Ep 196: Marielis’s Birth Story – Healing from Postpartum Psychosis

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In this episode we have Marielis sharing her experience with postpartum psychosis. I usually don’t do two birth stories in a row but in light of the Lindsay Clancy case I thought it was important to release this one today. If you haven’t heard about it yet, Lindsay Clancy strangled her three children and is now a paraplegic as a result of a suicide attempt. It is suspected that this was due to postpartum psychosis.

Postpartum psychosis is relatively rare, occurring in only 1 to 2 births out of 1,000. And homicidal behavior is uncommon among those with the diagnosis. Psychosis is a disturbance in an individual's perception of reality which can manifest in the form of delusions and hallucinations among other symptoms.

This is what Marielis experienced after giving birth. Once she realized something was wrong, she did everything right: listened to her intuition, communicated that she felt off, sought help early, and followed through on her medication and therapy plan. Today she is doing well and wants to spread awareness in hopes of preventing future tragedies.

In this Episode, You’ll Learn About:

  • What psychosis felt like for Marielis
  • What the early signs were that something was wrong
  • How her condition made her feel about her baby
  • Why being a woman of color made her hesitant to seek care
  • How her family supported her during her mental health crisis
  • How Marielis’s psychosis was treated
  • What risk factors increase the likelihood of postpartum psychosis
  • When postpartum psychosis presents after birth

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Transcript

Dr. Nicole (00:00): In this episode, you're going to hear about Marielis's experience with postpartum psychosis. Welcome to the All About Pregnancy & Birth podcast. I'm Dr. Nicole Calloway Rankins, a board certified OB gyn, who's been in practice for nearly 15 years. I've had the privilege of helping over 1000 babies into this world, and I'm here to help you be calm, confident, and empowered to have a beautiful pregnancy in birth. Quick note, this podcast is for educational purposes only and is not a substitute for medical advice. Check out the full disclaimer at drnicolerankins.com/disclaimer. Now, let's get to it.

(00:52): Hello there. Welcome to another episode of the podcast. This is episode number 196. I am so glad whether you are a new listener or a return listener, that you are spending some of your time with me today. So this episode is a bit out of order in the sense that I just had a birth story episode last week. However, with the recent story of Lindsay Clancy, I thought it was important that we talk about postpartum psychosis today. If you haven't heard, Lindsay Clancy is a mom in Massachusetts who strangled her three children to death, and then she tried to commit suicide. As a matter of fact, she's a paraplegic now as a result of her suicide attempt, and it's suspected that she suffered from postpartum psychosis. And in this episode, we have Marielis sharing her experience with postpartum psychosis. We actually recorded this episode back in the fall, but there were some audio issues, so we had to record it again.

(01:54): And I'm actually grateful that we got to record it again because I think she added some additional context and details that really give a complete and full picture of her experience with postpartum psychosis. So you're just going to learn quite a bit from this episode today. Now, just a quick overview. This was her first pregnancy, first baby. She had a pretty normal, healthy, uncomplicated pregnancy. She did have a unplanned C-section, but otherwise things were pretty straightforward. And then about a week after her baby was born, she started to feel a bit weird. She subsequently was diagnosed with postpartum psychosis, and she's going to share all of those details about that journey in the episode. Now, I'm going to give it away that she is doing well now today. She's doing great. She was checked into a mental health facility for six days when the diagnosis happened. She has subsequent therapy and treatment, and she feels like herself again and is doing well. But you're still definitely going to want to hear the details of how she got to that point today. So without further ado, let's get into this conversation with Marielis about her birth story and her experience with postpartum psychosis.

(03:25): All right. So Marielis, thank you again for coming onto the podcast again. The first time we recorded, and unfortunately the audio wasn't great, but your story is so important that we really need to talk about it. So I'm glad that you came back. So we can do a take two.

Marielis (03:41): I'm so glad to be here and talk about this and just raise awareness about it.

Dr. Nicole (03:45): Yeah, absolutely. So why don't you start off by telling us a bit about yourself and your family.

Marielis (03:50): So I am from Puerto Rico but I live in Florida. I only have one baby. She's a year old now. She just turned a year old. And first pregnancy, first birth first everything. First time mom, everything.

Dr. Nicole (04:09): All right. And you said you're from Puerto Rico, but you're where now? Florida. Florida. Florida. Okay. All right. So let's talk about, in order to understand the birth, and we're, we're going to be talking a lot about your postpartum period, but let's talk about what was your pregnancy and your prenatal care?

Marielis (04:24): So pregnancy was just very smooth. Nothing, no nausea, no crazy cravings, nothing, no issues at all. I had a little bit of a high thyroid, but that was about it. And I was on medication for it. I feel like I was stressing out a little bit. Maybe towards the end I was like, I get everything ready. Right, right, right. I'm the same person. I have want everything a certain way, the nursery and everything. So

Dr. Nicole (04:52): That was just

Marielis (04:53): The third in a third trimester.

Dr. Nicole (04:55): Gotcha, gotcha. And did you see midwife or physicians?

Marielis (04:59): It was a midwife.

Dr. Nicole (04:59): Midwife. Okay. And you were overall happy with the care that you received?

Marielis (05:03): Yes, I was very happy with the care I received. They were incredible.

Dr. Nicole (05:07): Good, good, good, good. So what did you do to prepare for your birth?

Marielis (05:11): So I was taking birthing classes. I was doing hypno, birthing, that's what it's called, hypnobirthing, that kind of Gotcha. I was preparing to do everything natural. I had no intentions on doing an epidural. I mean, I was doing, what ended up happening is I was doing the night, was it nitrous or something? I was doing that for a while.

Dr. Nicole (05:37): Got it, got it, got it. And what are some things that you wanted for your birth?

Marielis (05:40): I definitely wanted skin to skin, like cord clamping. I just wanted it to be very intimidating, just, well, it was in the hospital anyway, so it's not like we could have a lot of people there, but. Right. And her father. Gotcha.

Dr. Nicole (05:55): So, gotcha, gotcha. So let's talk about then, what was your labor and your birth?

Marielis (06:01): I got to the hospital when I was four centimeters dilated. But yeah, that kind of gave me a kick. I was like, oh, wow, I can do this. I can do that.

Dr. Nicole (06:08): Yeah. And how far along were

Marielis (06:09): You? I was 40 weeks and five days.

Dr. Nicole (06:11): Okay, so five days past your due date. Okay.

Marielis (06:14): But it was my first birth, so apparently that's normal. And so if she wasn't going to come the day after, they were like, oh, we're going to start induction. And I was like, no, no, no, no, no. I want natural. Natural. And they were like, mean, she can't stay in there forever. Like,

Dr. Nicole (06:31): Let's wait.

Marielis (06:33): And I was on, nitris, kind of stopped working, so they put me in the shower.

Dr. Nicole (06:41): Did that help or?

Marielis (06:42): Yeah. Yeah. Yeah. It helped. It helped. Yeah. I was, I got to be like, I don't know how many centimeters, but I have to be almost ready to push because I'm at right step forward. I feel like I was in here forever. I must be ready. So I come out and then I'm only at six, and we waited another hour. I was still at six. We waited another hour. I was still at six. And I was like, okay give me the epidural. Give me the epidural. Okay. Cause I mean, clearly something's not right there. So sure. Give me the epidural. Then a few hours later, I was at nine centimeters. I was able to take a nap. So I took a nap. And

Dr. Nicole (07:22): Which often helps.

Marielis (07:24): Yeah. Yeah. So I took a nap, and then I was at nine centimeters for I don't know how many hours, Dr. Nicole (08:13): Well, you couldn't have known. I

Marielis (08:14): Know, I, I was feeling bad in my head. I'm just like, oh, sure. So many professors that were going

Dr. Nicole (08:19): On. Right.

Marielis (08:20): So yeah, we C-section, everything was fine. I breastfed her for the first time. It was just perfect.

Dr. Nicole (08:26): Oh, and how did the C-section go? Was that pretty straightforward and

Marielis (08:29): Pretty straightforward? Amazing. After the smallest incision, it was just okay. He did such a good job. It was a lot of fun. Actually. I was laid out on the table. They let me play my own music, and I was just nice sitting on the table dancing, okay. Was a lot of, everybody was like, oh my God, I love your music. It was fun. It was a good time.

Dr. Nicole (08:50): Okay. What kind of music were you playing? We have to

Marielis (08:53): Know. Oh, it was a whole mixture of stuff. Like Spanish music, I don't know, little Wayne,

Dr. Nicole (08:58): Just everything. It was

Marielis (09:00): Like, I created this playlist for birth. That was every song that I've ever memorized, every song that I know every lyric to, that's what I want so that I can be distracted while I'm giving birth.

Dr. Nicole (09:13): That's a smart idea.

Marielis (09:14): I was just like, okay, I'm going to be in another world. I'm just going to be my head somewhere else. Hopefully this is a good distraction. Which it was when I was getting right. I was just like having griddle time. He was like, do you feel them? Do you feel something? And I was like, yeah, I feel something, something. There's something going on down there. He was like, yeah they're just drawing a smiley face on your stomach A little house stick figure. And I'm really for can. So I can see they were cutting open.

Dr. Nicole (09:45): Yes.

Marielis (09:47): I's good. Distrac a good job. Distracting me.

Dr. Nicole (09:55): Oh, that's good. Yeah,

Marielis (09:56): It was good. It was a good, it was fine. But I had a little bit of stress because my parents were here from Puerto Rico and some other family, my grandma and stuff. And they were leaving, I think it was two or three days after. So I was rushing to get out of the hospital, kind

Dr. Nicole (10:14): Of. Sure. But

Marielis (10:16): I was just like, I'm good, doctor. I'm good. Which I was good. I was fine, but I could have stayed longer. I feel like I shouldn't Gotcha. Rush out of the hospital. But I did rush out of the hospital. And then when we got home

Dr. Nicole (10:30): And you said you were breastfeeding and that was going okay?

Marielis (10:32): No, they were like, she's losing a lot of weight, so we have to give her some formula. And I was just like, no, no. Same thing. I was just like, no, I just feel like I'm the type of person to picture something a certain way, and I want it that way,

(10:48): Which is what happened. So I didn't get the breath I wanted. I didn't get to breastfeed. I mean, I breastfed, but I didn't get to Sure. Still get your formula. I wanted the nursery a certain way. I just had this picture in my head that I wanted it this way, and then it just had to go that way. It didn't go that way which got me a lot of lessons which we'll get into. Sure. Yeah. So I got out of the hospital as soon as I got home. As soon as I got home, I had this picture in my head again. I got home with my mom and dad and my grandma who were leaving to Puerto Rico. But I got home and my entire family was there. My entire family was there. So it was kind of overwhelming. Some kids jumping around and I birth, everybody was there. I feel like it wasn't what I pictured in my head. So I'm just telling you all the stressors that I had, all the things that went happening. Yeah. Back to back. And

Dr. Nicole (11:42): Of course, they didn't mean anything, but they wanted didn't anything at all. They didn't mean anything. But it's a lot after you have a baby, to have so many people. It's a lot.

Marielis (11:50): Which, no, of course, I wanted my family to meet her, obviously in my head. Ok, they're leaving first, so let's have a little intimate thing. But not that, I even don't even think I even voiced that at one point. At any point. Sure. So I just had this picture in my head. So then she was here for a week. My parents were here for a week. They left the day that they left. I didn't sleep that entire night. I couldn't sleep. I just felt like I needed to be awake in case she needed something. I just felt like I had to do her home. Nobody's going to take care of her, me or kind of thing. And I just had mentality. I was just like, I can't go to sleep. And so I didn't really go to sleep that night. So that whole night I was awake, and then I started having the delusions. So I had postpartum psychosis. So

Dr. Nicole (12:38): Yeah, tell us. Yes. So tell us about that. How did that start?

Marielis (12:42): So at first it was, I felt like I was here sometimes. And then I felt like I wasn't here sometimes. So it was kind of like a light switch. I was here and I was present, and I was able to function properly. And then I was manic for a certain amount of maybe hours or something like that. And I would feel feelings, and I can remember thoughts that I was having, but it was just very manic. I wanted to buy things. I wanted to go out. I wanted to go run away, or I don't know, people were watching me. It was just a whole very manic, very just in and out. I wasn't in touch with reality at. And then sometimes I would be here and I'd be like, what did I just miss? What did I just miss? Listen. I would write myself notes. I would record myself, tell myself these things, like relax, this is not true, or this is not happening. Or try to calm myself down so that I can watch or read these things when I wasn't here. So I could not freak out. Which I don't even know if that helped or not. But just what I thought in my head would help me. Oh, if I tell myself to relax, relax or something.

Dr. Nicole (13:48): Right, right. So did you have a sense that something was off?

Marielis (13:53): Yes. So that I had a sense that something was off. I told her dad, I showed her the paperwork on I that they gave us from the hospital. Postpartum depression, postpartum blues or baby blues all the things that are there. But psychosis was a sliver, this big just oh, sentence or two kind of thing. It just wasn't very in depth. So he was just like, oh, it's on your head. Just try to relax. You have to. And then my mom was like, oh, be careful. Cause postpartum depression, da da, da. And I was like, how do I be careful? How do I can't control? How do I control? So I'm stressing even more like, oh, these people think these people. If they think I can control it, then I can probably control it. And I feel like I can. I thought about that kind of thing. It was just And

Dr. Nicole (14:39): Were you hearing voices telling you things?

Marielis (14:42): I was hearing voices. I was hearing alarms. I was hearing ambulances. I was hearing it was just hallucination. Just hallucination. My main symptom was paranoia. I didn't want to go by the window. I didn't want to go outside. I felt like they were coming to get my baby coming to take her at. And then to some point where it was like, is my baby even here? Is she even real? Is she alive? I haven't seen her. I haven't really, yeah, I just felt like I wasn't in tune with reality. So then the times where I was here and I was in reality, were getting shorter and shorter. So I was kind of more manic and more not here. And

Dr. Nicole (15:23): Were you sleeping at all

Marielis (15:24): Or No, no, no, no, no, no. That was for two days. I didn't sleep. And I was trying to hide all this from my mom. I was like, don't tell my mom. I know what it's like to be a mom now. I know what it's like. Kids, I don't tell my mom. And obviously they told my mom. And she surely got on a plane, got right back on the plane, came right back. So

Dr. Nicole (15:44): Your mom had left at that point?

Marielis (15:46): Yeah, she was already gone. She was al. She was gone. Okay. And then I didn't sleep that one night. And I didn't sleep. I didn't sleep maybe two or three days. And then she just had right back. Cause they were telling her that something is definitely wrong. So I heard a few of your podcasts and other people's podcasts. And I just feel like a lot of minorities don't get the help that they need because I don't know if it's that they don't believe mental health or you can control your mental health if they can fix it with tea or with this. And then they feel like people you can get your kids taken away if you have this kind of stuff. So we have to hide this. What I'm saying, it's a lot of so my mom felt she can come back and she can feed me food and she can get me the family around.

(16:36): My family was around, they would always FaceTime me, call me. I wouldn't even sure. They were trying to support me in any way that they could. And it was hard for me. It was really, really, really hard for me because they would FaceTime me crying, crying, and I'm like, why are you crying? Why are you guys always crying? I'm just in my head, what's going on? What's wrong with me? Some, they're crying because of me. I did something. What did I do? Did I hurt someone? Did I hurt myself? Did I hurt my baby? Is I just felt like something happened that I missed. I missed something because I wasn't fully here. So I, I felt like I did something.

Dr. Nicole (17:09): So did you ever have any thoughts of hurting your baby?

Marielis (17:12): Me? No. I didn't. But a lot of people do have those thoughts. A lot of people do have those violent thoughts. I did have thoughts of running away or I don't know. People were out to get me very, very much paranoia. I didn't have any thoughts of hurting myself. But I did question if I had hurt someone because I wasn't in my brain. I was like, I didn't sure what had happened. So I personally didn't have thoughts of hurting myself or my baby or anything like that. Sure. I felt like since I wasn't here, I was just worried as to what did I do? What will I do? I'm alone. Nobody leave me alone. I couldn't have to be by someone at all times. Somebody had to seen my baby at all times because I just didn't know. I didn't know who I was and I wasn't here.

Dr. Nicole (17:54): And what was the time period that all of this,

Marielis (17:56): So this has been the first two weeks that she was born. So this is the first week. So my mom was here for a week. She left two or three days. I couldn't sleep. She came back

Dr. Nicole (18:07): And she was thinking, I'm going to help her. I don't, because like you said, are they going to take the baby away? Are they going you and are. You're in the Hispanic community. I'm in the black community. We have those communities of color. We have those concerns. Yeah. Yeah. Is somebody, you know, CPS going to get involved? Those kinds of things.

Marielis (18:24): Exactly. Exactly. Don't, I'm not sure which podcast it was. I just remember people say that minorities get the least amount of help with this kind of stuff. I'm just like, and that was running in my head at that time. Sure. Is this because of this? They think it's something that you can just snap out of or something. Be careful or try to control something that you can control. Which it was just out of my control completely. I just wasn't me in that timeframe. I just wasn't me. And I say that to say, some people do have violent thoughts. Some people act violently in those cases. Some people go to jail. Some people do get their kids taken away. Some people, it's a scary thing if you don't get the help that you need for this. Absolutely. So my mom asked for a few days and realized it wasn't something that I can control. It wasn't something that she can help. It wasn't something that anybody could help. So she took me to the hospital first. We got finally it was a few days before we could get somebody over Zoom to help me to nurse me something. And she was like, she has psychosis. You have to take her to the hospital. You

Dr. Nicole (19:39): Have to. So was this the midwife or was this a

Marielis (19:42): No, no, no, no, no, no, no. We went to the doctor for a checkup. We went to the midwife checkup. And the doctor that did my cesarean was there. And he was just prescribed me some kind of medication, some kind of mood stabilizer or something like that. And so that wasn't enough going. We didn't think that was going to help. We didn't think, I don't even know if I even took it at any point, but we just were like, no, that's not the solution that we needed, basically. So she was like, when the psychiatrist told me that needed to go to the hospital, that's when she was like, okay, we have to take her her.

Dr. Nicole (20:20): So you were able to find a psychiatrist who saw you over Zoom? Yes. That's pretty impressive. No,

Marielis (20:26): It really, really was impressive. It really was. It was days before we could, they were searching and searching and searching and searching for somebody that would take payment. Just payment. I'll pay you in full here. I'll pay you in full. Can you see from right now? It was very, very hard. And giving the symptoms or people, the symptoms that I had, they were kind of just like, oh, take her to the hospital. But they were just like, well, let's see if we can can speak. Cause I kind of felt like I wanted to speak when I had that, when I had the psychosis, I was just spilling my guts. Everything came out. Everything has trauma. Every single thing that's ever happened to me basically just came out in that moment. And a lot of people say that psych, that this postpartum, this type of part, postpartum breaks up marriages, breaks up families, because there's just a lot of stuff going on that you can't

Dr. Nicole (21:20): Control. So the psychiatrist saw you and was like, take her to the hospital right now?

Marielis (21:23): Yeah. And then my mom yeah. They took me and I was admitted and I was in there for six days

Dr. Nicole (21:32): And the psychiatric unit in the hospital.

Marielis (21:35): So you have to enter through the hospital and you have to wait for, first of all, a covid test. Second of all a room to open up, I guess. So I was in a hallway at the hospital for I don't know how long. It felt like I was there for days. I don't know how long it was. I was in a hallway on a hospital bed, lined up with some people that were also in a hospital bed waiting for my covid results to come back. So I was just kind of going, people would walk by and I'd be like, do you believe in reincarnation? And just random things. I got some things that would just go on in my head was just, I wasn't here. It wasn't me. It was just me in my head because I couldn't do anything or go anywhere. I was just on this little bed, just psychosis, running wild in my head, basically waiting for these results.

(22:24): I finally got the results back and they put me in a room. I think they injected me with B12 or something, some kind of energy to give you some energy to see if I don't know what, I don't even know. And they were giving me my thyroid medication, and I think they gave me mood stabilizers. Yeah. Okay. I was in the bed for, I don't know how long as well. I don't know how this, I was in there for six days. I don't know what part was what. But sure. I got a roommate and she was like, Hey, why don't you let me take you on a tour? There's phones. You can make a phone call. And I was just like, no, no, no. I'm scared. I'm scared. I can't can't. She was like, right, just come. Just come. She grabbed me by the hand.

(23:03): She was like, just come. Just, it's fine. It's fine. She took me to the phones and I called my sister. And I don't know how many days I've been in there now. It's been a few days. But I called my sister and she's like, I'm actually here. I dropped some clothes off for you. And I was like, you're here. Well, I want to see you. I want to see you. Are you really here? Or am I hallucinating? Because I went through some crazy thoughts. So I'm like is this real? This real? If you're really here, I want to see you now. She's like, well, I can't see you. I can't see you. So she was like, do you have a window? And I was thinking, and I was thinking, I was like, wait. Yeah, there's a huge window where in my room. And when I look out that window, I remember that. That's where she dropped me off at. I, for some reason, I'm in psychosis, but I remember that you dropped me off there. So go there and I'll come over there and I'll see. I dropped the phone. I just dropped the phone. I didn't even hang it up. I didn't even hang it up. I just dropped it. And I ran to my room. And when I saw her around the corner, my flight, every ounce of sight, closest that I had left my body,

Dr. Nicole (24:15): Everything

Marielis (24:15): Just flooded back. Everything was just, I just felt me again when I saw her. Right. This is, she's really here. I really hear her voice. I don't hear anything but her voice. Everything is just, I'm just like, I, right. That was

Dr. Nicole (24:32): It. Right. And then after that, you felt like yourself?

Marielis (24:37): Just like myself. Ever since then. And that was a year ago. Dang. Which is a really, really interesting story because a lot of people don't come back from it right away. A lot of people don't come back from it at all. A lot of people have it. And then they have episode or they take months. They have to be on medication for month. So I choose to believe that. I was very, very lucky. But I did have a lot people, lot of people praying for me. A lot of people coming to visit me at the hospital. A lot of people just came to see me at the window. My baby came to see me at the window. It was luckily I had the support that I had and I got the help that I

Dr. Nicole (25:20): Needed. Sure, sure. But you got the help you needed. So you were there for six days. And then were you on medication afterwards?

Marielis (25:26): Yes. I was on medication for six months. Afterwards. They decreased it every month. It, they were mood stabilizers, but at a very low dose. Cause I was breastfeeding.

Dr. Nicole (25:35): Sure. And then did you have a history of depression or anxiety or anything?

Marielis (25:41): I've never had any history of mental health, nor does anybody in my family.

Dr. Nicole (25:45): Nothing. Nothing. Okay. Wow. Did you continue to see a psychiatrist or do you feel like now things are in a good place? I

Marielis (25:55): Was seeing a psychiatrist for those six months that I was on medication. And I was also seeing a therapist who specializes in psychosis. And I still see her. I still see her. Just, therapy is good for everyone, obviously, but

Dr. Nicole (26:07): That's the truth. Yes.

Marielis (26:09): Yeah. I've been seeing her this whole time and,

Dr. Nicole (26:18): And then when you look back, it's just interesting to me how you knew something was wrong and you were in and out of yourself and just, it's just cra. I mean. Oh.

Marielis (26:30): And I just knew when I said it, from the moment I felt it, I remember the exact moment I felt it. I remember that my baby's father gave me my meds, my meds for my C-section. They just had a C-section my whatever, my Tylenol or whatever I was drinking, that kind of stuff. And I was just like, I don't trust it. I don't want to take these pills. Don't something telling me not to take these pills. Something is telling me that. You're like, I don't know that you're trying to poison me or something. I just felt in my head, no, this is weird. This is weird. And ever since then, I told him, I was like, I didn't take those meds. They were on the counter. Cause I don't want to take them. Something's not right. Something doesn't feel right. And he was just watching ever. And then when the doctor, the check and he told psychiatrist or the doctor that did my cesarean, that I wasn't feeling something was wrong and he prescribed me that stuff. But I was in the doctor's office and I was texting him and I was like, something's not right. They're trying to take my baby. When I got into that, I knew something was wrong. I was just like, no, no, no. Don't leave my side. He can't leave me. Couldn't come in and

Dr. Nicole (27:45): Right.

Marielis (27:45): Something's not right. There was actually a doctor or a nurse there who was Colombian. She was Spanish too. And she was like, oh, you're such a strong Hispanic woman. You're very, very strong and hardheaded. I know how Hispanics are. And she was just hinting out, if you need help, if you need anything, help sure say that it's OK to be strong and ask for help. Right. Hinting at that. And I was just like, she knows something's wrong. They know they're going to take me or they're going to take my baby. It was just, that's where all went downhill. And it was just four, seven. Watch from there were just like, oh

Dr. Nicole (28:25): My

Marielis (28:25): Gosh. Shov right here. And even through all of that, even after leaving to the hospital for six months, I was still able to breastfeed after. And I'm still breastfeeding after.

Dr. Nicole (28:36): Oh, look at you.

Marielis (28:37): I'm just so proud of it. I'm just so happy about it. I still left to the hospital for six days. Didn't my boob leaking all over a hospital gown. It was just so bad and right to breastfeed. And she's healthy and I'm healthy. Sure. She's so perfect. Ever since there's nothing, no. Not even an ounce of like, oh, did I just hear? Heard anything.

Dr. Nicole (29:03): Right. Right. Wow. So I guess this recent story of the woman who maybe have postpartum psychosis and killed her children. When you hear stories like that, how does that make you feel?

Marielis (29:16): Well, I really want to talk about this. I really want to talk about this really bad. Cause I feel like when I got out of the hospital and I had just put my family through so much, I had to put on this brave face. Nothing. Just nothing happened. I feel like I didn't get to deal with what I went through. And then I saw a video of what happened with her, with this woman. She was a nurse. She had three kids and her husband left for five minutes to get takeout. And she strangled her kids. And then she tried to jump out of she did jump out of a balcony.

(29:57): She didn't die from that or anything. And she had postpartum psychosis. She was actually actively getting help for that. I think she was in, obviously she was home, so I don't think she was admitted or anything like that. But so it just hit me so hard. It just hit me so hard. That could have been me that, but you just never know. And then I just see people, how could she do that to your kids? And how could anybody do this? And I'm just kind of, it's not her. It's not her. It wasn't her. She wasn't there. That wasn't her. And to think that she's going to come back to herself because this is only temporary. This only lasted a year, max a year. She's going to come back and she's going to realize what she did. You know what I'm saying? And it's just going to be so hard. Yeah. She's going to be prosecuting that kind of stuff. And it was just so hard. It was so hard to see that story. It was so hard to see the comments that made about that and so hard to realize that happened to me.

(31:06): I really, really want to raise awareness about post cause. Sure. It's so rare.

Dr. Nicole (31:12): Right.

Marielis (31:13): There's not enough research on it. People don't talk about it enough because it's so rare. But it's so important. It's such a medical emergency.

Dr. Nicole (31:22): Absolutely. And

Marielis (31:23): You have to be treated right away, right away. And if you don't, bad things can happen. And so blessed that wasn't happen to me, but

Dr. Nicole (31:34): Yeah. Well, how do you feel about having more children?

Marielis (31:38): So my mom is like, you want more kids? Are you crazy? Crazy? I, no, I don't think you should. I want more kids. I feel like I said, I feel like a lot of things that, a lot things happened to me that played a part into why I got the psychosis. And I feel like I've learned so much from it. Main thing being let go of this perfect picture that you have in your head. If things don't go that way, it's ok. It's ok. Right, right. The flow, relax. Right. It's very, very important to be stress free in your trimester. Well, in every trimester. But mainly I feel like mainly your third. You need to be getting rest. You need to be not reorganizing a nurse for

Dr. Nicole (32:31): Sure. Sure. Focus

Marielis (32:32): On what your body's about to go through. Sure. For a C-section even that wasn't your plan.

Dr. Nicole (32:39): That

Marielis (32:39): Even cross my mind every a million years.

Dr. Nicole (32:42): Never. Never that. I was just like,

Marielis (32:43): That will never happen. So it's fine. Not even a thought ran through my head.

Dr. Nicole (32:48): Yeah. Yeah. And then have you connected with anybody else who has had postpartum psychosis?

Marielis (32:55): Not specifically, but I am in group, in a psychosis group where just a lot of people on there who had it and who don't. I don't know. The first post that I saw when I joined the group was, does anybody actually really get over postpartum psychosis? And I'm just like, people don't get over this. People really linger. That kind of lingers sometimes if you're not careful. If you're not, you're not actively looking to, but they give suggestions on ways on how to prevent it and being stress free. Medicating yourself before you give the birth, because already. So I feel like I definitely would have kids. I would just take very, very precautious. Sure, sure. Take off trimester two, I'm not going to work. I'm just going to relax. Right.

(33:52): Be as bossy as I

Dr. Nicole (33:53): Can. Gotcha, gotcha. Gotcha.

Marielis (33:56): Crib a little.

Dr. Nicole (34:00): Well then as we wrap up then, what would be your favorite absolute piece of advice that you would give to anyone? Listening.

Marielis (34:06): Check on your friends. Check on your family. Check on everyone that has recently given birth. Check on them. Ask them if they need anything. Even if it's an hour of sleep, if you can watch the baby for one hour, just to have them sleep or relax or something. Get them out of the house, invite them somewhere or that's

Dr. Nicole (34:30): It. Yeah. Well, thank you so much for being so open about sharing your story. It's just really important for people to hear about this and understand and know that this happens and that you can come back from it. I think that's really important to know. You can't come back from it

Marielis (34:48): As long as you're actively working on things that need to change within yourself or drink your prenatals. And

Dr. Nicole (34:58): Just to be aware of it. Because it was like,

Marielis (35:00): I think that's what I want to get out of this talking about this is more awareness on this because it's an emergency. And so I feel like people around, the people that are giving birth also need to know about this. Everybody needs to know about this because it could be you. A loved going. Depression. Depression. It's not that. It's not just as easy as go outside or take whatever. It's different. It's different from depression. And people don't even

Dr. Nicole (35:30): Know that. And that I had never heard it framed like this. And I think that's a really, really important, this is a true medical emergency. We think of things like bleeding or all of those things in an emergency. We don't necessarily think of mental health crises as an emergency, but this really is a true emergency.

Marielis (35:52): No there, there's people out there that have had this, that have violent thoughts to hurt anybody themselves or anybody. So you know, never know what's going to happen. Luckily I had, if I didn't have people around me, you know what I'm saying? Who knows what would've happened if I didn't have the support around me. If it was just me and my baby home alone, who knows what could happened to me? Because once I had it, I didn't want to look at her. I didn't want to hold her. I was just like, somebody take care of her. Cause I'm busy trying to not be

Dr. Nicole (36:19): Crazy. Right, right.

Marielis (36:20): Yeah. So I just feel like people, everybody should be aware of this. Cause it could happen to you. It could happen to anybody that doesn't suffer has never had a history of mental health. It could happen to anybody.

Dr. Nicole (36:30): Absolutely. Absolutely. Well, thank you so much. I so appreciate you coming on.

Marielis (36:34): No problem. Thank you for having me.

Dr. Nicole (36:44): Wow, wasn't that an incredible story? I'm so glad that she is doing well today and that Marielis is happy and healthy and was able to fully recover from her postpartum psychosis. And I so appreciate her coming on to share her story today and raise awareness about this important topic. Now, after every episode, I do something called Dr. Nicole's Notes where I talk about my top takeaways from the conversation. And my Dr. Nicole's Notes are going to be a little bit longer in this episode because first I want to share a little bit about postpartum psychosis. So postpartum psychosis is relatively rare. It occurs in about one to two per 1000 births. However, 4 million women have babies every year in the us. So that actually translates into about 4,000 cases a year of postpartum psychosis, most, which we don't hear about. That risk increases with certain risk factors.

(37:39): The risk is higher for women who have a previous history of postpartum psychosis. It goes up to one in seven births. The risk is higher in women who have a history of bipolar disorder. It's one in four births. And if a woman has a history of bipolar disorder and a family history of postpartum psychosis, those women actually have a one in two chance of having postpartum psychosis. Postpartum psychosis is most often seen in patients that have been or will be diagnosed with bipolar disorder. But it can also occur in women who have a history of major depression disorder, schizophrenia or s schizoaffective disorder. And there is a good subset of women who experience isolated postpartum psychosis that does not progress to mood or psychotic episodes outside of the postpartum time period. And that's what it seems like Marielis had. Now, psychosis, to be clear, is a disturbance in an individual's perception of reality and it can be manifested through one or more of the following ways.

(38:44): One is delusions and delusions are fixed. False beliefs and delusions in postpartum psychosis typically involve delusions surrounding the baby Over half, about 53% of women with postpartum psychosis have delusions like their baby is ill faded, or their baby is the devil or someone is going to take their baby away. People also have hallucinations, which are sensory experiences without actual sensory stimulation. So you can feel things, hear things, see things taste, things that smell things even that aren't actually there. Psychosis also involves thought, disorganization, and disorganized behavior. Now, most commonly it presents within two weeks of childbirth and persistent severe insomnia. So more than just not being able to get enough sleep before when you have a new baby, it's persistent and it's severe insomnia that's actually not related to caring for the newborn. So the newborn pieces can be fine without much issue, but you're still having persistent severe insomnia that is often the first indication of impending postpartum psychosis.

(40:04): Okay. So persistent severe insomnia is often the first indication. Interestingly, that seemed to happen in Marielis's case as well. Now there is also an increased risk of suicide and postpartum psychosis as well as homicidal behavior, although actually homicidal behavior is rare. So the suicide risk increases as high as 11% in women with a first episode of postpartum psychosis. And then regarding homicide approxi, approximately 4% of women with postpartum psychosis have been found to commit infanticide or kill their children. So thankfully, not very common. Now the next point that I want to mention is that I want to reiterate this because this is something that I don't think we say a lot of in the medical profession. And honestly, it is not going to be your ob gyn who diagnoses you with pre postpartum psychosis. If it happens within the first two weeks, which is most common you are very likely not to see your OB gyn for six weeks postpartum.

(41:18): So it very well may be your pediatrician. In the case of Marielis, they had to find another healthcare provider who was able to diagnose her. I don't know how they were able to find a psychiatrist to do a Zoom appointment that quickly, but thank goodness they did because it probably saved her life. But I want to highlight that this is a medical emergency, all right? We don't often think of psychiatric things as being medical emergencies, but this is a really true medical emergency that needs prompt attention. So if you see someone around you, if you yourself are having difficulties, then get help quickly because it is a true medical emergency. And I totally get the hesitation potentially about seeking out mental health, especially in communities of color. I am not making it up. This isn't like some, oh, you're worried for no reason that CPS may be involved.

(42:14): Child Protective Services. There are ample studies that show that black folks and brown folks have CPS called or involved in their care more than white people. So I totally get that hesitation for those of you who are from those communities of color. But this is a real true medical emergency and you want to get help for sure. And I wish I had a better sense or I hope we get to a point within obstetrics care that we are the ones who are checking in on folks more frequently. But no, that it probably, but no, that it's probably not going to be your ob gyn who diagnoses you with this because typically you're not going to be seen for six weeks, and this is going to happen within the first couple weeks after birth. And then the final thing I want to say is she talked about, Marielle has talked about how the stress of the nursery or the stress of how she didn't anticipate or wasn't prepared at all for the possibility of a C-section, how those things may have weighed into her experience.

(43:21): We don't know what causes postpartum psychosis, and actually there isn't evidence that stressful life events lead to postpartum psychosis. But I do think stressful life events can contribute to depression. They can contribute to your overall mental health. And in the case of birth, one of the ways to, of course, decrease the perception of stressful things is to understand what possible things can occur and be prepared for that possibility. Arming yourself with more information is not going to manifest tragedy. It just helps you to be in a better spot to deal with the ups and downs of things that may happen during your birth. Of course, listening to this podcast is a great way of doing that. But there are other things like childbirth education or reading books. Of course, you can check out the resources I have. You can come join me in the birth preparation course, dr nicole rankins.com/enroll.

(44:16): But please educate yourself and prepare yourself for these possibilities to kind of decrease that. I'm, I'm not going to say it's going to decrease the stress or well, and maybe it will actually, but it'll certainly help you deal with it better when you are more prepared for the possible things that may occur. All right. So there you have it. Do me a solid share This podcast with a friend. Sharing is caring and everyone needs to hear about this topic in particular. Also be shared to be sure to subscribe to the podcast wherever you're listening to me right now. And let me know what you think about the podcast. Leave me in review an Apple podcast or in this particular episode, shoot me a DM on Instagram at Dr. Nicole Rankins. I love to hear what you think about the show. And again, make sure you're prepared for birth. Head to my website, drnicolerankins.com. I have tons of resources there. Follow me on Instagram for more information. Just find sources that you trust to help you be prepared and ready for your birth. All right, so that's it for this episode. Do come on back next week and remember that you deserve a beautiful pregnancy and birth.