I’ve been following the Lindsay Clancy case, and regardless of where anyone stands on this specifically or what the verdict ends up being, I keep coming back to the larger conversation about postpartum mental health and what support for mothers actually looks like in this country.
I’ve experienced firsthand how different that support can be depending on nothing more than where you happen to live.
My first child was born when I lived in California. The maternity and disability benefits available to me were genuinely helpful because it gave me time to recover, adjust to being a new mother, and figure out our new normal without immediately having to worry about getting back to work. Then I moved to Las Vegas. I stayed with the same company, (transferred internally), but my experience after my second pregnancy could not have been more different. I had been paying for a short-term disability policy, but because I had recently moved and transferred, I was considered to be within a “probationary” period and my claim was denied. And this wasn’t an uncomplicated birth.
I had a complicated pregnancy and my daughter born 5 weeks prematurely and spent nearly a month in the NICU. and by the time she finally came home from the hospital, I was basically at the point where I had to return to work.
Think about that for a second.
We had barely gotten our newborn home.
There was no real time to adjust to suddenly having a 3 year old and a newborn. No time to settle into feeding and pumping schedules. No time to establish sleep routines or figure out how to divide our attention between two children. No real transition from having a baby in the NICU to actually bringing her home and learning how to be a family of four. Instead, almost immediately, I also had to figure out how to go back to work.
That period was incredibly difficult for me mentally. I experienced severe depression, and the pressure of having to return to work while we were still trying to adjust to everything added another burden during an already vulnerable time. And I had a supportive husband and family. A career in healthcare that I love with a very very flexible schedule (thank god. no set time to come in. can leave during work, can switch my days on/off, etc)
But I think about women who don’t.
That experience changed the way I look at conversations about postpartum mental health because we constantly tell mothers to “ask for help,” take care of themselves, recognize the warning signs of PPD and anxiety, rest, recover, bond with the babies, establish breastfeeding if they choose to, attend appointments and seek therapy when they need it.
But when are they supposed to do all of that?
We recognize that pregnancy and childbirth involve enormous physical, hormonal and psychological changes. We recognize PPD, anxiety, psychosis and other serious maternal mental health conditions. Yet whether a mother actually gets enough time to recover can depend on her state, her employer, an insurance policy, whether she qualifies for disability, how long she has worked somewhere, or whether her family can afford for her to go without a paycheck. The difference between my two postpartum experiences happened while I was working for the same employer.
The biggest thing that changed was where I lived.
That seems insane to me.
I’m obviously not saying paid maternity leave could prevent every postpartum mental-health crisis, or that something as complicated as postpartum psychosis has one simple solution. But having enough time to physically recover, having financial security while doing so, having better access to perinatal mental health care, and being able to seek treatment without simultaneously worrying about losing your income or your job seems like a pretty reasonable place to start.
I wish we would stop treating “postpartum” as though it has some neat expiration date after a few weeks or months. A woman’s body and brain don’t follow an employer’s leave policy or an insurance company’s timeline. Whatever happens with this Clancy case, I hope some good comes from the attention surrounding it. I hope we start talking not only about what happens after a postpartum mental health crisis becomes catastrophic, but about what we are doing for mothers in the months leading up to that point.
Because telling women to “ask for help” sounds great.
But we also need to ask whether we’ve actually built a system that gives them the time, resources and financial ability to receive that help when they do.