Pregnancy is joyful, scary, beautiful, and hard work. As is postpartum. As is motherhood.
Whenever hormonal imbalances and a lack of support are present, depression and anxiety will be the natural result. It is so important that we don’t limit this to the postpartum period. The earlier we are supported, the faster we are able to make our way to the other side.
In today’s episode, we’re talking to Angela Mancini, a Doula, Licensed Therapist, and Perinatal Mood Disorder Specialist.
As a professional who experienced dark days of depression herself, she is here to speak on the stigma as well as the path forward.
In this episode on pregnancy depression, we are sharing:
- The dark days of postpartum depression and how it can develop in pregnancy
- Angela’s journey as a licensed therapist who experienced postpartum mood disorders, as well as the stigma for professionals in this field
- Roots of postpartum depression can often be traced back to pregnancy
- What are the first symptoms to look for
- How to find emotional support before birth and postpartum
- When birth is connected to trauma
- Rewriting the story
Welcome to the Postpartum University podcast where we support you and your provider in understanding the science, the art, and the sacredness of healing after birth. I’m Maranda Bower, your host, your postpartum nutrition specialist, and homesteading mom with four wild kids. It’s time to get you the holistic whole body healing that works. Hello everyone, welcome to the podcast. It’s Maranda Bower, of course. And today I have an incredible guest, as always. And this time we’re gonna be talking about a topic that one hasn’t normally heard about. Like we do not have this conversation. So today we’re gonna open it up to Angela Mancini. She is a certified birth doula, licensed therapist, perinatal mood disorder specialist, and a yoga instructor. And she’s here blending all of her modalities to speak about pregnancy, depression, you guys. So I am very excited to have this conversation. Thank you so much for being here.
Angela: Thank you so much for asking me, and this is amazing. I’m so excited.
Maranda: So tell us a little bit about how you came to be the incredible professional that you are in this world right now.
Angela: Yeah, you know, rewind. I graduated in 2015 with my masters. I had no idea what I wanted to do or where I wanted to go with it. So I bounced around. I had a lot of different jobs, just trying to figure out where I fit in this therapy field. So I had my son in 2017, and he was a really colicky baby. I thought that was normal. I thought this like postpartum rage that I was feeling was totally normal ’cause I was like, “Okay, he’s a colicky baby. Like it’s okay to be mad about that.” Kind of just kept going with my life. After I had my daughter in 2020, there was kind of like a double-edged sword, I guess you can say, ’cause it was COVID. She was delivered in April of 2020, so just the chaos of that. But after I delivered her, she was like the perfect little baby, and I still was feeling horrible. I was feeling sad, I was feeling angry, and I got to the point where I wanted to end my life. So when I got to that point, I was like, okay, this is not okay. I know this is kind of like a red flag for me. So I told my husband and, you know, he was obviously upset, but he helped me get back on my feet, helped me find services. But it was difficult to find services. It was difficult to find people that specialized in this area. I told myself when I get better, that I’m going to be that person that I was looking for. So I did that and I started La Luna Counseling and Wellness. Luna is my daughter’s name. So that’s really where it came from. I thought I would just be like a one-man show and, you know, whoever was looking for services would come. And, you know, it really grew and expanded and women were really looking for this type of service. So that was that. And then I started noticing a trend of, you know, I would see women throughout their pregnancy and then just sort of go like, all right, well, good luck during your birth. And then they would see me after to really discuss how the birth went. And I was like, you know what? Like I need to bridge this gap. Like there needs to be this like therapeutic support during a birth. So I went in August of 2021 to go get certified in birth dual to work, but I was pregnant with my son. So I gave birth this past February, February 2022. And then after I, you know, I had pre-eclampsia, NICU baby, super trauma. And then I, in April, I finally felt stable. And I was like, you know what? I’m going for it. And I did it. And now it’s happening. It’s moving. And I think it’s such a beautiful bridge, I guess. Having that therapeutic support in the birthing room. So I just want to point out and clarify if I’m wrong here.
Maranda: You’re a licensed therapist who experienced traumatic birth experiences and postpartum mood disorders. Yes.
Angela: Yeah. And I want to say that because oftentimes we think that, you know, as an expert, we couldn’t possibly do that, right? I know that in my own experience, and I’ve shared in several podcast episodes in the past, that, you know, it felt really shameful as a professional to even mention that this was something that I personally was going through, right? I suffered from postpartum depression and anxiety and rage and even had postpartum bipolar with my third. And so feeling like I could tell someone that was not an option because I’m a professional in the field and this wasn’t supposed to happen. So if you’re hearing that, just take note, that’s not true. We get you, we understand you and we know that clearly you are not alone in this experience. That does not make you a failure or anything of the sort.
So with that sidetrack, let’s get back on conversation here and tell us a little bit about this depression and bridging the gap, right? We have depression and anxiety that we often talk about in the postpartum period. What we don’t talk about is often how it sometimes develops in pregnancy.
Maranda: Yeah. We call it pregnancy depression. Is this documented in the DSM-5? Like, what, does it look the same? Can you talk a little bit about what this is?
Angela: So yes, it can develop during pregnancy. Honestly, I see it a lot if someone’s going through, you know, fertility journey or, you know, any sort of IVF treatment. It starts even from like before pregnancy. But, you know, when you’re pregnant, your hormones are, you know, fluctuating, you’re making a human, so it is. It’s almost comical that people don’t know that this is a thing, or that, you know, professionals, doctors, no one’s really looking for that. They’re looking for it after, but it’s definitely happening during. It would be perinatal, like a perinatal depression or anxiety, things like that. But, it, I mean, it’s sad, it’s sad that, you know, it is this stigma, like you said, especially with professionals, that nobody wants to talk about it and we’re humans, every, I mean, people are having babies every hour, every minute, I guess, and, you know, no one wants to talk about the effects it does not only to our physical body, but our mental health.
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Absolutely, and I find that when I work with postpartum moms, and one of the common questions that they ask me is, you know, what I’m not sure this developed in postpartum, I think it happened much sooner during my pregnancy. So this is a very common thing that we are seeing, and I know in my own experience, and I’ve shared this story numerous times, about being pregnant. I remember it was my daughter’s third birthday, I was three months pregnant, and I literally could not get out of bed. I was crying my eyes out. I didn’t know what to do. I couldn’t move. My husband literally carried me to the shower, like, and helped bathe me and get me ready for my daughter’s birthday party. And after that, we had, that’s when we, we had the serious conversation. That’s when he knew, and I knew something is really wrong here. But this perinatal depression does exist and anxiety does too. And I’m wondering, is it the same if we went to a provider, would they know that this is something that we were going for or looking at or presenting as, is there another set of symptoms that we should be watching for?
I mean, I would definitely be looking for, you know, any sort of baseline that you know, this is not me. So I mean, it could be as simple as, you know, just feeling a little bit more anxious, feeling like that pit in your stomach, those intrusive thoughts, those, you know, obsessive qualities that you’re like, wait a minute, like, I definitely did not, you know, have these thoughts before. I definitely didn’t feel this sad before.
Angela: I wasn’t crying as much as I’m used to cry or whatever the case is. I feel like, you know, a provider should be looking out for those things. And I think it should go beyond that, you know, what 10 question questionnaire, when you go to your six week or eight week postpartum visit for your OB/GYN. I feel like everyone knows how to answer those questions. If you’re even reading them, it’s just like, no, no, no, no, no. And then you just give on, you put your business, you know.
Maranda: So true. So true. And, and honestly, in like my own experience, it was like, there’s no way in heck that I’m going to actually put down on paper what I’m experiencing. So yes, I appreciate you saying this. So let’s talk about how you find this emotional support. I mean, we talk about having emotional support often in and the labor and birth. We don’t talk about the emotional support anytime before that. And we talk about emotional support after labor and birth, only in the form of depression and anxiety. So if you have depression or anxiety, obviously seek emotional support and care, but we don’t like beyond that, you don’t talk about it. So what can we do to get the emotional support and the mental support that we need for the entire experience of motherhood and our entry into motherhood?
Angela: So I mean, you can definitely, you know, reach out to some sort of mental health person in your community. But I also feel like hiring a birth tool. A birth tool is not someone who’s just going to show up. Well, I shouldn’t say that because some people do that. But most of the time, birth tools are not just someone who’s going to show up to your labor and delivery, they’re supporting you throughout your pregnancy. So, you know, sometimes people, therapy is not the route that they want to go. And that’s completely fine. But having someone there to ask those questions, because when you’re in an OB/GYN office or wherever a midwife office, you might not want to ask all those. You might think as silly questions or they might say like, hey, we’re going to schedule an induction date. See you next week. And then you’re like, what is an induction day? What does that even mean? Like having that support throughout your whole pregnancy is so crucial. I always tell my birth tool clients, you know, if you hire me really early at 10 weeks, I don’t want to just see you at your 32-week prenatal visit. Let me know how how your doctor’s visits go. Let me know if you have any questions about packing a bag. Let me know if you have trouble putting your car scene in your car. I wanna know all of these things ’cause I’m there to support you.
Maranda: This is such a massive topic. And I hope that, especially if you’re a doula and you’re listening in, that you can really expand your services well beyond and support women and families deeply and the preparation of their motherhood experience. Whether it’s their first kid or their 10th kid, there’s so much support that is needed here in this space. I wanna open up the conversation and talk about birth trauma because there is so much here in this conversation. And you mentioned it as a topic that you can speak on here, especially in relationship to depression and anxiety post birth. How does birth trauma impact depression and anxiety and the postpartum experience?
Angela: So let’s kind of just think about your baby is coming into the world for the very first time. If it is a beautiful experience, you’re in your bathtub surrounded by lights and candles and flowers, you could still get postpartum depression and anxiety because of the hormone influx and all of that. But your baby was brought into the world in such a beautiful way that you might be less inclined to get postpartum anxiety and depression. But if your baby was brought into this world, let’s say with a cord wrapped around her neck, had to go to the NICU, inhaled any sort of fluid, it’s like the very first idea of having your baby in the world was automatically linked to trauma or life and death or some sort of anxiety that what in the baby’s first few seconds of being born.
Angela: So like for example, my birth trauma was my son had come out and he had inhaled amniotic fluid and I had no idea that that was happening and when baby came out they put him in front of my face and said like oh me baby and then he was gone so I was like wait what just happens like how where did he go so from that moment on it was always for me like okay he inhaled something his lungs are affected now I’m constantly making sure he’s breathing at home or I’m constantly making sure like is he is he okay is he not blue because there was my first picture of him was he was blue so for me it’s like this deep rooted anxiety of is my baby okay all the time you know what I mean so it’s it’s heavy it’s definitely luckily I have support and I have people in my corner because I built that support team to be able to be like everything is okay.
Maranda: Yeah for sure and birth trauma often it looks different for everyone right and it’s very much based on your experience we can have the most gorgeous experience in terms of what the provider sees or what the doula sees or what like a standard you know quote unquote I’m using quotation marks you can’t see me but I’m using quotation marks in the air here like the most perfect beautiful intervention free you know everything that you thought it was and still have birth trauma because of the pain or because whatever the reason was right you can still interpret it in that manner and that’s completely acceptable and oftentimes it revolves around some sort of loss loss of autonomy loss of who we are loss of trust in our partner or our self or the system or whatever it may be or or your own abilities to parent as a mother and that completely impacts the way you are going to experience the postpartum period because not only are you healing your own body right now you have to heal emotionally and mentally from a massive impact that you are going through as well and I bet this is also impacting the pregnancy and birth of future children.
Angela: Totally. I feel like for the people that are reaching out to me, majority of them, this is their second, third, fourth baby because they want to redo that story. They want to change the narrative of what birth means to them so they want to feel more empowered, more knowledgeable, more you know everything. They want that support so that they can build it up in themselves and kind of rewrite that trauma. So oftentimes like I feel the exact same like when somebody approaches me and says oh my gosh is pregnancy depression a real thing or is pregnancy anxiety a real thing or am I just am I crazy right? That’s usually the the standard question that I get in my inbox almost on a weekly basis here and oftentimes it’s related to a previous birth experience and a postpartum experience that was incredibly traumatizing or challenging and all forms and fashions and then that comes up again and we ruminate on it. It comes back into our body right? We feel it on a cellular level. It impacts our emotions and our our mental capacity and so many things. It just causes a lot of extra stress right? And then we’re thinking oh my gosh what’s going on? So if that’s you or maybe you’ve had a difficult pregnancy and postpartum experience in the past or labor and birth in the past, note that with another pregnancy you might want to look at getting some support early on for mental and emotional health, whether that’s through hiring a doula who you can bounce questions off of or finding a counselor in your area where you can get that kind of mental and emotional support or even having a couple of best friends on standby. Like let them know, here’s what I’m experiencing or what I’ve experienced in the past and I need that support. Can I rely on you, right? I am so excited for this conversation and I hope it has helped so many people and just like eye-opening experience that yes, we can go through this. It looks very, very similar and there’s so many things that we can do to help ourselves. Where can people learn more from you?
Angela: So they can go to my website https://lalunacounselingandwellness.com/ or they can go on Instagram is @la-luna-counseling or if it’s, ’cause I’ve realized that some people don’t wanna just talk about births which I’m like, okay, I guess that’s okay. So, I made a birth doula Instagram at la-luna-birth-doula.
Maranda: And of course, you know, if you’ve been listening in on this show for a while that all of these links are in the show notes so you don’t have to memorize them, just go click on the links below. Thank you so much for this conversation, Angela. It’s been a pleasure.
Angela: Yes, thank you so much.
Maranda: Love this episode. Let us know by leaving an amazing review. Your support is everything. Want more? Head over to postpartumu.com. That’s postpartum, the letter u.com and explore how we support moms like you and holistic whole body healing that’s specific for the unique needs of mamas in the years postpartum. See you there.
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