Blog post

Postpartum Depression after Miscarriage

May 20, 2018

Mothers who have given birth in the first or second trimester are not immune to postpartum depression because the length of their pregnancy was shorter than desired.

According to the National Institute of Mental Health, indicators of Postpartum Depression (PPD) can include:

  • Feeling sad, hopeless, empty, or overwhelmed

  • Crying more often than usual or for no apparent reason
  • Worrying or feeling overly anxious
  • Feeling moody, irritable, or restless
  • Oversleeping, or being unable to sleep
  • Having trouble concentrating, remembering details, and making decisions
  • Experiencing anger or rage
  • Losing interest in activities that are usually enjoyable
  • Suffering from physical aches and pains, including frequent headaches, stomach problems, and muscle pain
  • Eating too little or too much
  • Withdrawing from or avoiding friends and family
  • Having trouble bonding with her baby **
  • Persistently doubting her ability (to be a mother)
  • Thinking about harming herself

**I added the asterisks for clarification, because while attachment is reciprocal, bonding isn’t.  What I mean is a parent can (and should be provided an opportunity to) bond with their baby who isn’t alive.

Increasingly, information, screening and resources for postpartum depression are accessible to mothers who have given birth in the third trimester, live birth outcomes.  Though this is only a start and a far cry from adequate support for such mothers, the message is resonating:

“I’ve just had a baby.  My body is doing all kinds of hormonal and physiological gymnastics.  This means that sometimes not everything lands on its feet but instead I can feel like I’m crashing down.  There is help for me.”

So, for just a moment, let’s back up, to define postpartum:

Postpartum: Following Childbirth

First and second-trimester moms, you can find yourself in that statement.

Bereavement

You may have heard of the more recent “bereavement exclusion” within the diagnosis of major depression.   Dr. Pies, writing for the National Center for Biotechnology Information, does a fair job of considering the pros and cons in this decision.  He writes, “Though bereavement-related grief and major depression share some features, they are distinct and distinguishable conditions. Recognizing major depression in the context of recent bereavement takes careful clinical judgment.”

Major depression and postpartum depression are not synonymous, but I include his quote here to start to draw a picture.  Bringing postpartum depression and bereavement together into the context of the newly postpartum mother who has given birth in the first or second trimester is an important, though neglected issue.

Related: The Absent-Minded Griever: Distracted After Loss

When Postpartum Depression & Bereavement Meet

Most of us in the healing community strive to bring awareness to parental in so doing, actually serve to normalize grief.  We mothers who have labored and given birth to our babies not alive, through the course of childbirth, have had more physical contact with a person who isn’t alive than the majority in our culture.  When my loved ones tell me not to hold my baby after birth, it is as if to tell me that my baby is dirty because he is not alive.  Similarly, when my loved ones tell me to put my feelings down, to put my relationship with my baby away, it reiterates this sense that my instinctual motherhood is bad and that I am wrong.  The work of resources like Still Standing is to proclaim the truth that we are mothers, our perspectives matter, our experiences are important and our babies count.  A person can find meaningful ways of integrating an ever changing bereavement through the very llong-termcourse of their lifespan.

Bereavement is defined as the internal workings of grief connecting to the outward demonstration of mourning.  Bereavement is not just a feeling, but requires attention to the person’s holistic, physiological, psychosocial wellness.

Postpartum depression isn’t just feeling blue or seeming a little moody.  While it is under the umbrella of a mood disorder, it is certainly more than a mood – it has deep, psychological roots that must be cared for.  Depression under any of its names is something that can erode a person’s wellness and is something within our control to receive treatment and relief from.

Do You Have Postpartum Depression, Bereavement or Both

“I feel like I must be going crazy, but that’s actually more normal than I thought.  It is my body’s reaction to all I’ve just been through and am going through.”

While the prospect of contending with a mood disorder can be frightening, for some the notion is actually very empowering.  Because PPD means that it connects the mother to birth, to the reality of her child.  This can be very validating in the early days postpartum.  But it is bereavement, not depression, that has the possibility of a healthy long term component.  Because while PPD may connect the mother to the birth of her child, bereavement is one dialect of the language of long term love.

So how does a mom who has given birth in the first trimester know where things might move between bereavement and postpartum depression?
And how does she get the help she is worthy to receive?

The answers are even more complicated than the mix of bereavement and postpartum depression.  These are just two results of a mother giving birth, and are only very superficially touched on.

It is my hope that we can all begin to have the conversation: within ourselves, with our loved ones, with our trusted healthcare providers, and if we’d be so brave, with each other.

For more resources on this subject, stillbirthday provides resources to families prior to and during childbirth, and immediately postpartum, in all trimesters.




  • Heidi Faith

    Heidi Faith is the founder of stillbirthday and its headquarters The M0M Center. Stillbirthday is the developer of the Birth & Bereavement Doula® certification and free, printable birth plans for mothers experiencing birth in any trimester, because a pregnancy loss is still a birth, and is still a birthday.

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