BOSTON —   “Keynahore poo-poo-poo”. Traditionally, Jewish women have heard this response throughout their pregnancies whenever they talk about their expectant babies. During pregnancy, Jewish women are discouraged from having baby showers and from making major baby purchases because “G-d forbid something should happen.” It is expected that once a Jewish woman gets through her pregnancy and delivers a healthy baby with ten fingers and ten toes, she can then sit back, relax and bond with her new bundle of joy.

Unfortunately, this foregone conclusion about the blissful postpartum period is not a reality for between 10 to 15 percent of all postpartum women, both Jewish and gentile. For these women their reality is postpartum depression (PPD). PPD can occur any time during the first postpartum year but is more common in the first few months. PPD can be exhibited by tearfulness, insomnia, agitation, sadness, hopelessness, intrusive negative thoughts, panic attacks, guilt, low energy and loss of appetite. These symptoms directly impact a woman’s ability to care for and bond with her new baby. Often, a woman does not recognize these symptoms as PPD and instead either believes she is suffering from something physical or that these feelings will “just go away”. When she does seek help, she is often misdiagnosed by her closest health care providers.

Just ask Susan Kushner Resnick, the Sharon author of “Sleepless Days: One Woman’s Journey Through Postpartum Depression.” Resnick experienced anxiety and sleeplessness for four months after the delivery of her second baby. She was fearful of being alone with her kids and felt numb instead of joyful. Her symptoms became so bad that she began to worry that she would become suicidal if she couldn’t find help. Unfortunately, her symptoms were misdiagnosed by her then primary care physician who told her that she was suffering from “housewife’s anxiety” and should therefore take a vacation. At four months postpartum, she confided in a lactation consultant who happened to recognize that she was experiencing severe PPD and referred her to a specially trained therapist who got her on the road to recovery.

In my own experience, I felt an unabating adrenaline rush going through my body, which began shortly after delivering my baby. My heart was racing and I could not sit still. I could not eat or sleep. Worse yet, I could not hold my new baby without crying. Convinced there was something wrong with my hormones, I called my obstetrician daily. I begged for a high-tech test that would identify what was wrong with me. My obstetrician was at a loss. I also begged for a sleeping pill but she told me that I needed to stay alert because my baby needed to feed every few hours. When I took my baby to the pediatrician for his first week well-baby visit, I wanted to ask the staff for help but I felt like they were only concerned with how my baby was doing and would not be able to help me. Through my own research, I discovered the Massachusetts Warmline of Postpartum Support International and was connected with a clinical nurse specialist who specializes in PPD. Through medication, talk therapy and good social support, I recovered in time.

A Danvers woman who prefers not to be identified described her difficulty recognizing that she had PPD after the birth of her first baby. “When my son was a newborn, he had such horrible acid reflux that I was constantly calling the pediatrician. I felt anxious, irritable and angry with anyone who tried to help.” She went on to explain that once her baby’s reflux was resolved she couldn’t understand why she still felt so badly. “It took a while but I soon realized that there was something really wrong with me.” Fortunately, her primary care physician recognized that the Danvers woman had symptoms of PPD and prescribed and followed her on an anti-depressant.

House bill 3897, An Act Relative to Postpartum Depression received a public hearing on Wednesday, January 27, 2010 before the Committee on Financial Services. Experts in the fields of child development, women’s mental health and pediatrics all testified to the importance of early detection and treatment of PPD and other emotional disorders during pregnancy and the postpartum period. They agree that left untreated, mood disorders during pregnancy and the postpartum period can have serious consequences to the baby including miscarriage, pre-term birth, difficulty bonding and caring for the baby, abuse and neglect. Four survivors of PPD also testified.

This bill, sponsored by Rep. Ellen Story of Amherst, calls for universal routine mental health screening of all pregnant and postpartum women. The legislation calls on obstetricians, midwives, pediatricians and primary care providers to learn more about detecting emotional disorders in pregnant and postpartum women with a simple, low-cost self-screening tool. Once a woman is deemed at risk, a well-informed provider can discuss treatment options and make a referral to a specially trained mental health professional who can provide further evaluation and treatment.

The Center for Early Relationship Support at Jewish Family & Children’s Service of Greater Boston (in Waltham) has a model therapeutic program for women suffering from PPD. The program offers clinical intervention during home visitation by specially trained psychotherapists. The program also offers a weekly PPD support group. For more information about these services and more call JF&CS at 781-693-5652.

For more information about PPD and other emotional disorders related to childbirth visit Postpartum Support International at http://www.postpartum.net. For resources on the North Shore visit http://www.northshorepostpartumhelp.org. To learn more about the PPD bill in Massachusetts email (JavaScript must be enabled to view this email address)

Lisa Waxman, LICSW is a survivor of PPD, a Massachusetts co-coordinator of Postpartum Support International and the family advocate of North Shore Postpartum Help. She is also a board member of the North Suburban JCC in Peabody.