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If I'm a Happy New Mother, Then Why Don't I Feel That Way?
A Few Facts About Postpartum Reaction

by Ahava Winston, Director of NITZA, the Jerusalem Postpartum Support Network

A new awareness is beginning to dawn concerning the devastating and sometimes dangerous reactions which afflict many new mothers (first time or multi-para). It is not a new phenomenon but there is greater understanding today of how to help these women and their families and promote recovery.

Any new mother or father will tell you: the time surrounding childbirth is a very vulnerable one. Bringing a helpless being into the world, whether the first or fifth, can be an overwhelming responsibility. An estimated 80% of mothers after birth develop the `blues' and approximately 15-30% will suffer a little discussed phenomenon, Postpartum Depression or a related syndrome.

Chaya considered her fifth birth a normal one. Her husband visited her in the hospital with goodies and warm wishes from friends, but something was wrong. A benign comment from her husband irritated her. She became easily annoyed, hurt, tearful. Fortunately, Chaya and her husband had a close relationship, and she was able to express her feelings to him. After a few sensitive days passed, a little more sleep and additional emotional nurturing from her husband, she returned to her normal self.

Sometimes, though, symptoms continue and interfere with coping ability and normal functioning. In such cases, a woman may have Postpartum Adjusting Disorder, the most common Postpartum disorder experiened by 1 in 5 women and lasting as long as 2 or 3 months, resolving on its own. However, when symptoms worsen and coping becomes too difficult or painful, we enter the realm of clinial Postpartum Depression. Symptoms are similar to the blues, but more severe and sometimes more diverse. It is even possible for a whole year or more to go by before the onset of depression.

Yehudit was thrilled with her new baby girl, particularly after three boys. The blues came and went and she seemed to be adjusting with her large brood. But about two months later, she found herself crying for no reason - when nursing the baby, while cooking, cleaning and davening, as well. An overwhelming feeling of emptiness and despair had crept in. Sometimes later, she awoke with a start in the middle of the night. Her heart pounding, she felt a sudden panic come over her. Fears flooded her mind. She knew they were baseless, but she couldn't help it. She felt confused as the symptoms lingered into the next day. The following week, again, she would be suddenly overome with fears and palpitations. Her fingers tingled and she was nauseous. She began to fear staying home alone and asked her husband, Dovid, if he really had to go out.

Dovid assured her that he was there for her and would not leave her. He made an appointment for Yehudit to see their General Practitioner, who fortunately suggested they consult a psychiatrist. Reading her thoughts, the doctor quickly said, "What you are going through is far more common than you think. You're having a Postpartum Reaction which is highly treatable but best diagnosed and treated by a psychiatrist knowledgeable in these areas."

After a week of hesitating, deliberating, and worsening of symptoms, Yehudit agreed to make an appointment. She found the doctor understanding and informed, and was comforted to know that she was not going crazy, but, rather, was among many others suffering a Postpartum Reaction. A few weeks later, after starting conventional psychotropic medication, she was feeling her usual self again.

Today, as in the past, there remains a stigma attached to illnesses such as Postpartum Reactions. This interferes with mothers and their families getting the proper help in time, which only aggravates the situation. As more information becomes available, as more women come forth for treatment, and as communities beome more aware and better informed, slowly the stigma is dissolving. Women must realize they are not to blame fo their negative feelings as we begin to understand the multiplicity of factors, including pure physiological ones, beyond their control.

It must be remembered that seeking medical help and using available support systems is not a violation of the immutabble principle of trusting in Hashem. Even the great rabbis of the period of the Mishna invoked the assistance of fellow rabbis to aid them during sickness (Brochos 5b0. Some will say that this a test. If they trust sufficiently, they will get better. A religious Jew walks a difficult tightrope between trusting in Hashem and making sufficient practical effort to bring about a desired result. Besides which, in this case, the mother is responsible for the welfare of her family and must seek necessary help, the sooner the better, for their sake as well.

Medical consultation, professional counseling and using available support systems might be neessary in order to alleviate the situation, aside from extra household help and other means of relieving stress on the mother and family. The Rambam writes that since the time of the Mishna, a person is obligated to seek out professional medical help when the situation warrants it. Certainly prayer and Tehillim will help, but Hashem plants emissaries in this world, and it is a mitzva to seek them out when necessary and to use their available services. The world revolves upon chessed, and sometimes, we necessarily find ourselves on the receiving end, for a reason.

Tragically, there are too many stories of women who suffered Postpartum Reaction and did not seek the necessary treatment. Ignorance, fear, shame, lack of funds... one or all of these may have been the reason. Prompt treatment may save a woman her marriage, her baby from abuse, or even her life. The prognosis for all Postpartum Reactions is excellent. However, the earlier the intervention, the simpler and more effective the treatment and the recovery process will be.

It is important to acknowledge that the period after birth is a stressful time for the husband, too. At this difficult stage, his wife is relying on him to be extra helpful around the house and emotionally sensitive - all the time. It is not abnormal for a husband to forget to show care and concern towards his wife. This is a very trying time for any marriage, even the best. If expectations are disappointed and roles become less clear after a birth that does not cause PPD Reaction, how much more so if a Postpartum Reaction does develop. Additional stressors such as preparing for Shabbos on time can further increase marital tension.

In order to help the situation, husbands might think to themselves: "If, G-d forbid, my wife would come down with a debilitating illness, would I expect her to get out of bed and get the kids ready or have the house clean and the meals made?" Encouragement can come from your Rav and through talking to other husbands who have gone through similar experiences with their wives. It is important and encouraging to look forward and tell oneself with confidence that b'ezras Hashem, both of you will look back and see how the episode helped you grow closer to each other, and in your emuna-bitochon.

If you are suffering, you are not alone. You can get help. With Hashem's help, you can recover.

Founded just two years ago, NITZA, the Jerusalem Postpartum Support Network, offers support groups, one-on-one volunteer services, professional counseling, medical referrals when necessary, support and guidance for husbands and financical subsidies toward treatment and recovery. The JPPSN aims to broaden public awareness through lectures and literature in order to eliminate the fears and stigmas which inhibit women and their families from seeking help.

For more information, please contact: NITZA, the Jerusalem Postpartum Support Network, POB 292, Telzstone, Harei Yehuda, Israel. Tel. 02-533-2811; e-mail: pinahav @


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