How We Neglect Pregnant Women’s Mental Health
My world turned upside down in mid-2021, when—in the midst of a pandemic—I welcomed my second baby in two years. Our brood doubled in size from two kids to four, and a lot changed in our home. For one, our cat was displeased with the new young people and went so far as to poop on our master bed to send a message (it was received).
That may have been the least impactful change. As childcare grew scarce and I dropped balls at work and home, a combination of postpartum depression (PPD) and anxiety hit like an avalanche. The challenge with a mental health issue is that it isn’t clearly labeled as such; at first it can appear quite convincingly that you have indeed become a failure, and that the future is hopeless. With the encouragement of loved ones, I ultimately got some help and could see my PPD for what it is.
But until then, for months I could hardly see the path in front of me, much less my identity in the mirror. After a while, you just go into survival mode. I had already given birth to three children—surely going from zero to one child was the hardest? But now, as I welcomed our fourth (and I am a fourth child myself), my eyes were opened anew to the selflessness of my mother in welcoming me. That’s when I realized that, while some aspects of selflessness are cultivated like virtues, some happen to you as you accept losing parts of yourself, intended or not.
That’s what happened as I welcomed my little “Pep.” Perpetua, we named her. A girl with the biggest, most expressive eyebrows I’ve ever seen on a child. (Also with the loudest scream I’ve ever heard—and I’ve heard the cries of 15 nieces and nephews!) I ached with how much I loved watching her face light up with delight, eyebrows raised high in surprise or flattened straight across her face when choking with laughter. I crumpled when they furrowed low over her tear-soaked eyes, tightly shutting out any consolation. The incessant noise overpowered any solution-oriented thoughts I could muster. Perpetua. Her name signifies, literally, it will never stop. Was this my new normal? Have I lost myself forever?
Big, Little Worries
Some might say I could have avoided all of this. An ultrasound OBGYN tried to warn me, at my just-before-twenty-week scan, that this child might have a birth defect—cystic fibrosis (CF) to be exact, since I’m a carrier. If my husband got tested and turned out to be a carrier too, there would be a risk of our child having this congenital disease, and I would still have time to do something about it. Never mind that the New York Times found that a number of medically prescribed prenatal tests show false positives for genetic abnormalities 85 percent of the time. Never mind that this man was also the father of my three older children, all born without CF, making the risk factor seem slim. I couldn’t imagine listening to worries about a possible congenital disease and terminating one of these three sweethearts in the womb.
Since it would make no difference to the prenatal care the child would receive, my husband never got tested; we would love this child either way. Abortion wasn’t an acceptable option, because we don’t believe certain conditions make certain people “unfit” to live—or raise—in one’s family or the world at large.
But I was alarmed at the pressure I felt from the sonogram OBGYN to consider aborting my wanted child. I thought her advice revealed a eugenic line of thinking that’s infecting OBGYN medicine—to view certain lives as more valuable than others. And I still think that—there remains an abundance of evidence to support the troubling eugenic trend in abortion pressure. But upon further reflection, I wonder if there was an additional possible motivation behind her pushing me to reconsider letting my child live.
Is it possible she was trying to save me the trouble . . . of a fourth child? Of a child during a pandemic? Of any child at all? No doubt she’s seen stressed-out moms suffering from postpartum depression and struggling to make it all work. In other words, she’s seen me in the future. She’s seen moms carrying even heavier burdens too, with special-needs children, or with chronic illnesses themselves, with financial hardships, unsupportive partners, the whole gamut of suffering. I remember how much she urged me to think about it a little longer.
She probably sees herself as the mythical Cassandra, offering abortion as a charitable gift—an escape route from the stress that children of any health condition will necessarily bring, at least into the immediate future of any active parent. Perhaps she wanted to impress this on me, woman to woman, while my husband wasn’t there, because, after all, I have the authority to pull the trigger. As the mother, I also have the surest burden.
Big, Little Eyebrows
My fourth-born wasn’t born with a rare disease, but there is something different about Pep. Her huge eyebrows are unlike anyone else’s in the world. She roars fiercely to imitate her favorite stuffed animal, a lion. Her loud baby scream has shifted to a voice that belts wordless sounds to the tune of “Million Dreams” from The Greatest Showman. And to witness this natural wonder develop in front of my eyes, all it cost me was letting her grow in my body. Never mind my thinning hair and shortened fuse postpartum. No hardship I experienced could excuse removing her from existence. Still, the fuse needed attention, so I noted the warning signs of postpartum depression, sought advice from my doctor, and accepted her referral to a therapist. (What a difference a call makes!) I wasn’t alone with these burdens. I felt helped.
After the birth of Pep, the Dobbs decision was released and Roe v. Wade was overturned. The public response from abortion supporters stunned me. I had known people believed these things before, but the newly brazen voices in the resistance blew my mind: We’re going backward in women’s rights and advancements, they’d say . . . as if abortion somehow helps humanity? Our mothers and grandmothers had more rights than we do, they’d say . . . as if it was good that our mothers and grandmothers had “rights” to terminate us? Every mantra seemed as half-baked as it was shrill and urgent, as if to discourage thinking it through and encourage the rush to pile onto the bandwagon. Some would exclaim, “Why should anyone care if others have abortions? Don’t want an abortion, don’t have one.” Really? I don’t know, I’d think to myself, pondering as I made my way down my busy street . . . why should we care about people we’ve never met dying in Ukraine? Why should I not drive off the bridge right now? Why should we care about human life at all? If any of us post-birth people matter, then terminating pre-birth people isn’t inconsequential.
Perhaps the most commonly heard battle cry: A woman can do what she wants with her own body . . . as if this entire issue wasn’t about giving a separate human body a chance to exist—a body just like those we see in our friends’ ultrasound photos, just like those little ones on life support in the NICU, just like our body when we were in our mother’s womb. Just like my little Pep in utero was when I was encouraged to abort!
Postpartum depression is a doozie to begin with, but noticing the chasm of assumptions about the value of human life separating me and those in my neighborhood and social media feed was another level of disorienting.
But the most discordant claim of all those I heard during this season of momhood was this: A woman should be able to abort a child if it will cause her mental distress. Giving birth certainly caused me mental distress, and research shows that’s pretty universal, even for those who don’t experience clinically significant diagnoses. How could this make sense? I couldn’t help but think how horrible it must be for women who might have kept their child if they had received the support they needed.
Wanted: A Helping Hand
The aggressive coarseness of the pro-abortion advocates stunned me. I’m sure many consider abortion to be like bailing a woman out of a pregnancy . . . but I’ve been pressured to abort a wanted child, supposedly to reduce my burdens. That experience was painfully eye-opening. Now abortion-centric language sounds to me like hectoring women, at their most vulnerable, into believing their depressed, worst thoughts and acting upon them. I contrasted the doctor pushing me to consider abortion with the doctor who helped me postpartum. If a baby stresses you out before birth, why are you encouraged to abort rather than to get through it with mental health support? Meanwhile, after birth, if I am struggling mentally, I’m not encouraged to give up my child, but to get through it with mental health support.
Wouldn’t it be better for women if we treated mental health needs across the board, both before and after we give birth?
How can we as a culture accept anything less, under the guise of women’s health? How can we as a medically advanced society ignore the science of the preborn child’s growth? How can we as artists and poets and creatives and family members and human beings (who were once fetuses ourselves) act like it’s inconsequential if a child in the womb doesn’t make it out? These little people are not make-believe in there—their scientifically verified existence is apparent on any ultrasound or pregnancy app. Their realness is not dependent on whether others opt into acknowledging it.
I for one couldn’t accept a world that wouldn’t welcome little Pep and her expressive eyebrows, or my niece, whom my sister brought into the world unexpectedly at age 19, and who was born with health issues that trouble her to this day. (You won’t find a more encouraging, powerful soul in the world.) None of us are guaranteed a life without struggle. Don’t we all need each other to get through it?
Sure, I’ve struggled with PPD. And my sister, who had an unplanned pregnancy, struggled with a lot more than I did. And my niece struggles with more than anyone I know. And I’m sure my mother shouldered her own burdens by giving birth to me, her fourth-born—yet it’s still right that we’re here. We are needed in this world. We need each other. I think we know this in our hearts, but perhaps we need to hear it again and again, in our stories, in our posts, in our media.
I know and love people who have had abortions; some of them have shared with me their post-abortive pain decades later. They need support, too, and while it’s sadly not offered at your average doctor’s office, support and resources are available for these people too. We might feel alone at times, but none of us are really ever alone. We shouldn’t listen to fear-based voices that suggest as much in our darker moments. And we should take care not to be those voices, either.
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Original Bio:
Mary Rose Somarriba is editor in chief of Verily Magazine.