Brace yourselves everyone! This is a long (and I mean LOOOOOONG) article. And that’s because we’ve got that much to say about this headline. You can’t call it an ultimate guide if it’s not that ultimate in length anyhoo.
I imagine that as you’re reading this, you’ve just had your baby and it’s been a couple days since. Heck, maybe it’s been longer than that, let’s say 3 weeks.
And I’ve got to ask: how are you doing, connecting with your little one? Are you getting extra smiles and giggles with your new squish, your partner, and the squish’s siblings? Are you noticing all the cute new details in your new little human’s faces, and actions?
Or does something feel…off?
I’m not talking “off” like, oh I’m having a bad day, it’ll pass, I’ll shake it off, kind of off.
I mean when I ask if you feel off I’m referring to extra off, like, you SHOULD be connecting with your new little squish, and you SHOULD be happy with your new family addition.
And yet…and yet. Maybe you’re not.
Let’s be real. Parenthood alters your life completely, adding hormones, feelings, and extra layers of anxiety that are all attached to preparing for and giving birth. Everyone’s birth journey is going to be different, in so many different ways. My team and I at Stages are birthers ourselves and can confirm, there’s the “Baby blues” that almost every family and birther goes through.
But then there’s the extra giant, dark mass that keeps hanging out in the corner of the room. That mass you don’t want to look at. But it’s there. It’s there, in the back of your mind.
I’m talking about that unspeakable dark mass you’ve been dreading about feeling during your pregnancy, yet here you are, stuck in the thick of it.
I’m talking about that dark mass known as postpartum depression.
I’m not writing this guide to tell you how you ought to feel about your birth, or whether or not what you’re feeling as a birther is right or wrong. I’m writing this because I’m a concerned doulatog and mother myself, and maybe your loved ones, the ones who are part of your birth support network, are showing concerns that they’ve already mentioned to you, yet those concerns really aren’t sticking in your mind because the dark mass says no and rules over you with its iron fist made of fear, self-loathing, and disgust.
My team and I at Stages offer services as postpartum doulas. We’re here to help support you after your baby is born, and yep, that also includes support during postpartum depression. And we want you to know about these do’s and don’ts of what to expect from a doula during this time.
First, a little know-how. What are “The Baby Blues”?
Feeling sad the first few days after birth? You may be experiencing what you may have heard as “the baby blues.” These affect parents of any education level, culture, income, age, or race.
You may experience the baby blues between 2-3 days after your baby is born. The blues usually last up to 2 weeks, with no treatment required as it goes away on its own.
Your hormones, estrogen and progesterone, decrease after birth, which cause mood swings. The placenta pumps out progesterone and other hormones during pregnancy. It’s the birth of the placenta that stops the production of these hormones. The sudden drop in progesterone is what causes your milk to start making, then the baby’s behaviours at the breast “call” it in, so to speak.
The baby blues often come as part of this occurrence, and can be physiologically normal. However, it’s when these feelings start to interfere with your well-being, the well-being of your baby, or they don’t start to diminish or get better over time—that’s when you need to be concerned.
Symptoms of the baby blues includes:
- Restlessness or anxiety
- Feeling grumpy or impatient
- Crying for no reason
- Feeling sad and “not like yourself”
- Concentration issues
- Mood swings
- All of the above starting a few days after birth, then going away on its own after a few weeks
During this stage it’s best that you not put blame on yourself. It’s not your fault you’re feeling these, and you have done nothing wrong. The baby blues are normal, and it’s okay to feel all the feelings you feel, and experience all the feelings you experience.
What is Postpartum Depression?
This is that dark mass in the corner of the room where it’s not just “the baby blues” anymore, but a real, strong, all-encompassing presence of extreme sadness, rage, and fear. It’s when “the baby blues” become worse and last longer than 3 weeks. This would be a good time to find someone to talk to, your doula, your care provider, or someone who is knowledgeable about postpartum.
You may be feeling more than embarrassed to speak up about your feelings, because why shouldn’t you be happy? You just had a baby! That’s what the people in your life may be expecting you to feel, is that happiness.
Instead, it’s the opposite. You’re probably feeling so alone, isolated, scared, or so sad that you feel sad, and so very confused that you’re feeling any of these feelings in the first place and you don’t know why. Or, on the opposite side, there’s a lack of feeling any happiness, maybe it’s simply apathy. You feel disconnected from your new little squish. Not just them either, from your partner, your other children…and on, and on.
Here are some symptoms and signs that those baby blues turned into the dark mass of postpartum depression:
- Extreme emotions, or complete disconnect from emotions
- Extreme lack of motivation
- Eating too much, or a complete loss of appetite
- Sleeping too much or not nearly enough
- Constantly tearing up, snapping at your loved ones, zero control over your anger
- Extreme guilt or worthlessness feelings
- Loss of interest in activities you previously enjoyed
- Withdrawing from everyone, family and friends, your birth support network, you name it
- Physical aches and pains that are consistent, and constant
- No interest in your newborn, or resentment towards them
- Thoughts of hurting the baby and oneself, and everyone around you
Common causes of postpartum depression include changes in your hormones, a history of depression in yourself or immediate family, a lack of emotional and birth support, isolation, and your birth and postpartum needs not being met.
During pregnancy there will be changes that can also have a severe impact on your mental health, such as extra weight gain, unsatisfying support and relationships within your birth network, a severe lack of psychosocial support, previous unfavourable pregnancy outcomes, and unplanned pregnancy or underlying medical conditions.
Postpartum Misconceptions
Misconception 1: It’s just the “baby blues.”
Within days of delivery, the majority of parents who have given birth will have the “baby blues” and it typically will go away just as fast as it came. Symptoms of postpartum depression last longer, are more severe, and can happen at any stage of birth for parents.
Misconception 2: You must be okay if you’re not crying.
Frequent crying can be a sign of depression, but symptoms of postpartum depression can also include low concentration, insomnia, low appetite, lack of motivation, feeling worthless, and all of the above and then some. When trying to cope with newborn demands and your family’s needs and your own needs, the symptoms become way more intense.
Misconception 3: I didn’t experience postpartum in my first pregnancy, so I can’t possibly experience it during my next pregnancy.
If there’s a history of mental health disorders in a previous pregnancy, it increases the likelihood of recurring in subsequent pregnancies. Postpartum depression can happen during ANY pregnancy.
What Doulas Do and Don’t Offer for Postpartum Support
Your doula is experienced in:
- Postpartum physical and emotional needs of new parent
- Newborn care, helping you realize what is normal, and common issues
- Breastfeeding support and issues
Your doula cares for you and your family’s needs with things such as:
- Helping with meal prep
- Laundry
- Light housework
- Caring for siblings; helping to adjust (and make sure naps are had)
- Help with errands and seeing kids off to school
- Overnight care
Your doula is known as a “neutral nurturer,” which means they don’t “know” you but they support you without any judgment.
Family member support can be a challenge, as when going through postpartum you can be sensitive to criticism and any unwanted advice. Your doula acts as your guide to help you build confidence and your ability to parent your baby.
When talking about hiring a doula, sometimes it’s easier to ask what they don’t do, over what they do offer, during your consult. Why? Because all of us are different and unique in our needs, what support needs to look like, and how you receive it.
The Standards of Practice is my guide to being the best doula I can be for you and your family.
Now, I can tell you what I don’t do.
I DON’T drive you; I don’t have the insurance for it, and I wouldn’t feel safe with it. Some doulas may have insurance and are perfectly content with driving. However, I DO stay home with the baby, accompany you, or meet you there.
Doulas, unless they have further training, DON’T provide medical advice or medical care. Doulas cannot offer answers to questions that are medical or prescriptive in nature as well as in my opinion shouldn’t answer questions that are out of their knowledge base or scope of practice.
Why? Because in training, things like feeding, food prep, sleep, etc. are touched on, yet not always fully trained, so our understanding and bias on any given topic may be incorrect. I know this to be true, because I have been schooled on this very subject, when I thought I knew the answer, and gave incorrect and damaging advice. I am naturally curious and the curator of random facts, so doing a deep dive in with you to find the best answer for yourself, a new fact about myself, or connecting you with one of our valued Villagers is what I do.
Most doulas DON’T do deep cleaning, however, we do light household chores, some meal prep, and run errands with or for you.
Our Stages doula’s role is that of a coach or a wilderness guide, your personal GPS system and navigator on this journey, one where our role is to provide guidance, encouragement, and support when you need it, while you grow your confidence as a parent, and we work ourselves out of a job. This is why the question of what it is that you don’t do is an especially important one for the initial connection.
Speaking of connection…I have a story to tell you. I hope you’re still with me at this point (and if you are, THANK YOU!! It really means a lot to me that you’re still with me in this guide so far).
Okay. Here we go…deep breaths, Candice. You got this.
My Postpartum Depression Story
I have always had an underlying anxiety. It comes with the stories and territory of the life I lived.
When I was pregnant for the first time, the one thing I didn’t notice was that I was feeling sad, angry, and terribly impulsive with my emotions and thoughts.
I was about 23/24 weeks pregnant when they noticed intrauterine growth restriction (IUGR). My baby was measuring at 19 weeks, and her little head at 15 weeks. We were given the options of bedrest at home or hospital, weekly ultrasounds, and then given the very real talk that she may not make it. Even though I was at the stage of viability and they could do something, they didn’t know if her small in age size would survive.
I believe I disconnected mentally and emotionally when I received that tidbit of information. It didn’t help that the DR had zero bedside manner for a first-time parent having a panic attack. I left feeling alone and isolated; that everything happening was my fault, and I was going to lose my baby.
Fast forward; there are these super specialized DR’s that work with Neonates (infant babies, preemie babies, and babies in the womb). I was sent to see one. I don’t know what I said, other than relating what the DR said to me, but he knew that something was up, and made some referrals.
At the time, I saw mental health as a stigma, not the form of health care we’re gradually understanding and knowing it to be today. I was very embarrassed and resistant to it, so when the medication that I agreed to take wasn’t working, I didn’t say anything, and kept it to myself for 7 years.
At that time, when my second baby was born, my sister-in-law had an infant loss. My baby was 3 weeks old and they were across Canada. Not only was I now experiencing depression, and anxiety, I started feeling rage. I kept this secret a little closer and a little tighter to me. I was so afraid, I felt so alone, and so scared because I would hit (spank, like I was as a child) my children.
Luckily for me, with the loss of my niece, and my known depression and anxiety, Gloria from Pacific Postpartum Support Society would call me almost daily to check in, I don’t know if she had to, or if that was because she felt me on a deep level. I trusted her, so I called PPPSS (Pacific Postpartum Support Society) and asked to talk to her. I was honest, and she connected me with help. However, the spanking would still occur on occasion despite my best efforts. Fear, hurt, disgust, self-loathing, anger, and embarrassment all perpetuated what I was feeling.
I am an attachment parent. I don’t believe in hitting or spanking kids, I think that sends messages of wrong, bad, not good, etc., which increased my feelings of low confidence and inadequacy during those 7 years. I would have such bad anxiety attacks that I wouldn’t be able to function. I not only cried most of the time, I wailed too. I had ruminating thoughts of people taking my children, and ranging thoughts of hurting everything and everyone, including my children.
For 7 years I felt these feelings of terror, wrongness, isolation, and harmful things. My suffering in silence made it so the fear and the stigma had a stronger voice. I lied to myself, I lied to others, I wasn’t living in alignment with who I am, or who I feel inside.
Then through a series of fortunate and yet unrelated events, I had gone to my DR, and she asked if I was smoking. Which, at the time, I was also hiding, desperately fearing rejection, isolation, and judgment. I was my own worst enemy, and running from myself while afraid of everyone else.
My DR asked why I didn’t quit even though I was desperately fighting to do so. That’s when it all came out. She asked about the medication I was taking, and I told her.
Since we switched the medication, I have successfully been a non-smoker for 6 years. I have done counselling and found relief and tools through coaching. No more ruminating thoughts about strangers taking my car with my babies in it while I checked the mail, or forgetting my children somewhere. No more hitting, WAY less yelling, no more crying and wailing, and no more rage. I can feel it when my anxiety kicks in and I am more likely to remove myself from over-emotionally connecting, which is always going to be a learning-in-progress.
My silence not only hurt me, it has hurt my marriage, my family and those around me, including my kids. Till this day, one of them struggles with severe anxiety and the other has a very low tolerance for the overwhelming, which in both cases I blame myself. However, I didn’t know better; fear won for a long time. I didn’t speak to anyone, I kept it to myself.
This is the first time I am actually talking about all this publicly. I have shared with very few people what I did. I share this story now because I know now that it is fear, both mine and in general, that perpetuates the myths and stigmas about mental health. It is fear that drove my actions and my inactions when it came to not seeking support for myself, as fear often does when Fear shows up. Its main purpose is to keep us safe from predators and our lives. Now fear shows up in our social lives.
The good thing is I work everyday to correct the relationships that I damaged, fix the communication between myself and my children, and build better, tighter and more authentic relationships, restoring love, affection, and community. I have learned to give myself grace to fail while I am learning, the grace to be compassionate with myself even when I am my own worst enemy, to look at these past actions with curiosity, and forgive myself.
We all have our history and our stories. However, the choice isn’t in how you let it define you; the choice is, what do we do with it? Seriously, every day since I got healthy, I am learning how to ask questions, support families, set up your villages, grow our communities, get in front of the conversation, educate postpartum people on what is out there, who are there supports, I even have Village members who support birth trauma, mental health, and depression in postpartum.
I was lucky that I had Gloria. Not everyone has someone who will call, who will notice the warning signs, who will be there with you. We are all born into the postpartum time, we are all affected by the postpartum period, and when YOUR needs are not being met, when your self care isn’t being cared for, there is nothing to give your baby. Birthers should come first, support surrounding the birthers and baby, resources, and community, because if your rest and needs are met, then you are meeting the needs of the baby.
In other news, conversations around pregnancy, birth, and postpartum are going to start changing as I begin to learn and enter my own new learning environment of coaching, mentorship, and birth + postpartum coaching. While on my own more recent growth journey, of letting go of the stories, accepting responsibility, and changing the self-talk, I started to notice how my thoughts about birth shaped my feelings around it. I then took actions based on these thoughts and feelings.
I have noticed the thread of misinformation, body misalignment, and mistrust that I had at the time played a role in my birth experience. I have learned that we only decide what to accept as true and possible for us, however, becoming aware of the conversations we have with ourselves can help you to change our minds and shape our actions.
By changing the conversations, we change our actions. Outcomes may not change because those are outside of ourselves, however, the conversations inside are really important to look at too. What that means for you, as I grow and become the very best version of myself, is that in turn trickles down into the conversations we have, the way we talk about ourselves and birth.
Extra Helpful Resources
If you’re at all struggling with or feel you may be struggling with postpartum depression, and you’re looking for some extra helpful support at this point in the guide, it really doesn’t hurt to talk to a professional. Below is a list of resources that may help you in your journey during this stage.
Pacific Postpartum Support Society
Call: 1-833-456-4566
Text: 1-604-255-7999
Monday to Friday from 10:00 am to 4:00 pm and on Saturday on-call from 12:00 am to 4:00 pm.
Wellness Together
https://www.wellnesstogether.ca/en-CA
Text: 741741 WELLNESS
Mood Disorders Association of BC
Visit www.mdabc.net
Call 604-873-0103 (in the Lower Mainland)
1-855-282-7979 (in the rest of BC) for resources and information on mood disorders. You’ll also find more information on support groups around the province.
For even more resources, I and my team at Stages Family Services are a phone call away. You can click here to discover our postpartum services, and also book a consultation and get more support.
Big, big hugs from me and all of us here at Stages. I hope my story helped you in some way. I really do.
