of me and one follows behind,” Porten explains in a now-viral Facebook post that’s already garnered more than 39,000 engagements, more than 32,000 shares and more than 10,000 comments at the time of this writing.
After checking her in, drawing blood and taking a urine sample, the hospital staff removed and locked up all of Porten's clothes and flip-flops, gave her a pair of socks, and fed her a turkey sandwich since she’d missed lunch. She wasn't seen by a social worker until 10:45 p.m.
The social worker ultimately decided that Porten didn't need to be there nor did she need to be put on a psychiatric hold. The social worker began to process Porten's discharge.
“Not once during all of this has a doctor laid eyes on me,” she writes. “Not once. Not even before they decided to call the cops on me. The social worker hands me some papers and discusses the information in them, telling me she thinks these ‘will probably be good resources for you.’ I leave the ER at midnight, my spirit more broken than ever, no medication, no follow up appointment, never spoke to a doctor. This was a 10-hour ordeal that I had to go through all while caring for my infant that I had with me. And that’s it. That’s what I got for telling my OB that I have PPD and I need help. I was treated like a criminal and then discharged with nothing but a stack of xeroxed printouts with phone numbers on them… Ladies and gentleman, our healthcare system.”
Porten is not alone in experiencing PPD. Of course, childbirth affects a woman’s hormones immensely, which means it can incite a range of emotions — from elation to fear to anxiety. It’s not uncommon for mothers to experience mood swings, anxiety and insomnia after giving birth, especially within the first two weeks post-delivery. In fact, more than one-third of mothers have experienced mental health issues related to parenthood. But for upward of 20 percent of women, according to the Centers for Disease Control and Prevention, these complications devolve into depression.
PPD can develop anywhere from a few weeks into motherhood to even a year after delivery. It’s “a severe, long-lasting form of depression” after childbirth, according to the Mayo Clinic, and it’s often exacerbated when women have endured problematic births with potentially traumatic procedures, such as emergency caesareans. Likewise, the recurrence risk is high for women who’ve struggled with PPD before according to the research published in PLOS Medicine.
Porten’s Facebook post doesn’t mention whether or not she’d experienced PPD with her firstborn, but the research suggests mothers who’ve endured PPD with their first child are more likely to experience it again with subsequent births. A team of Danish researchers conducted a study to describe the risk of postpartum affective disorder (an umbrella term that includes PPD and other postpartum conditions such as postpartum psychosis) among women with no prior psychiatric episodes. By compiling data from national registries, they were able to look at a cohort of 457,317 first-time mothers and their subsequent births between 1996 and 2013.
The researchers found that 0.6 percent of births resulted in serious PPD. And after the first year postpartum, 27.9 percent of those women were still in treatment for the disorder; after four years postpartum, that percentage dropped to just 5.4 percent. Moreover, the researchers found that the recurrence risk (or the chances of a woman experiencing PPD again) is quite high — 15 percent for women prescribed antidepressants after their first birth and 21 percent for women who were hospitalized for an affective disorder after their first birth. The risk of PPD after a second birth was 26.9 times higher in women who were prescribed antidepressants after their first birth compared to women who had never had PPD and 46.6 times higher in women who had been hospitalized for depression after their first birth.
These mothers who are at a greater risk of PPD need support — both in understanding their condition and in medically treating those conditions. But many of them don’t seek help. And Porten’s story shows us why.
A BabyCenter survey of more than 1,400 mothers and pregnant women called attention to the significant number of women who do not get prompt treatment for PPD: 21 percent of the mothers polled said they had either been given a diagnosis of PPD or felt like they might have it, but an overwhelming 40 percent of them did not seek any medical help for the condition. Why? For 30 percent of them, they felt strong enough to “get over” their feelings without a doctor, and 26 percent said they felt their symptoms were not serious enough to warrant a discussion. Meanwhile, 25 percent said they were too embarrassed to admit their feelings, 23 percent said they felt guilty about those feelings, and 16 percent said they did not want to be labeled as "mentally ill."
And most women probably don't want to be escorted to the ER by the police, either — as Porten was. But we live in a culture that consistently shames both women and mentally ill people of all gender identities, so it’s no surprise mothers have these apprehensions.
Porten made an edit to her Facebook post to explain that, while she won’t be taking legal action, she does want her message to “spread far and wide so that awareness can be made.” She wants to fix what she calls the “broken system.”
“The fact of the matter is, even if I was mentally unstable, suicidal, and unfit to parent (which I am not), the way the situation was handled is not helpful,” she explains. She also asks the following questions to help crowdsource ideas and hopefully inspire change:
- “Why is the way I was treated standard procedure?
- “What can we do to improve standard procedures for all postpartum mothers, but also specifically those at a higher risk for developing PPD and presenting with signs of PPD?
- “Who is most qualified to make suggestions for improvements?
- “Who is actually capable of making the changes to standard procedures, and how can we can contact them?”
Porten later revised her post to add:
“I may be marginalized as a woman, but I am white and heterosexual and hold privileges in these places. I am scared for our mothers of color and our LGBTQ mothers who seek out help in these situations.
“Why was I let go, when so many others would have been put on a mandatory 72-hour psychiatric hold, and had their children taken away?
“Why do a disproportionate number of women of color who have PPD not receive the services they need, even when they initiate treatment?
“Why are a disproportionate number of women of color who have PPD misdiagnosed?
“Why are black women half as likely to receive mental health treatment and counseling as white women?
“What can we do as a community to lift up our marginalized members and make sure they receive the quality care that we ALL have a right to?!?”
Porten is working with 2020 Mom, the nonprofit host of Federal Maternal Mental Health Lobby Day and a leading advocate for maternal mental health in California. Four bills are currently being introduced, and Porten will be posting the dates, times and locations of #4Bills4CAMoms rallies for anyone who’d like to get involved in the action.
PPD needs to be taken seriously among health care professionals. But for something to be taken seriously, that doesn't mean it's criminal.
Originally published onFairygodboss.