Content Warning: This post describes sensitive topics related to postpartum mental health.
I have a distinct memory of waking up a few days after the birth of my daughter—who is now ten—trapped in a net of anxiety. Convinced that I had made a huge, irreversible mistake, my brain panicked at the absoluteness of a newborn. I could just leave, I thought. My mom would raise the baby if I left. These were not the ideas I expected to have as a new mother. Ashamed, I confined them to my brain where they pinged around in a constant prattle of dread, while, exteriorly, I did my best to smile. When I couldn’t smile, I hid in the shower. The hot water turned my skin red and I cried, until someone yelled for me to come feed the baby.
My pregnancy was blissfully smooth. I conceived quickly; I didn’t have morning sickness. All my prenatal checks were uneventful. My labor, however, was ragged and rough. I was 41 weeks pregnant in June in North Carolina when I thought my water broke. A pH-test at the hospital confirmed I was leaking amniotic fluid, but because I wasn’t having contractions, the doctor administered Pitocin. The chain reaction that followed is perhaps no surprise: the contractions were unbearable, I asked for an epidural, I pushed for several hours. I vomited. I sucked on ice chips. I pushed some more. And some more. We could see the baby’s head, but I could not get her out. (I have small hips; her head, I would later learn, was 99th percentile). The doctor finally decided I needed a C-section. The medicine administered for the C-section made me shake, and I thought I was having seizures. No one told me the shaking was from the medicine until crying, I asked the nurse anesthetist, “I can’t stop shaking. Am I okay?” My arms were strapped down so I wouldn’t flop my hands into my own guts. The fact that restraining a woman during a C-section is standard medical procedure for some hospitals doesn’t make it less traumatic.
After the C-section, I watched my then-husband fumble for ten minutes, trying to change my daughter’s diaper while I lay on my back in bed, like an injured beached whale, unable to sit up because my abdominal muscles had been pulled apart.
There is, of course, no way to know if I still would have struggled with my mental health after my daughter was born if my labor had been different. While postpartum depression is the most common complication of childbirth (Toohey), “the specific causes of this disorder are complex…presenting a formidable challenge in prediction” (Lilhore et al). There are many known risk factors for perinatal mood and anxiety disorders (PMADs), including a traumatic birth experience, but people with no known risk factors can suffer from these disorders and people with a slew of risk factors may not.
At my daughter’s one-week well child check, I started weeping in the examination room when the pediatrician asked me how I was doing. I was not okay, and I knew it. I had already checked in with my ob/gyn practice, but the doctor there (who was not my normal care provider) told me that since I didn’t have a history of mental illness, it was just the baby blues. “It’s normal to cry after you have a baby,” he told me. “Okay,” I thought. This will get better. But my intuition told me something was wrong, and I needed help.
The pediatrician gave me contact info for an amazing resource—the late Bill Meyer, who, at the time, was the Director of Training for Social Work and Associate Professor in the Departments of Psychiatry and Ob/Gyn at Duke. When I called him, Bill listened to me sob my way through my fears. By this point, I believed I was permanently broken. I was terrified to be alone with my daughter because of a plague of intrusive thoughts about hurting her. Bill assured me that because I was bothered by the thoughts, that was a strong indication I wouldn’t act on them. But I was terrified of snapping. I mollified my fears by promising myself I’d end my life before I ever hurt my daughter. I was in a dark, dark place.
In addition to helping me start therapy, Bill lined me up with a psychiatrist who prescribed Ativan and Zoloft. I experienced what I think many women experience. I didn’t want to take medicine in case it would hurt the baby. I felt weak and stupid, but I was also so, so desperate to feel better. So, I took the medicine and it did not hurt the baby. I went to postpartum support groups. I did therapy. I leaned hard on my support network. I chanted the mantra, “I will be healthy. I will be happy.” And little, by little, I got better.
Another critical aspect of my healing journey was poetry. I have my MFA in creative writing, and working on poems is a cathartic process for me. As such, poetry became a huge part of my recovery toolbox. As I wrote about my experience and as I became healthy again, mourning the loss of my former identity and growing into my new identity as a mother, I daydreamed about my poems as a means of recovery for other people affected by PMADs. That daydream, I hope, is on the cusp of reality. My debut poetry collection, snarkily titled, All That We Ask of You Is to Always Be Happy, will be released in February 2025 from CavanKerry Press. It’s not an easy book—it could be triggering for people who are currently struggling with PMADs—but it’s an honest book and an honest look (rhyme intended, #poet) at the complex world that is maternal mental health. In the forward for the collection, Dr. Riah Patterson, who is the Medical Director of University of North Carolina’s Perinatal Psychiatry Inpatient Unit notes that “While no experience will be exactly alike, these poems capture the essence of perinatal mood and anxiety disorders (PMADs) better than the Psychiatrist’s Diagnostic and Statistical Manual of Mental Disorders ever could.” When I read Dr. Patterson’s words, I felt a huge sense of fulfillment—I want this book to help people understand what it’s like.
I thought it important for the poems to explore the emotional landscape of PMADs, but also to be grounded in science, so several of the pieces contain epigraphs from experts in the maternal mental health field. One such poem, “Root Cause Analysis of Perinatal Mood Disorders" explores “causes” of perinatal mood disorders with an epigraph from Karen Kleiman, who wrote the book This Isn’t What I Expected, an amazing resource for people affected by PMADs.
Root Cause Analysis of Perinatal Mood Disorders
Postpartum depression is a complex combination of biological, emotional, and behavioral changes. The exact cause of the condition is still unknown.
-Karen Kleiman, MSW
Red impatiens limp in the hanging basket above a watering can.
Audio hallucinations, ghost-cries haunt the cochlea.
Reusable diapers and their sweet, ripe stink.
Natural birth, epidural, visualization, midwives, doctors, hospitals, doulas, Pitocin, water birth, forceps, the abdominal muscles split apart, shifted to the side.
The dog’s fur piling up in corners on the hardwood floor.
No paid maternity leave.
A framed wedding picture of a woman you no longer recognize.
The universal choir’s song: Enjoy this time. It goes by so fast.
Mastitis; cracked, chafed nipples; and America’s insistence on breastmilk.
Each stagnant week and its million days.
A shitty swaddle blanket that falls loose no matter how hard you try.
Despite the origins of PMADs being complex and varied, what we do know for certain is that these conditions are highly treatable. As such, we need to consistently and thoroughly check in on new moms so they can get the help they need like I was able to do. We need to continue the conversation about perinatal mood and anxiety disorders—through poetry, through research, through any means we can.
Works Cited
Lilhore, Umesh K., et al. "Prevalence and Risk Factors Analysis of Postpartum Depression at Early Stage using Hybrid Deep Learning Model." Scientific Reports (Nature Publisher Group), vol. 14, no. 1, 2024, pp. 4533. ProQuest,, doi:https://doi.org/10.1038/s41598-024-54927-8.
Toohey, Julianne. “Depression during pregnancy and postpartum.” Clinical obstetrics and gynecology vol. 55,3 (2012): 788-97. doi:10.1097/GRF.0b013e318253b2b4
Bridget Bell (b. 1983) is a poet, educator, proofreader, and bartender. She teaches composition and literature at Durham Technical Community College and proofreads manuscripts for Four Way Books. Her debut poetry collection, All That We Ask of You is to Always Be Happy explores perinatal mood and anxiety disorders.
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