The Weird Thing About Telling So Late

When I was going through IVF, I told people even before there was a chance I'd be pregnant. I didn't particularly enjoy my family & friends going through the 2ww with me, but the whole process was so intense that everyone ended up knowing. Clearly, as soon as the results were in, everyone knew that too...

This time, Ohad & I really enjoyed having a secret (we didn't even really feel any need to tell when we did)... we knew I was pregnant when Yedda offered to send me to BlogHer & we knew when I ordered the tickets to take Lilach to Croatia. I was careful when I tore through the airport in Atlanta trying to catch my flight (I did) and I avoided riding a gondola in Venice because I get seasick easily even when I'm not pregnant... I was also careful not to volunteer for anything at the school...

When we announced this pregnancy at the end of the 16th week, it was still not obvious. I could still wear my normal clothes for a few weeks, but now (it seems way too suddenly) I'm wearing maternity clothes and it's clear I'm pregnant.

I guess a pregnancy becomes 'real' for me at a many different points:

- a positive home pregnancy test

- a positive beta test (blood)

- the first ultrasound when I see a heartbeat

- the first ultrasound when the fetus begins to look like a baby

- when my ordinary clothes stop fitting

- the first time I *definitely* feel the baby kick

- when people can tell by looking at me and...

- when we tell people.

But maybe this one (telling people, especially family) has more weight, because when other people know, it's no longer just a fantasy (that for some odd reason the ultrasound machine seems to believe), it's not only part of my life, but part of theirs too...

In any case, it's fun that it's gone by so quickly, just strange.

On Saturday, we finish 24 weeks.

Postpartum Depression - MOTHERS Act

As my contribution to this day I decided to write a post that's hopefully somewhat enlightening & that might help lift the taboo from postpartum depression (also known as postnatal depression), particularly in women who suffered from infertility prior to the birth of their child/ren. (Interested in articles about PPD after Assisted Reproduction? See the bottom of this blog post.)

Infertility usually means at least a year of unsuccessful attemts to conceive before turning to a medical professional for help. After this, it's a process of many months or even years before a baby becomes a reality. During this time, having a baby often becomes a woman's goal in life (I'm deliberately leaving out the father here, because I want to refer to my thoughts on what might contribute to the incidence of PPD specifically in women), often taking a toll on her education, career, marriage, friendships, etc. Having a baby is the goal & the baby can become idealized, frequently as a warm, cuddly creature dressed in pastel colors, who coos on cue and smiles lovingly at her mommy...

I think it's rare for a woman to be prepared for the reality of motherhood (not exactly the description above, at least not all the time). Although I have a sister who is 9 years younger than I (and therefore I should have known something about having a baby), when I first brought Hadas home from the hospital, all I could think was, "OK, so what do I do with her now?" When she cried and I didn't know how to calm her, I was practically in tears. She was a fairly good sleeper - at night - but during the day, she demanded pretty much constant attention - 16 hours a day. She was alert, interested in everything, a good eater and mostly happy, but it was tiring - day after day, every day. I didn't have many people to interact with or places to take her, so aside from walks, we were mostly at home. My whole life changed when she was born but, of course, having her had been my choice, something I'd waited for for over 3 years (3 years of TTC + 9 months until she was born). How could I possibly complain about having a beautiful, healthy baby?

Fortunately, I have no personal experience with PPD, but I'm guessing that's how it is - there are the perfectly normal hardships and then the depression that sets in. On top of that, is the guilt for feeling the way you do - or for completely losing control of your emotions.

Having the "baby blues" is normal, but baby blues are very different from Postpartum Depression. Here are some brief descriptions adapted from emedicinehealth (in purple):

The "baby blues" are a passing state of heightened emotions that occurs in about half of women who have recently given birth. It peaks 3-5 days after delivery and lasts up to 2 weeks, during which time the woman may cry more easily than usual and may have trouble sleeping or feel irritable, sad, and "on edge" emotionally. Baby blues don't interfere with a woman's ability to care for her baby.

Postpartum depression is depression that occurs soon after having a baby. Some health professionals call it postpartum nonpsychotic depression. It occurs in about 10-20% of women, usually within a few months of delivery. Symptoms include depressed mood, tearfulness, inability to enjoy pleasurable activities, trouble sleeping, fatigue, appetite problems, suicidal thoughts, feelings of inadequacy as a parent, and impaired concentration.

A woman who experiences postpartum depression may worry about the baby's health and well-being. She may have negative thoughts about the baby and fears about harming the infant.
Postpartum depression interferes with a woman's ability to care for her baby. It can also lead to suicidal and homicidal thoughts.

Having PPD, from what I learned is a serious problem, but what is really important is to know that it's treatable. Treating PPD is the best thing a woman can do both for herself and for her baby. Women with PPD may have difficulty taking the first step, or even acknowledging that there is a problem. If you're a woman with PPD - tell someone. Let them help you get help. If you have a friend with PPD, find out more about getting help for your friend. If the first professional doesn't help, persist until you find someone who does.

Getting help means giving yourself an excellent chance of going on to having a healthy, rewarding experience as a mommy.

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Special thanks to Katherine Stone who took the time to speak to me at BlogHer 2007 and who, as a survivor, devotes incredible amounts of time and energy to increasing awareness about postpartum mood disorders.

Recent research performed by Karin Hammarberg (link to doctoral thesis), who also published an article entitled "Assisted conception is a risk factor for postnatal mood disturbance and early parenting difficulties" in Fertility & Sterility (link to abstract) has indeed shown a higher incidence of postpartum mood disorders among women who conceived with the help of ART.

An additional article I read, entitled "Impact of a multiple, IVF birth on post-partum mental health: a composite analysis", published in Human Reproduction (link to abstract, full pdf available from that page), suggests that the higher incidence of multiples in IVF births is a factor that raises the risk of PPD after ART.

Feel free to ask for explanations :-) This post is just getting too long...

Support for the MOTHERS Act

October 24th is blog day for the MOTHERS act.

Katherine Stone from Postpartum Progress (who I was fortunate enough to hear speak & actually got a chance to chat with at BlogHer 2007) posted all the relevant information. - Here's a tiny excerpt from Postpartum Progress just to clarify:

"What is the MOTHERS Act? The Moms Opportunity to Access Help, Education, Research and Support for Postpartum Depression Act, or MOTHERS Act (S. 3529), will ensure that new mothers and their families are educated about postpartum depression, screened for symptoms and provided with essential services. In addition, it will increase research into the causes, diagnoses and treatments for postpartum depression. The bill is sponsored by Senators Menendez and Durbin."

I will be blogging about postpartum depression on this day, with an emphasis on PPD in women who conceived using ART. If you have any information or insight on this topic, please feel free to share it.

I have also added a button to my sidebar, where you can click for more information.