Filed under: The Baby Diaries | Tags: American doctors, American medicine, baby blues, birth, British doctors, depression, French doctors, French medicine, insomnia, new infant, post partum, Susan Sontag
Depression is melancholy minus its charms…Susan Sontag
Having a baby triggers a heap of emotions both good and bad – pleasure, joy, enthusiasm, apprehension, anxiety, and, often, depression. Yes, that’s right. I’m daring to talk about the elephant in the room. The one that Brits don’t generally like to talk about and Americans talk too much about. When Brits talk about depression, their views often reflect their ignorance and outdated myths (or repression): it’s a sign of “weakness,” it’s self-indulgent, and one needs to keep their “chin up,” be positive, and all that. One thoughtless English ‘friend’ recently said to me, “Oh, I simply don’t have the luxury of depression!”
Regarding depression following the birth of a baby, rest assured it’s a complication of birth, not narcissism or an inadequacy on the part of the mother. It can happen a week or two after giving birth, it can happen a year after giving birth, or it can happen after nursing stops. Experts no longer regard depression’s cause as being purely physical, circumstantial, or emotional, but, rather, a combination of reasons. Physically speaking, after a woman gives birth, there’s a dramatic drop in hormones (estrogen and progesterone), and other hormones produced by the thyroid also drop sharply. There are changes in blood volume and pressure. Changes to the metabolism and the immune system. The mother’s lifestyle and emotional circumstances also can prompt depression. Perhaps the baby is demanding. Maybe there are other siblings. Perhaps she has difficulty breast-feeding. Or there’s a lack of personal and practical support. Her body changes, she feels less attractive. She struggles with her sense of identity as she feels a loss of control and independence.
The most common form of depression is called “the baby blues.” This lasts for a week or two, and causes the new mom to be moody, anxious, irritable, tearful, and unable to concentrate (though what new mother doesn’t feel this?). The second type is called “postpartum depression.” Symptoms include a loss of appetite, insomnia, intense irritability and anger. Overwhelming fatigue. No interest in sex. No sense of joy in life. Feelings of shame, guilt, and inadequacy. Severe mood swings. Withdrawal from friends and family. Thoughts of harming oneself or one’s baby. Difficulty bonding with the baby. The third type, and the most severe type of postpartum depression, is called “Postpartum Psychosis.” Symptoms include confusion, disorientation, hallucinations, delusions, paranoia, and serious consideration about harming yourself or your baby.
As mentioned, there has historically been a stigma to speaking about depression, so one is understandably reluctant and embarrassed to talk about it. But it is important for your own health, as well as your baby’s health, to talk to your doctor (in the first instance) about any combination of the aforementioned symptoms you may feel. Left untreated, each of these depressions can become more severe in nature and can lead to a chronic depressive disorder. Even when they’re treated, there’s an increase in a woman’s risk for future episodes of severe depression. Also, left untreated, the depression will affect your child negatively: studies show that the children of mothers with untreated postpartum depression have an increased likelihood of developing behavioral problems, such as sleeping and eating disorders, hyperactivity, temper tantrums, delays in learning development, language, and socialization skills.
The good news? It’s not your fault if you’re feeling depressed. And, contrary to the US, where doctors are so used to people asking for help with depression that there is an inadvertent “business as usual” approach, and contrary to the UK, where the whole “keep calm and carry on” myths prevail (it’s ironic to me that this British slogan was first used during WWII, and Winston Churchill was depressive and quite open about this fact), and one must beg for help with depression, the French are incredibly sympathetic, and they believe in a comprehensive approach. One that incorporates modern medicine, such as anti-depressants and sleeping pills, as well as holistic care such as acupuncture, meditation, vitamins, and yoga. So, if you’re feeling bad, and you suspect that you may be depressed, go talk to your local French doctor and read up on the maladie. Discover what it entails and how common it really is – you’ll be surprised at how much better you feel afterward, if only by learning that you are not unique in your feelings after all.
Filed under: The Baby Diaries | Tags: airline travel, American doctors, antibiotics for infants, baby illness, coach class, ear infection, Ernest Hemingway, French doctors, health, travel with infants
Never go on trips with anyone you do not love. Ernest Hemingway
When my boy turned six months old we decided that he was old enough to make the big trip to the west coast of the USA for a visit with my family. Life a good Frenchwoman, I utilised the healthcare services before leaving: I took my boy to the doctor to confirm everything was okay, particularly the ears, I have problems with my ears, too; got a few ‘in case’ prescriptions, then went to the chemist and bought saline solution for the boy’s nose, Doliprane for any pain or fever, cortisone cream for any skin irritations, and his regular creams and soaps. Luckily, my husband went to the US with me. I could not have done this trip alone.
Before boarding the plane in Geneva, we cleared the boy’s nose and gave him Paracetimal to help him relax. When the plane descended, I nursed him to help prevent pain in his ears from altitude pressure changes. It was the long-haul flight out of London that was rough. In the first instance, the airline provides either a cot or a little seat for the baby to have on take off and landing. Our boy was too big for the cot and the seat made him sit up and therefore not get comfortable for sleep. All around us babies and toddlers slept, but not our boy. By the end of ten hours, he was fussy and folks on the airplane kept giving us dirty looks as though we were pinching him. By the 12th hour of flying, I was about ready to pull my hair out.
Shortly after arriving in the US and settling into my family home, the boy came down with a fever. He was listless, hot, and clung to me as a baby monkey clings to its mother. We decided to visit a doctor and were only able to see a paediatrician because my nephew has been going to him for ten years and recommended us to him (really). The doctor told us that our boy had had an ear infection before the flight (?), which had worsened during the flight, now necessitating a ten-day round of antibiotics. We followed his instructions. Ten days later, my boy was not much better and we only had another few days before making the flight back to France. Should we cancel? We booked another appointment with the paediatrician who advised that he be given a strong dose of antibiotics shot into each of his little thighs.
The hardest thing for me was that I had gone to the doctor’s office without my mother and without my husband The doctor told me that, as the next level of antibiotic, an injected antibiotic, would be very strong, it would be best if I stayed at his office under supervision for an hour to make sure that there is not an epileptic fit, seizure, or heart attack (?!). I was terrified. I desperately tried to call my husband at my mother’s to consult him, but he was not picking up. I then tried to get my mother’s attention in the car outside where she sat waiting for us to leave, in order to get some advice and encouragement, but the doors to the clinic were closed and she did not see or hear me. I made the decision alone to do it. The two nurses came into the room while he was laying calmly on his back with his little legs in the air. They put on blue plastic gloves and held up the shots. At this moment, he realised something was wrong. They simultaneously gave him the injections in each of his little thighs and he began screaming. Afterwards, I took him to my breast in order to nurse him and calm him down. It was the very first time he bit me, which hurt and caused me to cry out, but I figured it was fair. I sat worried and alone with my little person that whole hour, wondering whether I’d done the right thing. Worried that his body would reject it. Worried that his ears would not be better for the flight back and he’d be in so much pain or he’d go deaf.
The flight back was gruesome. He did not sleep, and I was in a chair that had a broken armrest and video. But we got back to France. My boy did not go deaf. The infection was cured. The French doctors told me that it was best to have given him the injections, that it was not the Americans’ being overzealous about the administration of antibiotics.
It will be a year before I make that trip again.
Filed under: The Baby Diaries | Tags: babies, baby, baby health, carte vitale, Chamonix, French Alps, French doctors, health in France, healthcare, healthcare in France, infant care, l'Assurance Maladie, Mark Twain
The only way to keep your health is to eat what you don’t want, drink what you don’t like, and do what you’d rather not. Mark Twain
Today I went to the doctor with my boy for a check-up and we had an interesting conversation. She is a ‘stand-in’ for our regular doctor. Originally from Marseille, she loves the mountains and her husband works for the mountain rescue. Normally, she does research on frostbite for a national study and she’s also six months pregnant (and looks great. Unlike the bulk I was, and remain – I’m still wearing my maternity clothes!).
After she’d checked my boy’s weight, vitals, and head circumference, etc., we got to chatting about life in Southern France (I hold onto the idea that I will live there one day, put perhaps it won’t be until I’m in my 50’s, like Colette). From there, we began talking about the state of French industry. Recently, France has lost two manufacturing company contracts, which were employing/would employ thousands of workers because of inefficiency and the demand for guaranteed lifetime contracts, respectively. After that, we segued into the dire state of the French healthcare system. I’m a great admirer of their system – a winning combination of socialist and capitalist care – and I’ve been the grateful recipient of many medical services in France. Nonetheless, I am aware the system is bankrupt. That it has been so for thirty years. It seems to me that to raise the cost of doctor’s visits, hospital stays, and long term care, SLIGHTLY, would help the system immeasurably. It may even save it. Aren’t the French meant to be collectively oriented? Why isn’t this happening?
What she told me was surprising. Particularly from a French person. She said that the French complain about the 23e or 28e they must pay for each doctor’s visit, which is the amount one pays before being partially reimbursed. In reality, only about 10e per visit goes to the doctor. Unlike their American counterparts, for example, doctors here are not getting rich through their vocation. She told me that when the doctor is unable to process a Carte Vitale (one’s personal health card which is registered with the health authorities, is run through a machine at the chemist, the hospital, by doctors at every visit, and then is automatically reimbursed for a given treatment) and must give them a brown form to fill out and send to the l’Assurance Maladie (health office) for reimbursement, instead, the French patients complain about having to pay for the price of a stamp in sending the form in for reimbursement.
She is very pessimistic that anything will change in France, despite the dire state of affairs within the medical arena and the economic problems for the country as a whole. She believes that in general, the French believe that they are “entitled.” They do not care whence their rebates, subsidies, incentives, reimbursements, and retirement plans come from, only that they receive them and pay as little toward them as is possible. She believes that short of a huge philosophical shift in thinking, which is not likely to happen as the general population in France refuses to accept that there is a problem that requires everyone to adapt, the French medical and economic systems are doomed. I want to believe this is not so.
Filed under: The Baby Diaries | Tags: American in France, expatriate, family, France, French doctors, Geneva, infant jaundice, newborn, newborn gas, newborn weight gain, sleeping with a newborn, US culture, US politics
‘So live that you wouldn’t be ashamed to sell the family parrot to the town gossip.’
Will Rogers
I had been a bit confused when I was only prescribed the mid wife (sage femme) and the physiotherapy at the hospital after my son’s birth, but now I’ve discovered my regular GP will be my baby’s doctor. I figured I would get a paediatrician assigned, but it turns out there aren’t many to spare in France.
Adhering to the old wives’ tale that one should not take a newborn out of the cloister of its home till it has been alive for two weeks, I took my son to my GP when he was 15 days old. The doctor told me that my son’s jaundice is gone, which is good (the time spent in the window like a plant worked!). She also told me that he was not gaining weight at the rate that he should be, necessitating that we monitor this closely. I left the doctor’s office completely freaked out and cried. I don’t want anything to be wrong with my baby and I’m scared because he’s such a defenseless little thing.
Luckily, my brother and my sister-in-law (belle-sœur) arrived from Seattle to help us out. They have two children of their own, now ‘tweens.’ I figure the fact that their kids have survived thus far makes them ‘old hands’. Moreover, it’s wonderful to have my family nearby. It’s hard to be so far from them. It takes 14 hours flying, through 9 time zones, to get to where they live, which prompts my feeling rather isolated on holidays and in vulnerable moments (for any of us). My husband and I drove to Geneva to collect my brother and sister-in-law – our boy’s first ‘big’ outing – and dined at an outdoor café on the lake. I had been a little nervous about nursing my son in front of my brother, but then realized it’d be stupid to go and secret myself away each time the boy ate, which is every hour. Besides, scarves are immeasurably helpful for discretion (and luckily I carry one always, stuffed into my purse or in a pocket, even before I began nursing!).
I live in an almost perpetual state of embarrassment for being an American in Europe given the antics of American politics, the regular shootings, and the disparate tax rates. But every once in awhile, I am reminded how wonderful we Americans can be. My brother and his wife are full of optimism and earthy pragmatism. They’re open and encourage others to be so. They’re warm and gracious. When I told them that the French doctor had said that my son was not gaining weight as he should be, they assured me the rates of growth are different, particularly in this early stage, and the important thing is that he is not losing weight. When I told them that I didn’t know how to pass the time with the baby, who doesn’t seem to be able to do anything, they didn’t pretend to have all the answers. Instead, they assured me that no one really knows what they’re doing when they have their first child and you simply follow your new-born’s cues: eat when he eats. Sleep when he sleeps. Go outside and take a walk when you’re bored and stir crazy. They advised me to enjoy this initial period of my baby’s new life as though we’re both convalescing (we are!). I admitted that I’m sleeping with the baby on my chest, which ‘everyone’ tells me not to do, but which seems right – I can’t move with the caesarean anyway- and they didn’t judge me. Instead, they went to a local baby store and found a soft, little, slightly slanting bed so the baby’s head is a bit higher than its lower torso, with two detachable soft sides to it to keep the baby from rolling, which the baby can sleep on and which fits right between the pillows that my husband and I sleep on.
I never imagined I’d be so grateful for assistance – even the opportunity to give the boy to another pair of trusted hands in order to de-gas him is appreciated. I don’t think I have needed help as I do now. Perhaps it’s that in the past I was too proud to ask for and accept it, and now that there’s another person involved, I don’t have that same sense of ego?
Victoria Jelinek 