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Prepared for Postpartum
Understanding Postpartum Depression
By Kim Byrum Skinner
Dr. Cynthia Evans thought she understood the textbook ins and outs of postpartum depression. That is, until she became pregnant. A doctor and faculty member with The Ohio State University Medical Center's Department of Obstetrics and Gynecology, Dr. Evans playfully dismissed friends' postpartum warnings, believing, like most women, she could manage "life after baby" with a little mind-over-matter resolve, no prescriptions required. Well-informed as any new mother could be, she was, nonetheless, overwhelmed.
"The baby eats every two hours, literally around the clock, which means you're up, too, feeding the baby," says Dr. Evans. "It's a real awakening. It's day after day without a break."
Dr. Evans was confined to six months' bed rest with her daughter and later gave birth to a son prematurely. "I remember a good friend telling me that maternity leave was so much harder than being on call as a physician – lots tougher," she says. "I laughed at her, too. But she was absolutely right."
Dr. Evans found that the time after childbirth was much more difficult than she ever imagined. "It's such a misunderstood time," she says. "There's this expectation that you have this bubbly little baby and should be happy, but the reality is, it's extremely hard work. The baby cries. It's completely needy. Your needs go to the bottom of the list. It gets trying, especially without any support. When people expect you to be happy all the time, that's hard. That's why, a lot of times, people don't admit this and just say they're doing fine."
A practicing physician for the past 13 years, Dr. Evans believes when it comes to PPD – a condition that affects roughly 10 to 30 percent of women – education and preparation are keys to a healthy transition. "People don't really talk about it, though," she says. "People assume life is good. You've got this gorgeous baby. Everyone's approached you with, 'Isn't life wonderful?' But you haven't slept or showered in weeks. Your hormones have gone totally berserk, and you think you should be happy. People shouldn't be embarrassed to seek treatment. Ever."
Psychotherapist Kevin Malarkey, who launched his own Columbus, Ohio-based company, Life Strategies, couldn't agree more. After watching his wife, Beth, struggle with the birth of sons Alex and Aaron, Malarkey developed "Focus on the Parent," a two-part, informational course at Doctor's West Hospital. He also hit the lecture circuit with vigor and began penning workbooks and other educational materials to help a misinformed public steer clear. The couple's third child is on the way.
"Beth didn't even have postpartum depression, but I got to thinking about how hard it must be," he says. "My wife's real strong. She runs marathons – takes pain a lot better than I do. In fact, most women take pain a lot better than their husbands. That's not unique. But here she was, pregnant and sick. I saw how hard it was."
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