For NICU Families, Postpartum Depression And PTSD Are Even More Likely
LAUREN GILGER: Postpartum depression is the most common complication of childbirth. Recently on The Show we brought you a series of conversations about postpartum depression and why it can be so difficult for many women to be screened and diagnosed. One group of parents that is even more vulnerable to this are those whose children are born with serious health conditions and have to spend time being treated in the neonatal intensive care unit or the NICU. So, now let's hear one of those families stories. Laura Vargas, [March of Dimes Gretchen Carlson Advocacy Fellow], and her husband were overjoyed when they found out she was pregnant with their first child. But then they got some bad news from their doctor. Their baby was intrauterine growth restricted, or IUGR.
LAURA VARGAS: It was a roller coaster. We would go through periods where we thought, "OK, it's gonna be OK. Everything's gonna be fine. The placenta will fix itself. We'll be all right." And then we went through periods where we were just really, you know, devastated by news.
GILGER: That news came at 25 weeks when Vargas and her husband were told their baby could not be saved. At that point she told me they had to consider all of the options in front of them.
VARGAS: We had to talk about the options that were available, and that's why we did so much testing. Because we wanted to try to understand why. We really didn't know why this was happening to the pregnancy, and so we did have to talk about options. We did have to talk about, kind of the natural process that occurs of a stillborn baby.
GILGER: Yeah. Those are such scary possibilities. And at the same time, you know, you probably looked pregnant and people were probably talking to you about the baby all the time. How did you handle that?
VARGAS: We kept a lot of it to ourselves. Only our family really knew what was going on with us. And we pretended. We pretended that everything was OK, and we talked about things as if we were having a healthy pregnancy. And I think the hardest part for us was it after 25 weeks when we were told that our baby couldn't be saved we still had to go to ultrasound appointments. And so we still had to watch our baby on the screen. And people want to be happy for you. They want to talk to you about your baby. They want to talk about names. They want to talk about, you know, what you're going to do. Did you have your baby shower? And they don't know how to handle that. And even like an ultrasound tech doesn't really know how to handle this very depressed and upset family that is just. you know. going through kind of a really difficult experience.
GILGER: When was he born?
VARGAS: He was actually born at 28 weeks. He ended up growing just enough that he was able to be given a chance. So, I went into the hospital I was monitored for a week until he was not doing well at all. And we then had a C-section. So he was born one pound three ounces at 28 weeks. And they were very frank with us that he was given a 50/50 chance of survival and a 50/50 chance of severe disability.
GILGER: Wow. So how long did you spend in the NICU?
VARGAS: Three months. So, he was there exactly three months.
GILGER: And tell us about that experience. This was probably more helpful than you thought it might be, but I can't imagine easy.
VARGAS: It was a really difficult experience, and I think the entire time we just kept one foot in front of the next. Just keep going forward, just, you know, try to survive every day. Try to spend their time with him. And I felt like at the time, after having been told that he wasn't going to survive, I felt that he was living in overtime, that I was getting this extra time with him. And even if I got a few few hours or a few days, that I would be grateful for that time with him.
GILGER: What did you name him?
VARGAS: Lucian. His name is Lucian Vargas.
GILGER: So the NICU, then you realized later, it sounds like, became a very — like a trigger place for you. When you had to go back. Tell us about that experience.
VARGAS: Yeah. So, we never ended up back in the hospital with my son. He left after three months and was able to stay home. A lot of babies do end up back in the hospital, but he didn't. But through the advocacy work that I do I ended up being able to do this marrow project. We're still working on it right now. In a NICU right by my house. It's not the NICU that my son was in. But I went there to see the space and to meet with some people that we're collaborating with and to talk to the hospital staff. And so being there, I didn't realize how hard it was going to be. I didn't realize how much of a trigger it was going to be. And just walking in there just seeing seeing the space and seeing the babies, it was incredibly difficult. And it was like a physical reaction to the space.
GILGER: What was your reaction — what was physical?
VARGAS: I just I got goosebumps. I started feeling like my chest was compressing. I started to — I wanted to just break down and cry so badly, because I just, I felt for these parents. I felt for these babies. I felt for this ... difficult place that all of these people are in. And it every time I would hear the monitors, I would just think about my own son and how difficult it was to get him through that.
GILGER: When did you realize later on that you were struggling with postpartum depression?
VARGAS: About a month after my son came home is when ... I stopped sleeping. I started getting insomnia. And so my my son was on this very regimented schedule. When he came home he was only about 5 pounds, so we had a very regimented feeding schedule. And so I started having insomnia and not being able to sleep, and yet I only had this like little tiny window. And I was exhausted. So it started with that, and then I started to feeling a lot of anger and a lot of anxiety and a lot of depression. And I start having so much anger, and I was taking it out on my husband. My husband who had been there for me through this entire experience, who is the only person who knows what I've been through. But I was so angry at everything that had happened, and that we didn't get that typical birth experience. That we were robbed of that. Until it started coming out in these different kinds of ways. And so about a month after my son came home is when it started, and about two months after he came home that's when my husband said, "You need to go see someone, and I'll go with you."
GILGER: What was that like? I mean that must have been such a curveball, after focusing, first of all, so much on the baby for so long, and then, you know, he makes it out of the hospital — which was, I'm sure, a happy thing. But then all of a sudden you're the one who needs help. How did you how did you approach that?
VARGAS: Well, I think that's the part that I didn't understand, because when I went through everything, I was fine. I was like, OK. I was just still going. And yet he was home. He was doing OK. He was growing. And why wasn't I happy? Why wasn't I filled with this? But you can't deal with the level of trauma in the NICU experience while you're inside the NICU experience. When you start to feel safe, when you start to feel like your baby might survive. That's when you can start to deal with all of the emotions that you've kind of tucked away in a box in the closet, that you just don't want to think about — and can't think about when you're in the middle of it.
GILGER: And now you are doing some research and advocacy on behalf of, in particular, mothers who have been through the NICU experience. And what did you find about how common this is that that mothers who have been through this are diagnosed with postpartum depression, and how how difficult it can be to recognize?
VARGAS: It is very common. About 39% of moms, 36% of dads have postpartum depression-type issues. PTSD is right up there too for our NICU families. It's much higher than what it is for, maybe a more typical pregnancy — because there's so high-risk. And it concerns me even more because their babies are so high-risk and postpartum depression, PTSD — those things, they have long term impacts on children. And so we have to really address it early on. As early as we can with moms in order to get them the help that they need so that way they can have healthy babies.
GILGER: From a policy point of view, I know you you're doing this advocacy work now to try to bring this issue to lawmakers. What kind of difference do you think they can make? What are you asking for?
VARGAS: I absolutely think that they can make a difference. What I would like to see is is a stakeholder meeting, a comprehensive stakeholder meeting of all the different parties that are involved in this. We can require screening. We can lengthen out the period of time in which a woman does get screened. I mean, typically you're screened at six weeks after you have your baby. Well, there's a lot more time in there in which symptoms might develop, and you're not going to be caught. We can look at screening for higher risk folks. There are a number of different risk factors that you can see, maybe in pregnancy, and if you did a screening process within pregnancy, then you could see those that are more likely to have problems and we can really help with that. There are other options in terms of coverage for Medicaid. We don't in Arizona cover postpartum depression screening. We don't require it for our Medicaid families.
GILGER: How is Lucian now?
VARGAS: He's wonderful. He's still very tiny. He's only about 21 pounds, which is pretty small for an almost-4-year-old, but we're working on that. But it took him until he was almost 3 to meet up with his peers developmentally. But he is just wonderful. He's just crazy and — very opinionated, at this point.
GILGER: As 4-year-olds are. All right, Laura Vargas. Thank you so much for coming in.
VARGAS: Thank you.