More than once, my dad told me I shouldn’t have a third baby. I bristled every time he said it, accusing him of saying I’m not capable. He would throw his hands up, say it’s not about that, but he could never quite get the words out to tell me what it really was about. But I know what he was afraid to say. He was afraid that if I had another baby, it would kill me. I know because I’ve had that fear, too.
Although I never admitted it to anyone, the possibility of death lay on my chest after my second baby was born, threatening all the time to crush the air out of my lungs.
No one tells you what postpartum depression is really like. I had a vague idea of what to watch for: sitting in a dark room alone with the baby. Crying randomly. Being unable to get out of bed. But none of that happened to me. I got up, I functioned, I cared for my daughter and son alone for 12 hours at a time some days. We went to the park, library story times for my 2-year-old, the house of a friend who was home with her own baby. It was exhausting, but I was doing it. I wouldn’t let myself not do it.
But the fact that motherhood suddenly felt so impossible after my second baby was born was a shock to me; maternity leave after my first had been blissful. I couldn’t understand what was wrong this time.
“Postpartum depression — although we use that as the overall term, most women will say: ‘I wasn’t depressed like I couldn’t get out of bed. I knew I had to get out of bed. Maybe I didn’t want to. But I often felt much more anxious than depressed in the beginning,’” says Suma Karandikar, a certified perinatal mental health provider and the owner and director of Thrive Postpartum, Couples and Family Therapy in suburban Chicago. “The symptom that we hear the most is probably anxiety or agitation. You feel like you’re not yourself, you don’t know where you’ve gone. There’s an identity component.”
Karandikar said that when she had her children in the early aughts, there wasn’t nearly the awareness about the issue as there is now. Now women are screened for postpartum depression at their OB/GYN’s office or even at their child’s pediatrician’s office. But even so, she said women who are struggling know how to respond to avoid getting flagged and therefore often aren’t connected with treatment.
My postpartum depression was sneaky and hidden from everyone, including me. It was marked by a raging anger at everyone around me for not noticing that I was drowning. But what was there for them to see? A tired but functioning young mother of two? I wrote an email to a friend, trying but failing to vocalize what was actually going on. “It is really lonely,” I wrote. She replied: “I’m sorry. I’m here for you.” But “here for you” is metaphorical. It does not necessarily entail a person getting in a car or on a plane and showing up at your front door, taking your face in their hands, and saying: “I am here. I am really here, with you. What do you need?”
I thought I would know what suicidal ideation would look like: thinking people in my life — my children, my husband — would be better off without me. But that never happened, either. Of course they wouldn’t be better off without me. They would be devastated, their lives marked by an eternal grief. Plus, who would wash their clothes and schedule their doctor’s appointments and literally pump fluid from their body to feed the baby? No, I didn’t think anyone would be better off without me — except for myself. What if I could just shut down my brain, stop thinking about all the other choices I could have made or lives I could have lived, end it all and step out of this hell? What a relief that would be.
I felt a rising fear that the idea of relief would grow a little too enticing. What would happen when I couldn’t contain my devastation in my own body and it exploded onto everyone I loved?
It did, eventually. I don’t mean I tried to hurt myself. But after the Thanksgiving holiday, as my parents packed up their things and planned to hit the road at 6 a.m., I went down to their room, sat on the edge of their bed and started to sob. The baby at that point was 3 months old, and I had another four weeks before I returned to work. The idea of being alone with my children again terrified me.
“It’s all right, it’s all right,” my mother soothed. “It’s really hard. It’s okay that you don’t like this.” Maybe she was reliving her own experiences taking care of three children. But my father looked at me like he never had — scared and confused — maybe because I looked to him as I never had. Perhaps I crushed 28 years of being smart, together, Type A with a 15-minute breakdown.
I am naturally a people-pleaser, hardwired to power through a challenge without raising alarm bells. According to Sheehan Fisher, an assistant professor of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine, that’s not unusual for mothers struggling with postpartum depression or anxiety, which studies from the Centers for Disease Control and Prevention show can impact 13 percent of women overall who have a live birth in the United States.
“There’s a lot of pressure on moms and women in general to suck it up. So if you’re susceptible to that, that’s doubled down during this very vulnerable period of time of high stress, a lot of bodily and hormonal and life changes,” Fisher said. “I think a lot of moms struggle with this idealistic view of ‘I have to be able to do it all, I’m going to handle it with a smile on my face,’ but that isn’t even fair to any human being to be under that much pressure.”
Sometime between six months and my son’s first birthday, not long after I returned to work, the darkness cleared. But a new nagging concern still hung over everything. I had always wanted three children. One of three myself, I liked the sibling dynamic in that triangle. But after I made it through my second maternity leave, I wondered about round three: If the darkness returned, would I be able to survive it?
I wasn’t sure. The more distance I got from the birth of my second child, the more clearly I could see that something had been wrong. I started to find the words that had eluded me for so long and tentatively began to share them. First with my husband, then with a close friend. And the more I talked about it, the more power I had to name what had happened: I had suffered from postpartum depression.
My husband and I went around and around on whether to have a third baby, trading positions more than once. We have two beautiful, well-loved children. Did we need to roll the dice? But to let it control future decisions felt like a mistake. I didn’t want to treat my postpartum depression as a random disaster — like a lightning strike — and desperately try to shove the memories into an inaccessible corner of my mind. What if instead we pried the experience open, let it deepen our understanding of ourselves and each other, and moved forward?
We decided to go for it, with me promising to be more vocal about struggling and my husband promising to watch more closely for signs that I was struggling. We talked about structures we could put in place to ensure a smoother postpartum period, from the large (keeping full-time child care for the other two kids) to the small (investing in a wireless breast pump for more convenient, less isolated pumping).
When the anxiety hit hard in my first trimester, we talked about that, too, and agreed I should find a therapist who specialized in postpartum depression. I cried on and off as I talked her through my history during the intake session, almost a full two years after my son’s birth. “This is clearly trauma you’re still processing,” she said.
So we started exploring my feelings, which felt not just shameful but contradictory, pinpointing stressors that contributed to the experience, acknowledging the disappointment I had felt when reality did not line up with my expectations. And over time, we created a plan for my upcoming postpartum period: a therapy schedule, a discussion about antidepressants, prearranged support, and coping tools for things I know I struggle with — things like asking for help.
People typically do not jump in cars or on planes and arrive on your doorstep to hold your face in their hands unless you ask them to. That has been a hard lesson for me to learn. The thought of asking for help had always made me feel like a failure; actually doing it is the only thing that has ever made me feel less alone.
As I write this, I am days from my due date. I am not sure that things will be better this time around, but I am hopeful. I have a therapist and a doctor who are aware of my history and ready to suggest more aggressive measures if things take a turn. I have established, more open communication with my husband about my fears.
And for the first four weeks after the birth, I’ve asked people I love to be with me, and they’ve promised to turn up on my doorstep.
Lauren Chval gave birth to her third child on Jan. 16.