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The perinatal mood disorder we urgently need to talk about.
By Danielle Jernigan — Written on Oct 13, 2022
I was 43 when I conceived my daughter. As a woman who grew up in a family of 9 composed of mostly boys, and whose first child is a boy, I desperately wanted my second child to be a girl.
On the day I received the call that the test results were in I hurriedly grabbed my bag and drove the 7 minutes to the birth center to pick it up.
I entered the building and climbed two flights of stairs to the birth center's main office and approached the receptionist's desk. After we exchanged pleasantries, she placed the envelope containing the test results in my hand. I am proud to say that I carried that envelope all over one flight of stairs before I could no longer resist the temptation.
I ripped open the envelope and there written in bright red ink were the words It’s a girl!
I was elated! I screamed and tears of joy came as I ran well hobbled down the stairs and exited the birth center clutching the results in my hand.
However, before I could get to my car fear set in, my body began trembling, and the tears turned into deep sobs. I couldn’t quite comprehend my reaction, so I called my sister to help me process it.
After I shared the news and she held space for my tears and fears she spoke these words, “Now you get to be the mother you always wanted but never had.”
My mother is a strong beautiful woman but also carried a lot of unpacked trauma, which left her unavailable in the way I needed her.
My sister and I both felt like motherless daughters. And she and I fought hard to learn from the mistakes of our parents. But could I be the mother and woman I wanted in a way that my daughter would need me? I knew deep down that I, too, had a lot of unpacked traumas and profound secrets I buried.
And knowing that I was carrying a daughter triggered them all.
What postpartum PTSD looks like
As my past started to haunt me the nightmares began. I started to relive the sexual abuse I experienced as a young girl and woman which led to persistent insomnia, nightmares, and panic attacks.
My daughter stopped breathing in-utero at 38 weeks. After I was induced she was born two days later both limp and blue. Instead of holding her close to me as soon as she made it earthside, she was given to the neonatal team to be poked and rubbed until she took her first breath and had a proper Apgar score.
With Zoë's first breath, I whispered in her ear how thankful I was that she made it, and she began to nurse. The medical team deemed my birthing experience successful while I silently cried inside. Did anyone just witness what happened other than me? And in the days and months that followed, no one asked me how I was doing mentally.
They were rightly concerned with whether my bleeding was normal and whether I was able to pee. How was breastfeeding going? But nobody asked if my nightmares and panic attacks had returned. Or why I struggled to let Zoë out of my sight.
My rage was explosive, and my tears never seemed to stop. I even thought about suicide often.
I was hypervigilant about who was near my daughter. I didn't even allow my daughter's father to change her diaper without me watching. Paranoia set in and I returned to the old habit of keeping a knife in the drawer next to my bed even though there was no real threat of danger. But somehow just the act of knowing it was there comforted me.
I also experienced anxiety and panic attacks which were triggered by the negative thoughts I was having. I was crying excessively — much more than I considered normal.
When I finally got the nerve to share this with my midwife, she labeled it as just anxiety and depression.
All mothers get a little anxious and the hormone shifts of pregnancy can trigger nightmares, my midwife said. There was no probing, no asking about my history but I knew I was dealing with a different kind of pain. So, I joined a postpartum support group, got myself a counselor, journaled excessively (if that’s even possible), and practiced yoga more than normal.
I must say I hid it well. I am a Black woman who grew up with the "Strong Black Woman" model. You hid your pain and did what needed to be done – survival was of utmost importance. I believed in the "Ride or Die" culture that said no matter how much pain you're in, you keep going.
So I taught yoga, tried to meditate, attempted to finish graduate training in trauma studies (it was a feeble attempt), completed my doula certification, and stayed in an abusive relationship. And even though I was struggling myself, I ran mom support groups, taught prenatal yoga classes, and continued emotionally supporting mothers during their pregnancies and births.
Until I couldn’t.
It would take until my daughter was 18 months old before I would get an official diagnosis of complex PTSD and later comorbid postpartum PTSD and depression.
We don’t talk about perinatal PTSD or comorbid postpartum PTSD with depression but we need to. Here is why.
In America, up to 45% of all mothers report experiencing birth trauma and the experience of birth trauma tends disproportionally affect the Black population.
And now with the overturning of Roe vs Wade, we can expect to see those rates go up.
We often forget that a woman experiencing an abortion is in and of itself an emotionally traumatic event — even though it's her choice. Now a woman can also be criminalized for making that choice.
Historical trauma such as sexual abuse and birth trauma is directly linked to postpartum PTSD, yet it isn’t normally screened for, and it often co-exists with postpartum depression, which makes symptoms like suicidal ideation even worse.
But the norm is for a woman to just be told she is just depressed, and her history — which is vital to an accurate diagnosis — is often rarely discussed in detail. It may be that she doesn’t feel safe sharing her history. But in reality, often nobody asks.
If you think you may have perinatal PTSD here's what to do:
1. Trust your intuition
Write all of it down. Journal your feelings your thoughts and symptoms and share this with your healthcare team. If they don’t hear you, keep talking. It’s important to be clear about your history and all of your symptoms.
2. Be radical about your self-care
This is what I believe saved my life. I did things like savoring a cup of tea, taking a walk outside even in the snow, meditating, and journaling my feelings.
3. Create a support team that listens
Listening is different from hearing. Research shows that when a person can talk freely about a traumatic event past or present, they move into what science calls "perinatal posttraumatic growth" because they can make sense of what happened to them.
4. Write through it
Expressive writing is a proven method to process traumatic events. The page is always a safe place to bear your soul. And this act of being your own witness can transform the painful experience into growth.
I lived for 3 years not knowing I was suffering from postpartum PTSD.
Looking back, it was my self-advocacy that made all the difference. I knew what was happening in my mind and my body, yet it was dismissed because it didn’t fit the standard model. Perinatal PTSD affects your entire life, and it interferes with your ability to connect with your child.
I’m grateful I had the self-knowledge and awareness to advocate for myself and my daughter and create a village of support that helped me heal. Once I did I was able to overcome and connect with my daughter in a way I could have never imagined and this made the fight worth it.
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Danielle Jernigan, MS, is a former medical scientist turned doula, writer, and trauma-informed book coach. Her work is dedicated to helping Black mothers who have experienced complex trauma heal through writing and publishing those stories to share with the world.