I don’t know where to begin telling the story of my experience with postpartum depression, and I still don’t have total objectivity about it.  My baby’s first year feels like a tangled mess that I will try to unravel in a few pages.

I have always been a very independent person.  In my 20's I went to college, traveled, established a career.  I enjoyed having the freedom to do as I liked.  In my early 30's I began to feel the “now or never” pressure to make a decision about motherhood.  My now-husband and I knew we would be great parents, but we also knew we would live a happy life together if we did not have children.  We decided we would casually stop using contraception, and I was pregnant within a couple of months.

This first pregnancy ended early in miscarriage.  However, my body kept acting pregnant, and hadn’t begun the process of expelling the “products of conception.”  My HCG levels continued to be very high and I had debilitating nausea for weeks, even after the pregnancy ended.  I eventually ended up getting a D&C.

I felt relieved after this pregnancy.  I wasn’t sad about the miscarriage; I knew miscarriage is very common and did not mean I couldn’t have a healthy pregnancy.

One menstrual cycle later, I was shocked to find I was pregnant again (oops!).  This time I had no nausea, and over the months of my perfect pregnancy with my daughter, C, I fell in love with her.  My ambivalence about being a mother had vanished.  My husband and I got married when I was in my third trimester.  At 39 weeks I went on maternity leave and sat around the house waiting for labor.  I ate, slept, and took walks.  I meditated on the vision of my baby and the mother I would be to her.  I waited for her to tell me she was ready for the unmedicated hospital birth I had planned.

One afternoon at 41 weeks, just a few days after we had an ultrasound and saw C healthy and sucking on her fist, I noticed I hadn’t felt her move for a few hours.  I could write pages and pages about what life brought me after that moment.  C was stillborn.  My heart was broken.  I asked the OB to cut her from my body because I was angry at my body for failing her.  I wanted to hold her body as perfectly as it could be, and I didn’t want to labor to hold her misshapen and grotesque.  My husband and I grieved and will never stop grieving the death of our precious girl.

I wanted to be pregnant again immediately, to fill the void in my heart and my body where C had been.  We waited eight months as we grieved and I tried to get my body to a healthier place.  In June of 2012, I learned I was pregnant with F.  From the beginning of my prenatal care we began discussing how to decrease the likelihood of another stillbirth.  I learned that because I had a history of c-section, I could never have labor induced.  I knew I was likely to carry late, and the OB wanted to deliver F as early as safely possible.  We negotiated for another c-section at 39 weeks.  F was born perfect and healthy.

While, blessedly, the recovery from my c-section with C was uneventful (I was discharged 24 hours later), my recovery from F’s c-section was complicated in almost every way.  Within hours of his birth I had an adverse reaction to a medication that plunged me into the worst depressive episode I have ever experienced.  I told my husband that if I could move my legs, I would jump out of the hospital room window.  That was the moment I first thought, “I’m not fit to be a mother.  What have I done?” Several hours passed before the medicine left my body,but that feeling haunted me in a small way for months afterward.  I stayed in the hospital for over three days experiencing cold sweats, fainting spells, constipation, and excruciating pain from gas introduced into my body.  Through all of this I attempted to sleep and breastfeed my baby.  These were the days in which the seed of post-partum depression first sprouted.  My body was battle-weary and emotionally I started to unravel.  I felt ill-equipped to parent my baby before I even left the hospital.

At home, we struggled to breastfeed.  F had lip- and tongue-ties that weren’t diagnosed for a week or two.  I had a prior breast surgery that meant even once my milk was “in,” I wasn’t producing enough to feed him even if he were latching properly.  We began supplementing with formula via catheter after putting him to my breast.  For four weeks my husband and I teamed up for every feed.  I would put the baby to breast, then my husband would bottle-feed milk or formula while I pumped.  Putting the baby to breast was agony; F was a very spitty baby, and he once spit up about a tablespoon of blood that terrified me until I realized it was my own blood.  I was in such pain that I often shouted at F when he wouldn’t latch, and my husband would hover over us, worried I would hurt the baby.  (I never did.)

Concurrently during these first four weeks, I developed insomnia.  Everyone hates sleep deprivation, but I believe some people are more susceptible to its effects.  I know now why it is used as a form of torture.  I came to dread nighttime because I knew that if I fell asleep, I would be woken by a crying baby, and I didn’t know when or if I would have another chance to sleep before morning.  Well-wishers would advise I take naps or “Sleep when the baby sleeps!”  These ideas are only useful if the body complies with the need for sleep.  At one point I was so sleep-deprived that as I was pumping in the wee hours of the morning, I hallucinated that books were moving on the bookshelf.  I have heard the colloquialism “outside my mind” to describe insanity, and that’s I how I felt during those early weeks with F.  I felt like my normal mind had been left behind and was replaced with a mind that couldn’t organize or process the chaos having a baby had brought to my body and my life.

At four weeks, my husband returned to work and I realized that our feeding regimen was unsustainable while I was home alone with the baby.  At that point I gave up pumping and we decided to exclusively formula feed.  This decision was the greatest heartbreak I experienced second to C’s death.  Also at this time, my husband, as lovingly as he could, told me that he was scared to leave me home alone with the baby.  I was scared, too, but even more scared to hear my husband echo those feelings back to me.  I felt completely incompetent to care for our baby, and to hear that confirmed by my husband was devastating. 

I knew I was experiencing post-partum depression, but as a mental health clinician, I reject that label.  I think it is a label that is affixed to women who lack support, lack sleep, whose bodies are healing, who feel guilty that their expectations do not match their reality, who are grieving losses, who are struggling to redefine themselves as mothers.  

When we experience symptoms of post-partum depression, we are the embodiment of a society that undervalues motherhood and denies the importance of community in raising children.  I understand the usefulness of giving a name to this problem, but it seems that PPD is often discussed as if the problem lies solely within the individual, and not also in the environment outside the individual.

What I needed most during those early months (besides sleep) was company.  I had some friends who brought us food or offered to do our laundry, but I didn’t have a guide.  I didn’t have a maternal figure whose parenting style I could emulate.  I once told my sister that I had a feeling of anticipation, like at any moment a knowledgeable person would knock on our door and say, “Step aside, I’m here to show you how to do this.”  I needed someone to run errands with me and hold the baby so I could change after he saturated my clothes with spit-up.  I needed someone who could help me cloth diaper and explain why every.damn.diaper. leaked.  I needed someone to talk to me about sleeping arrangements and how to help each family member get enough sleep.  I needed someone to help me decide how to go back to work and when, how to find and choose childcare.  I needed someone to talk to during the long days alone with a small infant.

My husband was available for these discussions in the evenings, but our personalities and roles as parents are very different.  He is laid-back and passive about most decisions.  I crave structure and predictability.  I have become the information-seeker and the decision-maker about nearly every aspect of F’s care.  In those early days, this role was especially burdensome.  When I was frustrated with cloth diapering, my husband didn’t see any problem using disposables.  When I struggled to make decisions about baby-wearing, my husband suggested I use a stroller.  I felt alone and overwhelmed by my own expectations of myself as a parent.  

During F’s first six months, I sought medication for depression and sleep, and I went to therapy.  My husband and I experimented with sleeping arrangements; since F was bottle-fed, we could alternate being on “baby duty,” so I was guaranteed a full-night’s sleep at least every other night.  Around six months I figured out how to guide F into a napping routine that was somewhat predictable.  Once F was sleeping through the night, my husband began “baby duty” full time so that I could have 6-7 hours of quiet, uninterrupted sleep.

During the second six months of F’s life, I felt the fog lifting.  I started to lean into the chaos by becoming more flexible.  I learned to loosely structure our days while expecting F to challenge that structure.  I gave myself permission to turn on the TV or leave dirty dishes in the sink, to save important tasks for after F’s bedtime.  We left the house more often because F stopped spitting up and began to eat solids, so I wasn’t panic-stricken about whether I had enough cold bottles and the means to warm them.  My body finally began to heal from three pregnancies in two-and-a-half years.

Throughout F’s first year, a river of grief rushed below the surface of my day-to-day struggle to parent him.  Renewed grief over C’s death.  Grief that I couldn’t breastfeed F.  Grief that I was pregnant three times and never went into labor.  Grief that I never had the unmedicated vaginal birth I wanted.  Grief and guilt that I don’t enjoy being at home full-time when I would have given my life to spend one day at home with C.  All of those feelings needed time to heal before I could focus on how to be a better mother to F, and slowly that healing happened during the latter half of F’s first year.

In F’s early months, my husband spoke the most supportive words anyone has said to me so far.  He told me, “No one knows this baby better than you do.”  I laughed at him at the time, because I felt like anyone – literally, ANYONE – could do a better job with F than I was doing.  Now, I believe those words.  After a year with this precious, sweet-tempered, healthy boy, I know what he needs and how to meet those needs.  I know that as imperfect as I am, I am perfectly suited to be his mother.  We fit together.

I can’t say I’ve left PPD behind me.  I still struggle to get a solid night’s sleep.  I shout at least once per day when F, who is now a quick and clever toddler, challenges my expectations.  I’m still learning balance, how to meet F’s needs and also remember that I am an individual who has needs, too.  Finding childcare I trust and working part-time is an evolving goal that I hope will take me closer to being the mother I want to be.  I have days when the despair descends on me and I count the hours until my husband gets home from work.  But I know now that I will survive it, and on those days I have at least a few tools available to sweep us out of the doldrums.  I know we’ll be okay.