More than 5% of women who gave birth in 2021 had suicidal thoughts in the two months after pregnancy, according to a report from Public Health France.
“I felt like a monster. I said to myself: ‘You don’t have the right to cry, you have a husband, two children, a house, you’re not legitimate’…” Doriane may be a secretary for institutions in the health field, but it took her almost a year to understand that she had gone through a “postpartum depression” after the birth of her second child.
His case is far from isolated. Anxiety, dark thoughts, depression… In 2021, 16.7% of women experienced deep and persistent discomfort in the two months following their birth. The mother who suffers from it may feel “overwhelming fatigue and lack of pleasure in taking care of your child”, explains Jacques Dayan, professor of child and adolescent psychiatry in Rennes, and author of the book Postpartum depression. According to a report from Public Health France, published Tuesday September 19, 27.6% of women felt significant anxiety after giving birth and 5.4% had suicidal thoughts.
An environment that can promote depression
At Doriane, the The first problems appear in the first months of pregnancy. Anxiety gradually increases while she is weakened by repeated urinary infections. Two months before giving birth, she was urgently hospitalized because of sepsis, a blood infection that poses a risk to her life and that of her baby. Alone in her hospital bed, she begins to regret her pregnancy and wonder “what could she have done to deserve this.”
In addition to his illness, his superiors tell him that his employment contract will not be renewed. Because “an important project”, paternity leave granted by her husband’s employer is also postponed to several weeks after the birth of the baby. Those around him are fatalistic: they tell him that “that’s how it is now”, and that we will have to learn “to fend for yourself.” Unemployed and without childcare, she “is forced to spend a year at home” to take care of her children alone, while she dwells on dark thoughts.
No time to take care of yourself
Doriane experiences the first months after giving birth like hell. “My daughter didn’t sleep more than three or four hours straight a night, and the rest of the time she cried constantly“, she remembers. The young woman doesn’t dare talk about it to anyone, not even her husband: she doesn’t have the energy and doesn’t see “who could [lui] help anyway.” During a consultation with a general practitioner, she burst into tears, without being able to explain the causes of her discomfort. The medical staff tells her to take care of herself, but with her two children whom she takes care of almost alone, she doesn’t have any. “no time.” She wonders what other mothers do “on social networks and in [son] entourage, who look so perfect. To the point of ending up saying that “everything would be simpler” if she died.
“I regularly imagined leaving the keys in the mailbox before hanging myself.”
On a medical level, depression is characterized in particular by a state of unhappiness “which has been repeated almost every day for at least two weeks”, describes the Health Insurance website. Between the drop in hormones following childbirth and the apprehension of a new life, “Postpartum anxiety is normal and can be relieved by a supportive environment”, explains Jacques Dayan. On the other hand, “even with the best will in the world, only therapy can overcome a depression,” continues the specialist. “At best, the spouse, friends and loved ones will play the role of facilitator.” For Doriane, the turning point will come when she finds a job, which allows her to get her head above water. Discovering testimonies on Instagram from women who are going through the same thing as her is also a big help to her. She finally overcomes her feeling of shame to make an appointment with a therapist: “That’s when I started to get back on track and create a bond with my child”she analyzes with hindsight.
A necessary diagnosis
Psychological monitoring may be accompanied by antidepressant treatment, “depending on the diagnosis established with the healthcare professional”, adds Jacques Dayan. Astrid benefited from it at 25, although she does not feel “strictly nothing towards [son] child: no love or maternal instinct.” A situation “much more common than we imagine, and that does not mean that the mother will not take good care of her baby”comments Jacques Dayan, who believes that the maternal instinct is “an approximate concept tinged with ideology.”
After her pregnancy, Astrid “suddenly wants to leave [son] companion” and this “wakes up every day with the anxiety of having to [s’]caring for a child for at least another 18 years.” She has “hesitated a lot” before taking the antidepressants he had been prescribed, for fear of “turn into a vegetable and get addicted“. In the end, she especially regrets not having started her treatment sooner: “That’s what allowed me to lift my head, over time, and create a bond with my child.”
What are the factors that promote the onset of postpartum depression? “It’s difficult to anticipate, you could very well have one at the birth of your third child, while the first two pregnancies went very well, or the opposite” explains Sarah Tebeka, psychiatrist at thePublic Assistance-Hospitals of Paris and co-author of the Public Health France report on postpartum depression.
The public establishment is currently investigating the determinants which fuel this psychological disorder. Studies “point to increased risks for people who have a history (for example, if they have already suffered from depression or if they suffer from a pathology such as bipolar disorders), or even for people who are isolated and/or in unfavorable economic conditions”continues the psychiatrist, who cites two American works published in 2022. “When you are poor, you are more at risk of being poorly informed and distanced from the healthcare offer”agrees Jacques Dayan.
A mandatory prenatal interview
Doriane and Astrid had never heard of postpartum depression before becoming involved. “In fact, when we become pregnant, we are offered a range of options to take care of our physical health and that of the baby. We wonder whether we should breastfeed or not, but we talk very little about the mental health of the mothers”, estimates Elise Marcende, founder of the Maman Blues association. She herself suffered from postpartum depression before campaigning for better care for this mental disorder, and creating talking circles for women who suffer from it.
Since May 2020, early prenatal care has been compulsory for all pregnant women. This time for discussion allows you to discuss, among other things, the psychological dimension of pregnancy with a health professional. But only 36.5% of women had benefited from it in 2021, according to figures from the Ministry of Health (PDF document). Since July 2022, a postnatal interview must also be carried out between the fourth and eighth weeks following childbirth. Finallyan experimental system has been set up in certain sectors such as Brittany, Réunion, Aquitaine, and even the metropolis of Lyon.
Called Panjo (for “Promotion of health and attachment of newborns and their young parents”), it allows mothers to benefit from six to twelve visits from a midwife at home for a year after childbirth. “The objective is to secure the bond between mother and child”explains Nolwenn Regnault, head of the perinatal health unit at Santé publique France. For Sarah Tebeka, the quality of screening and care also depends on the training of “all health professionals, in particular those who are in direct contact with pregnant women.”
“Deconstructing the image of the perfect mother”
Chloé Bedouet, perinatal consultant and creator of the Instagram account “Mother’s Disease“, believes that it is also essential to “better distribute the burden of parenting.” The duration of paternity leave has been slightly extended in France: since July 1, 2021, it has increased from 14 to 28 days. But it remains much shorter than that of women, which lasts a minimum of 16 weeks. Another major challenge is to “deconstruct the image of the mother perfect”continues this specialist.
For example, we can “Imagine that a woman is fine because she is wearing makeup, whereas she has put on mascara precisely because she knows that it helps her to stop crying. It’s normal to break down, or not to not just feel happiness.” The consultant recommends that those around them develop a “active listening, avoiding putting your own feelings on the person concerned.”
“Phrases like ‘it’s the greatest gift in the world’ can prevent a woman from allowing herself to feel and express her discomfort.”
Chloé Bedouet, perinatal consultantat Franceinfo
For Chloé Bedouet, better “lend a shoulder, listen to mothers confide without judging them, offer help to go to medical appointments, prepare a meal and admit when you don’t know how to do it, or when you don’t know what to say.”
Since she has been undergoing therapy, Doriane has in any case “forward”. Aware that episodes of postpartum depression can have repercussions on the child’s health, she says to herself “Attentive to [sa] mental health and that of [sa] small”. Above all, she learned “to let go” : “Too bad if I don’t have time to clean or prepare a good meal. I leave things in a mess and cook frozen foods when I don’t have time. It doesn’t matter.” With her story, she hopes “break the taboo” And “help speech to free itself”. “No woman should ever be ashamed again”she concludes.
If you need help, if you are worried or if you are faced with the suicide of a member of your entourage, there are anonymous listening services. The Suicide listen line can be reached 24 hours a day, 7 days a week on 01 45 39 40 00. Other information is also available on the website of the Ministry of Solidarity and Health.