In 2009 I was pregnant with my little boy. I selected a midwife and within the first few visits to my midwife, I said to her that I was concerned I was at-risk of developing Postnatal Depression. I explained that I was having relationship problems with my husband, that I did not have sufficient family support and that I’d had clinical depression before. She made a note of it, but did not assess my symptoms or screen me for depression at any time throughout my pregnancy. At around 20 weeks pregnant, I informed her that in fact my husband and I had separated.
Throughout my pregnancy I was very anxious and had a great deal of stress – the midwife described me in a written report to the Health & Disability Commissioner as an “overly-anxious mother”. In hindsight, I believe I had undiagnosed prenatal anxiety and a psychotherapist Susan Goldstiver who works at the Postnatal Distress Centre has the same opinion after hearing my story. At no time during my pregnancy did my midwife tell me she felt I was over-anxious nor did she assess my anxiety nor refer me to any other health professionals (such as my GP) to do this. Instead, her response to my phone calls and emails reduced.
I attended ante-natal classes during this time and the Childbirth Educator touched briefly on it but gave very little information on Postnatal Depression and none on Antenatal Depression/Anxiety.
Early in my third trimester, I saw my midwife’s “back-up” as she was unavailable. This “back-up” midwife suggested to me that I should be referred to Maternal Mental Health and said I should request this from my midwife. My midwife agreed and said she’d put through a referral. One week from my due date where I was to be induced, I discovered Maternal Mental Health had never received a referral from my midwife and could not see me since my due date was imminent.
Postnatally, after what I now describe as a traumatic birth with post-operative complications and breastfeeding difficulties (my son had a tongue-tie), my (new) midwife told me that if I was still crying by day seven that she would refer me to my GP for postnatal depression.
My thinking was irrational and thought if I made myself stop crying that I would not have postnatal depression and would not be diagnosed with it. So I forced myself to stop crying. She gave me an Edinburgh Postnatal Depression scale to fill in, which I did. The score was around 17 indicating moderate depression. She never collected it or asked for it and so I didn’t give it to her as I was afraid of the results.
Over the following nine months I experienced deep depression including suicidal thoughts, extremely low energy, low motivation, low mood and tearfulness, anxiety, irritability, anger and an overwhelming feeling that I couldn’t cope with a baby at home on my own. Finally, at nine months post-partum at the insistence of my husband and a counsellor I went to see, I went to see the GP who diagnosed me with Postnatal Depression and put me on medication. I really was unable to rationally come to the conclusion myself that I had postnatal depression let alone problem-solve what to do about it and I relied on others to confront me before I did anything about it but by that stage it had gone untreated for 18 months - throughout my pregnancy and nine months post-partum.
I feel that I was let down in a myriad of ways throughout my pregnancy and post-partum:
Insufficient information given in my Ante Natal class on postnatal depression
Lack of screening/assessment despite being at-risk, information about postnatal depression, support and referrals by my midwife ante-natally or postnatally
Failure to follow through on assessment of my potential depression/depressive symptoms by my new midwife despite my being at-risk
No information about Postnatal Depression given to me by my GP, only information about medication in response to my concerns re: breastfeeding and a pamphlet on a support group (no information on diet, exercise or a referral to a counsellor)
The consequences this experience has had on me and my family:
Postnatal Depression was not fully treated so that I never fully recovered and ended up with chronic depression
Undiagnosed ante-natal anxiety and postnatal depression affected my relationship with my husband that I believe it contributed to our separation during my pregnancy and the second time after he was born
Undiagnosed Postnatal Depression and chronic depression has placed a huge strain on relationships with my extended family
Some interruption in my attachment with my son early on
Traumatic birth experience resulting in some post-traumatic stress
Profound grief adding to the trauma surrounding my birth and all the complications that went wrong - of missing out on holding my baby directly after birth which felt and feels like a great loss to me. It was such a special moment that I had looked forward to all of my life
Just survived through those first nine months post-partum and missed out on the joy of having a baby – what will be my only baby as it turns out
My son (now 7 years old) has now been diagnosed with anxiety and having to access Child Mental Health and Ministry of Education services