An Uncertain Darkness: Pregnancy After Postpartum Depression
Somewhere several months into my second pregnancy, I ordered and began to read a book titled, “What am I Thinking: Having a Baby After Postpartum Depression” by Karen Kleiman. It’s a valid and sobering question for the mother recovering from PPD, one I had to grapple with during the thick of my illness and in the settling aftermath as we riskily pursued another pregnancy.
Whether to face another “fourth trimester” after depression is a very individual and personal decision, and there is no one “right way” to proceed. In my case I knew, even in the midst of my depression’s hellish brunt, that this was somehow all worth it. I found that I could cope in those early days by affirming that our daughter, as a new, living, awe-inspiring human, was worth whatever temporary emotional struggles I was facing for bringing her here… and that another child would be equally worthy.
I also always knew that I wanted more than one child. I felt like PPD had stolen so much from me already and, in a rather stubborn sense, I refused to let it also take the hope of further growing our family in the future. So I honestly never entertained the thought of stopping after my first baby. Some women can’t and won’t gamble with their mental health in this way based on their own experiences and recovery, and that is the best and bravest path forward for them. But despite my depression, we chose, with no prophetic sight to guide us, to feel our way through life’s uncertain darkness by inviting more life into this world through my broken body.
For a woman who has experienced a postnatal mood disorder, there is a 50% chance that she could relapse in subsequent pregnancies. Choosing to conceive again, we suspended a weighty coin toss over our lives with no assurance of how things would land. I’m a very fearful person naturally, so I should have been paralyzed and racked with fear at the prospect of another depressive episode, something I would never choose for myself or wish on literally anyone. So really, what was I thinking?
Overall, I had peace with the decision to conceive again, even though you could classify my case of depression as “severe,” and even though, against the aforementioned book’s recommendations, I wasn’t 100% recovered from my first episode before getting pregnant again. (In fact, I’m still not totally recovered from it; I don’t know if a person ever fully returns to their old skin after something like that. You kind of arrive at a new normal, and continue to heal in slow, small ways everyday after that).
Perhaps that peace was a providential installment, much like the inexplicable perspective I had during my brief bout with cancer in college. (To appreciate what a miracle that was, you should know that a person with a long-standing cancer phobia actually developed cancer. Hello, Worst-Nightmare-Coming-True). I knew PPD could happen again, but I was determined to try being hopeful for a change.
I also soberly realized that hope might drop out from beneath me at any moment. A key part of my therapy for anxiety and depression focused on acceptance. I had to accept my despair and darkness as a burden that God, for whatever reason, asked me to carry for the last two years. And in my efforts to continue submitting to that heavy load, I put myself in a place where He could foist it back into my hands again, imperfectly trusting that He’d somehow help me to bear it.
I also knew that a different person would be facing this illness if it decided to come back for more; a person weathered but more calloused to its stings; a person who knows now that the disorienting thick of postpartum depression is in fact temporary (something you literally cannot believe in the midst of it); a person armed with months of therapy and new knowledge about this serious but survivable ordeal. I was humbly hoping that, even if it happened again, my previous fight with this old foe would equip me to rally in the next round.
And so the big question looming over all of this backstory and speculation: Did it happen? Is it happening right now? Knowing about my history, many of you dear friends have asked how I’m doing, usually with a pointed and compassionate clarification that you mean mentally as well as generally. And I am actually so, so thankful for those questions. They tell me that the secrecy and delicate silence surrounding this rather common illness is losing its hold on us culturally. They assure me that my community is keeping a watchful eye on its members and that we are feeling brave enough to ask a new mother how she is doing… really doing… and opening ourselves up to whatever raw, uncomfortable answer she might lay out before us. Thank God for you all.
Postpartum Depression can occur at any time during the two years following a pregnancy, so I’ve been prayerfully and cautiously optimistic when I answer that, at several weeks out, I’m doing really well. In fact, I’m experiencing my second bout with motherhood much as I expected to experience the first. I’m tired, frazzled, and stretched in a dozen directions, but joyful… and that’s just normal. And, oh, how I desperately wanted normal in the black aftermath of my first birth. Like I wrote above, I’m still not 100% recovered in the broadest sense of the word, and some of my usual anxieties have flared a little after this recent birth. But these days I’m functional and coping and, as a gift of grace from God, I’m happy. And that’s more than enough to be thankful for.
