First, Put On Her Shoes

If you want to truly help someone, you have to get down in the ditch with them.

You can’t stand at a pulpit.

You can’t wag your finger.

You can’t pity.

Everyone seems to get all ruffled at some point about this – how to be helpful. We’re familiar with the ‘new baby’ etiquette tightrope. At what point does my offer to help cook or clean or hold the baby become imposing? Am I neglecting or smothering? Was my little parenting ‘tip’ more like unsolicited advice? Is it my place? Am I doing too much? Not enough? Should I do/say anything at all?

First, put on her shoes. Stand in her place. 

Want to say the right thing? If you were the recipient, how would your advice sound?

Want to do the right thing? If you were the new mom, what would you need most from those around you?

That’s only ONE RULE to follow. It’s not easy – it requires you to stretch your empathy. But all that should be expected of you is that you try.

Just because it’s hard sometimes to know how to help, does not mean it’s right to avoid offering your services, or asking if everyone is doing OK. Assuming everything is fine over there at the house of a new baby, might help you dodge the awkwardness of a complex social situation, while meanwhile a new mom could be drowning.

The costs are too high. When we add maternal mental illness to the mix of new motherhood, silence and inaction are harmful.

If you proceed with concern and respect, it is far better that you screwed up than the alternative, which is – you didn’t ask how things were going; you didn’t pop your head in; you didn’t offer to wash some dishes or make dinner or give Mom a break; you didn’t ask if a mom was needing to reach out to a doctor or professional, and harm was done by your inaction. And if it turns out that what Mom truly needed most at that time was space to breathe alone with her family, then perfect. Affirm that with her, and feel good knowing you did your job as a decent human being – which, believe it or not, includes a shared responsibility for looking out for the well-being of mothers and their families.

Organizations that advocate and raise awareness of maternal mental illnesses do this, of course, on a wider scale. 

They have two important responsibilities, 1) to educate the public, and 2) to build up and protect the community they stand for.

These groups or organizations have to be particularly careful with how they help, because their reach is broader, and their actions have more repercussions.

Therefore, they need to get it right. They need to be able to exist between the people they protect and the rest of the world, and portray the most accurate representation of the issue they are working to raise awareness about.

That is what led me to respond to a post on the Facebook page of Saskatchewan’s leading provincial maternal mental health organization, in which a media release by Fox News was shared about an American mother who experienced postpartum psychosis and took the lives of her three children. It is a devastating, heart-breaking, shocking story. It has high emotional impact. Therefore, it needs to be shared responsibly by parties that are invested in its subject matter.

Thank-you Motherfirst for your continued efforts to raise awareness, and for keeping the conversation going on postpartum mental illness, but I strongly feel the need to clarify for some readers who may not know about postpartum depression and anxiety vs. postpartum psychosis

Infanticide is extreme, horrific, devastating, and tragic. It is the ultimate example of a breakdown in our system meant to protect both mothers and children.

It is also blessedly rare.

Postpartum psychosis is a health emergency. A mother can experience delusions, hallucinations, and a complete disruption in thought process.

Postpartum psychosis occurs in about 1 in 1000 postpartum women.

The rate of psychosis leading to infanticide is about 4% of the 1 in 1000.

Postpartum depression and anxiety on the other hand are EXTREMELY common. Some studies of western countries like ours, such as Australia, estimate that it may occur in as high as 25% of all mothers.

No doubt we all need to do more in our communities to prevent tragedies like this. But this one is an extreme example. Postpartum mental illness is not present exclusively or defined by the mental state of women who hurt their children. It happens to nearly 1 in 6 women in Canada – your mother, sister, neighbour, or friend.

Unfortunately, public perception of postpartum mental illness remains heavily influenced by headliners like this one – a disproportionate stereotype that further embeds a culture of silencing, shame, and fear, preventing women from recognizing their symptoms, or seeking help. It may also be highly triggering in mothers at risk for perinatal anxiety or OCD – conditions sensitively covered by Karen Kleiman and Amy Wenzel in their book Dropping The Baby and Other Scary Thoughts.

As advocates we have a responsibility to portray an accurate and representative image of maternal mental illness. It’s not just the women like Andrea Yates and Carol Coronado. It’s also the young mom you might know who just can’t stop crying, or who hasn’t slept in three days because she’s afraid the baby will stop breathing in the night.

As long as the dominate public perception remains fixed on the extreme tragedies, we need to expertly bring the conversation back a little closer to home, and not overrepresent stories based on what garners the most media coverage. Thank-you.

Community organizations need to remember that these news stories are not only emotionally disturbing to the public, but they are even more so to parents of children, perhaps way, way more.

They need to be shared with care because they are highly triggering. They can create fear – in the general public and in those struggling with mental health disorders.

To mothers with anxiety, specifically postpartum OCD, these news stories are bombshells. They are terrifying; gut-wrenching, day-ruining, paralysing. They take on the form of intrusive thoughts, dreaded what-ifs.

“If it could happen to her, what-if.”

“If I got that sick, what-if.”

“I just CAN’T stop thinking about that thing on the news, what-if.”

To an audience of mostly individuals who have suffered or who are suffering postpartum mental illness, how would the casual sharing of a news story like this be received? Like a punch in the gut, maybe?

Does that mean censoring? NO. Does that mean perhaps instead making a short reference to the incident and then promoting a discussion that is open, honest, accurate, and inclusive? Yes.

And we need to bring to light the stories that don’t make headline news. We need to provide a voice to those who are marginalized. That means giving a voice to the silenced victims of postpartum psychosis, so that they can share their story. That also means giving a voice to the suffering silent majority who are not sick enough that the media cares, but more importantly, whose quality of life is impacted.

Sometimes it’s tough to know what’s best to say. 

But having postpartum mental illness is tougher.