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 @
netvision.net.il.
