June 22, 2006
Special Delivery - When Baby Brings More Than Expected
Sarah Berger had a tough pregnancy. Berger, who asked that her real name not be used, had severe morning sickness for six months, and then was on bed rest for her last 10 weeks. But it wasn't until her baby came home that trouble really began.
"On the third day, I remember this dark cloud descending on me.... I cried all the way home from the hospital," she said. As she prepared for her son's brit milah, "I started falling apart," Berger said. "I couldn't eat, I couldn't sleep and I couldn't stop crying."
She called her obstetrician, who suspected that Berger had postpartum depression (PPD).
Experienced by about 10 percent of new mothers, PPD's symptoms include sadness, apprehension, difficulty making decisions and changes in sleeping and eating habits. The symptoms of PPD last longer and are more intense than the tearfulness and fatigue characteristic of the "baby blues," which generally subside after two weeks.
"Despite the common belief that motherhood automatically brings ... a state of bliss and contentment, in reality the postpartum period is a time of increased vulnerability to psychiatric illness, particularly for women with past histories of depression or serious anxiety disorders," said Dr. Vivien K. Burt, professor of psychiatry at the Geffen School of Medicine at UCLA and director of the Women's Life Center of the Resnick Neuropsychiatric Hospital at UCLA. "We don't know for certain what causes postpartum depression, but we believe it stems at least in part from the rapid decline in estrogen following childbirth," she said, noting that during pregnancy, estrogen levels rise several hundred times and then drop back to prepregnancy levels within several days following childbirth.
Women suffering from PPD often fail to receive help for a number of reasons. They might be ashamed of their feelings, or they simply might not know where to turn. And not all obstetricians and pediatricians are as attuned to the condition as Berger was.
After she began seeing a therapist and taking medication, Berger quickly responded to treatment. When PPD hit again after the birth of her second child, she knew what to do.
Now Berger helps other women experiencing the condition by volunteering for New Moms Connect, a PPD support program offered by Jewish Family Service of Los Angeles (JFS). Volunteers for this free service help new moms and family members via telephone calls, home visits and referrals to community resources.
With a grant from the Jewish Community Foundation, New Moms Connect was developed as a response to calls received by JFS from new mothers "who were depressed and felt they had no one to reach out to," said Debbie Fox, director of child and family services for JFS. "Their husbands had no understanding of what was happening, they had no understanding and their families had no understanding."
"There's so much pressure to be joyous when a new baby comes," said Tamar Springer, a licensed psychotherapist who supervises the program's volunteers. "A woman may be reluctant to come forward with her feelings.... Our goal is to decrease stigma, educate the community and help people understand that this is a medical disorder that's not something to be ashamed of."
So far, 10 volunteers, including Berger, have undergone training. One is a nurse and another is a dentist. All are mothers.
Berger said she chose to volunteer because she felt there was a lack of information about PPD both in the Jewish community and the community in general. She was pleased to be part of an effort to "let women know about it ahead of time instead of just getting hit with it afterward," Berger said.
In her role, Berger listens as the women describe their situations, asks questions and makes suggestions for how new mothers can get support, whether by hiring temporary household help, attending a new mothers group in the area [see below] or seeing a physician. She often refers women to UCLA and Cedars-Sinai Medical Center, both of which offer PPD programs.
So far, she has spoken to about five women over the phone and visited two more in person. Her husband has also spoken with one of the women's husbands. She advises new mothers "to surround themselves with what makes them comfortable" and to articulate their preferences, rather than let other people decide what's best.
Berger, who is Orthodox, said that certain factors can intensify the problem in her community. In her lactation consulting practice, she said, "a lot of the moms I deal with ... are very young -- around 19 or 20 -- and are extremely unprepared" to deal with the changes that a new baby brings.
When family and friends learn about PPD, their reactions can vary. Berger said that after a friend heard a mutual acquaintance talking about Berger's PPD, the friend told Berger that her openness might result in difficulty finding a shidduch (match) for her children.
Despite such comments, Berger felt that the experience also had its benefits. "It's taught me a lot about myself and about how I want to raise my children and the kind of person I want to be," she said.
When Mom Needs Help
A New Moms Connect Peer Support Group, which started June 21, is still accepting participants. The six-week session, designed for mothers with babies newborn to six months, meets Wednesday, 9:45 a.m.-11:15 a.m., at The Parenting Place at the Los Angeles Jewish Home for the Aging, Grancell Village, 7150 Tampa Ave., Reseda. The program is also sponsored by JFS and the Valley Beth Shalom Infant/Toddler Program. For information, call Donna Ramos at (323) 761-8800 ext. 1213.
New Moms Connect (323) 761-8800, ext. 1028 (calls generally returned within 24 hours).
The Woman's Life Center at UCLA (310) 825-9989
Cedars-Sinai Medical Center Postpartum Depression Support Group (310) 423-1510
Postpartum Support International: www.postpartum.net.