August 5, 2007

Ann Dunnewold, Ph.D, author of Postpartum Survival Guide, joins our conversation!

I've had quite the response from my last two posts that hit on the emotionally-charged issue of taking anti-depressants while pregnant and/or breastfeeding. Every comment has been great and I really appreciate the personal stories and thoughts that have been shared.

I was especially thrilled to see a comment today from Ann Dunnewold! Ann is a psychologist and nationally-renowned expert on postpartum depression. Of her several books on the topic, my favorite is "Postpartum Survival Guide." Her latest book, "Even June Cleaver Would Forget the Juice Box," provides solutions to the "mommy madness" that tends to pervade our lives as we feel pressured to aspire to perfect mommyhood.

On that note, her comment is awesome:

"I am so glad you brave women are talking about these issues. We need more honesty among women that this decision is hard--and that pregnancy or postpartum is not always a glowing Hallmark card experience.

"The official professional position is that a comprehensive "risk-benefit analysis" is necessary, because there is no "Right Answer". This means weighing the possible effects on the mother and baby of either choice —medication or doing without. There are documented serious negative effects of not treating depression and anxiety during pregnancy, including low birth weight. Over the twenty years that I have worked with postpartum moms, information has changed as research and drugs continue to evolve. Responsible, caring healthcare providers are usually glad to look at the issues for any individual’s case. If not, get a second opinion.

"For the facts about meds during breastfeeding, one of the key experts is Dr. Thomas Hale, who has a website at and is the author of a great resource, Medications and Mother's Milk. Dr. Hale is VERY reassuring, feeling most meds are safe--but he is addressing breastfeeding, not pregnancy.

"The most important point in the posts here that I want to re-emphasize is that women need to stop judging each other. Society as a whole is hard enough on us, setting up perfectionist, unreachable standards for mothers. We need to keep in mind the absolute truth, for the majority of women: that we are all doing the best we can do. No woman I have ever seen in my office takes medication for fun. Women take them to function.

"We need to support, not criticize, each other's choices—and know that there as many valid choices as there are women in the world. Trust that you have made the best decision for you, given available info at this point in time. Don’t second guess or torment yourself with “what ifs” once you have decided."

Thank you so much, Ann, for taking the time to visit my blog and to share your valuable insight with us. You're the best!!!


Girl Detective said...

"The most important point in the posts here that I want to re-emphasize is that women need to stop judging each other. Society as a whole is hard enough on us, setting up perfectionist, unreachable standards for mothers. We need to keep in mind the absolute truth, for the majority of women: that we are all doing the best we can do."

I love this statement, because it encapsulates so much of what I strive for in life, and try to communicate on my blog.

After my 6wk check, my OB referred me to a psychotherapist when I said I was feeling angry all the time. Together, they started me on Zoloft, the safest AD since I was BF. I started at the lowest dose, and as I moved up and didn't see sustained improvement, they referred me to a psychiatrist to manage my meds. The three of them worked with me to get me into a day hospital program, and to make the switch first to Prozac, as I was in the process of weaning, and then to a mood stabilizer once weaning was achieved. I did my own internet research to back up what I discussed with them, and felt medication was the best thing for me, and by extension for my family. I also took a big leap and decided to trust them and not spend a great deal of time second guessing--they're the experienced caregivers. I decided to do enough research to be well informed, but not so much that I'd freak out over the many mixed messages.

Long comment, but the upshot is that my docs recommended meds during breastfeeding, I took them, and together with therapy and a vacation, they have made a significant positive difference in the lives of my family.

Kristin said...

Thanks, Girl Detective, for your awesome comment! I'm in awe of how well you advocated for yourself and got through your ordeal so successfully. What a great story of empowerment.


passing as myself said...

This discussion continues to be enlightening and empowering!

As one of my own recent, and horrible, experiences with a doctor can attest to, not all caregivers are as informed and understanding as they could be.

If you're not getting the help you need, keep looking! You and your children deserve the best.

Kristin said...

You're totally on target with that one! One thing I think we often lose sight of is the fact that we're the ones who have "hired" our doctor -- and we can just as easily fire them when necessary.

Anonymous said...

I just wanted to say thanks to Ann Dunnewold. When I had my first daughter and PPD in 1999, there were only a couple of books on PPD out there for lay people. My older daughter was really collicky and either screamed or nursed 23 / 7, I had at that point no friends who stayed home with kids who could help out and no family nearby, I was in pain from C-section and breastfeeding, I was so tired it really wasn't safe for me to drive, I needed 5 pillows and a nursing stool to nurse and then still had to expose my breast to get baby to latch on correctliy etc. While the other book said stuff like "go get a manicure [not so relaxing with a screaming, squirming baby on your lap]"; "go to lunch with friends [what friends? who would drive me? where could we go where screaming baby or topless nursing would be acceptable?]", "let your husband care for the baby and take a long bath [but what to do when he brought the baby, who'd only slept for 5 minutes off the breast before she realized she'd been tricked, woke up screaming, and convinced hubby that she needed to eat again?"]. Instead it acknowledged how hard taking care of a new baby, and how impossibly hard taking care of certain new babies under circumstances, could be. So some of the suggestions were more practical (including quick summaries of the chapter for the mom with just a minute to skim), and even when they were still too much to follow, at least I didn't feel this disconnect between my reality and the all of the recommendations I was receiving. So, thank you, Ann.