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PERSPECTIVE

The Pregnancy Taboo

As a mother-to-be, I'm experiencing not unremitting joy but depression. My situation isn't unique.

(Illustration by Katherine Streeter)

I was 4 1/2 months pregnant, and my mind was on anything but what color I would paint the nursery or the lullabies I would sing to my newborn son. Rather than basking in the glow of impending motherhood, I was drifting into darkness and despair. At times, I was seized with horrible thoughts - that the baby was dead or would die - and my terror of losing him kept me from bonding with my unborn child. Ashamed and afraid, I told no one about what was happening to me.

In recent years, celebrities like Brooke Shields have helped shine the media spotlight on the problem of postpartum depression, or PPD, and Washington has taken notice. In May, after Shields testified about her own battle with the disease, Senator Robert Menendez of New Jersey introduced a bill that supports screening for PPD during the first year of postnatal checkups. As I would soon learn, though, antepartum depression, which occurs during, not after, pregnancy, is a kind of orphan disease in the media, with few celebrities willing to adopt it as a cause.

It's as if most people can accept a mother who becomes depressed after giving birth, when the reality of caring for a newborn sets in. However, in this "post-feminist" world of family values, it seems far too taboo to dissect feelings women may have about being pregnant in the first place. As a result, depressed pregnant women often stay silent, putting themselves and their babies at risk.

A series of recent studies, including one at Mass General last January, is finally shedding some light on the problem. What researchers now know is that one in five pregnant women may be suffering from depression, experiencing symptoms ranging from self-doubt to obsessive thoughts of suicide. Like PPD, antepartum depression may be partly due to the hormonal shifts that occur during pregnancy, but myriad factors can contribute to the problem, including relationship difficulties and a lack of support from family and friends.

In my case, the circumstances of my pregnancy were not exactly ripped from the pages of a storybook (although I wonder how many pregnant women actually experience that fairy tale of nine months of joyous anticipation). My husband and I were struggling in our marriage, and my pregnancy, at age 40, came as a surprise. Despite my situation, I knew from the beginning that was meant to have this child. So for the first few months, I did what I thought a good mother-to-be should: I cut out caffeine and sugar and became a gold-star customer of Amazon, ordering books with encouraging titles like Great Expectations and The Happiest Baby on the Block.

But as the days passed, nothing could distract me from the darkness rolling in. I started having panic attacks, usually when I couldn't sleep, and I knew I was in trouble. By that point, I'd done the research. I understood that taking an antidepressant could cause my son to have withdrawal symptoms after his delivery and birth defects (two studies in The New England Journal of Medicine last month said the risk of birth defects is low when antidepressants are used in early pregnancy). Part of me also worried about admitting I was anything but unambiguously thrilled about being pregnant.

In the end, though, I decided that trying to uphold the myth of an unwaveringly happy pregnancy would take a greater toll on my unborn son and me than admitting I was depressed. In April, I started on a low dose of Zoloft and began reaching out to family, friends, and all those involved in my child's and my own well-being. I wish that more depressed pregnant women were encouraged to come forward and that their doctors were there to support them. Now with just a month and a half until my due date, I am finally starting to climb out of my dark hole of despair. Hope, the most essential part of all to giving birth, is slowly returning.

I have read that being pregnant is the closest you'll ever get to the other side, with the soul inside of you straddling the worlds of darkness and light. Even in my most difficult moments, I have always felt this joy radiating from the life within me, as if someone, somewhere, sensed I was in trouble and sent in reinforcements. Every day I feel a little more of that joy as my son and I move closer to the light.

Jody Santos, a documentary filmmaker and writer, teaches at Assumption College in Worcester. Send comments to magazine@globe.com.

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