The following is an article by the Canadian Perinatal Mental Health Collaborative as part of their #thisismystory campaign shedding a light on the need for improved perinatal mental health care in Canada.
Sarah Cunningham of Oshawa, Ontario, wanted children for as long as she could remember.
“I have always loved and worked with children,” Cunningham told us. “My husband and I wanted to get pregnant immediately after getting married.”
Cunningham and her husband, Kyle, tried to become pregnant for more than six months. Although Cunning felt in her gut that something wasn’t right, she was brushed off and told to keep trying. Once she finally got the referrals and testing she pushed for, she was diagnosed with polycystic ovary syndrome (PCOS) and referred to a fertility clinic.
Over 1.4 million Canadian women may have PCOS, emphasis on the word “may” because, just like perinatal mental illness, though it’s common, and in the case of PCOS, one of the most common endocrine disorders for women, it’s not properly diagnosed or managed in Canada.
Cunningham became pregnant after three months of fertility treatment.
“My pregnancy was amazing,” Cunningham said. “I was one of those ‘unicorns’ that other moms hated – no morning sickness, nothing. Aside from the usual aches and pains, I loved every moment of being pregnant, and assumed I would love motherhood just as much.”
Though she had planned a drug free, vaginal birth, after 24 hours of labour, Cunningham delivered her daughter, Leah, via C-section. The entire experience left her feeling out of control and she was both mentally and physically distressed.
“Immediately following the birth, I was physically in pain from having an unplanned C-section, and emotionally, I was all over the place,” Cunningham described. “I couldn’t stop crying but this was chalked up to the ‘baby blues’. When I realized how unhappy I was feeling, I was plagued with guilt. This baby was everything I had ever wanted. Why wasn’t I happier? I felt that if I was suffering from postpartum depression, it somehow made me ungrateful.”
Breastfeeding also proved difficult.
“We were sent home after two nights in the hospital and told not to worry, that my milk would come in,” Cunningham said. “Unfortunately, days later, we were readmitted to the hospital because our daughter was dehydrated and had to stay overnight. She had all kinds of blood taken and had to be supplemented with formula which made me feel like a failure.”
Cunningham doesn’t understand why she wasn’t screened for perinatal mental illness during pregnancy or postpartum.
“I went through infertility, had a traumatic birth experience, a colicky baby, and sleep deprivation that likely put me at a higher risk,” Cunningham explained. “I think something else that put me largely at risk for postpartum depression was the loss of my own mother when I was young. I had no idea how intensely the grief would return after becoming a mother myself and how much I would need her there for it all, especially after having such a bad experience.”
At her six-week postpartum check-up, Cunningham’s obstetrician (OB) did ask her how she was feeling. Cunningham replied that she was crying almost all the time, that she didn’t feel herself and that she felt anxious at times too. After explaining how she felt, the OB in turn replied to Cunningham, “But it’s not postpartum depression, right?”
Cunningham got the impression that the OB was trying to tell her what she felt was normal, so she stopped asking for help. It wasn’t until three months later, when she was four months postpartum, that she ended up making an urgent appointment to see her family doctor. Cunningham was desperate for help. She told her family doctor she was feeling rage, hopelessness, and exhaustion, all of which were “severely” uncharacteristic of her. Cunningham told her family doctor she couldn’t go on feeling the way she did. The doctor placed her on a four month wait list to see a general psychiatrist.
“I was crushed,” recalled Cunningham. “This was by far the most frustrating part of the journey for me. I couldn’t wait four months. The only way that I finally got the help I needed was by seeking out private therapy on my own, with a psychologist specializing in maternal mental health. This was both costly and time-consuming but well worth it. I also asked for a referral to the Women’s College Hospital Reproductive Life Stages Program, which I finally started after another long wait.”
Cunningham was officially diagnosed with postpartum depression, nine months after first seeking help but was discharged with no follow up plan from the Reproductive Life Stages program only three months after starting it due to the fact that the program doesn’t treat women past one year postpartum.
The psychiatrist from the program did offer to continue seeing Cunningham slightly longer than the year mark but Cunningham declined as she was going back to work and could no longer commute from Oshawa to Toronto to attend the appointments.
“It took a lot of advocating for myself before I received any help,” Cunningham said. “Once I started therapy and medication it was a huge game changer. I wish I had started them sooner. I am lucky to have a wonderfully supportive husband, but the illness definitely put stress on both of us and our relationship as we were completely blindsided by it.”
Cunningham wants parents to know that perinatal mental illness is common, treatable, that you deserve to get help, and that needing help doesn’t make you a bad mom.
“I thought motherhood would be the happiest time of my life,” said Cunningham. “This was something I had wanted so badly for so long, I thought it would be perfect. I had heard of postpartum depression before, but didn’t consider it would happen to me. I had no idea how common it was.”
As far as a message for our elected leaders, Cunningham wants them to know that perinatal mental health needs to be a priority.
“So many moms are slipping through the cracks,” said Cunningham. “Every health professional who sees babies should be educated about perinatal mental illness and the signs and symptoms. It’s absurd, and sad, that moms and dads are not routinely screened for perinatal mental illness, and that only one postpartum check-up is scheduled.”
If you would like to tell your story and contribute to the #thisismystory CPMHC campaign, please email us at firstname.lastname@example.org.