Words: Helen Massy
Thankfully these days I see more and more campaigns that support open discussion about previously taboo subjects; post-natal depression, baby loss, miscarriage, abortion, and women’s health.
Hashtags like; #breakthesilence, #simplysay and #maternalMHmatters are trending frequently. Finally, women are beginning to open up about their long-suppressed experiences.
Post-natal depression is widely recognised, and there are, in my opinion, support services widely available. As a mother of three children, I have been made aware of post-natal depression signs and asked after each birth about my feelings and how I am coping. Through five pregnancies, I felt confident that I had support available should I develop post-natal depression. However, I was not prepared for ante-natal depression at all…
Ante-natal depression affects more than 1 in 10 women. This fact surprised me as I have never heard anyone mention ante-natal depression.
Perhaps terms such as ‘pregnancy blues’ were floated around but I never heard an official title. Whichever way you look at it pregnancy is a hard and different experience for every woman. Physically, the weight gain, shortness of breath, aches, pains, and multitude of other symptoms really take its toll. On top of that, there are the raging hormones and the constant worries about reaching full term. My most recent pregnancy was by far the toughest and it took me by surprise. A little background about me may explain why….
I am a military spouse, and military life circumstances can make things complicated at times. I became pregnant with our third child whilst on deployment in the Falkland Islands with our children aged four and two. We planned to return to the United Kingdom (UK) just before the baby was due, and then continue on to the next scheduled deployment in Canada after birth. Due to some minor, benign heart problems in previous pregnancies I had routine tests to keep an eye on things.
Unfortunately, the results returned were not routine, and professionals advised me to return to the UK immediately. We had no home in the UK and we were unsure about how severe my condition would become.
Knowing we had a strong support mechanism in the UK, as a family, we decided that my husband should remain in the Falkland Islands a little longer to ensure that our belongings were shipped on, and everything was organised. Over time, I was physically becoming more unwell.
Thankfully, the military community is an incredible one. Between the military, our friends and our family, we returned to a home. I could not have had more support. Family came to stay with me regularly to help with the children and medical appointments until my husband could return. Friends offered to help with shopping, meals and anything I needed and I had support from many wonderful people.
Despite this, I was struggling. Physically I could barely manage to get up the stairs due to breathlessness. Chest pains were debilitating and I could not manage everyday tasks with the children. Some days I could not leave the house. It hit me hard. I am particularly stoic by nature, a health care professional by trade and usually unwilling to ask for help. Symptoms of antenatal depression began to set in and I was feeling hopelessness, guilt, anxiety, a lack of energy, isolation, and I became short-tempered with loved ones and even the children.
I remember going to an appointment with my community midwife and praying she would ask me about my mental health. It was bad luck that my usual midwife was on annual leave and someone else took the appointment that day. She had not read my background and did not ask about my mental health.
Everything was done in a bit of a hurry and I just went through the appointment without saying a word. Inside my head, I was willing her to ask that one small question “how are you coping?” I was not coping, although to the outside world I put on a pretty good show of having it all together. I felt ridiculous for feeling like this as it was my fifth pregnancy and third baby– I should have it all together. I had so much support so why was I struggling? Why did I feel like this? I was embarrassed to admit that I needed help.
Due to my medical condition, I saw a health professional at least once a week of either a midwife, obstetric consultant or cardiac consultant. I never once asked for help. I cried all the way to one appointment with my obstetric consultant and then wiped away the tears to walk in with my head high. I must impress that my care was excellent. It was not the fault of those looking after me that I never voiced how I was feeling. I never let it show. There was never a reason to ask me about my mental health and I have never had any concerns before. So why didn’t I say anything? In all honesty, I didn’t realise how bad it had gotten. When you are immersed in those feelings you cannot see how you have changed. I just felt that I was being a bit melodramatic and should get on with it. I felt ashamed and uncomfortable talking about it.
On his return my husband was amazing. He supported me in every way he could, but even then, I did not discuss my feelings. He tried to get me to talk about it, he tried to be there for me and lighten the burden. Although I let my feelings out a little, I never fully released my emotions. I wish I had. I did not know ante-natal depression was a condition and I did not know that there is support out there. My anxiety grew and the night before my planned induction I had a feeling of impending doom. I felt hopeless. Thankfully this was entirely unfounded and I had a straight forward birth resulting in a healthy baby girl.
Within less than a week I felt like a different person. Almost like a personality transplant and the relief was incredible. Hindsight is a wonderful thing and at this point, I realised how bad my ante-natal depression had been. I was asked about my mental health constantly after birth as awareness of postnatal depression is strong. Ironically, I was completely fine and genuinely happy to no longer be feeling the awful fear and anxiety I had been immersed in. It was only after the birth that I voiced this to a midwife. About three weeks after the baby was born I fully broke down to my husband and explained everything I had been feeling. It was cathartic and necessary. Finally, I could see the light, enjoy life, our children, and move on.
Why am I sharing this story? I want to break the silence on another taboo topic. Pregnancy is not an illness, but that does not mean it is easy or cannot cause an illness. Women get pregnant regularly but that does not mean it is straightforward.
You never know what symptoms will occur, what feelings will develop, or how hard it might become.
In fact, 12% of women experience depression in pregnancy, and 13% experience anxiety (with many experiencing both).
I am incredibly lucky to have three healthy, wonderful children and that my life is back to normal. I now look back and see what a struggle this last pregnancy was. I can see how asking for help would have made it easier as there are so many different treatment options available. We need to keep discussions open and ensure everyone knows that help is out there. If you are ever sat in an appointment willing someone to ask you how you are feeling, please think of this article and tell them. It may not be as common as postnatal depression, but it does not mean that ante-natal depression is not as serious. Let us continue the trend of hashtags and break the silence around ante-natal depression.
It does not matter if it is your first or tenth pregnancy, there is help out there and your family, doctor or midwife can help you find support to get through it. By speaking to a health care professional, they can guide you to your nearest support network. There are also several charities who you can reach out to for help:
PANDAS (Pre and Postnatal Depression Advice and Support)
MIND
Helpline: 0808 1961 776 (11am – 10pm 7 days a week).
Infoline: 0300 123 3393
National Childbirth Trust
Support line: 0300 330 0700
Tommy’s
https://www.tommys.org/pregnancy-information/im-pregnant/mental-health-during-and-after-pregnancy
Pregnancy phone line is currently closed due to COVID-19 however, you can contact the team via email at midwife@tommys.org
This is great. I had AND but didn’t even know it existed until I got it, although I was all prepared for PND. I think it’s important to highlight that it’s really important to get it treated because it is a big risk factor for PND
thanks so much for sharing verity! I agree”