Background: Deb is married with a son aged 3 and a daughter aged 1. She is from an Anglo-Australian background. Deb is a student and lives in a regional town.
About Deb
While Deb enjoys being a mother, she experienced postnatal depression and suicidal thoughts after the birth of her second child. She is taking antidepressant medication for postnatal depression and consults a psychiatrist she is happy with. Deb receives good support from her husband, mother and wider family. She thinks it is important that women talk about their experiences.
> Experiences of health services during pregnancy, IVF and surrogacy - Deb described the challenges of choosing antenatal care in a small town
You can have private. You can go private and see an obstetrician. Or you could give birth in a public hospital in [town name] an hour and a half away. But what actually ended up happening was when we had private care and we were just going to do shared care. So we were just going to do the public system to give birth. And we ended up having our private anyway, because he was the one on call.
And I think being down here in [town name], you have a choice of three, or maybe four. One of them was supposed to retire. I'm not sure. Three obstetricians and that's it. And two of them are married, so husband and wife, and so it's really hard to find someone that you trust. You can go north, but then you have to go to [hospital name] Hospital and we didn't want to do that. [It's an hour away] and that's a big thing. That's where we went for the ultrasound and it's a whole day. It's a big experience to go, so we didn't want to go for that.
> Experiences of miscarriage - Deb thought women hid their experiences of miscarriage, and was amazed by the number of people who said they had experienced it after she talked about her own miscarriage
It was like when we had miscarriages you have to wait until you're 12 or 13 weeks before you tell anyone that you're pregnant. But when you find out that you've lost a baby, it's been a big secret and you can't tell anyone about it first. It's hard when people say, 'oh, when are you having another one'? And you're just sort of looking at them, thinking, 'well, I was going to and we lost it'. So it's sort of like it's hidden.
And what we found amazing was, when we had our miscarriages and we just spoke about it, that people would come in and they'd say, 'oh, that happened to me, that happened to me'. You know, nearly every person that you spoke to would say that they'd experienced it too. And I don't understand why it's a secret. I don't feel like that - I don't really feel you should be ashamed of anything with regards to, I guess, mental health or miscarriage - I don't think anything should really be a secret. I guess people don't want to feel embarrassed. I'm not sure. But we need to work against that. I don't think anyone should feel embarrassed.
> Caring for a baby - feeding and sleeping - Deb struggled to find support for breastfeeding at the regional hospital she gave birth at
And they didn't really offer to assist with breast feeding. It was really hard to get lactation help from them. And when we came home - I couldn't move while we were in the hospital [because of post-partum surgery]. So they would pass her to me and walk out, so I had to try and feed her while lying down. And that was really hard and when we came home I ended up with cracked nipples and she was vomiting blood and it was horrible. And I rang them up and I said, "Oh, can I speak to the lactation consultant?" And they asked me where I lived and then they said, "Oh, sorry, we can't help you. Bye". And hung up. And I was really shocked by that. I was really shocked that they would say that they just weren't going to do it.
I ended up ringing the family health nurse that works out of the town - next town across. And she came to our house and was really, really good. She was really helpful. But it was hard to find someone who would actually be willing to help, which is really odd.
I know that the hospital were expecting us to formula feed with both of them, with my son. They wanted us to formula feed with both kids. With my son, they were like, "Where are your bottles? It's time to give him a bottle". And we went, "We're not going to".
And that seems to be - not just from that hospital, but also from the [second hospital name] - that seems to be the experience for that. I know a girl, she was asleep and she woke up and her baby was gone and the nurse was giving it a bottle. She didn't even get a chance to breastfeed it. I guess they expect [bottle feeding] and then you don't get the support to breastfeed.
Surprisingly, the hospital's been the place where I've actually been criticised for breast feeding in public. There was a pregnant lady there and she asked me if I couldn't afford a bottle. And I was like, "What?" [laughs].
In the hospital there's posters [supporting breastfeeding], so it's really odd. And people are always surprised that we breastfeed - it's like it's generally expected that you'll formula feed.
> Experiences of health professionals in early parenthood - Deb lived in a regional area and found it very difficult to access help for breastfeeding
Then when we came home we had some issues with her, breastfeeding, and that was really hard to find support for that in our area, because we sort of dealt with the outpatient clinics.
I ended up with cracked nipples and she was vomiting blood and it was horrible. And I rang them up and I said, "Oh, can I speak to the lactation consultant? " And they asked me where I lived and then they said, "Oh, sorry, we can't help you. Bye". And hung up. And I was really shocked by that. I was really shocked that they would say that they just weren't going to do it.
And ended up ringing - there's like the family health nurse that works out of the town - next town across. And she came to our house and was really, really good. She was really helpful. But it was hard to find someone who would actually be willing to help, which is really odd. Yeah, I don't know what I would do if I had another child.
> Understanding antenatal and postnatal depression - Deb felt her postnatal depression was related to her second baby vomiting constantly, as well as her decision to start a university course
Then when we came home we had some issues with breastfeeding, and that was really hard to find support for that in our area, because we sort of dealt with the outpatient clinics. And [laughs] she was vomiting. She still vomits, but she basically threw up all day, every day, projectile vomiting. And then it was really hard to try and find out a diagnosis for her. Basically it got to the point where paediatricians just said, "Oh, we'll just wait for it to stop. We'll just wait for her to get bigger". So, yeah, that was really tough. It was really hard.
I think the experience of being so sick and I ended up having to have three blood transfusions in the hospital after she was born, and I think that was what made it hard this time to bond with her. Because it was completely different with my son. It was just the complete opposite experience. And - I'm doing uni now, which I wasn't doing when he was born. But that felt like that was something which was - because by distance, that was something which was good to do - it was nice to do that. But, with the second one, it's harder to manage your time better, especially when they need to be held upright for 24 hours a day. But, we got there.
[Before we had children] we lived in a little, one-bedroom flat. It was really green [laughs]. Everything was green. The walls were green. The floors were green. We had a routine before we had our son and then I guess it just continued on and it was just a big shock to the system to have a baby [our second] that was so in need. She needed to be held constantly and we have an ergo carrier and basically someone had to be wearing her or holding her, because she was vomiting. And that was really stressful. That was really, really stressful to be constantly covered in spew [laughs].
Like, I didn't want to kill my daughter, but I also didn't want to have to hold her constantly.
> Understanding antenatal and postnatal depression - Deb felt that a lot of informal knowledge about mothering or parenting had been lost due to becoming 'isolated' from extended family
In an absolutely ideal world, I think it would be excellent if you could go to a circle of women - and you could say, this is what's happening, and they could help you to figure it out. I think we've become so isolated from our aunts and our grandmothers and I think that the best thing has been to turn around and to ask my aunts and my grandmother and even like some of my mum's friends to get an experience off them. And, I don't have to follow everyone's advice, but I can take what I want from their advice.
I feel like it would be better to be able to obtain access into like a database of minds and be able to pull from other people's experiences. Because I know that if you're reading a fiction novel and you come across something and you go, 'Oh my God, that's what's happened to me in real life', it has to come from somewhere. You know, the author has to have pulled that from somewhere.
And I think in an ideal world you would be able to just get advice from people without feeling ashamed of what you're experiencing. Because most of the time, if you feel ashamed about something, like postnatal depression and you say, 'I'm experiencing this. I don't know what to do'. Most of the time someone will say, 'I had that. Something which really helped me was to have a bath with my kids every night and just have that experience. Just don't worry about anything else. Just get in the bath with them'. And, you know, I've started doing that and it has been really helpful for me as well.
> Experiences with health professionals for antenatal and postnatal depression - Deb lived in a regional area and when first experiencing postnatal depression went to stay with her aunt, a mental health and maternal child health nurse who lived on the fringes of a large city. She contrasted the services available locally with those in her aunt's area
We ended up going to see a psychiatrist and we had to organise that privately, because it doesn't really exist in the public system around here. I went to stay with my aunt - both her and her husband are mental health nurses and she used to be a mothercraft nurse as well.
She's not in this area, which I think is different, because when we probably had the biggest crisis, maybe the second biggest, with my mental health, and I went to stay with her, the services that were available up there, she couldn't believe what wasn't available here. She couldn't understand why there was nothing around us.
You can go as an outpatient back to the hospital and you could stay for two weeks and have a mental health plan and mental health team. And they'll come to your house to visit you and that. They will phone you every second day and through the public system you can access a psychiatrist and all this sort of stuff. Whereas around here there's one mental health nurse for, I guess, postnatal and early childhood and she works - some days she'll drive five hours to get to where she needs to be for work.
So, you know, it's really hard to feel like you're, I guess, important to these people because they've got so many people to look after. So you have to go private, or you don't get the care. There's one just opened, a private mental health hospital. And that's only opened probably four months ago. And you can go and stay there. They're really good up there, but they're always really busy too.
We did qualify for a health plan, some sort of thing. And we decided against it, because someone, like a childcare worker, would come to our house for from nine to five every day and I didn't really want to have someone here. I probably would have rather that there was like a support group, or if you could access less hours for someone. I think that might be helpful for some people, but we didn't think it would be helpful for us. So that's why we didn't go for it. I mean, if we'd just decided to take that and someone else might actually need that - we didn't feel like we needed that.
> Experiences of medication for antenatal and postnatal depression - Deb tried two other antidepressant medications before finding one that suited her. Even then, she had to adjust the dosage
Sertraline (ZOLOFT) was the first one. Basically I couldn't keep myself awake. I couldn't - I would literally just fall asleep. I was so exhausted that I would go to bed at seven o'clock and then I would still find it difficult to wake up in the morning. So I went back to the doctor, because I felt that wasn't working, and she sent me to the psychiatrist, which was really - really helpful. He tried decreasing my dose and giving me another medication called Reboxetine (EDRONAX), which is when I felt like I was going to have a heart attack. I couldn't see, I couldn't hear properly. I couldn't hold anything, so I'd drop it. I was shaking.
And we went to the doctor and it was a hypersensitivity and I basically had to ride it out and wait for it to finish. So then he changed my medication to - can't remember what it's called. Just gone blank. Oh, that's it, Dothiepin (DOTHEP).
It felt too low. When I first started taking it, I felt really good, and after about probably five days I could notice that I was slipping back. One of the biggest indications for me when I'm going to experience a bad period, is that I don't do the washing up. If I get up in the morning and I haven't washed-up I sort of think back to how I've been feeling and that I need to get on top of things again. Because if I let things like the kitchen or the washing get on top of me, I find it harder to do everyday things. But I blow them out of proportion as well. Like, I can't do anything until the washing-up has been done and it's just ridiculous. So we've increased my medication since and that's been really helpful.
I started on 75. I then increased - no, I started on 50. I then increased it to 100, which was the dose that he wanted me to be on initially. And when that happened I ended up sort of swinging right back to feeling my absolute lowest again and unable to cope with anything. So we cut it back to the 50, then I've since increased it to 75 and not long - probably four weeks ago - increased it to 100 and I feel like it's working a lot better now.
> Social support during experiences of antenatal and postnatal depression - Although in the early stages of experiencing postnatal depression Deb thought the problem was her relationship with her husband, she said ultimately going through that experience made their marriage 'stronger'
So I feel really proud of this, that I guess our relationship is stronger now. I know that he's going to back me up. Not that he wouldn't back me up before, but we haven't experienced anything like this. He's been extremely supportive. Extremely supportive. His work has been supportive too, if he's had to take some time off. And - and I feel that without that support from him - you know how people get those little things on their shoulders, the little devil and the little angel? He's sort of like - sometimes I think, "God, I'm really stressed out", and then I think, you know, he said to me last night that he thought I was getting really stressed and I needed to take some time out. He's just really level-headed and able to provide me with a ground that I can understand more than if I was on my own. I don't think I could manage myself on my own.
Yeah, like he'll say things like, you know, he'll come home and he'll look round. He'll say, "Did you have a really bad day today?" It's like the keys are still in the door or the house just looks like a cyclone has been through it. And, it's like he just knows then that I would be fragile for the rest of the night, so without asking, he'll just do little things. Like, he'll take the kids for their bath, or try and make it a bit easier. And that's been, I guess, one of the best - the best things to come out of it, is that, you know, we know - I guess we know each other a bit better now.
And there's learning to be an individual as well. Like, we know each other and I guess since feeling a bit better from it, I've realised that I need my own interests and he needs his. We can't just be in our relationship with our kids and just be us in this house with the curtains shut. We need to have outside interests that are separate from each other, and that makes us all happier people.
He works on his car and he goes to car events and that's something that he does. Whereas [I have] uni… So, to have our own thing that we can then talk to each other about has been one of the biggest realisations of what we need in terms of how to run our family. So it's like you need to manage yourself as well.
> Recovery and getting better after antenatal and postnatal depression - For Deb, recovery was ongoing. She said antidepressants, seeing a psychiatrist, and her own efforts to avoid getting overly stressed had helped
I still see the psychiatrist. I went from seeing him every three weeks to - we've just put a six-week gap in between my appointments, which is a big step forward. I don't get phone calls anymore from the mental health team, so that's also another step forward. But the plan is to increase my medication again, so that I can, I guess, feel more steady on a day-to-day basis, and then we'll sort of have the six-weekly appointments for a while. And if I feel that I reach a crisis, or that it's not working, I have a really good rapport with him and I can just ring up and say, you know, "I need to see the psychiatrist. There's something that's not right". And I guess that's also part of learning to stick up for myself.
I think when we've really realised that we turned a corner was when I could get through - I could get through just general daily tasks and then they'd be done and I'd turn around and I'd say, "Hey, we had a really good day". Like, I wasn't stressed out, I didn't have a panic attack, I didn't feel like I couldn't cope with anything. So it sort of - I guess it happened without me noticing.
And I'd had a couple of really good days and I thought, 'Oh, my God, that's what's been missing from our day, is being upset or being really stressed'. And if I feel like I can cope, my perspective is that the kids, they don't misbehave, they don't - they don't test me or stress me out. Whereas if I'm already stressed, everything they do will stress me out. So with my medication increases, that's been a big thing which has changed. Probably the biggest thing.
But, yeah I feel like things get easier the sort of - the further we go, the more time that's passed, things are easier, and the more work I put into it. I know that if I stop and think and take some deep breaths and then do something that it's going to be a better experience than if I just continue on a spiral of being stressed. So that's been a big thing for healing. And taking myself seriously has been another one…If I don't like how our life is going, then I guess I'm really the only person that can change it.
> Diverse families - Deb felt becoming a parent at a young age had made her mature and learn how to 'stick up' for herself, especially in terms of accessing healthcare
You really need to stick up for yourself in terms of accessing healthcare. And people saying, "Oh, we'll just give you some medication and off you go". And I feel like that's probably not enough. You really need to push for more. And that's been a different experience altogether, learning to say, "Well, no, actually I don't want that".
I think in having kids young you go from high school to tertiary education to having these teacher figures who are telling you what to do, that when you end up in an experience of having babies, the doctors sort of take on that role. And the doctor's saying, "No, you'll do this". And you're used to teachers saying, "No, do this". So you have to learn to question what they're telling you and that's been probably one of the best things to learn.
Especially the healthcare system is generally pretty good. You go to hospital if you need something and they look after you. And having your own experiences from - my brother used to go to hospital a lot. He was really ill when he was little and he'd go there and he'd get better and he'd come home. And I've learnt now that my mum is pretty good at sticking up for herself.
So then you need to, I think, learn that yourself as a parent, rather than just agreeing blindly to what people are telling you. So that's been a big thing to learn, but at the same time it's been a big part of maturing, not only as a parent, but as an adult. And then my own personality growing, that I think I know who I am better now than before I had kids, and especially before I had my second child.
> Approaches to parenting - It took Deb a while to learn to trust her own 'instincts', and to 'stand up' for herself when health professionals' advice conflicted with her parenting approaches
I think I probably would have pushed - I would definitely now, from what I've learnt and from the experience I've learnt that I need to stand up for us a lot more. Because you - you go in there, especially with your first baby, and you trust them. And when I was trying to feed my son and even within the hospital and we really struggled. Um, so I Googled it on my phone and I was trying to feed him and I got him latched and I was really excited and a nurse actually came in and unlatched him and told me to put a shirt on, because I was trying skin to skin, because that's what Google told me to do.
So I - I guess I didn't really know - when I had him, I didn't know that it's my choice. And there they - they basically said, you know, what - what the nurses say is like the golden rule. But we didn't really realise. And then we started, um, just really trusting our instincts and going from there and it turns out - we were reading in a magazine, it was about attachment parenting. And a lot of the stuff that we did - it was really exciting to know that it had a name and that it was legitimate, even though the nurses or doctors might tell you that you shouldn't do it that way. So that was good. It was good to experience sort of something outside of what the medical profession tells you.
Yeah, and that seems to be - I mean, not just from that hospital, but from the [hospital name] Hospital, that seems to be the experience for that. I know a girl who, um, she was asleep and she woke up and her baby was gone and the nurse was giving it a bottle. She didn't even get a chance to breastfeed it. Like, it just was like they - they - I guess they expect it and then you don't get the support to breastfeed.
Surprisingly, the hospital's been the place where I've actually been criticised for breastfeeding in public...
More about Deb
Deb became pregnant when she was 19, and married her partner three weeks before their baby was born.
Deb described having a 'natural birth' with her first child. She was criticised for breastfeeding her son in hospital and felt that she was expected by nurses to formula feed. At this time, Deb believed that what the nurses advised her was the 'golden rule' she needed to follow. She said that being a young mother, she hadn't learnt yet how to stand up for herself. Deb later found information about attachment parenting on the internet. She was excited to learn that her style of parenting 'had a name and that it was legitimate'.
Deb described having a 'really good postnatal period' with her son and said she and her husband 'couldn't wait' to have more children. They conceived again, however Deb experienced a miscarriage due to antiphospholipid syndrome. After receiving treatment she soon became pregnant again.
Although Deb's daughter was born quickly, she had a facial contusion and after the birth Deb needed three blood transfusions and a uterine balloon. This was a 'really tough' time and Deb felt she didn't get support from the nurses in hospital.
Deb described caring for her daughter as the 'complete opposite experience' to her son. She felt her bond with her daughter was impacted by her difficult recovery from the birth, and her daughter's frequent vomiting which made breastfeeding difficult.
Soon Deb found she had 'lost interest' in things she previously enjoyed and struggled to look after two children and do her university course. Her GP diagnosed her with postnatal depression and prescribed antidepressants (sertraline (ZOLOFT)). Deb felt 'really, really tired' while taking sertraline, which made everything 'a lot worse.' She felt 'suicidal' and 'robotic' and described 'isolating' herself socially. One night, feeling 'at a loss' and unable to 'function', Deb called Beyondblue and was referred to 'really helpful' mental health services in the next town.
After this Deb's GP referred her to a psychiatrist, who changed her medication to Reboxetine (EDRONAX). However, Deb was 'hypersensitive' to it and it made her 'shake'. The third medication she tried (Dothiep (DOTHEP)) has been better and Deb is now working with the psychiatrist to adjust her dosage.
Deb said over time she has learned to better 'handle' her 'mental health'. She feels 'really proud' she persisted with breastfeeding her daughter, as it helped their bonding as well as her own mental health. Deb has felt well supported by her 'level-headed' husband as well as her mother and an aunt with professional experience with maternal mental health. While she had a good GP and psychiatrist, Deb experienced difficulties accessing mental health support locally.
Deb and her husband enjoy parenting and are looking forward to the future. Deb said 'dealing with' her 'mental health' has meant having to 'learn to manage a new personality'. She feels it's important women talk to other women with similar experiences, and believes new parents should trust their instincts and be assertive in accessing healthcare.