The doctor noticed I was depressed immediately.
After the initial intake, she looked in my eyes and declared, “You’re depressed.”
“Yes,” I responded.
This wasn’t news to me. My daughter was five months old, and I knew what I was experiencing. The doctor began to list a number of suggestions for things that might help. I had a response for every one.
“Can someone help you with the baby?”
“No. Everyone works and no one has time.”
“Could you take her to daycare?”
“No. I am breastfeeding her on demand, she won’t take a bottle, and we can’t afford it.”
Finally the doctor concluded the meeting with, “Well, there has to be something you can do,” without offering any more suggestions.
I guess that’s not fair. She did offer suggestions: a weekly massage and acupuncture routine that could be done in her office. The total cost of said treatment would be more than I could afford. I thanked her and left the office. A couple of months later I received a $400 bill for my visit.
Then there was the therapist I saw who was referred to me by another mom who had survived postpartum depression. This therapist was supposed to be one of the best in the city for helping moms through postpartum depression. I saw her two or three times, but each visit cost around $275. She did not take insurance, which is something I kept coming up against when I identified the best therapists for women with postpartum depression.
“It’s worth the money,” someone told me.
Sure, I thought, but only if the money is actually there. I can’t fabricate money. I believe this therapist may have been able to help me, but I really needed to see her at least once a week, and we simply did not have the resources for that.
By the time I saw the specialist who worked specifically with women who had postpartum depression, I had identified that that quality was one of the most important in my recovery. After seeing a therapist through my husband’s job who told me to “stop doing that” when I explained how my daughter’s crying triggered my anxiety and forced me to immediately drop what I was doing for her every whine and cry while simultaneously trembling, I knew that I needed to work with someone who understood and was sensitive to what I was experiencing.
My problem, which I suspect is a problem felt by many in my position, was getting access to the care that I needed. Every single specialist who worked with women who had postpartum depression did not take insurance except for one. I ended up seeing the one who accepted insurance, and even then she didn’t accept my insurance. She told me that she had tried to work with my insurance company, but they claimed that there were already plenty of therapists in their network. Even though she did not take my insurance, she agreed to charge me what a normal copay would be. I was relieved to finally find an affordable option.
The whole process was extremely troubling to me. One of the things I was able to do during that time, which is not easy for someone suffering from depression, is advocate for myself.
After almost a year of not feeling well, I realized that I had to take matters into my own hands. That’s when I became more proactive. This was nearly impossible when my daughter was first born, and I wonder if I had had someone truly advocating for me who knew the proper information to help me find appropriate care, I might have suffered less.
The U.S. Preventive Services Task Force recently recommended that all pregnant women and new mothers get screened for depression, but that is not where the work ends. It’s actually where it begins. How a doctor goes about laying out the resources available to a mother can make a world of difference in whether or not she follows through with seeking help.
I have heard other mothers in postpartum support groups say that the way their doctor dismissed them or just threw medication at them without listening to how they were feeling really turned them off from seeking help. It’s important that mothers who are suffering from a postpartum mood disorder work with understanding and sensitive practitioners. It’s crucial in those early months when a new mother may be feeling misunderstood, isolated, or like nobody cares or understands what she is going through.
The issue of insurance and cost of care were both a really huge barrier. I identified so many resources that could have helped me that I simply could not afford. My inability to access the best care made me feel that my recovery was not valued as much as the people who could afford the best resources.
There is room for much improvement. I hope that by talking about the barriers I encountered, it will encourage people to create programs that are accessible to all mothers, regardless of their ability to pay.
I hope that more resources like the free postpartum depression support groups I found will be made available. I hope that insurance companies will work with more specialists in postpartum depression who, in turn, want to work with the insurance companies. I hope that the specialists who do not accept insurance will find more ways to make their services accessible to more women. I hope doctors who screen their patients for postpartum depression will do more than hand the mother a prescription or piece of paper and send her on her way.
I hope more people will see the value in taking care of mothers so that we can take care of our families. We need to talk about how we can do better.
This article was first published on Postpartum Progress.
