14 Ways "Black-Ish" Normalized Postpartum Depression

A recent episode of the ABC sitcom “Black-ish” focused on postpartum depression and mental health. This is incredible progress.

I was very pleased to watch television this week and see a mental health focus for an entire episode of the ABC sitcom “Black-ish.” This is incredible progress. As a licensed mental health therapist, I understand well the stigma facing mental health and how much awareness and education is needed.

In the “Black-ish” Season 4 Episode 2 – Mother Nature, Bow is feeling overwhelmed after the birth of her son and learns she is suffering from postpartum depression. Dre urges her to get help and stands by her side while she works through it. Meanwhile, the kids baby-proof the house in an effort to help their parents out.

Here are 14 ways this episode of “Black-ish” normalizes mental health for new mothers experiencing postpartum depression.

1 | Honoring mothers is not dishonoring fathers

In the first two minutes of the episode, we see Andre Johnson Sr., or Dre (played by Anthony Anderson), recognizing the pride a man feels when having a newborn baby. He also honors women for the feat of carrying a human being inside their body, and now holding and nurturing that child for the rest of their lives.

“Mother nature has given women everything they need to sustain life with comfort and ease.” A man honoring and praising a woman for her motherhood does not take away from his honor or manhood, it enhances it.

2 | Your family may notice you acting differently but may not understand you are dealing with a mental health issue

Dr. Rainbow Johnson (Bow), played by Tracee Ellis Ross, is visibly showing signs of depression – easily distracted, lack of motivation, frequent crying, low energy, insomnia, etc. As narrated by Dre, the family is aware that something is “wrong” and take steps to help Bow, but are initially unaware she is struggling with a mood disorder.

3 | Having a mental health diagnosis is not a sign of weakness

Dre’s mother, Ruby Johnson (played by Jennifer Lewis) makes the following statement when referring to Bow’s change in behaviors, “This is what new motherhood looks like…she’s just weak.”

There’s often a perception that acknowledging the presence of a mental health diagnosis or even getting help or treatment is a sign of weakness. It is not!

In the last scenes of the episode Ruby ends up apologizing to Bow and tells Bow she’s not weak. Ruby admits being weak for not being there to help Bow through this experience.

4 | Having experienced postpartum depression during a previous pregnancy is a risk factor, but is not the only indication

Dre makes the statement that Bow didn’t experience the symptoms she’s displaying presently after the birth of her other children, and he doesn’t understand why this pregnancy is different.

While previous experiences with postpartum depression are a strong indication of present or future indications, they’re not the only factor that must be considered. Factors such as previous experience with depression, a family member who’s been diagnosed with depression or other mental illness, medical complications during childbirth, mixed feelings about the pregnancy, whether it was planned or unplanned, and others. In Bow’s case, the fact that the baby came early, Bow’s age (meaning it was a high-risk pregnancy), and other factors make experiencing postpartum depression very likely.

5 | Postpartum depression is not the same as having “baby blues”

One of Dre’s co-workers attempts to diagnose Bow as having the “baby blues,” which is used to describe the feelings of unrest, tiredness, worry, and fatigue many women experience after having a baby. It’s normal for a mother to experience worry or concern over being able to provide care for the newborn baby, and this is present in approximately 80 percent of mothers.

However, postpartum depression is extreme feelings of sadness and anxiety that affect the mother’s self-care or that of her family. This affects approximately 15 percent of births. A new mother should not try to diagnose herself but consider speaking to a mental health professional to get an evaluation if she or another family member is concerned.

6 | New mothers can experience postpartum depression and not know it

Dre takes the advice of his co-workers and reads through a magazine targeted to women where he discovers his wife may be experiencing postpartum depression. The suggestion from the magazine encourages Dre to be gentle with his approach in discussing this with his wife.

While magazine or online questionnaires are no substitute for mental health treatment or assessment, the advice given in this occasion was helpful. Having a discussion with a new mother about the possibility of her having postpartum depression should be done very delicately and in a supportive manner.

7 | Mothers should not try to self-diagnose themselves

Bow makes this statement, “I do not have postpartum depression. I am a doctor and I would know.”

While the character of Rainbow Johnson is a medical doctor, she does not specialize in mental health or psychiatry. Postpartum depression doesn’t discriminate in race, profession, socioeconomic status, or anything else. A diagnosis of postpartum depression is not an indication of weakness or failure in the new mother; rather, it’s an indication of something that affects many women. Luckily, there’s help for it.

8 | A woman experiencing postpartum depression is not someone who needs to be fixed

In one scene, Dre asks Bow over and over if she’s okay and tries to engage her in activities. Bow responds, “Please stop trying to fix me.”

It’s important to recognize the new mother not as something that has been broken and needs fixing, but as a human being who is experiencing a mood disorder and needs lots of support. This mindset of the mother being “broken” may cause her symptoms to worsen. She may feel like her body is failing if she can’t breastfeed, or her skills as a mother are failing if she is unable to console her child, or any other self-defeating thought.

9 | Just because someone else did not seek treatment after giving birth does not mean this is healthy for everyone

Dre’s mother, Ruby, discusses Bow’s ability to parent with Dre, comparing Bow’s present actions with her own experience after giving birth to Dre. She says, “I didn’t go to some quack doctor because I was mentally ill with some made-up disease.”

Dre quickly corrects her and explains that postpartum depression is not made up, stating that many women experience it. The Center for Disease Control estimates 11 to 20 percent of new mothers experience postpartum depression. Just because your mother, sister, grandmother, aunt, best friend, or whomever didn’t receive treatment for postpartum depression doesn’t mean that is the best course of action for you.

10 | Recovery from postpartum depression is not instantaneous, it takes time

One of Bow’s children asks, “Why isn’t she getting better?”

Sometimes the expectation for the new mother, or her family and friends, is that she will get better quickly. This process takes time and can be incredibly frustrating for the new mother. Support, encouragement, and space will be vital to her during this time. The best thing family and friends can do is to keep communication open and provide the new mother with what she asks for.

11 | Experiencing postpartum depression is not a reason to allow people to walk over you; establish and reinforce boundaries

One of the scenes shows Ruby and Bow discussing why Ruby made the decision to give Bow’s child baby formula instead of the breastmilk Bow had pumped. Bow assertively tells Ruby she has crossed a line.

It’s important to seek the counsel of a mental health professional regarding healthy behaviors and practices, but at the end of the day you are a mother and it is your child. No one should ever make you feel bad for wanting to raise a healthy baby and no one should violate your wishes as the child’s mother. This may mean setting boundaries with your family, in-laws, friends, significant other, or other people.

12 | The new mother needs support and unconditional love from her significant other

If the new mother is fortunate to have the support of a significant other, that person should be prepared to fully support and love the new mother unconditionally.

In the scene when Bow tells Ruby to get out of her house, Dre supports his wife, even to the point of asking his own mother to leave their house. Bow needs this support during this time. Ruby also calls Bow crazy and says she is overreacting.

Name-calling and unrealistic expectations will only backfire and make things harder for the new mother. The feelings the new mother is experiencing are real, and they should be honored and given space to be worked through.

13 | Everyone around the new mother will feel powerless to help and that’s okay, because it’s not about them

Dre is speaking to his father, played by Lawrence Fishburne, about Bow’s seemingly lack of progress. He states, “I feel powerless.”

It’s not uncommon for men to feel like the woman needs fixing and it’s their job to fix her, but the new mother just needs time, support, and unconditional love to help her during this time. Let’s us not forget this woman just carried a human being inside her body and now that human being is a newborn baby who is crying and solely dependent on the new mother for everything. No pressure at all, right?

14 | Counseling or therapy and medication management are proven treatments for postpartum depression

There still continues to be a stigma around mental health. It is everyone’s responsibility to become informed and to inform others so we can break the stigma.

In the last few scenes of the episode, Bow talks about the therapeutic homework her therapist assigned to help her through this experience. Bow also expresses initial frustration at her therapist, which is normal for anyone entering therapy. Bow’s continuation with therapy and her medication helps her eventually work through and improve her mood.

If you or a loved one may be experiencing postpartum depression, please contact a mental health professional for an evaluation.

The Surprising Science of Dads in Pregnancy and Postpartum

Science has something to say about just how much influence dad has, whether he wants to or not, from the very beginning.

What comes to mind when you think about pregnancy, prenatal care, birth, and newborns?
It’s a blur of frequent checkups, peeing in a cup, peeing a lot in general, nausea, heartburn, crazy hormones, baby care, I’m so tired, and wow, why are diapers so expensive?
Most of these thoughts are centered on mom and baby. Rightfully so, as women are the actual vessels housing the little energy-sucking bundles of ever-loving joy and sacrificing body, brain, boobs, and bubbly drinks to grow them and care for them.
But where is dad in all this? His role goes way beyond being just a sperm donor and side spectator throughout the process.
Although we may recognize the importance of a father’s presence in raising kids, we often isolate the pregnancy and newborn time period as mom’s job. But science has something to say about just how much influence dad has, whether he wants to or not, from the very beginning.

Before pregnancy

Age

It’s no secret: Today’s women are waiting longer to start families, due to factors like personal and career goals and advancements in reproductive medicine. So it would make sense that dads are getting older, too. Indeed, the typical man with a newborn is 3.5 years older than his counterpart four decades ago. The rate of new dads over 40 in particular has more than doubled.
Along with increasing age comes unexpected impacts on the family. It can take longer to get pregnant, and the risk of miscarriage is higher. There is also a higher chance of birth defects, genetic disorders, and psychological conditions in offspring. But there are big benefits, too, like financial stability and emotional preparedness, plus the possibility of producing smarter kids and the extended effect of increased lifespan for future generations.

Lifestyle

We’ve also focused responsibility for smoking and drinking during pregnancy solely on the woman, but a man’s lifestyle habits have a surprising impact as well.
A study in International Journal of Epidemiology showed that children with a father who smoked earlier in life (but had quit prior to conception) had a more than three times higher chance of early-onset asthma than children whose father had never smoked.
A review by National Drug Research Institute found that men who drank 10 or more alcoholic drinks per week during preconception carried a two to five times increased risk of miscarriage. Additionally, paternal alcohol consumption was associated with a greater risk of negative outcomes for infants, including ventricle malformation, low birth weight, low gestational age, and even acute lymphoblastic leukaemia at high-level use.

During pregnancy

Symptoms and hormones and emotions, oh my!

Women may be the ones doing all the “hard work” but aren’t the only ones who suffer through a pregnancy.
Ever heard of sympathy pregnancy symptoms? Yeah, this is a real thing. It’s called couvade syndrome, defined as a phenomenon in which a male experiences symptoms of pregnancy during the time his partner or another woman he is particularly close to is pregnant. They may have weight gain, nausea, mood swings, fatigue, sleep loss, and other telltale symptoms.
Many men also have real hormonal changes during this time with a drop in testosterone and estradiol levels, as evidenced by a study published in American Journal of Human Biology.
So women aren’t the only hormonal hippos in the house! (Not sure if this is good or bad?)
Add to that all the pressure and stress associated with a new baby, and you have a recipe for a male version of prenatal depression. A study published in BJOG: An International Journal of Obstetrics and Gynaecology reported that new depression in fathers was linked to a 38 percent increased risk of very preterm birth. That’s quite a significant number and indicates that a father’s health is important because it has spillover effects on the rest of the family.

After pregnancy

Dad depression

The underlying changes dads go through don’t end when the baby is born. The postpartum period, although supposedly a joyful new chapter in life, brings new challenges and stressors for both parents.
Postpartum depression is a hot topic these days, with an estimated one in seven new moms affected. Increased awareness is a good thing, as more moms are getting the help they need. But most don’t realize dads can feel the baby blues, too. Up to 10 percent of new fathers experience symptoms of depression, according to researchers at the University of Southern California.
An interesting study published in Hormones and Behavior revealed a link between a drop in testosterone and increased risk of paternal depression. On the other hand, men with high testosterone weren’t affected by depressive symptoms, but there was still an important family implication: Their mama partners were more likely to be depressed and reported more aggressive behavior coming from their man.
Clearly, dad’s hormones and emotional state affect mom and the family’s overall well-being. This is all very eye-opening in light of our current social views of pregnancy and medical care protocols focusing solely on mother and baby.
“We often think of motherhood as biologically driven because many mothers have biological connections to their babies through breastfeeding and pregnancy,” said Darby Saxbe, lead researcher. “We don’t usually think of fatherhood in the same biological terms.”

Remember the father factor

It’s clear that fathers have a huge impact biologically and emotionally through conception, pregnancy, and the postpartum period, but they are unfortunately very underserved in the medical community. Shouldn’t paternal education and care be part of the process?
We often expect men to just support their partners, but they may not have adequate support themselves even while suffering from hormonal imbalances. That is certainly something to think about!
The real question is, would the supposed-to-be-strong, nothing’s-wrong-with-me, manly man admit that he might need help?
What do you think? Share your thoughts below.

New Research Suggests Treating Anxiety Doesn't Have to Take a Backseat During Pregnancy

A new study about the safety of benzodiazepines during pregnancy might give mothers some peace of mind about treating anxiety during pregnancy.

For many women, pregnancy is a period of anxiety and stress. Financial worries, fears of about impending parenthood, and concern for the health of child can weigh heavily on women, especially those with histories of mood and psychiatric disorders. However, a new study about the safety of benzodiazepines during pregnancy might give mothers some peace of mind about treating anxiety during pregnancy.
The study, published in JAMA Psychiatry, found a slight increased risk of adverse birth outcomes associated with benzodiazepine and serotonin reuptake inhibitor use during pregnancy, but the risks were minor overall. Women who used benzodiazepines such as Xanax were more likely to deliver by cesarean section. Babies were also more likely to have low birth weights, and six out of every 100 born required the use of ventilators. The average length of pregnancy was also shortened by 3.6 days, the study found.
The use of serotonin reuptake inhibitor (SSRIs) such as Lexapro, Prozac, or Zoloft, had similar effects on the pregnancy. Preterm birth was more likely, and pregnancy was shortened by an average of 1.8 days. An extra 15 out of every 100 babies born required minor respiratory interventions. Women were also at a slightly higher risk (five out of every 100) of high blood pressure.
While the use of these medications are not without risk, the overall effects are fairly minor. For many women, the benefits that come with treating mood disorders may significantly outweigh the slightly shortened pregnancies and extra support required at birth. The authors of the study study say their research suggests women should not feel pressured to stop their medications during pregnancy.
Not all studies have given expecting mothers such comforting news. Past research has suggested that children exposed to long-term benzodiazepine use in utero were more likely to internalize problems at both one-and-a-half and three years of age. Other research has found that children whose mothers used SSRIs while pregnant were more likely to be diagnosed with a psychiatric disorder by age 16 than those whose mothers did not (14.5 percent vs. 8 percent, respectively).
Of course, women with more severe mood disorders which require treatment through pregnancy might be more likely to have children with similar disorders, regardless of their prescription drug usage. The American College of Obstetricians and Gynecologists notes that while anti-anxiety and antidepressant medications during pregnancy may be a concern, discontinuing medication use can present new challenges including a lack of adherence to prenatal care, inadequate nutrition, and increased substance use.
Non-pharmacological treatments can act as a first-line therapy for pregnant women exhibiting mild-to-moderate symptoms of anxiety disorders and depression. For women who are interested in stepping back their pharmacological use during pregnancy, therapies such as bright light therapy, cognitive behavioral therapy, interpersonal therapy, and group therapy have been shown to be effective. But research on non-pharmacological treatments for anxiety and depression in pregnant women is limited, and these treatments may not be sufficient for women with more pronounced mental health needs.
Estimates vary wildly, but as many as 10 to over 50 percent of pregnant women experience anxiety disorders or symptoms at some point during pregnancy. Similarly, about 13 percent of pregnant women and new mothers experience depression. The factors that increase the risk of depression during and after pregnancy are numerous and varied, and include:

  • personal and family history of depression
  • being young, substance abuse, stressful life events
  • marriage or money problems
  • anxiety or negative feelings about the pregnancy
  • problems with previous pregnancies or birth

In January of last year, the US Preventive Task Force recommended that prenatal and postpartum women should be screened for depression. Despite these guidelines, many expecting mothers do not receive any sort of prenatal screening for mood disorders. And early detection may be key. A Dutch study found that women who were screened for postpartum depression at three weeks were less likely to be depressed nine months later than those who were not.
Women who are already receiving treatment for anxiety disorders should discuss with their doctor the benefits and drawbacks of staying on prescription benzodiazepines and SSRIs. With new research highlighting the relatively minor effects on babies’ physical health, mothers should be better equipped to make an informed decision about their treatment.

Could You Benefit From a New Mom Mentor?

If you don’t have family or friends nearby, becoming a mom can be isolating. Mom mentoring programs can help.

A woman peered into the double stroller and asked, “Are they twins?”
“Yes,” I responded.
“That must be difficult,” she said.
I heard this comment often when my twins were first born. It was difficult. Really difficult. When I think back to that time period, two things helped me get through it: joining a group for moms of multiples (twins, triplets, etc.) and having a mom mentor.
A mom mentor is a mom to older children who gets matched with a first-time mom. She provides support and feedback for the new mom. In my case my mom mentor was assigned to me through a mom group. She called me weekly in the beginning and then less often as I became adjusted to my new role as a mother of twins.
There are various types of new mom mentor groups available. I spoke with the founder of two, one of which I participated in. Both mentor programs use peer volunteers who are matched up with a recent-mom mentee.
The mom group I belonged to is called Keeping Pace with Multiple Miracles. I spoke with Pam Pace, one of the founders, about the mentor program she created with co-founder Donna Baker. The mentor program began after Donna and Pam met in the hospital in 1994. Donna gave birth to triplets while Pam was on bed-rest, pregnant with triplets. Donna became a mentor to Pam when her triplets were born three months later. They continued to support one another and then founded the non-profit group. Their sister-like bond became the inspiration for the support they hoped to provide other mothers.
I also spoke with Christine Sweeney, LICSW, who founded the Parent Connection in 1991. This program is based at Best Israel Hospital in Boston, MA. It was created due to a need the OBGYN nurses identified during follow up calls from women who recently gave birth. Many of the new moms reported feeling overwhelmed or early symptoms of postpartum depression.
Christine Sweeney, Pam Pace, and some women who participated in the mentor programs reported the following benefits:

Provides you with a support system

When you first become a mother you may feel alone. If you don’t have family or friends nearby who understand your experience, it can be isolating. For many women, having a mentor provided a support system they were lacking. Even women who did have family or friends nearby stated that they didn’t always feel comfortable sharing the negative aspects of being a new mom with them.
Alexis Petru participated in the mentoring program Mentoring Mothers, located in San Francisco, CA. According to Petru, “there’s still a stigma for women to talk about the ‘dark side of parenting.’ We’re still supposed to subscribe to that Hallmark-approved ‘enjoy every moment’ romanticized view of motherhood. During my mentoring group it was the first time I could really vent about my complicated feelings of motherhood … the anger, frustration, sadness and loneliness that goes along with the joy and wonder of raising children.”
Sweeney noticed a similar experience in her mentoring program: “Since there isn’t an agenda, expectations, or judgments, women feel safe discussing their struggles. Some women who had difficulty getting pregnant may think they can’t complain about how hard it is to be a new mom. A mentor gives the new mom a sense of relief and safety that they can talk about their feelings.”

Increases your confidence

Being a new mom is overwhelming. A lot of new moms question if they are correctly taking care of their baby. “A lot of new moms have questions about breastfeeding. Their mentor can help them provide answers and give them a sense of what is normal,” said Sweeney. The mentor can answer their questions and let their mentee know they are making progress which increases their confidence.

Provides you with resources

In addition to answering questions, a mentor can help their mentee when they might not know how to ask for help or realize they need it. “Sometimes the new moms might have marital problems or financial issues and the mentor will help them to get the resources they need,” said Pace. Sweeney also added that mentors are occasionally the ones to identify when a new mom is struggling with postpartum depression and will help the mentee receive the proper mental health services.

Helps you to be a better mother

By having a support system and the proper resources new moms are better able to care for their babies. Mentors help care for the new moms when they are focused on caring for their newborns. This enables the mentee to be a better mom to their newborn.

Where to find a new mom mentor program

Check with your local mom’s group or at the hospital where you delivered your baby to find a mentor program for new moms.

How to find a mentor

If you don’t have a mentor program near you, ask a friend or family member if they can be your new mom mentor or if they could recommend someone to mentor you. A weekly check-in phone call offering support and advice is what most mentors provide for the new moms.

Why Weaning off Antidepressants Wasn't the Right Choice for Me

After popping my last pill, I felt almost triumphant. “I’m med-free!” I croaked. Fairly quickly, I noticed some changes.

A little over six years ago, life was pretty chaotic. I had a newborn in the neonatal intensive care unit and a toddler at home as I recovered from major surgery. I’ve always been a worrier and prone to rumination, but becoming a parent – especially the second time around – amped up my natural tendencies. I felt as though I was drowning on a daily basis.
At the hospital for a follow-up appointment, I was anxious, scared, and crying so hard I could barely get a sentence out. The doctor listened to me for a while, and after we talked more, she prescribed an antidepressant. A little orange pill became part of my daily routine. Soon thereafter, my daughter came home from the NICU. The roller coaster of motherhood began to slow down and smooth out.
Earlier this year, as my former preemie thrived in kindergarten, I began to feel guilty that an antidepressant still had a place in my medicine cabinet. After all, the crisis that had triggered the need for the med was far in the past, and I was feeling so much better. Life was stable. I exercised regularly, went to therapy, and had a few good friends I knew I could lean on for emotional support. Why on earth was I still taking these pills?
My mind made up, I took the entire summer to carefully wean off the medication that had been in my system for more than half a decade. I was certain that stopping the antidepressant would enable me to lead a more authentic life – a life untarnished by unnecessary chemical interventions. After popping my last pill, I felt almost triumphant. “I’m med-free!” I croaked.
Fairly quickly, I noticed some changes. I’d wake up in the middle of the night, tossing and turning for hours, my mind racing and a tightness building in my chest. I felt anxiety creep back in, that sinister and familiar intruder, as my brain began to play its tortuous what-if game. On beautiful, warm afternoons, while my kids frolicked in the backyard or chased frogs at the neighborhood pond, I sobbed hysterically because my brain kept replaying scenes from sad 80s movies. Things that should’ve been a blip on the radar now regularly brought me to tears: bad traffic, a botched drive-thru order, or cereal spilled on the floor.
All of this wasn’t ideal, but I chalked it up to the cost of keeping it real. Wasn’t that precisely what I had wanted? “This is how I’m supposed to be,” I declared one day to my husband.
Then one weekend, when my husband was away on a business trip, I basically lost it. My daughters had been playing outside when my six-year-old suddenly approached me with a guilty expression. “Mama, I, um … I drank some muddy water from the backyard.” My heart jumped into my throat. “You did what?!”
In that split second, my mind tumbled down a rabbit hole as anxiety ripped the logical, calm part of my brain to shreds. I pictured amoebas and parasites from the mud now worming their way into my daughter’s intestines. I ran through a list of possible symptoms she could develop and panicked about what antibiotic she might need. Tears stung my eyes as I contemplated whether she’d miss her first day of school due to severe illness. Before long, I was crying, my kids were crying, and I was frantically texting my husband and phoning the on-call pediatrician.
My daughter ended up being just fine. But the incident forced me to recognize that unmanaged anxiety and depression don’t impact only me – they affect my family too. If my kids continually see me unraveling in extreme anxiety and fear, will they learn to cope in a similar way with life’s uncertainties? Will my own neuroses someday become theirs?
Ultimately, the way we manage our mental and emotional health is different for everyone. Therapy, the development of coping skills, and the cultivation of a trusted support network are all parts of an equation that may or may not involve medication. It took weaning off my antidepressant to show me that, at least for now, medication is a critical factor in my own equation. Without medication, my life did not become more authentic or real as I’d hoped. Instead, I began to view life through the dark lens of anxiety and depression. My world became a realm ruled by excessive worry, a place where monsters appeared out of thin air, and flesh-eating amoebas lurked in the soil behind my house. Without medication, all of the other tools I was using to manage my symptoms failed to work as effectively as before. It was like baking a cake and skipping the egg or another key ingredient. The end result – in this case, my life – was a sad, gloppy mess.
My fear that medication was causing me to miss out on an authentic life was unfounded. Looking back on it, I can honestly say that when I was taking my prescription, I never felt as though the world was all cupcakes and rainbows. I simply felt like I could deal with life, whatever it might bring. In the end, that’s the attitude I know I need to model for my children.

New Research Shows That Dads Can Also Experience Postpartum Depression

With an upsurge of dads now playing a key role in raising children, more men are experiencing postpartum depression.

For many, the first days, weeks, and months of parenthood can feel like an emotional roller coaster. Stress, hormones, and learning to juggle the many responsibilities of taking care of another human being can wear us down and impact our emotional well-being. Many women may feel a bit “blue” during this time, while some face a serious mood disorder known as postpartum depression.
According to the American Psychological Association, up to one in seven women experience postpartum depression after giving birth. It can last for many weeks or months if left untreated, and can make it very difficult to get through the day, let along care for a baby. Most people realize that women are at risk of experiencing postpartum depression, but new information warns us that dads are at risk as well.
With an upsurge of dads now playing a key role in raising children, more men are experiencing postpartum depression, also called paternal postnatal depression. Experts from the University of Southern California found that 10 percent of men report symptoms of depression after their child is born, which is twice the typical rate of depression in males. These symptoms can include feelings of isolation, irritability, fatigue, low motivation, weight gain or loss, changes in appetite, inability to experience pleasure, and even outbursts of aggression or anger.
Over the past few years, several studies discovered that men have biological responses to fatherhood, particularly with fluctuating testosterone levels. These changes are thought to be a result of men adjusting to childcare priorities. For example, testosterone can drop due to sleep deprivation and stress, which are quite common when trying to manage a newborn.
Now a new study published in the journal Hormones and Behavior by a team of researchers from University of Southern California, University of California at Los Angeles, and Northwestern University found that after the birth of an infant, decreased levels of testosterone in men were linked to an increased risk of postpartum depression. On the other hand, fathers with higher testosterone levels reported more parenting stress, and their partners reported more relationship aggression from them. The same study also revealed a surprising link: When a father has low testosterone, the mother reported fewer symptoms of depression herself.
The results were announced after researchers reviewed data from 149 couples with new babies who were part of the National Institute for Child Health and Human Development’s Community Child Health Research Network. Fathers’ testosterone levels were tested by taking saliva samples when their infants were nine months old. Both parents were also asked about any depression symptoms they noted at two months, nine months, and 15 months postpartum. They were also asked about relationship satisfaction, parenting stress, and partner aggression.
This new research is so important because it shows how both parents can suffer from depression while trying to care for an infant. Many men may not realize that they are struggling because of an actual change in their hormone level. They may try to be the strong one and not admit to the feelings they are battling on a daily basis. It is critical that dads speak up and get help if they are struggling with postpartum depression not just for themselves, but for their entire family. Depressed dads are more likely to physically punish their children and less likely to read and interact with them. Sadly, this behavior can result in kids with poor reading and language skills, in addition to behavioral problems.
Fortunately, postpartum depression is treatable for both moms and dads. If you or someone you know is struggling with the symptoms, contact your physician who can suggest antidepressants or direct you to a therapist. Talk therapy has been proven to help those suffering to work through their emotions and identify effective strategies for managing their moods. You can also find support by contacting Postpartum Support International and the Postpartum Health Alliance. Exercise, a healthy diet, mindfulness meditation, and restful sleep are also good remedies for balancing mood and hormones. Do keep in mind, however, that experts are now advising against treating postpartum depression in fathers by providing testosterone supplements because too much of the hormone can trigger aggression and end up adding to the family’s stress.

The Wee Hours of Motherhood: Healing After Birth

There is no such thing as a magical, all-knowing “maternal instinct” that just kicks in and makes everything all right overnight.

In an age before antibiotics, rest and sanitary conditions were a new mother’s best chance at recovering from the physical upheaval brought on by childbirth. It made sense to support a woman’s healing through loved ones coming together to pick up her household chores, keep her and the baby clean, and allow her some time to rest and bond. In line with this wisdom, traditional cultures the world over have communal rites and practices that support a new mother’s need for recuperation after the birth of a child.
Traditional societies recognized that birth requires recovery, yet these rituals of rest and attendance to a mother and child may have also signified an ancestral knowledge that the skill of mothering does not happen in an instant. That there is no such thing as a magical, all-knowing “maternal instinct” that just kicks in and makes everything all right overnight. That the move into motherhood happens in a series of small steps, and that we do not touch down gracefully on the landing pad so much as orbit in space a little while, burning through fuel and trying like hell to read our instruments.
These rituals recognized that while new mothers recover physically, they are also transforming psychologically. And that this profound change is probably best supported by a period of recuperation and compassion.
As Anthropologist Sarah Hrdy points out in her review of mammalian mothering, even in the animal kingdom. Mothering does not “just happen” after the birth of a child. Animals such as mice and sheep require the smells of their newborns to kick-start the complicated chemical and behavioral cascade of lactation, grooming, and protection that the rearing of young entails. The “maternal instinct” is less a guarantee than a gradual adoption of new behaviors. Behaviors that must be reinforced by practice, and that can be disrupted by challenges in the environment.
Human mothering is a much wilder card, with no universal behaviors that new mothers engage in across the species besides perhaps cleaning the baby after the birth, and gazing at its face and body. After that, the way we approach the birth of a child is as wide and varied as the customs and communities of the planet we inhabit. Mothering a child and learning how to seamlessly meet its needs is not hard wired. It’s a learned skill that requires time, space, and patience to master.
As we learn to care for our babies, research has established that between two to four weeks and three to four months postpartum, our brains are increasing in volume in at least nine known areas. Neurologically speaking, this is a very big deal. Your postpartum brain is learning so much and taking in so many sensations and signals it is actually growing – and quickly.
But learning new routines is hard. It can feel lonely and chaotic and unclear at first. From a psychological perspective, it’s likely this feels tough because our brain’s favorite thing to do – recognize a pattern and stick with it – isn’t possible. Human beings are creatures of habit. To veer away from a habit and to figure out something new requires our brains to build new pathways, To literally re-wire. This uses up energy the brain would much rather apply to the millions of other tasks it must execute on our behalf. It’s tiring. And to work, it needs rest.
Today, in our modern towns and cities where so many mothers are away from their extended families, modern life means it isn’t always possible to pull down the shades and retreat from the world along enough to allow our brains and bodies the time they need to learn and heal. But that doesn’t mean we don’t still need the opportunity to do so.
So what to do?
It would appear those still dark, wee hours of motherhood have some lessons to offer.
While it is still dark outside (figuratively and literally), we are forced to accept that we can’t see as far ahead as we might like. We feel the need to find one another and huddle close for warmth. We aren’t running around, ticking items off of lists, and generally tiring ourselves out. We are resting. We are processing information. We are restoring our strength for what lies ahead.
The oxytocin response of new motherhood directs us to “stay and play” with our new arrivals. It is our body’s signal to us that it is okay to slow down, to worry less, to connect with our new child and to hold her close. There is a deep wisdom in this gentle nudge; the closer we are to our babies in the earliest of days – without the light and din of the outside world and all of it’s tempting, familiar pull – the faster we can learn the new patterns that motherhood has to teach us. The sooner we can heal. The better we might feel.
Wherever you can, listen to this nudge. Make the time to rest, recuperate and simply be with your newborn. Our societies may have forgotten the importance of allowing new mothers enough time and space to accommodate the enormous task of learning to care for our new charges, but mother nature has fail-safes. If we are not afforded time by others, we can make it for ourselves. By being conscious of the fact that motherhood takes time to learn, and that we deserve compassion and support from ourselves for this process, we can still benefit from this ancient knowledge.
The wee hours of motherhood are a time to recover, recuperate and learn. Enjoy the stillness.
Academic sources:
Duhigg, C. (2014) The Power of Habit: Why We Do What We Do In Life And Business. Random House.
Hrdy, S.B. (1999) Mother Nature: A History of Mothers, Infants and Natural Selection. Chapter 7: From Here to Maternity. Pantheon Books, New York.
Kim, P., Leckman, J. F., Mayes, L. C., Feldman, R., Wang, X., & Swain, J. E. (2010). The Plasticity of Human Maternal Brain: Longitudinal Changes in Brain Anatomy During the Early Postpartum Period. Behavioral Neuroscience, 124(5), 695–700.
This article was originally published here.

The Postpartum Body Struggle: Comparison Only Makes it Worse

You see it all the time: celebrities back to their “pre-pregnancy size” after what seems like days after they’ve given birth. The pressure is immense on us non-celebs to get back in shape as quickly as possible.
It’s tough: Between constant feeding and catching up on sleep how are you meant to fit the time in to exercise? Plus, your focus should be on your new baby, right?
I remember being pretty comfortable with how I looked when I was pregnant. I put on two stone (as you usually do) but mainly just the bump. I have to admit there were times when I was close to my due date where I wondered how on earth my stomach would shrink back to it’s existing size. I mean how the hell does it stretch that much?
I remember briefly looking down at my stomach a day or so after I gave birth and seeing hanging flab a bit like a deflated balloon, but feeling amazed at how much it had reduced already. I remember reading that breastfeeding helped burn calories, so I had it in my head that every time I fed I’d lose a bit more weight. However, even though I was breastfeeding and my stomach did shrink back down (never quite to my pre-pregnancy shape), I noticed I did feel a bit larger than I was before, especially a few months after giving birth when I stopped breastfeeding. I don’t just mean my stomach. I noticed my thighs and hips had expanded a bit more for example. I remember mentioning this to my husband and he suggested I actually looked better for it, but I just couldn’t get passed it. You find yourself looking in the mirror and pulling an “urgh” face.
Part of me was thinking, “Get over yourself, you’ve done an amazing thing and gone through a massive physical experience so why should you still look the same?” But another part of me felt just a bit negative about myself. I wanted to be able to fit into my old clothes again, even though I knew this wouldn’t happen straight away.
I was annoyed at myself for feeling this way, but where did these thoughts come from? The fact that I’d always been a certain size and rarely put on weight? Or was it from the so-called “celeb culture?” I for one actually struggle with the term “yummy mummy.” It implies you need to make yourself look good all the time as well as look after your new baby – many of us even struggle to get a shower as a starting point!
I used to read loads of celebrity magazines when I was breastfeeding or Millie was asleep. Nearly every main article focused on weight – who looked good, who’d put on weight – and this was positioned as “loving their curves.” To me it still brought negative connotations. I’ve stopped reading them now as I found it initially fueled my worries and insecurities and after a while I got bored of reading about this again and again. You can’t escape it though. Film, television programs, magazines – imagine the pressures on young girls nowadays. Being thin seems to be the norm.
The reality is, all of those celebs will have personal trainers with fitness programs, hair stylists, and beauticians on tap. I’m sure they also feel insecure about how they look and to be honest, they have much more pressure to look good in case they get papped for those magazines!!
I love this recent quote from Kate Winslet, whom I consider to be a great celebrity role model:

“But at a certain point, when you achieve a lot of your goals and you can be proud of your work, you start to relax more about who you are. And that includes your appearance and self-image – I don’t think I look too bad for a mother of two. But women shouldn’t have to feel the pressure to compare themselves to actresses or models.”

Ultimately how you feel about your body is your own personal challenge. I’ve accepted that although I won’t necessarily be the same size again, I still want to exercise, but not because I felt pressure to be thinner. Doing exercise doesn’t just keep you fit and healthy physically – it also improves your mental health and that is just as important, if not more so!
At the end of the day, I’m not just a mum, I’m an individual who wants to be happy and enjoy life. I’ll tone up and get fit but it’s on my terms – when I’m ready and have the time to do it!
This article was originally published here.

So You're Considering Encapsulating Your Placenta — Here's What You Need to Know

Placenta services are an unregulated industry, but there are certain standards, trainings, and precautions your professional specialist should follow.

Are you considering hiring a specialist to encapsulate your placenta?
Placenta encapsulation is an awesome process that transforms your baby’s placenta into capsules. You can take your “placenta pills” as a postpartum wellness supplement. Placenta encapsulation can improve your overall postpartum recovery experience, and may help: balance hormones, support lactation and enhance milk supply, replenish iron, minerals, and vitamins, mitigate postpartum bleeding, provide natural pain relief, ease “Baby Blues,” decrease severity of postpartum mood disorders, and boost energy.
Once you have decided that encapsulation is right for you, the next step is to find a qualified placenta specialist. So you search Google for “Placenta Encapsulation near me,” but what next?
Here are six tips to help you hire the best placenta encapsulation specialist:

Find a specialist who is “triple trained”

Placenta services are an unregulated industry, but there are certain standards, trainings, and precautions your professional specialist should follow. You want to find a placenta encapsulation specialist who has:

1 | Completed training and certification with a comprehensive, research-based placenta education program

Ask your prospective placenta encapsulator with whom they have trained. Check out their certifying agency’s website to learn about the curriculum and requirements. Is their organization listed with the Better Business Bureau? If yes, what is their rating? Does internet search results return positive feedback? You can search for a placenta encapsulation specialist in your area by using this directory.

2 | A current food safety certification

A food safety certification ensures that your placenta encapsulation specialist has tested knowledge in food hazards, proper hygiene practices, cleaning and sanitizing processes, and time and temperature controls.

3 | Completed an OSHA compliant Bloodborne Pathogens training

It is crucial that your placenta encapsulation specialist has demonstrated competency regarding the precautionary guidelines and decontamination practices for handling potentially infectious and biologically hazardous materials. The professional you hire should have completed the Biologix Solutions Bloodborne Pathogens Training for Doulas and Placenta Encapsulators or something similar.

Decide which preparation method is right for you

There are two preparation styles for placenta encapsulation, the Raw Foods Inspired method and the Traditional Chinese Medicine (TCM) method.

1 | Raw foods inspired method

This method is based largely on the principles surrounding the raw foods philosophy of eating. Raw foods principles teach that food is most nutritious if it is heated no higher than 118 degrees Fahrenheit. Above this temperature certain enzymes will begin to degrade. For the Raw Foods preparation, your placenta is cleaned, sliced, then dehydrated at either 110 degrees Fahrenheit or 160 degrees Fahrenheit overnight. The Association of Placenta Preparation Arts recommends drying the placenta at the higher temperature of 160 degrees Fahrenheit to ensure any possible pathogens are eliminated. Then your placenta is ground into a fine powder and placed in capsules. With this placenta process, it is thought that the potency of hormones and nutrients will be best preserved and available for your body.

2 | Traditional Chinese medicine method

Traditional Chinese Medicine (TCM) has been incorporating placenta in powerful remedies for 1400 years. It is used to increase lactation and augment the “Qi” or life energy, after birth. The many hormones and nutrients found in placenta, can help you heal and find optimal balance during the postpartum transition period. With the TCM method, your placenta is cleaned, lightly steamed with ginger and myrrh, sliced thin, and dehydrated overnight. Then your placenta is ground into a fine powder and placed into capsules. Steaming the placenta with “warming herbs” is an integral part of this preparation method. In Traditional Chinese Medicine, a mother’s postpartum body requires heat and warmth to replenish the energy that is lost during childbirth. Raw foods are generally seen as a cooling element. Therefore, consuming raw placenta is not recommended for the tonifying elements needed to nourish the blood and restore energy and balance to the body.

Know where your specialist performs their work

A placenta encapsulation specialist will prepare your placenta either in their work space or in their client’s home. With both work spaces, your “triple trained” placenta encapsulation specialist should implement identical sanitizing protocol. Also with both methods, capsules will usually be processed and made available within 72 hours of birth.

1 | Specialist’s work space

Your placenta encapsulation specialist will either personally pick-up or use a courier service to collect your placenta from the hospital or birth center, and have it brought to their work space. Their work space can be a family kitchen, a dedicated encapsulation processing space in their home, or a dedicated space in another location, like a studio or a commercial-style kitchen. Once your placenta capsules are ready, your specialist will most likely bring the pills to you, at home.

2 | Client’s home

After having your baby, you, a family member, or a friend will bring the placenta to your home. Your placenta encapsulation specialist will then come to your house to process your placenta. The capsules will be left with you, or arrangements may be made to take them to your birthplace if you are not home yet. When encapsulation is performed in your home, you or family may choose to observe the process, and have a discussion about the preparation method, and get answers to questions regarding the placenta, you birth experience, or the postpartum healing process.

Consider hiring a professional that offers complimentary services

In addition to placenta capsules, look for a placenta encapsulation specialist that offers other placenta specialties, like placenta art prints, tincture, or mother’s broth. You may also want to find a placenta encapsulation specialist that provides additional prenatal and postnatal services to the community, like childbirth education classes, or birth and postpartum doula support.

Hire a well-respected, highly reviewed, and experienced specialist

Using a placenta encapsulation specialist recommended by a trusted friend is a great option. But make sure to do your own research on any prospective encapsulator. Look through their website, check their social media accounts, and read or ask for testimonials. Schedule a call or meet with the placenta encapsulation specialist you are interested in hiring. Get an idea of who they are, how and why they chose to become a professional placenta encapsulator, and ask them how many placentas they have encapsulated. It is best to find a professional that has overwhelmingly positive reviews and testimonials from previous clients.

Have your questions answered before booking services

Your placenta encapsulation specialist should return your email, message, or call promptly and provide you with an overview of their services, fees, policies, and protocols. You should also see if your prospective specialist has a comprehensive Frequently Asked Questions (FAQs) page on their website. You want to feel confident about your specialist and her services before paying a deposit.
Placenta encapsulation is a great option for new mothers looking for a more natural approach to the postpartum recovery process. It is important to find a truly professional placenta encapsulation specialist if you are wanting this service.
This article was originally published on TheNurturingRootOhio.com

My Baby, My Breast: a Parent Knows When Nursing Is No Longer Best

As a new mom who did not successfully breastfeed, I have so often felt like a lesser mother over the past year whenever someone asked me, “Are you still breastfeeding?” Which is usually followed by, “Oh no, what happened!?” I have heard so many references to breastfeeding that at times I have felt as though mothering is breastfeeding, and because I am not doing so I must be less of a mom.
The “breast is best” mantra-turned-guilt-trip started for me before my daughter was even born. In my last group prenatal meeting, one woman said she planned to feed her baby formula, but felt like the healthcare community would only give her information on breastfeeding. After a deafening silence, the lactation consultant said, “That’s because we now know that breast milk is better.”
As if that icy tidbit wasn’t enough, she went on to caution, “I will just warn you that this is a very pro-breastfeeding area.” I swallowed hard, internalizing this information as a non-negotiable item, like so many women must do.
When our daughter Summer came, she came with a force. For the first week of her life, we called her “the tomato.” In nearly all of her waking moments her little newborn face was scrunched up and beet red, her lungs working over-time with what we called “the bird call cry.” One of the nurses on the labor and delivery unit asked us, “what is wrong with her?” Very reassuring to brand new parents.
When we got home from the hospital, disaster struck. Summer just couldn’t seem to get the milk she needed. She would worked up and arch her body into the most extreme contortions. I would arch along with her and try to aim my nipple into her mouth. Even when I got to her when she was still sleeping, the beginning of breastfeeding sent her into a tizzy. I was naked more than I was clothed, soaked in my own milk as my daughter cried, bit my nipple, bent her body, and flailed about.
For the first 72 hours of her life, my husband Nick and I slept for a total of three hours. I was so tired that at one point Nick had to remind me of Summer’s name. I began to get scared by how I felt – that I had no control over anything. The baby blues were also setting in and I couldn’t stop the tears. I would sit and cry as my milk leaked and stained my shirts, the couch, the floor. I studied the breastfeeding diagrams that made it look so easy. All the while Summer would wail uncontrollably in my arms.
We called the hospital lactation consultant who gave us advice over the phone. We called to make an appointment with that joyless lactation consultant from the prenatal group, but she was on vacation. We spoke to the midwife who told us not to worry, that Summer would get it soon. The pediatrician told me to supplement with pumped milk if I felt Summer was not getting enough to eat.
Not once in all these discussions did anyone mention formula.
On Summer’s one week birthday, I was tearfully sitting at the kitchen island, trying to nurse while Nick was at the grocery store. My sister-in-law sent me a text wishing Summer a happy one-week birthday. I read the text as if looking at it from a million miles away.
Happy? That word was not a part of a lexicon to which I could remotely relate. When Nick came home from the store and found me sobbing in the same place he left me, he said we needed to make a change.
We brought out the breastpump – something I had been nervous about, as the lactation consultant had ominously warned about introducing a bottle “too soon.”
Summer drank much better from a bottle. For the first time she showed us that her needs were met. For the first time, we regarded her with something other than pure terror. Pumping and bottle-feeding offered more of a solace, but the schedule was relentless. Pump, feed a bottle, tiny break, pump, feed a bottle – I never felt that I was bonding with my baby because it was too hard to hold her while I was pumping, which was most of the day.
Moreover, that humorless machine with all its wires was a bear on my nipples. Wearing clothes over my chafed breasts was excruciating, no matter how much nipple cream I applied. The pump kept us tethered to home, because, really, who is going to pump in public? I hoped to break the need for it, and so kept trying to teach Summer how to breastfeed. Alas, it always provoked a nearly violent reaction in her, which was hard for her (and me and Nick) to recover from.
When Summer was five weeks old, Nick broke his arm and couldn’t hold Summer. As he sat in the emergency room, I sat in bed with my mind racing. He came home, and we jointly agreed: it was time to switch to formula. Nick and I have strived to create an egalitarian household since the day we met. He advocated for formula from the minute breastfeeding proved a complicated endeavor. I surprised myself by declining that route at first because of the pressure I felt from society, although I knew that it was at the cost of our household’s peace.
After we began to formula feed, we got our groove as parents. We shared equally in caring for Summer, and Summer was well-cared for! By ditching the pump we could hold her as much as she needed. Feeling confident that we could meet her needs, our parental love flowed.
I look back at that time and feel rage, rage at society for pushing that breast is best – that if you don’t breastfeed, your child will die of SIDS, or be sick all the time, or have diabetes later in life, or be obese, or have a lower IQ. These cure-all claims by the breastfeeding-or-bust community are at best flawed and at worst pose a threat to new parents’ mental health. Unsurprisingly, recent studies point to correlation, not causation, with breastfed children, and look at what else is going on in a child’s life to help them advance. One such study found that when socioeconomic considerations are accounted for when measuring childhood IQ’s, “the standalone effect of breastfeeding seemed to disappear.”
Common sense suggests that all this pressure poses a risk for postpartum depression. Unsuccessful breastfeeding is a physical strife that feels emotionally harrowing as you’re unable to fulfill your baby’s needs. You then also have to battle society’s unceasing chorus that you’re creating risks for your child if you don’t breastfeed, challenging your very vulnerable identity as a new mother. One UK study found that women who unsuccessfully attempted to breastfeed were “two-and-a-half times more likely to develop postnatal depression, compared to women who had no intention of breastfeeding.” Not once did this risk for postpartum depression come up with any healthcare provider as Summer and I (and Nick) struggled through this chapter.
Being a mother is more than producing milk. Being a parent is not a job – it’s a state of being. We don’t need to give ourselves peer reviews and grades. The ultimate goal is to be the love of one another’s lives, and do what needs to be done to feel that way. Hanna Rosin says it best in her 2009 article on breastfeeding: “It seems reasonable to put breast-feedings’ health benefits on the plus side of the ledger and other things…on the minus side, and then tally them up and make a decision.”
That is exactly what our family did – only I wish we did it on day two instead of day 37. It would have saved a lifetime of tears and allowed us to bond with our baby a month earlier than we did.