2023-10-21 04:00:00
Affecting thousands of parents each year, postpartum depression is still a taboo and shameful illness which has caused several family tragedies and left around ten orphans over the past 10 years in Quebec.
• Read also: Fathers “saved” by their baby after the death of their partner
• Read also: “I was a carcass empty of emotions”, testifies a mother
“I told myself that it just happens to other people,” admits Alicia Doyon, who is recovering from serious postpartum depression that she never saw coming. I was going into the river with my baby. […] I was very disconnected.”
Even though the birth of a baby is one of the most beautiful moments in the life of any parent, the adaptation does not always go as planned. About a quarter of mothers and 10% of fathers are affected by postpartum depression each year in Quebec, a still taboo and little-known medical problem that leads many into a dark spiral.
Moreover, mental health problems in the perinatal period cost $1.5 billion per year in Quebec (absenteeism, hospitalization, impacts on the baby, etc.), estimates a group of doctors and specialized groups in a letter sent to the government last April.
“The dangers of postpartum are really trivialized,” laments a Montrealer whose ex-partner committed suicide in 2017.
“I don’t understand how a society can abandon women and children like that in their moment of extreme vulnerability. It’s a little beyond me.”
A dozen orphans
Over the past 10 years, the Coroner’s Office has recorded eight cases of suicide among mothers experiencing postpartum depression. One of them even killed her baby before ending her life.
Around ten children are now orphans. Other recent cases could even be added (2022), since the reports are completed more than a year after the death.
“It’s so sad, we say to ourselves: the system has escaped,” reacts Marie-Claude Dufour, general director of the Network of Perinatal Resource Centers of Quebec, each time. We failed to help this person in distress. […] It hits our hearts, we still have a long way to go.”
Marie-Claude Dufour, general director of the Network of Perinatal Resource Centers of Quebec in Lévis. Photo Stevens LeBlanc, Journal de Québec / QMI Agency
Moreover, the number of suicides linked to postpartum is probably higher, believes Valérie Samson, nursing consultant in maternal-fetal medicine, at Sainte-Justine hospital.
“I wouldn’t be surprised if there were more. But there hasn’t really been any monitoring in this regard because we have to make the link between a severe mental health problem in the postnatal period and suicide,” she emphasizes.
“People still have a hard time thinking that a mother can voluntarily end her life, when she is supposed to be living her most beautiful moments.”
Shame, lack of access to services, ignorance of symptoms: there are all sorts of reasons why parents don’t get help. The signs appear in the months following childbirth (up to two years), but also often during pregnancy.
Symptoms of postpartum depression
Fatigue Deep sadness Crying Anxiety Insomnia Hypervigilance Disinterest in one’s child Obsessions Irritability Isolation Suicidal thoughts
Certain factors increase the risk of suffering from it
Past mental health problems (depression or anxiety) Recent stressful events Family instability (violence, poverty) Difficulty breastfeeding
“It’s like a defeat,” summarizes Ms. Samson.. The gap between the reality they experienced and the one they had imagined is enough to create great distress.”
Moreover, many women who have always succeeded in everything in their lives until the arrival of the baby are affected by depression.
“Mothers are ashamed when they come to us because they think things should be fine. They feel judged by those around them,” laments Ms. Dufour.
According to coroner’s records, several of the mothers who committed suicide sought psychological help, but it clearly wasn’t enough.
“She didn’t feel followed at all or helped,” says Matthew Lalonde-Therrien, whose ex-partner committed suicide in 2016, when their baby was nine months old.
These deaths inevitably cause tragedies in the family, first and foremost the bereaved father who finds himself with a baby to take care of.
Escape from the hospital
In 2017, a 33-year-old woman who was hospitalized in a psychiatric ward in Sainte-Justine even managed to leave her room to do the irreparable.
“The disappointment linked to the cesarean section, the guilt felt by the failure of breastfeeding often leading to a feeling of maternal incompetence in addition to the extreme fatigue felt in the perinatal period […] as well as anxiety secondary to her monetary concerns are all elements that may have contributed to causing postpartum depression,” wrote coroner Lyne Chouinard in a 2016 report.
TESTIMONIALS
The Network of Perinatal Resource Centers of Quebec collected various testimonies last summer which show that the stigma surrounding postpartum is still very real. Here are a few
“I found that my doctor was very lacking in sensitivity towards me during my pregnancy when I was very depressed, I had suicidal thoughts and I ate little.” “When parents struggling with mental health issues talk about it, some still think having a baby should be all rosy.” “It’s not frowned upon to experience mental health issues during the perinatal period, because it’s supposed to be such a beautiful time that parents don’t have the right to be exhausted.” “The concept of performance has been very strong in recent years. Often, parents impose this pressure on themselves and social networks help to spread it.” “It’s normal to be tired”
Furthermore, several mothers also deplore having difficulty obtaining help from health professionals, and are told banalities like: “It’s going to be fine” or “it’s normal to be tired.”
“Not everyone has the know-how to welcome suffering and pain. They are overwhelmed, there are plenty of excuses,” underlines Ms. Dufour, who believes that the training of health professionals must be improved to ensure better management of mental health.
Currently, the health network provides for a home visit from a nurse a few days after discharge from hospital. The mother should also see a doctor for a physical examination two months after delivery. No other follow-up is offered immediately.
“It’s definitely not enough,” reacts Dr. Tuong-Vi Nguyen, a psychiatrist specializing in perinatal care at the McGill University Health Center.
“There should be perinatal mental health services in Quebec in a different system, which can respond flexibly and more quickly.”
Next Monday, Minister for Social Services Lionel Carmant will announce $5 million per year in mental health assistance for new parents. Among the measures, home visits and postnatal calls will be increased, we learned The newspaper. The minister refused our request for an interview before the official announcement.
Since the pandemic, anxiety and isolation have also contributed to more distress, note several doctors. The pressure from social networks is also strong for many parents.
“We don’t see the images of the mother crying because she is exhausted from not sleeping. But we will see the lady well put together with her children dressed in white. Who do this? It’s a scourge, and it certainly contributes to a biased image of motherhood,” underlines Ms. Samson.
Listen to the interview with Alicia Doyon, a 33-year-old mother who suffered from postpartum depression, on Sophie Durocher’s show via QUB radio :
No miracle pill
Recently, the United States announced the arrival on the market of a new pill specifically for postpartum. Although he welcomes this new medication, a psychiatrist from Sainte-Justine believes that more investment is needed in information and education for parents.
“We must certainly not think that it is the magic bulletthat it will be the panacea and that it will solve everything,” underlines Dr. Martin St-André, head of the perinatal psychiatry clinic in Sainte-Justine.
Last April, a group of doctors and groups specializing in perinatal care wrote to Minister Lionel Carmant to ask for better services for parents. Among other things, we would like to see the creation of a provincial mental health screening and referral protocol for the perinatal period and for this to be recognized as a priority medical activity.
Despite everything, health professionals have noted an improvement in postpartum care in recent years.
“We can rejoice at the progress, we must not just focus on the glass being half empty,” assures Dr. St-André. There is a lot of work that is being done.”
Moreover, Sainte-Justine hospital set up the Grande Ourse kit for new parents last year. Advocating kindness and self-compassion, the document helps you take better care of your own mental health during pregnancy and after childbirth.
“It changed the journey of our patients,” rejoices Valérie Samson. There is a lack of knowledge about the resources available, sometimes it’s surprising.”
Already, the project is growing and other hospitals are sharing the tool on their site.
“As a society, we have a role to play, because trivializing difficult emotions is contributing to parents’ guilt over what emotions they may experience,” she believes.
Where to ask for help? At the psychosocial reception of your CLSC In the emergency room of a hospital With a family doctor In a community perinatal center Tel-Aide: 514-935-1101 Info Social: 811 Community and social resources: 211
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