“Love is Both Pain and Joy”

“Love is both pain and joy,” could have been the tag line of episode four of“Call theMidwife.” The young midwives Jennie and Cynthia observe the dynamic nature of love and childbirth. The pain of the contractions and the joy when the baby is finally out are the opposites of the same coin.  As a nurse midwife, I have the privilege of seeing this joy and pain played out. I have the unbelievable joy of handing a couple the babies they have longed for.

My husband turned to me during the show and asked, “What’s happening”?

“Eclamptic seizure,” I responded. As the tragic story line unfolded, my husband asked, “That can’t happen nowadays, can it?”  Sadly the answer is yes, it can still happen. We are better at recognizing toxemia or preeclampsia. We are better caring premature babies who are born early because of toxemia. We are better at preventing the damaging seizures that can be a complication of preeclampsia. But this disease is not gone.  We have made great strides in treating toxemia but we cannot control it or banish it from our midst.

The same is true for other tragic complications of childbirth, postpartum depression and psychosis.  The show’s writers hint at a tragedy in the one women’s pregnancy history. It is not until her baby is missing that it is revealed she had severe postpartum depression, maybe even psychosis after a stillbirth.  Even today postpartum depression is often talked about in hushed tones as if it were a stain on your character instead of a fairly common complication of childbirth. Estimates put the rate of post-partum depression between 10 to 25 percent. I am happy to say that nurse midwives and the medical community in general has gotten better at screening for  treating postpartum depression and psychoses. We will probably never eliminate every case of postpartum depression, but we can get a lot better at treating it.

Loving well and facing childbirth require bravery. Great rewards are there for those who dare.

Henry Ford Health System – Women’s Health

American College of Nurse Midwives

Center for Disease Control and Prevention – Depression

Women’s Mental Health

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