by Karen Kleiman
1) Choose the doctor you are most comfortable with, whether it's your Obstetrician, Pediatrician or Family doctor. Select the doctor you feel you can trust and who is least likely to dismiss your concerns. Most women wait longer than they should to let their doctor know how they are feeling. The longer you wait, the longer it will take to feel better. Let your doctor know as soon as you become worried about the way you are feeling.
2) Get information about PPD (postpartum depression). Learn about it so you can be adequately informed and ask the questions you need to ask. Do not be afraid to talk about your feelings. Be as specific as possible. Write down your symptoms, your questions and your concerns so you don't forget to mention anything. Bring the list to the office with you. Be sure to mention any previous experience with depression/anxiety.
3) Make sure your doctor knows how bad you are feeling. If some things are hard to talk about, try anyway. Let your doctor know if you are having scary thoughts or symptoms that are frightening you. These are symptoms, not reflections of your ability to be a good mother. Good mothers feel bad, too.
4) Do not let your fears of what they will think stop you from saying what you need to say. You will not be labeled "crazy" or a "bad mother." Do not overburden yourself with the pressure of trying to "look good" or keep up appearances. It might feel better in the short run, but it will interfere with your recovery and may prevent you from getting the proper assistance.
5) Ask your doctor to check your thyroid functioning and do a complete blood count so you can rule out any physical factors contributing to your symptoms.
6) If your doctor suggests antidepressant medication, make sure and take the time to ask all your questions. Do not hesitate to ask any and ALL questions you have, no matter how "silly" you think they may be. This is your body and you have a right to ask all questions before you make the decision to take the medication. Also make sure you make a follow up appointment with this doctor so s/he can monitor your adjustment to the meds. If you are breastfeeding, keep in mind that all medications are excreted through the breast milk, but many antidepressants have been studied and determined to be compatible with breastfeeding. Make sure your doctor is well informed and discuss all of your concerns before you decide what is best for you and your baby.
7) Ask for a referral to a good therapist who can help support you during this difficult transition.
8) If for ANY reason, you feel your concerns are being minimized, or not taken seriously or judged or casually disregarded, you are not in the right place. You can let your doctor know this directly, or you can simply ask for a referral to another doctor who is better able to meet the needs of postpartum women. It's essential that you be taken care of by a physician who understands and treats the complex needs of postpartum women with compassion. You are entitled to this and it will feel comforting when you find it.
9) If it would be helpful, ask your partner or a friend to accompany you for further support. This can be a good way to double check the information you're getting and help you clarify things later, since there may be a lot of information at one time.
10) Remember that even though it's hard to do when you are feeling bad, YOU need to advocate for your best health care. YOU need to be clear about what you need and determine whether those needs are being met or not. You have the right to expect your doctor to be informed and supportive. You also have the right to be an active participant in your healthcare and treatment plan.
Karen Kleiman, MSW, Licensed, Clinical Social Worker, co-author of This Isn't What I Expected: Overcoming Postpartum Depression and author of The Postpartum Husband: Practical Solutions for Living with Postpartum Depression, has been working with women and their families for over 20 years. A native of Saint Louis, MO., Karen has lived in the Philadelphia area since 1982 with her two children and her husband. After graduating in 1980 from the University of Illinois at Chicago with her Masters in Social Work, she began her practice as a psychotherapist, specializing in women's issues. In 1988 she founded The Postpartum Stress Center where she provides treatment for prenatal and postpartum depression and anxiety.
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