This is the last blog of our Maternal Mental Health series. For the last six weeks, dear reader, we have discussed the often misrepresented, largely misunderstood world of maternal mental illness. We have published stories from lived experience perspectives and given you the researcher or clinician’s perspective on the topics of perinatal OCD, postpartum psychosis, clinical and community mental health support, and childbirth-related post-traumatic stress disorder, and we will now close with a final interview led by Dr Jodi Pawluski. We hope that this series brings you a greater insight into maternal mental illness and demystifies its prevalence, symptoms, experiences and outcomes for mothers and their families.
I recently sat down with Emma Jane Unsworth, a bestselling author and mom of two, to talk about her memoir After the Storm: Postnatal Depression and the Utter Weirdness of New Motherhood (a must-read!), the stigma around maternal mental illness and ways to protect maternal health. (You can listen to our full conversation on my podcast Mommy Brain Revisited #34).
I’m a neuroscientist, therapist and author who focuses on understanding how the brain changes with the transition to motherhood and perinatal mental illness. I first met Emma when she was writing her memoir After the Storm as she was interested in how the brain changes with motherhood, and we’ve kept in touch ever since.
After the Storm
Before we get into Emma’s experience overcoming postnatal depression, let’s touch a bit on why she wrote her memoir. “After I had him (her son),” Unsworth says, “I started to feel very unlike myself…. I was furious all the time and at the world. Combined with that rage was an undeniable pressure to be enjoying myself, be grateful, to be doing my job…I wasn’t well, I was ashamed, and to be all these things and not have sleep was too much.”
It took months for Emma to reach out for help, but she did. One of the turning points in her recovery process was when her therapist “thought that everything I was describing sounded like a very reasonable response to the pressures of motherhood in the western world. The fact that she could call it reasonable felt so freeing for me and helped me to be kind to myself”.
Unsworth also wanted to help other women. “No one was talking about this [postnatal depression]. I felt I couldn’t find anything in books that was from a personal point of view, so I thought I want to put something out there about what I’ve been through and what often happens in the early months of motherhood — hard, lonely, dark months — but also make it a resource”. She wrote a piece in the Guardian that went viral, and her book After the Storm followed.
Today, two years after we first met, Unsworth has given birth to her second child without even a “whiff” of postnatal depression. The question is, how? How did she prepare and protect her mental health?
Birth Choices
Emma describes a “horrific birth experience” with her first child, which contributed to postnatal depression, so for her second birth, she planned a caesarean delivery (c-section).
“There is no easy way to get a baby out of your body” she says, but she wanted to have some control over the situation. We know that the realities (and often trauma) of birth are important players in maternal mental health, so preparing for birth is an important step. However, it is important to know that birth is often unpredictable.
Sleep is Medicine
The lack of sleep “destroys you and destroys your relationship…. it was awful… sleep deprivation was such a big part of my illness that I didn’t want to have that happen again”, Unsworth says. Unsworth saved up and hired a night nanny to ensure that her sleep was protected in the early months postpartum with her second child.
We often underestimate the importance of sleep for perinatal mental health, but “You need someone helping you at nighttime so you can recover from this massive thing your body and brain have done.” Definitely.
Reconnecting as a Couple
Another factor that Unsworth focused on was her relationship with her husband. Emma noted that with their first postnatal experience, “a lot had been destroyed [in their relationship], so we had work to do”. She and her husband went to couples counselling online and were able to talk through their experiences of the birth and postnatal depression, reconnect and communicate, and remember that there was “so much joy as well”.
The warped reality of motherhood
In her book Unsworth writes that becoming a mom “can’t be this hard or people wouldn’t do it”, but the reality is we don’t talk about how life-changing motherhood can be — the good and the bad — and the fact that it’s not a one person job.
Taking care of a baby is a “three-man job”, Emma says (100% yes!) with, ideally, someone cleaning up, someone prepping for the next shift, and someone caring for the baby.
Thinking about motherhood this way is key. It’s not a lone venture. It’s something that takes a community - a community that can take many forms. Maybe the community is full of family or friends, maybe it involves paid support, or maybe the Sunday night food delivery person is a member.
The point is maternal mental illness happens, but perhaps it would happen less if we talked more about motherhood and how important it is to support new mothers and parents.
InSPIre the Mind would like to thank Dr Jodi Pawluski and our previous assistant editor Melissa Bujtor for their initiative to demystify severe maternal mental illness and for envisioning this series.
If you or someone you know is struggling with a maternal mental illness it’s important to your healthcare provider. For more resources see PANDAS Foundation UK or Postpartum Support International.
To learn more about maternal mental illness check out the Maternal Mental Illness Series at InSPIre the Mind and other blogs on maternal bonding, Black maternal health inequality, and journalling for mothers, among others.