​These are my sad stones. I found them at the beach one day, when I felt the need to venture away from my home and my problems and spend time collecting my thoughts and just feeling free for a while. I had been crying daily, hit by a sadness I couldn’t even explain. It was a terrible time for me, and while I knew I should reach out to a professional for help, everything just felt too overwhelming. With a family of busy children, a nursing baby, and all that was expected of me, I couldn’t fathom finding someone to call from a random list of names, figuring out if my insurance would cover expenses, and taking the time to travel and sit with a therapist, pouring out my sadness…which I already didn’t have the energy to engage. There was just too much I already had to do, and I didn’t have the resources within me to do this for myself.
 
When I trained as a doula, many years before I ever experienced a perinatal mood disorder, I learned depression in pregnancy is more common than postpartum depression. This surprised me, and it took many years before I heard Birdie Gunyon Meyer, RN, MA, CLC, give the exact numbers: one in five women experience depression while pregnant, and one in seven experience postpartum depression. Dads can be affected as well – one in ten will experience depression before or after their child is born.
 
In my childbirth classes I often share we have ideas about how life will be after our baby is born. I liken it to a wall of decorative boxes where we have our existing activities and priorities. We expect to contain our new baby in the space we have carved out for him or her. The reality sets in, though, and suddenly we see that “baby space” has exploded, baby puke all over all the other boxes – everything smells faintly of sour milk, and we wonder, “Could this be right?” 

​Up to 80% of women experience Baby Blues. This is a short time of very strong emotions, tears, frustration, as we move into the role of being mothers. It is not supposed to last longer than two weeks – at that point, it is possible we have moved into a postpartum mood disorder. What can be confusing, though, is we often tell women to watch out for “depression,” for crying all the time, sadness, not getting out of bed, etc. We don’t often warn women there are other signs of something going on inside, and it may not look anything like depression.
                                                 
Pregnancy and birth is a time when hormones affect almost everything related to growing, having, and feeding a baby. Hormones affect our bodies, and they can also affect our minds. It makes sense to have emotional changes related to becoming a parent – as our bodies are prepared to grow, birth, and feed our new ones, emotional changes can help us prepare in other ways. There is a saying – worry is the work of pregnancy. Indeed, worrying can move us to action. If we are worried about birth, we can take a childbirth class or hire a doula. If we worry about how our babies will stay warm, we can gather clothes, blankets, a safe place for sleep, etc. Worry can help us be ready.
 
Many mood disorders are normal feelings that are working overtime. This is where anxiety, panic, or obsessive-compulsive thoughts and actions can appear. That doesn’t always come with crying all day or feeling sad. This can look like worrying something is wrong with your baby; needing to check on your baby while he or she is sleeping, counting baby’s breaths or heartrate, taking baby’s temperature; feeling overwhelmed about all the baby gear you must bring with you to leave the house and choosing, instead, to stay home. When these habits or behaviors interfere with the pastimes you used to enjoy, activities with friends and family, or needed tasks such as grocery shopping, it may be time to let your doctor know and ask for support.
 
Recently, because this is such a tender topic for me, I have set up a Postpartum Support International chapter for Kern County. PSI is an organization that provides resources for families dealing with mood disorders related to pregnancy and having a baby. Families can call for resources – therapists and groups that can help. They can call for information about mood disorders. They can also call just to talk to someone when they are feeling they need immediate support. If you are a professional who works with mothers and families dealing with perinatal mood disorders, please connect with me so you can be listed within the resource network of PSI of Kern County.
 
On PSI’s website it says this: “You are not alone. You are not to blame. With help, you will be well.” Reading this statement continues to bring tears to my eyes. It is valuable! We aren’t alone in this. We are not to be blamed. And we can, with help, be well.
 
I keep my sad stones in my kitchen window, to remember that time. As I picked each one up off the sand, they felt like heavy weights adding to my emotional burden. I held them, wet and cold, and wondered, how will I ever get through this? I did, though, with help and with patience, and I emerged feeling healthy and well on the other side. 

​I can look at them now for what they are – rocks. They are smooth to the touch, with tiny holes bored in them by sea creatures. Just rocks – nothing more, nothing less. But I remember, also, I was dealing with a real illness, and I don’t want to face that again. They remind me that if I end up there again, there is hope and there is help. And I don’t have to suffer alone. 

to recognize those amazing, top-level lactation professionals who have gone through the difficult steps to becoming International Board Certified Lactation Consultants. IBCLCs are at the forefront of breastfeeding difficulties -- or at least they should be. What seems to happen, though, is when breastfeeding problems arise in the early days after birth, many families turn to their doctors for breastfeeding help. It is natural to assume this provider who cared for you during pregnancy would have the skills to treat sore nipples or inadequate weight gain, right? 

​Liz is a friend of mine in medical school, and I am so glad she set her sights on becoming a doctor. I know she will do a world of good, absolutely A WORLD OF GOOD, because of her knowledge base and her passions. Liz gave a "Breastfeeding 101" presentation last weekend at Take Root: Red State Perspectives on Reproductive Justice conference. Spend 10 minutes watching this and you will gain understanding of why lactation knowledge is so lacking among our doctors, and why we should be shouting from the rooftops the value of IBCLC help and support. ​​

The last point in particular is one of interest to me: What if all residents received the same three-hour lactation education required by physicians when a hospital is working toward Baby-Friendly Hospital Status? That three hours could be a consistent way to provide lactation education to new doctors.

Three hours -- many of us would be happy if doctors received just three hours of education. Think about this: I just finished 90 hours of specific lactation education as I work toward becoming exam-eligible to get to IBCLC -- 90 hours! And there is something busy doctors out there can do to add to their skills in an easy, effective manner -- today, without even one minute of extra education: Get to know local IBCLCs, and refer to them often!