did get the treatment I needed,” she recalls, “I got
really angry that nobody was talking about it [PPD],
and nobody asked me how I was doing. Even when
I had described my symptoms, nobody was able to
tell me what it was that was happening.”
As wonderful as day programs are, they can be
prohibitively expensive, and most insurance carri-
ers will not reimburse for it. Nor will they pay for
drugs to treat postpartum depression: just last
week, the first FDA-approved treatment for PPD
was announced, with a price tag of $30,000.
“Health insurance companies sadly don’t value
women’s mental health. It’s been a real uphill bat-
tle,” Bellenbaum says. “There’s a lot of work that
needs to be done around bringing costs down.”
Thanks to people like Bellenbaum, who spear-
headed legislation around PPD screening in New
York State, awareness of maternal mental health
is on the rise, and treatment clinics are slowly be-
ginning to appear around the country. But the
screening procedures remain woefully inadequate.
Most prenatal clinics administer a questionnaire
designed to identify at-risk women sometime
during the first trimester and then again at the
six-week postpartum visit.
But for many women, these check-ins come
either too early or too late. And even the best-in-
tentioned providers can make women feel inade-
quate: At my six-week visit, the doctor took one
look at my daughter and cooed, “Aren’t you just
so in love with this little bundle?” I looked her in
the eye and pronounced an emphatic no. Need-
less to say, she looked terribly uncomfortable.
She had me fill out the questionnaire, perused my
responses and eyed me with concern: “Oh, you’re
going to score pretty high on the depression
scale.” No shit, I thought to myself.
The most commonly used screen is the Edin-
burgh Postnatal Depression Scale. Although it
does include questions about anxiety, it’s mostly
focused on depression.
“There’s a desperate need for measures to
screen for perinatal anxiety disorders,” Fairbrother
says. “It’s going to be really tricky to treat if we
don’t have screens.”
What’s more, screening without an increase in
awareness and education is just not going to cut it.
More and more women are getting screened, but
they may lie because of a reluctance to admit
they’re having thoughts of self-harm or of harming
their baby. Providers can also be part of the prob-
lem: “I’ve heard stories of nurses taking screens
before a women is discharged from the hospital
and saying: ‘I really think you should fill this out
again,’” says Bellenbaum. “If I give this to the doctor,
they’re not going to let you go home with the baby.”
I eventually found my stride with my daughter
and am beginning to imagine a world where the
two of us can live happily side by side. I can’t state
with any certainty whether it was the medication,
therapy or just time that began the healing pro-
cess—most likely it was some combination of the
three (and it doesn’t hurt that my daughter started
to smile and coo right around the time I was all but
ready to give up). What I do know with certainty is
that motherhood is hard, and no one should be
made to feel isolated and inadequate for having
feelings that are so devastatingly commonplace.OPINION