A Candid Look at Antenatal Depressive Disorders
An Unexpected Battle
For eight months, I tirelessly tracked my periods, stockpiled ovulation strips and pregnancy tests, and even borrowed a busty fertility statue curvy enough to make a Kardashian jealous. After putting our toddler to bed, wearing a stained nightshirt and messy topknot, I’d tap my fatigued husband on the shoulder with a raised eyebrow, tilting my head toward the bedroom—the epitome of romance. I brought home the sample cup and informed him what he might have to do with it, or rather, in it. I’d begun entertaining the pros and cons of IUI vs. IVF; had tests to confirm I was still ovulating; and agreed that, at my next appointment, they should push dye through my fallopian tubes to check for blockage. It’s a miracle anyone gets pregnant by accident.
The Financial Dilemma
“I just don’t know how we’ll afford another one,” my husband moaned. Child care is expensive and time is scarce for two full-time working parents who moonlight as a writer and a musician.
The Weight of Doubt
A part of me agreed that two children were too many. I imagined myself underslept and overstimulated, racing between soccer and ballet. I could picture the manic orchestration of two packed lunches instead of one; all those emotional negotiations, doubled. (Cheese string or cheese cube? Banana peeled or unpeeled? But you just asked for … ) I was also not particularly excited by the idea of repeating the postpartum period ever again, complete with its bloody nipples and night sweats, rageful fits, and submarine-size mesh underwear. But I had no idea about the emotional deluge that awaited me.
Facing the Curiosity
My first pregnancy, at 37, was a product of decision fatigue. I didn’t ache for a baby, but my curiosity poked at me. We conceived without much effort, and I was immediately at peace with the decision. I came to understand that I’m the kind of person who’d never be satisfied not knowing the dark, expansive truth about motherhood. Writers are addicts, too; motherhood was abundant with new material.
The Unbearable Pressure
This time, I was about to turn 40. As I considered the question, my OB-GYN spoke to me as if getting pregnant “at my age” would be a holy miracle worthy of its own biblical passage. Two of my closest friends had been in years-long battles with second-child infertility. I saw the money they’d spent and the disappointment they’d weathered. But, I have a brother and I’ve always found it deeply comforting to have one other person who will always speak the language of my childhood. So I persisted, like some baby-obsessed sadist.
A Sudden Revelation
“I know, I know,” I said to my husband. “But finances change. Biology doesn’t.”
The Impending Darkness
Then, on a Tuesday morning in May, while waiting patiently on the seat of my toilet, I finally saw the two pink lines. I burst into tears. They were not happy tears.
The Weight of Regret
A sick, sticky feeling of regret rose up to the base of my throat. Dread arrived in the pit of my stomach. I was having the kind of stark realization that comes at the instant you push a red button and immediately understand the deep, eternal consequence of your actions. Instantly I began to mourn my nightly eight hours of sleep, my early-morning writing time, the work I’d done to repair a fragile relationship to my changing body, and the dissolution of my little family of three.
A Familiar Fear
When you have a second child, people say things like, “You know what to do now! You’ve been here before!” And yet, this is exactly where my fear stemmed from. The first time, I only had my own optimism to rely on. This time I knew exactly what to expect, and I knew it wasn’t always pretty.
An Emotional Breakdown
First came the depression-crying, the kind of tears that run like a faucet, unprovoked and without warning. Nothing prompted them, and I couldn’t attach their overflow to any particular emotion. The crying just … happened. In the car, at my desk, while cooking dinner. I felt sadness as if it were a vague, misty concept that came knocking, uninvited in its hazmat suit, to fumigate my entire body.
Anxieties and Intrusive Thoughts
Next came the anxiety, a certainty that something would be wrong: with me, the baby, my pregnancy. I feared that because I was less excited about this pregnancy—more distracted, lethargic—that I would somehow damage the baby by osmosis. Too bad hormones don’t care about logic—or psychology.
The Ongoing Battle
Soon I began to obsess over the postpartum period, certain I would suffer from debilitating postpartum depression. If it’s this bad now, I thought. Aside from some white-hot postpartum rage, I’d managed to evade this common disorder—the subject, lately, of so many articles, books, and movies—after my daughter’s birth, but I remember seeing it from afar. It loomed just out of my periphery; if I’d taken just one wrong turn, I could have been enveloped into its blackness.
A Stigma of Silence
This fear only made the tears come harder. I imagined long, mind-numbing days at home, sobbing while the baby shrieked its tinny, incessant wails. I tried not to entertain what sort of intrusive thoughts I might have. I feared I would resent my new baby for taking me further from my writing, my body, my relationships, my daughter. That the baby would sense this anger and grow up to be the subject of one of the true-crime documentaries my husband and I often watched.
Unveiling the Truth
More than anything, however, I was caught off guard. I was officially middle-aged, a mother for three years now, and I didn’t consider that I could be this sad during my pregnancy. Especially a pregnancy I planned—and thought I wanted. I was drowning in the emotional quicksand of my own making.
Avoiding the Conversation
“We have this expectation that people are supposed to feel a consistent, simple way about something as enormous as creating and giving birth to and raising a baby, and that’s not fair,” Allen said. “It’s a huge thing.” Even for those who’ve gone to extensive lengths to get pregnant, it’s not so black and white. “Going through IVF and fertility issues is challenging, complicated, and traumatic, and so there becomes this huge expectation, but the reality is that being a mom is hard,” Allen said.
The Demise of Silence
Allen points to the now-archaic criticisms faced by Brooke Shields when she openly discussed her postpartum depression in the early 2000s. Today, there is more support for acknowledging mental health struggles, but the dialogue around depression during pregnancy remains sparse.
A Silent Battle
“Statistically, antenatal depression is almost as common as postpartum depression,” Allen told me. “There’s increased awareness about postpartum depression, but no one really addresses antenatal depressive disorders, and I have no idea why that is.” According to the Cleveland Clinic Journal of Medicine, 1 in 7-10 women will develop a depressive disorder during pregnancy. That’s more than a half-million women each year who will confront a depressive disorder at some point during or after gestation.
The Stigma of Shame
Part of me wonders if we put less emphasis on maternal health during pregnancy because there is no baby yet. Do we care more about the mother’s mental health after the baby’s born because, in society’s mind, if she’s incapacitated, who else will take care of the baby?! If you look at current public policy, it appears that some conservatives prioritize seeing the baby being born, regardless of the toll it takes on the mother.
A Hopeful Perspective
Still, as a woman who was born in the Deep South in the early 1980s, the voices that surrounded me in my upbringing—patriarchal and puritanical—had made me question and shame myself for my feelings. But in having these difficulties, I am reminded that I am human. I am reminded that it’s okay for my reality to contradict societal expectations. It’s okay for me to share my journey, my struggles, and my questions. It’s okay for me to believe in the beautiful mess of an honest life, nuance and all.
The Persistence of Hope
As I cradled my second child to my chest, I cried because he was finally here. I cried because, in that moment, I did not resent him. I cried because for some, the battle with prenatal depression does not have the same ending.
A Mother’s Reflection
Still, I worry about the chaos of my new life with a newborn and a toddler. I wonder how I will maintain my writing practice and excel in my full-time job with two children. Maggie Smith, a poet, once wrote, “How will my children feel if they think that being seen as a mother wasn’t enough for me? What will they think of me, knowing I wanted a full life—a life with them and a life in words, too?” What will my son think when he finds out that I felt sadness and doubt during his pregnancy? I hope he’ll see an imperfect woman who isn’t afraid to be honest, who asks difficult questions, and who believes in the beauty of embracing the messiness of life.
