May is Mental Health Awareness Month in the United States and the U.K. It’s also Maternal Mental Health Month in North America, and Mother’s Day is celebrated on May 14th in many countries.
Taking our cue from these broader conversations and celebrations, this month we’re exploring women’s reproductive experiences through the lens of mental health challenges and looking at some of the practical ways we can support women within the Church.
Maternal mental health matters deeply. Too often, though, the mental health challenges that can come along with pregnancy and following birth remain invisible, leaving women feeling alone and unsupported. The same can be said of the broader range of reproductive mental health experiences, which include the grief associated with pregnancy and infant loss and infertility, premenstrual dysphoric disorder, and mental health impacts related to menopause.
We want to acknowledge that the focus of this post is necessarily limiting and there are many painful, grief-filled aspects of being a woman and having kids (or not having kids) that we can’t comprehensively address here. But in the midst of a season when many people are celebrating motherhood, we believe it is valuable to look at the mental health challenges that can accompany women’s reproductive experiences.
We asked a number of women, whose voices we value deeply, to share their thoughts. Some of them have chosen to share anonymously.
This post is not graphic, but it does contain references to birth and pregnancy loss. Please take a moment to check in with yourself about whether you feel ready to engage with it.
When I was turning forty, a friend undergoing IVF treatment apologized for “dragging me through her drama” when I didn’t have to worry about fertility issues myself. Without thinking I replied, “Oh, I have fertility issues, just a different kind.” As a single person, it seemed like there was no place or space to grieve childlessness when I had never even been married or tried to get pregnant. Friends faithfully prayed for a spouse for me, but I felt selfish sharing the grief of childlessness too, which in some ways stung even more. Marriage has no age limit, but my window for having children was becoming shockingly small. Within the Church I not only bore the weight of my own grief, but I felt invisible among those who don’t know what to say to a woman who is neither a wife nor a mother. Friends in a similar place in life as me have expressed how this loneliness intersects with and exacerbates experiences of depression, anxiety, and other mental health challenges. Private grief can create a chasm, but I found comfort in Hagar’s words in Gen 16:13: “You are the God who sees me.” God not only sees my grief, but through Jesus sits with me in it and bears it with me—and as a Church we can be Christ to one another when we witness and share each other’s stories.
A little over a year ago my then youngest son cuddled up to me by the fire, and earnestly asked with his big blue eyes wide and wet, “Why did God make it so hard to have a baby?”
My little sensitive man had noticed the toll of my growing belly and growing anxiety. Like the experience of millions of women around the world, pregnancy was not easy. As the toil of carrying life manifested physically, the mental anguish became debilitating. Unexpectedly, my previous experience of postpartum anxiety returned early. A racing heart, dizzy spells, and the inability to catch my breath became constant companions. It was, indeed, hard.
As a mother to then three, now four, boys, I am practiced and at ease with putting others’ needs ahead of my own. So much so, that I wondered if I was worthy of the resources provided for maternal mental health. Was I taking the place of someone more in need, less supported, more symptomatic, less experienced, and more deserving? At my first appointment with the reproductive mental health clinic, tears of relief fell when the psychiatrist looked at me and said, “What you are experiencing is hard. We want to help. Women like you are the reason we exist.”
I don’t think I answered my son’s question, save for a tight squeeze and a whispered “thank you.” The same response I uttered at that first reproductive mental health appointment. It was a gift to have the hard recognized. In welcoming life, grace was found in the reminder that it is hard AND it is good.
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In “Not a foreigner: postpartum depression then and now,” Hillary Yancey writes about her experience with postpartum depression and how it has shaped her life.
Maternal mental health is essential, because when we can care for a mother, she can care more skillfully and wholeheartedly for her child. This bond, the parent/child attachment, is the foundation of our identity in the world, our ability to love and feel a secure sense of self, and trust in others. The struggles to negotiate the transition to motherhood are normative and commonly occuring, but what does not have to be normative is the failure of our communities to hold the mothers up, or the silence around the struggles. When communities can come around mothers to support them well, it not only matters to the individual who receives the care, whose struggles and suffering matter, but it can change the fabric of the next generation.
There’s a history of mood disorders in my family, and I have worked with mental health-related organizations, yet for many years I lived with premenstrual dysphoric disorder (PMDD) and had no idea. PMDD can be found in the Diagnostic and Statistical Manual of Mental Disorders. My PMDD symptoms impact half of every month. It felt like my symptoms were almost always present, so I didn’t think to track them with my cycle. For half the month, I experienced extreme exhaustion, poor sleep, difficulty focusing at work, and changes in mood. At times, I felt like I couldn’t function generally as a human. I attributed my issues to a possible vitamin deficiency or hormonal imbalance, but tests revealed no concerns there. I didn’t notice any improvement when I exercised, ate well, practiced mindfulness, saw my therapist, etc. Now, those things definitely help me, but they’ve only made a noticeable difference in conjunction with medication. PMDD is a new diagnosis for me, and I am still learning how best to live with it. Women with PMDD are almost seven times more likely to attempt suicide. Reproductive mental health matters because women matter. I hope as the conversation around mental health continues to grow, awareness of reproductive mental health grows as well.
After trying to have a second child for two years, receiving a diagnosis of polycystic ovarian syndrome (PCOS), and two miscarriages, I was wrecked with shame. Because I had always been a generally outgoing, cheery, optimistic person, when I told people in my church body, many said, “You are so strong. You will get through this,” and other well-intentioned platitudes meant to make me feel better and sent on my way. The problem was I wasn’t sure how to “be strong” in that moment, and if I am honest I couldn’t be strong in that moment. I needed support, but I wasn’t finding it in my church body like I normally did. When I did find support, most of my support system and coping tools came from outside of my church community. The people who helped me the most were those who allowed me to feel the many emotions that I was feeling. So often in the Church, we try to push those who are grieving past their sadness and into joy that they once experienced, but something that I have learned and that I return to often is that “God is near to the brokenhearted and saves the crushed in spirit…” (Psalms 34:18). My hope is that the Church would get more comfortable with the discomfort of grief and that we would feel more comfortable with being near to the brokenhearted, especially those who are good at putting on a happy face and are typically seen as strong. In some cases it’s the “strong” ones who need the most care.
May can be a bittersweet month of the year. On one hand, I look forward to Mother’s Day, and on the other, it’s the month I miscarried. At the time, I had a sixteen-month-old. When we found out I was pregnant, I mostly didn’t feel ready. So, when I learned I was going to be losing the baby, I think many people thought (and some even said), “It’s good you weren’t ready, that makes it easier.” The difference between the physical/emotional support I received in labour with my first child, compared to labour as I miscarried, was night and day. During labour with my daughter, I was supported by midwives, doctors, and loved ones. However, I was physically alone for hours as I laboured for the second time and ultimately miscarried. While I had several friends who had experienced a loss too, our journeys looked very different. In the immediate aftermath, I felt like I should have been more upset. Waves of grief came much later for me, years later. I don’t think I was ready to fully process everything right away. If you find yourself in a similar position, please know that your processing can look very different from others, and that doesn’t make it wrong.
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In “i carry your heart with me,” Kate Dewhurst discusses the journey of grief and her own experience with pregnancy loss.
When I was in my early thirties it seemed sometimes that God was playing a game of cat and mouse with me. I was the hemorrhaging woman of twelve years (seven weeks in my case) who was close, so very, very close to touching the hem of Christ’s robe, only to have it snatched away at the last second. The vulnerability I was experiencing left me feeling powerless, timid, and very insecure. I walked as if teetering on some soul-sucking edge, and my deepest desire was to touch Jesus’ robe and know health and joy. In the Biblical narrative the desperate woman does indeed receive healing; her flow immediately ceases, and she is able to rejoin the community once again. There would have been some people in the community who would have called her obstinate and rebellious because—according to Jewish law—by touching Jesus she had defiled him and made him unclean. But no, Jesus focuses only on her faith, her essence, and calls her his daughter, thereby implying connection and protection. Can you imagine her joy? Her hope? Her new life? My own recovery was not as instantaneous: after many years, though, I am enjoying health and joy. My health is multifaceted and—perhaps the most valuable to me—so is the mental health I now experience. I am whole, even while still on antidepressant and anti-migraine medications, and I am IN life! All praise and honour to Him whose hem I touch daily.
Prior to my own experience of becoming a mother, as a psychologist I had specialized in perinatal mental health. I had seen the data and heard the stories about how it feels to become a mother and how disorienting and beautiful it can be all at the same time. And then I became a mother. All I knew cerebrally, the data and theories, were inaccessible in the midst of the despair, rage, fear, and euphoria I felt in the early months postpartum. My experience of myself was changing so rapidly, who I knew myself to be seemingly completely inaccessible and obliterated. Never before has the idea of God as a mother1 been so vital for my survival: and God as a mother came to me through the other mothers around me, replying to my 3:00am text messages, rubbing my feet, doing my laundry, crying with me, laughing at the absurdity of it, seeing my distress and validating it, seeing my power and love, and validating it too. God in the form of other mothers was my anchor to know that all of what was happening inside of me, was known, felt, and experienced. If it was known in some way, I was not alone in it, and I could begin to find my way.
 Editor’s Note: The image of God as mother can be found in numerous places in Scripture. For further exploration, see Psalm 131: 2; Isaiah 66:13; Hosea 11: 3-4; Matt. 23:37; Luke 13:34.
Cover photo by Hugo Jones on Unsplash