We Can Do Better – Post Natal Depression ScaleAugust 2, 2018
We can do better
I was scrolling my Facebook timeline and I just happened to see a post created by Emily, a writer for Shower Arguments. A post of a situation that I know many of us have faced as a parent. I reached out and I am thankful, grateful and appreciative that she is allowing us to include her post here!
We Can Do Better – And We Need To Do Better When It Comes To PPD!
Today I went to my daughter’s two-week checkup. I stripped her down to her birthday suit and a nice nurse measured her head circumference, her height, and her weight.
The nurse meticulously recorded her percentages and wrote them down for me on a sheet of paper that also laid out developmental milestones for her age, normal bowel movements for breastfed and formula-fed babies, and reminded me to start tummy time and call the office if she gets a temperature above 100 degrees.
On her way out the door, she casually handed me another sheet of paper. “Oh, and if you could fill this out at some point today and give it back to us, that would be great.”
I glanced down. “The Edinburgh Postnatal Depression Scale,” it read at the top in bold font.
There were ten questions numbered from A through J, each with four answer selections.
Each selection was assigned a point value. There was a box to tally the total number of points at the bottom.
I started working my way through them.
And it didn’t take long to see that the fewer points you had, the “better.”
It didn’t take long to see that the questions were actually pretty ridiculous.
It didn’t take long to see that if this is how we are identifying perinatal mood disorders in this country, something is in fact, very, very wrong.
“I have felt worried and anxious for no very good reason.”
No, hardly at all – 0
Hardly at all – 1
Yes, sometimes – 2
Yes, very often – 3
So what if I get up at night sometimes to hover over the bassinet and make sure that she’s still breathing even though I know it’s highly probable that she is? Is that a “very good reason” or “no very good reason”? Is that, “No, hardly at all” or “Hardly at all”? Wait, isn’t that the same answer?
“Things have been getting on top of me.”
Yes, most of the time I haven’t been able to cope at all – 3
Yes, sometimes I haven’t been coping as well as usual – 2
No, most of the time I have coped quite well – 1
No, I have been coping as well as ever – 0
Is there anyone who doesn’t feel this way two weeks after pushing a small melon out of their hoo-ha or having their intestines literally lifted out of their abdominal cavity and then being sent home bruised and battered to take care of said melon whose activities are limited to eating, sleeping, and pooping, and who is totally incapable of communicating its needs beyond incessant crying?
And what is “coping as well as ever?” What if I haven’t been coping well all along and I didn’t even know?
“I have felt sad and miserable.”
What if I’ve felt sad and miserable but also elated and grateful and joyful . . . all at the same time?
No offense to J.L. Cox, J.M. Holden, and R. Sagovsky from 1987 (We haven’t come up with anything new in 30 years?), but this survey is complete and utter crap.
Oversimplifying Complex Things….
Not only does it completely oversimplify the complex physical, emotional, mental, and psychological aftereffects of having a baby, it also puts the onus on the individual to essentially diagnose and recognize something amiss within themselves.
Which, if you’ve ever been depressed or anxious or suffered from any kind of perinatal mood disorder, you’re not always rationally able to do. And even if you are, who wants to do that via a score of 0-30?
As if you’re just another number. Another statistic. Oh, you’re a 21? Ouch. You must really be effed in the head. What’s wrong with you? Oh, you’re only a 3? You’re good to go.
Look, I understand we need to start somewhere. Paper surveys are efficient, cost-effective, easy to disseminate en masse.
I’m sure if you do reach the number of points required to initiate action (whatever that is??), you end up getting referred to talk to someone face-to-face. I’m glad about this.
I’m also glad I got this at two-weeks postpartum instead of six when I’m due to see my own doctor. Because baby needs to be seen at two days, two weeks, and a month after . . . but mama can wait until six weeks.
So yes, these surveys can help. They can save lives. I’m glad of this, too. I’m glad there are women who are able to decipher these questions and answer truthfully and tally those scores and recognize that they need help from them.
But what about the women who don’t? The women who can’t? The women who are afraid of answering one way because they think they’re managing OK and that what they’re experiencing is normal but if they circle that answer and add up the score they’re going to be seen as not normal and not OK and then what if they’re not normal and not OK and why is this so damn confusing?
We can do better. Finding Better Ways To Communicate
We can find better ways of talking to women about what they’re going through after childbirth. Preferably through human interaction instead of outdated pieces of paper haphazardly passed out as an afterthought at the baby’s two-week appointment.
- We can find better ways of asking questions that aren’t so awkwardly phrased and downright moronic.
- We can find better ways of de-stigmatizing mental health issues than by having patients tally points for a score to determine whether they need help.
We can find better ways of addressing the complexities and gamut of human emotions experienced after such a life-altering event.
I’m not saying it’s easy.
I’m not saying there’s a clear solution.
I’m not saying I have an answer.
But I do know this:
We can do better. – Emily Solberg, Writer at Shower Arguements.
Thank you, Emily, for this! I 100% agree with you! Some of those questions even for myself aren’t speaking to me, they seem to have missed the mark. The options given are confusing as well, how they are set up.