Saturday, October 31, 2009

Postpartum Support and Prevention Plan

One of the missions of The Smiling Mask Team is to pay it forward and proactively educate. To this end, we continue to speak to create awareness surrounding Postpartum Depression. We are now educating at the YMCA prenatal classes in Moose Jaw. The most important message that we are advocating for is to seek help as soon as the mother feels she is suffering.

We have also created a Postpartum Depression Prevention Plan on our website, like the popular Birth plan, this tool helps a mother create a contingency plan in case of the onset of PPD symptoms. Having suffered, ourselves, and realizing that often mothers can’t summon the words to explain how they are feeling, we created a color-code system. We also suggest that mothers choose a support person who they can call upon to apply the code. We are also encouraging pregnant mothers to flag themselves using the risk factors listed in the prevention plan and to screen themselves at two weeks with the Edinburgh Postnatal Depression Scale. Ultimately, taking responsibility for our own health is the number one prevention tool to destroy Postpartum Depression!

Carla O'Reilly

Tuesday, October 27, 2009

Two articles you will want to read...

Make sure you also check out the videos at the end of this article, Getting help for postpartum depression written by Valerie Whiffen of the Globe and Mail. And, bravo to Julie Cugalj for bringing to light her experience When motherhood isn't a joy written by André Picard of the Globe and Mail.

Provincial project improving the health of families!

Dr. Angela Bowen of the University of Saskatchewan, recently, wrote this newsletter that we are more than thrilled to share!

Maternal Mental Health Strategy: Building Capacity for Saskatchewan

Maternal Depression is an increasingly urgent health problem.1 According to the World Health Organization depression is the number one cause of disability in women worldwide.2 Up to 20% of women may experience depression in pregnancy or postpartum.3 We have reported that 29.5% of Saskatchewan high-risk pregnant women are depressed.4 Women depressed in pregnancy are at risk for further and more severe depressions, such as postpartum depression. Untreated it can lead to psychosis, homicide, and suicide.5-7

Andrea Yates, the Texas mother who drowned her 5 children, and incidentally was a Registered Nurse, raised awareness of postpartum depression and psychosis.8 While they may not have made the headlines, sadly, we have had maternal suicides in Saskatchewan and only a few years ago a new mother attempted to kill her 3 young children.

While death is the gravest outcome of untreated maternal depression, there are other potentially deleterious effects, particularly during pregnancy. Women who are depressed are more likely to use alcohol, drugs, and tobacco and are less likely to have adequate prenatal care.9-11 Their pregnancies are more likely to end prematurely and have obstetrical complications11 and their babies are at increased risk for lower Apgar scores, lower birthweight, less frequency and shorter duration of breastfeeding.11-13 Children of mothers who are depressed are more likely to experience growth, attachment, psychological, behavioural, and developmental problems than children of mothers not depressed.14-16

Increased awareness and early identification can promote primary prevention and optimal treatment. British Columbia has a framework for prenatal and postpartum depression screening and care17 and BestStart in Ontario held a postpartum depression campaign in 2007-8.18 There has been increased awareness in Saskatchewan through a recent conference “Unmasking Postpartum Depression” in Regina, but we need to make a difference for individual women and their families.

The Maternal Mental Health Strategy: Building Capacity in Saskatchewan is a project that is funded through research funds from the Royal Bank of Canada (RBC) Community Development Fund at the University of Saskatchewan in partnership with the Saskatchewan Prevention Institute and the Health Quality Council, and with support from the Saskatchewan Public Health and Psychiatric Associations. Our goal is to increase the capacity to identify and support women at risk for mental health problems in Saskatchewan. The strategy includes an awareness campaign and engaging women and stakeholders to make policy recommendations to the Government of Saskatchewan.

Depression is treatable; however, too many women suffer in silence, unsure of what they are experiencing and too frightened to tell anyone. Increasing our capacity to identify and support these women will help to improve the health of families in Saskatchewan.

1. WHO. Women’s Mental Health: A Public Health Concern . Accessed 2006. WHO, 2006.
2. Allen LA, Woolfolk RL, Escobar JI, Gara MA, Hamer RM. Cognitive-behavioral therapy for somatization disorder: a randomized controlled trial. Arch Intern Med. 2006;166( Arch Intern Med. 2006 Jul 24;166(14):1512-8.):1512-8.
3. Marcus SM, Flynn HA, Blow FC, Barry KL. Depressive symptoms among pregnant women screened in obstetrics settings. Journal of Women's Health. 2003;12(4):373-80.
4. Bowen A, Stewart N, Baetz M, Muhajarine N. Antenatal depression in socially high-risk women in Canada Accessed doi:10.1136/jech.2008.078832, 2009.
5. Blazer DG. Mood disorders: Epidemiology. In: Sadock BJ, Sadock VA (eds). Comprehensive textbook of psychiatry. Volume 1. Philadelphia: Lippincott Williams & Wilkins, 1999:1298-308.
6. Heron J, O'Connor TG, Evans J, Golding J, Glover V, O'Connor TG. The course of anxiety and depression through pregnancy and the postpartum in a community sample. Journal of Affecive Disorders. 2004 May;80(1):65-73.
7. Morris-Rush JK, Freda MC, PS B. Screening for postpartum depression in an inner-city population. Am J Obstet Gynecol. 2003 May;188(5):5217-9.
8. Wikepedia. Andrea Pia Yates . Accessed 2004 February 6. Wikepedia.
9. Kahn RS, Zuckerman B, Bauchner H, Homer CJ, Wise PH. Women's health after pregnancy and child outcomes at age 3 years: a prospective cohort study. Am J Pub Hlth. 2002;92(8):1312-8.
10. Bonari L, Bennett H, Einarson A, Koren G. Risks of untreated depression during pregnancy <>. Accessed 2004 May 1. Motherisk Update, 2004.
11. Chung TKH, Lau K, Yip ASK, Chiu HFK, Lee DTS. Antepartum depressive symptomatology is associated with adverse obstetric and neonatal outcomes. Psychosomatic Medicine. 2001;63(5):830-4.
12. Hellin D, Waller G. Mother's mood and infant feeding: Prediction of problems and practices. Journal of Reproductive and Infant Psychology. 1992;10:39-51.
13. Zuckerman B, Bauchner H, Parker S, Cabral H. Maternal depressive symptoms during pregnancy and newborn irritability. J Dev Behav Pediatr. 1990;11(4):190-4.
14. Murray L, Cooper PJ (eds). Intergenerational transmission of affective and cognitive processes associated with depression: infancy and the pre-school year. Oxford: Oxford University Press; 2003. 17-42. p.
15. O'Connor TG, Heron J, Golding J, Beveridge M, Glover V. Maternal antenatal anxiety and children's behavioural/emotional problems at 4 years: Report from the Avon Longitudinal Study of Parents and Children. British Journal of Psychiatry. 2002;180:502-8.
16. Wilkerson DS, Volpe AG, Dean RS, Titus JB. Perinatal complications as predictors of infantile autism. International Journal of Neuroscience. 2002 Sep;9(112):1085-98.
17. BC Reproductive Mental Health Program. Addressing Perinatal Depression: A framework for BC's Health Authorities <>. Accessed. Ministry of Health, Victoria BC, 2006.
18. Dawson H. Postpartum Mood Disorders Provincial Public Awareness Campaign “Life with a new baby is not always what you expect” Toronto: Best Start Resource Centre 2008

Saturday, October 24, 2009

The Readers' Choice Award and the AWHONN Conference!

We asked and you voted! Our book, "The Smiling Mask: Truths about Postpartum Depression and Parenthood," has been shortlisted for the Readers' Choice Award!

The Saskatchewan Book Award's Gala will be held on Saturday, November 28th at the Conexus Arts Centre in Regina, Saskatchewan. After nearly a year of launching our book, we have been welcomed with open arms by communities across Canada and the United States. Our connections with mothers, sisters, friends and grandmothers speak volumes about the stigma attached to PPD.

After speaking at the 2009 AWOHNN (Association of Women’s Health, Obstetrics, and Neonatal Nurses) Conference in Winnipeg, Manitoba on October 15th 2009, we again received positive feedback and one of the attendees shared, “Hearing your personal testimonies gives a human face to this illness. No textbook can provide that level of awareness.” The beauty of this shared experience is that we also learn from the nurses on the front lines. We admire their knowledge and belief in valuing continuing education surrounding PPD!

Carla O'Reilly

Wednesday, October 21, 2009

Tracy Houk did it!

Our team had the pleasure of representing postpartum disorders, when educating families who attended the Regina Family Expo this past weekend! This time we had the distinct pleasure of sharing a table with Tracy Houk of Regina, SK who recently published her first beautiful book, "The Day I Gave Birth!" Her book provides genuine stories of personal insight into the labour and delivery experiences of 45 women. It's beautiful, please check out her blog at!

The afternoon was spent with her first introducing her book and then we would take over by saying, "Our book is about what can happen to up to 1 in 4 women after having birth! Allow us to further educate and make you aware and put you at ease. There are supports in place; it's a matter of learning them!" You get the was a fabulous day :)


Saturday, October 10, 2009

Conference & documentary update...

The Unmasking Postpartum Depression conference went beyond our wildest expectations! We were thrilled with the attendance, participation from everyone and passion from which the medical community spoke. It was evident by the enthusiasm in the room that change will occur in our jobs, community and approach to Postpartum Disorders. Education combined with empathy will have a positive impact to mothers, fathers and families suffering. The end result will have a positive and affirming impact on our children, our future!

We also had the opportunity to sneak-a-peak at our 40-minute documentary that serves as a resource for families and medical professionals. It was an absolute delight to be viewing it for the first time, surrounded by family and friends! Here's some of what our audience had to say…

Hearing the voices of those who experienced PPD first hand brings a new dimension to the illness and their stories. Seeing the raw emotion and the hope of healing with both the women who lived it and the husbands who stood by them helps the viewer gain perspective and insight. This is a must see for all couples as a testament to "in sickness and in health", and how love and courage mixed with hope can heal. This documentary creates a window for anyone whose mother, sister, aunt, cousin or friend experienced PPD; to understand the tug-o-war between the head and the heart, between love and fear for her child.
- Jill Poulton, Mother, Motivational Speaker, and Success Coach

Although the stories told in the film were familiar to me, having already read the excellent book, I was struck by the visceral impact of the images and the emotions presented. Even the most innocuous photograph of a mother and her baby is replete with meaning, and the images presented in "The Smiling Mask", accompanied by their stories of overwhelming confusion and despair, become a heart-breaking dichotomy of joy and sorrow. Fortunately, the film's message of hope rises above all of its pain, and assures sufferers of PPD that they are not alone, and never were. I recommend this film to any person with least spark of empathy in their soul.
- Dan Carr, Father and Web Developer

The documentary will be available for December, so purchase your copy, now, for the pre-sale price of $9.95, at and promote Education, Empowerment, Encouragement and Empathy!

Thursday, October 8, 2009

Carrie's Courage

Thank you for choosing to share you story Carrie, why do you think it is important?
I think speaking out about my experiences with Postpartum Depression (PPD) is important because I believe I can help other women going through a similar situation. I want to give other women and their families hope, and let them know that if I can overcome this illness, twice, then they can, too. I want to help unveil the mask so that other women won't go through what I did.

What were your symptoms like? How long did you suffer before seeking help?
With my first baby I was very anxious. I vomited a lot, had loss of appetite and lost a lot of weight. I was so worried that something was going to happen to my daughter. I feared that she would die. My daughter was colicky and cried a lot, so I was so worried about her and wondered what was wrong. I didn't get many breaks and I cried a lot, too; felt very depressed, and had trouble going to sleep at night. I used to dread the nights because I knew that I wouldn't get much sleep. My sleep deprivation caused more anxiety and depression. I also didn't want to be alone with my baby because I felt I couldn't look after her properly. I felt like an unfit mother, with the lack of sleep and with the level of anxiety I was experiencing.
With my second baby I knew that the chances of having PPD, again, were up to 80%. I felt fine for the first two weeks. I had my mom stay for two weeks to help, but after she went home my daughter became colicky and didn't sleep much. I was more depressed the second time, but the anxiety wasn't as bad.

What did you do in order to get help and why do you think it was so important for your family?
The first time I had PPD it took me three months to finally get medical help. I had heard about Postpartum Depression, but I didn't think it would happen to me. I also thought my sickness was because my daughter was colicky and I wasn't getting much sleep. That was part of it, but once my daughter was out of the colicky phase, I was still feeling the same symptoms. I went to see my doctor and she put me on an anti-depressant called “Paxil.” Unfortunately, it took awhile for the medication to work. I also joined a Postpartum Support Group at the YMCA and met three wonderful women who were going through postpartum difficulties, as well. We met once a week at the YMCA for the group and also started going out for coffee, afterwards. We also met for walks in the morning. I believe that talking to other women who were going through the same postpartum difficulties was the number one healing factor for me. The scheduled walks helped, as well because they gave me an outing to look forward to every week. Scheduling these walks helped me get out of the house and not make excuses why I couldn't go, and the endorphins released from the exercise made me feel good. After a month, of being on the anti-depressants, they finally started working and helped me feel more, emotionally, stable. I also joined a Women's Bible discussion group and found faith, again, in the Lord. I started praying often and read a lot of daily devotionals with other women.
The second time I experienced PPD, I went on the anti-depressant right away, but it still took a while to start working. I asked for help more, this time around, but it was still hard to do. Help was definitely a must because I had two small kids to take care of. It was much harder to get out of the house and go for walks this time with my girls so I talked to my friends, Carla, Tania, Cheryl and Elita, a lot on the phone. I also read Carla, Tania and Elita's book, The Smiling Mask: Truths about Postpartum Depression and Parenthood, which helped me stay positive and focused. Their stories of heartache and healing reminded me, again, that "this too shall pass" and I will be so much stronger for going through PPD. The "Strategies for Mothers with Postpartum Depression" section of their book really helped, as well. This information gave me strategies to practice and it really kept me moving forward with my healing journey. I read the book The Secret, as well, and it helped me learn how to think positive and gave me knowledge on how positive thinking is really powerful.

What steps did you take with your second pregnancy that was different from your first?
My husband and I hired a doula to assist us with the labour and delivery. That was the best thing I could have done for my family. During my second pregnancy we took hypno-birthing classes and our doula came out and taught us how to relax and do breathing exercises. These breathing exercises helped me relax during my pregnancy and were very beneficial during the labour and delivery. I had a much more positive and natural birthing experience with my second birth because of the preparation work and learning to breathe, properly. I never had an epidural this time around and had every intention not to get one. My delivery was much shorter and less work. I also had my doula and husband, right by my side, supporting me every step of the way. It was a very euphoric feeling after giving birth to her and I felt so much better the second time around.

What lessons have your learned from your healing that are positive for your family?
I have learned that going through Postpartum Depression is nothing to be ashamed of. I am using my voice that God gave me to help other women to speak out, as well. I have learned that being healthy in body, mind and spirit is very important for a mother to have, especially when looking after a newborn baby and other children. If the mother isn't happy and healthy, then the children and husband won't be either. I need to look after my body and mind by getting rest when I can, and ask for help. It “takes a village to raise a child,” and in other cultures and countries they have a whole village or community to help them. I have grown a lot in spirit by having complete faith in God and I know that He will take care of me if I let Him. I have learned to think positive and to count my blessings and be grateful for everything in my life. It takes practice, but it really is the key to happiness. I surround myself and family with other people that are spiritual and positive, as well, so I have help staying positive and keeping my faith.
If your daughters ever suffer from a mental illness how will you help them? What do you think is important for them to know, right now?
If my daughters ever suffer from any kind of mental illness, I would want them to be educated on the signs and symptoms of depression, and let them know that I will always be there for them to help them in any way I can. I would let them know that it is important to get some kind of medical help, or to talk to someone as soon as possible, so it can be dealt with right away and not escalate. I also want them to know other strategies that can help to overcome PPD. They should know that they should never be ashamed of a mental illness or for asking for help. They would be very courageous and smart for doing so. What I think is important for them to know, now, is to pray to God and give thanks for all they are blessed with. They need to be grateful for everything, and to not take anything for granted. I believe educating them on body, mind and spirit, now, will be key in helping them and, hopefully, preventing them from developing a mental illness. I want them to surround themselves with friends that are positive influences in their lives.
My experience with PPD has really helped me grow in body, mind and spirit and I've met a lot of wonderful and amazing women along my journey. I will continue to grow and pass all the knowledge onto my girls!

If you feel compelled to become an ambassador by showcasing your courage on our website, please feel free to contact us, we would be most honoured to showcase your story. If you have more ideas on how the message of hope and healing can get around our world…contact us at! Make a difference, today, by speaking out loud the valuable lessons you just learned. Even print and share this interview for others to read! ~ Carla O’Reilly, Elita Paterson & Tania Bird