Thoughts on Ignorance as a Cause of Post-Partum Depression

I am not a psychiatrist, a medical specialist, or even a scientist, but I have a sneaking suspicion that post-partum depression, while obviously a complex condition, is rooted at least in part in one phenomenon: distorted expectations from lack of sufficient and accurate information.

Likely owing to society’s desire to increase the population of humans, and general squeamishness and avoidance of gross subjects, most women are exposed to only a very topical and rosy view of pregnancy, birth, and motherhood throughout their lives leading up to the decision to reproduce. Everyone’s heard of “pregnancy glow.” On the other hand, things like pregnancy constipation, pregnancy constant flatulence, pregnancy insomnia, pregnancy leaking of urine, and pregnancy leaking of amniotic fluid are less frequently mentioned, if at all. After labor, everyone knows about the “bundle of joy,” but probably not the bundle of shit on the delivery table.

Unless a woman happens to keep company with a horde of brutally honest women who don’t mind sharing things like a desire to literally die during childbirth because of the horrible pain (thanks mom!); how badly their vaginas tore, got infected, then tore again; among other horrifying stories not fit for dinner conversation, a woman may find herself pregnant and learning these very real possibilities for the first time. Society wants you to think of the glow, not the farting, leaking, pain, tearing, and shitting, because if women carefully considered all these downsides, some undoubtedly would have second thoughts. It is true the more women know and contemplate the implications of these realities, the more careful they are going to be about their decision to reproduce, but this should not be a bad thing.

Again, I’m not a medical professional, but I speculate jumping into pregnancy imagining the glow and the rewards of motherhood, then being subsequently ambushed by a slew of physical ailments, followed by serious physical compromise or injury during labor, topped off with the reality of becoming responsible for a squirming, screaming, crying, shitting bundle of mess all while suffering sleep deprivation and possible problems with breastfeeding, is an easy recipe for depression.

This is exactly why all women should seek out all the relevant information, both positive and negative before deciding to have children. Having worked in the field of healthcare law for many years, I know the detailed and precise description of risks and complications, both common and rare, discussed with women before they have so much as an appendix removal, brow lift, or boob job. For almost all surgeries, no matter how minor, physicians will review risks, benefits, and alternatives, providing an overview of common complications, expected outcomes, and even some remote risks, such as death. They are required to do this for every procedure, even life-saving surgeries most people in their right mind would never refuse. The basic rationale behind this practice is that people should know what they are getting into, and that includes not only common and expected risks and outcomes, but at least an idea of remote and unlikely complications as well.

Yet, as it relates to reproduction, a completely elective choice in this day and age, women hear merely about “pregnancy glow,” “bundle of joy,” and perhaps vague references to fatigue and morning sickness before committing to something of significant medical, physical, and emotional impact not only for the next 9 months, but indeed, possibly for the next 18 years. With this in mind, it’s actually amazing more women do not suffer post-partum depression.

Of course, while society has a tendency to give women inaccurate impressions, women need to take responsibility for their own decisions. I doubt many women look into the full panoply of risks, complications, and outcomes associated with pregnancy, labor, and the post-partum period in great detail before deciding to become pregnant; I know I didn’t, and I am actually someone who really took my sweet time deciding to have children at all. I had cataloged in the back of my mind a collection of horror stories from honest women over the years, and went into this with an understanding of a lot of worst case scenarios, because that’s my personality. I figured if I could accept the possibility of these worst case scenarios, then I would not have any regrets, but as far as being actually informed, this is totally not sufficient, and I met with plenty of surprises upon finding myself pregnant.

As with most things in life, preparation is key, and I surmise the more women know, the more they can do to prepare emotionally and physically, and the less shock and disappointment they will experience, which in turn would reduce the likelihood of post-partum depression.

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