I was not supposed to be a mother.
Originally Published November 2018 on The Bump
Read the Original Article Here
The following is an interview with The Motherhood Center’s co-founder Paige Bellenbaum.
TELL US A LITTLE BIT ABOUT YOURSELF
I’m a California girl–born and raised in San Francisco. I moved to New York City in 2000 to attend Columbia University for my Masters in social work. I was all ready to move back to San Francisco, but right before then, I met my husband-to-be. In 2005, after one month of marriage, we found out we were pregnant. I guess I’m fortunate in the sense that my husband only had to look at me for that to happen.
After our son Max was born, I was immediately filled with intense anxiety, which led to severe postpartum depression.
Catherine Birndorf, MD, co-founder of the Motherhood Center, was actually part of my clinical treatment team, but we didn’t realize this connection until much later!
WHAT ARE SOME FEELINGS YOU EXPERIENCED BEFORE GETTING HELP?
It was the darkest time of my life and I almost lost my life because of it. It’s like being in an ocean and not being able to swim, and just waiting for someone to throw you a life preserver. I couldn’t believe that nobody was talking about it, despite the fact that research suggests 1 in 5 new and expectant mothers experience a perinatal mood and anxiety disorder, otherwise known as postpartum depression (PPD).
IS THAT WHAT MADE YOU BECOME A CHAMPION FOR THE CAUSE?
After I recovered with the help of medication and therapy, I became furious that nobody was talking about how common PPD is. Instead, women like myself feel guilty and ashamed for their feelings and thoughts and keep it to themselves. I worked with a New York state senator to draft legislation requiring new mothers to be educated about PPD before they are discharged from the hospital, and strongly encouraging ob-gyns and pediatricians to screen for PPD.
My primary goal in life is to make sure other women suffering from perinatal depression and anxiety don’t have to suffer silently, which is why I agreed to help open The Motherhood Center with Catherine!
CAN YOU EXPLAIN WHAT THE MOTHERHOOD CENTER IS?
The Motherhood Center is a first-of its-kind clinical treatment facility in New York City for pregnant and new moms suffering from perinatal mood and anxiety disorders (PMADs), otherwise referred to as postpartum depression. We offer various tiers of treatment based on the client’s symptom severity, including:
A day program with a nursery for the babies
Outpatient therapy and medication management
Support groups for new and expectant moms who are having a difficult transition to parenthood
Various classes and workshops preparing mothers for childbirth, breastfeeding support, and much more Clients are referred to us primarily by ob-gyns, pediatricians, doulas, psychiatrists and therapists, but we also get a lot of referrals from our social media efforts.
THAT’S INCREDIBLE! WHAT ARE SOME SERVICES IT OFFERS TO NEW AND EXPECTING MOMS?
The Motherhood Center is one of only a handful of “Perinatal Day Programs” in the US. Our Day Program provides clinical treatment for new and expecting mothers with severe PMADs, who are having a very difficult time caring for themselves and/or the baby.
Clients of the Day Program are with us five days a week, five hours a day and their babies are cared for in the nursery. Clients participate in therapeutic support groups, mindfulness, meditation, art therapy, yoga and more, and each one is followed by an individual therapist and psychiatrist that specializes in PMADs.
What truly differentiates us is that, unlike the handful of other day programs out there, we’re not affiliated with a hospital. We are a standalone center, meaning we have the ability to create a warm, nurturing, non-clinical environment for women receiving treatment. It feels like a giant living room!
HOW HAS THE STIGMA AROUND PPD CHANGED SINCE YOU FIRST GOT INVOLVED?
People are starting to talk about it more! Celebrities like Chrissy Teigen, Serena Williams and Adele sharing their personal experiences with postpartum depression gives permission to women everywhere to talk about it and hopefully seek treatment. Many states have legislation on the books, which includes mandatory screening, PMAD education, public awareness campaigns and more. And many national medical associations are strongly recommending screening for PMADs.
HOW CAN SOMEONE SUPPORT A FRIEND WHO’S STRUGGLING WITH PPD?
Ask mom how she is doing. All the attention is on the mom until the baby is born, and then mom is left in the dust. If mom appears to be overly anxious, depressed or easily irritated, is having obsessive thoughts that are running like a hamster wheel in her head or feels helpless or hopeless, she may be suffering from a PMAD.
You can let her know that she’s not alone—more than 20 percent of new moms experience postpartum depression and anxiety, and those are just the ones who talk about it. Tell her it’s not her fault and that she can feel better with the right support and treatment.
IF YOU COULD GO BACK IN TIME, PRE-BABY, WHAT ADVICE WOULD YOU GIVE YOURSELF?
I would have told myself women who have a history of depression and/or anxiety are at a much greater risk of developing a PMAD. I didn’t know that at the time. I would have had a treatment team all set up for me, and I would have warned everyone around me to look out for the signs. I would have screamed in my own face, yelling, “Asking for help does not mean you’re a bad mom! Every new mom needs help! We are one of the only cultures in the world that doesn’t have built-in support for new moms!”
WHAT WAS IT LIKE TO GAVE BIRTH TO YOUR DAUGHTER SO SOON AFTER OVERCOMING PPD?
It was the second hardest thing that happened after my PPD. My daughter was a huge surprise. It honestly compares to the immaculate conception (remember earlier when I told you all my husband has to do is look at me?!).
I was so not ready to have another baby. In fact, I was never going to have another baby after Max was born. I couldn’t tolerate going through that again. But after some serious soul searching (and therapy), I decided that I was not going to let my first experience define me. I took total control over my situation, and I created a plan that covered all the areas I felt had contributed to my PPD the first time. I did everything differently, and it paid off. I did have a PPD relapse when she was 9 months old, but it was less severe and I knew exactly what to do. Antidepressants are wonderful thing.
HOW DOES RAISING ONE CHILD DIFFER FROM TWO?
Going from one to two kids is like going from 1 to 10. My kids are two years apart, so they were both in diapers for a substantial period of time. And sorry, No. 2, but by the time mom gets to you, we have often been through the worst of it with the first one and now we have perspective. The second-born has to figure out a lot of things on her own!
WHAT’S YOUR GUILTY MOM PLEASURE?!
Red wine and binge-watching British crime shows with my 85-pound mama pitbull snuggled up under my chin.
WHAT’S ONE THING YOU THINK ALL NEW PARENTS SHOULD KNOW?
If you or someone you know is suffering from postpartum depression and you live in the New York Tri-State Area, call The Motherhood Center at 212-335-0035 to get the help that’s needed to feel better.
For national resources, visit Postpartum Support International (PSI). PSI has PMAD resources available in every city and town across the US.
In the past five years there has been a flurry of attention given to perinatal mood and anxiety disorders (PMADs) otherwise referred to as postpartum depression. Famous women like Gweneth Paltrow, Chrissy Teigen, Adele, and Adele's friend who just shared her own postpartum psychosis story, have come forward with their personal PMAD struggles. National medical associations like the AAP (American Association of Pediatrics) and ACOG (American College of Obstetricians and Gynecologists) now recommend screening for PMADs during pregnancy, postpartum and at child well visits. These are critical steps in changing the conversation and stigma that have historically surrounded PMADs.
There is one group of providers that are growing in popularity nationwide that can also play a key role in the identification of PMADs in new and expecting mothers – DOULA’s. A Doula is a person who offers non-clinical, judgement free support to others as they transition through major life experiences. Doulas specialize in different areas of perinatal care including labor and birth, postpartum, antepartum and death.
The doula movement arose in response to the lack of postpartum care available from traditional care providers in the U.S. Whereas the relationship between a woman and her OBGYN or her baby's pediatrician are undeniably critical to the physical health and wellbeing of both, a doula establishes a more intimate relationship with the new or expecting mom - allowing her more exposure to mom's emotional health. Often, doulas will come to the home prior to the delivery of the baby and have multiple meetings to establish a relationship and discuss the birth plan with the expecting mother, allowing a bird’s eye view to the woman's immediate environment. In doing so, Doula's are exposed to potential external stressors that may exist in the home or in the couple's relationship - both putting a woman at greater risk for the onset of a PMAD. They can also observe any obvious psychological changes in the woman over the perinatal period and in the immediate postpartum.
Recently, Doula groups like Carriage House Birth in New York City, are working with PMAD treatment providers like TheMotherhood Center to recognize the importance of integrating PMAD awareness into their doula trainings. Doulas need the basic skills to do the following: Recognize when a woman may be experiencing a PMAD; have the conversation with a new or expecting mother that appears to be suffering; and most importantly - refer a woman for support and treatment.
A doula doesn't need to be a professional mental health provider to recognize a PMAD. The signs can be easily detected for someone trained:
· This woman is excessively worried about her pregnancy or the new baby - contacting the
doula or pediatrician multiple times a day.
· She is crying frequently and saying that she is a failure, she can't do anything right, or that
she has made a huge mistake.
· She obsessively washes bottles, does laundry, ruminates about harm coming to the baby
· She tells you she feels helpless or hopeless - and she refrains from seeing friends and
family or leaving the house.
· She can't sleep when the baby sleeps at night, or she sleeps all the time - she has no
appetite and is having a hard time caring for herself and/or the baby.
· She is irritable and angry, sometimes rageful.
· In severe cases, she may share that she has thoughts of ending her life or the baby’s life.
With proper awareness and training, a doula can feel comfortable and confident recognizing these symptoms and having a conversation about them. She can say, "Becoming a new mother is one of the hardest things a woman can do, we don't talk enough about the hard part. It's very common for new mothers to feel anxious and overwhelmed by this new responsibility – being a new mom can feel like it's too much. What has it been like for you?" If mom says she is really struggling a doula can say: "I have heard so many women say exactly the same thing. You are not alone, and you can feel much better with the right support. I have some resources to help you get through this challenging time, and enjoy being a mother more. Should we make the call together?" Partners and other family members also play a critical role in the mental health of the pregnant or new mom and can be educated on where to go for help.
If untreated, PMADs can have a negative impact on the baby's development and the bond between mother and child. It's imperative for all providers that come in contact with new and expecting mothers to look out for the signs and symptoms of PMADs. PMADs are the most common birth complication among women. 1 in 5 new and expecting mothers experience a PMAD, and to her - it feels like she is drowning in an endless, dark sea, just waiting for someone to throw her a life preserver.
As seen in Every Mother Counts September 2018
To learn more about PMADs or for resources for women that are struggling visit Postpartum Support International (hyperlink http://www.postpartum.net/). If you are located in the New York Tri-State area call The Motherhood Center at call 212-335-0034.
16 months after my son Max was born, I felt like I was finally in the clear from my diagnosis of severe postpartum depression (PPD) and anxiety. It had taken months for me to seek treatment and months to get better, but I was finally enjoying the little guy. I remember the 16 month mark because I attended a Local PPD support group, finally feeling strong enough to be around other women’s pain. The group was a cathartic experience; I was able to tell the new moms that were struggling with PPD and anxiety in real time, that they were going to be ok. That I had felt their pain, went on medication, went into therapy and finally felt like myself again–plus one. I left the group feeling so thankful that my dark journey had finally come to an end.
A few weeks later, I was at a conference for work and realized I hadn’t had my period in a while. I wasn’t super worried because the last time I had sex with my husband barely counted, but I had a pregnancy test in my bag from an earlier scare (I had convinced myself that sex = baby = PPD), and so I decide to take it just to be sure.
I remember listening to Vampire Weekend in the background (to this day I can’t listen to them because it brings these moments back), and I laid the stick on the counter and started responding to work emails. I forgot about the test for a good 20 minutes, then returned to the bathroom to see the results.
PANIC. Sheer and utter panic as I picked up the stick. I shook it, I turned it around and around trying to make the positive line disappear. This can’t be happening; it must be an expired test. Surely it's wrong because I had it in my bag for some time. This. Isn’t. Happening.
You see, after postpartum depression with my son, I had no intention whatsoever of having another child. I did not ever want to go back to that place, ever. I couldn’t do this again–so soon –I had just started feeling like myself again.
That night I spent hours curled up in a ball on the bathroom floor holding the stick. I kept looking at it over and over again to see if the line had gone away. It was still there. In the morning, the line was still there and it was beginning to set in that I may actually be pregnant. I decided to call my husband. My postpartum depression with my son had really done a number on us as a couple. While I silently (and not so silently) struggled with becoming a mother, he made it a point to be out as much as possible. He didn’t know what to do to help me, so he self admittedly ran–literally. He began training for triathlons. I worried this news would destroy us as a couple. What should be one of the most exciting phone calls to make felt like the heaviest and darkest call ever.
I told him I had taken a pregnancy test and it was positive. I told him it was all going to be ok, and we could talk about it in person when I got back from my trip. He was with a friend when I told him the news so his response was infused with his typical dry sense of humor. He said, “Well this is going to be exciting.”
For the next two days at the conference, I made the mistake of confiding in a colleague who was immediately overjoyed with my news. When I explained to her that I didn’t think I could do it again after the first time, she told me that having two kids was the best thing she ever did, and I should just be thankful for this gift. I ran into the bathroom and cried.
The darkness was coming back. The feelings of hopelessness and helplessness that I had fought so hard to get rid of were creeping back in around the corners.
When I got home, I was happy to see my son, but was also hit with a wave of memories of how hard it had been when he was an infant. I told my husband that I didn’t know what I was going to do yet with this news, and I didn’t want to talk about it until I had a chance to process it. I shut him out and collapsed inside of myself to find the answer.
I called in sick to work for a few days and hid under my covers thinking about what to do. I didn't want this baby, and I didn’t want to have to go through what I went through with my son ever again. I called planned parenthood and made an appointment for the following week. I didn’t tell anyone.
But then, one night, my husband asked me to sit down on his lap. He told me that he knew I was struggling with this decision, and he would support me whatever I decided to do. He just didn’t want to lose me. We cried in each other’s arms, and I knew in that moment that we were going to figure it out–together.
Another baby. Wow. I began to slowly wrap my head around this reality. The more I did, the more I felt determined to have a different experience.
I took better emotional care of myself during my second pregnancy. I continued individual therapy and began couples therapy with my husband with a focus on becoming a stronger unit. Many times, on that couch he cried and told me how sorry he was that he didn’t know how to take care of me after Max was born and that he would do a better job the second time.
I went to acupuncture once a week and exercised and rested as much as I could. I thought a lot about what contributed to my PPD the first time: The isolation day after day alone with my son, feeling completely disconnected from achievements in my professional life, not having a community of like-minded new moms who were not afraid to talk about the dark side of having a baby, and most importantly, an overwhelming sense of shame at having to ask for help.
So I took control. I was going to be in charge of this experience–it wasn’t just going to happen to me. I created a postpartum plan, including all the things I needed the first time, but didn’t know. I had my mother-in-law agree to stay for the first month after the baby came (a mixed bag but she didn’t speak any English so I saw that as a plus) and my mom agreed to stay the month after that. I negotiated a part-time work schedule with my job, allowing me to work as many or as few hours a week as I could to stay connected. I lined up a group of second time expecting moms all due around the same time. I welcomed an epidural as my delivery with my son was physically and emotionally traumatic, all-natural 20 hours of labor that left me a shell of myself.
Most importantly, I made sure that everyone around me knew how to recognize the warning signs of PMADs with a treatment team at the ready. Karen Kleiman writes in her book, “What Am I Thinking? Having A Baby After Postpartum Depression”:
“The good news is that with proper preparation and planning and a healthcare team that is mobilized on your behalf, we can intervene in ways that will minimize the likelihood that you will experience a depression to the same degree that you did previously”.
And you know what? I had a totally different experience the second time around. All of the safety measures I put in place for myself paid off. All the support I lined up, the community I built, and the perspective I had the second time around made it completely different. And most importantly, I asked for help–every day, all the time.
I can’t imagine what life would be like without Ella. She is a strong-willed, confident, outspoken little terror and I love her madly
I am in no way urging moms who have experienced a PMAD with their first baby to try it again. I just want to plant the seed that for those of us who had a PMAD the first time around, there is hope.
Paige Bellenbaum, LMSW is the Program Director at The Motherhood Center of New York, which provides clinical treatment and support to new and expecting mothers experiencing perinatal mood and anxiety disorders. If you live in the New York City Tri-State area, call The Motherhood Center at 212-335-0034. For resources in other states visit Postpartum Support International.