Postpartum Psychosis Often Mishandled By U.S. Hospitals, Specialists Say : Shots - Health News Postpartum psychosis is rare but very real, doctors say. And, unlike in some countries, U.S. moms who need inpatient psychiatric care can't bring along their babies, adding to the trauma.
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She Wanted To Be The Perfect Mom, Then Landed In A Psychiatric Unit

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She Wanted To Be The Perfect Mom, Then Landed In A Psychiatric Unit

She Wanted To Be The Perfect Mom, Then Landed In A Psychiatric Unit

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SCOTT SIMON, HOST:

In the beginning, when her daughter was born, Lisa Abramson was smitten. She felt like she barely needed to sleep. She had so much energy. She was so excited.

LISA ABRAMSON: Which now I can look back and say, maybe that was a warning sign.

SIMON: Because then came delusions of helicopters circling her house and snipers on the roof. From KQED in San Francisco, April Dembosky has this story.

APRIL DEMBOSKY, BYLINE: That first week after her daughter was born, the world was nothing but love. Then, the baby started losing weight. The pediatrician said Lisa needed to feed her every two hours. All of a sudden, she felt like she couldn't keep up.

L ABRAMSON: It weighed on me as, like, I failed as a mom. Like, I can't feed my child.

DEMBOSKY: Even when she could get a break from breastfeeding and pumping, she still couldn't relax enough to sleep. As she got more and more exhausted, she started to get confused. People's voices were distorting. She went to a spin class but only lasted 10 minutes.

UNIDENTIFIED INSTRUCTOR: That's it. That's it.

L ABRAMSON: And it felt like - almost like the walls were talking to me.

UNIDENTIFIED INSTRUCTOR: Push. Push. Push.

DEMBOSKY: Then, Lisa noticed some police helicopters circling over their apartment.

L ABRAMSON: You know, there were snipers on the roof. There were spy cams in our bedroom. And everyone was watching me. And my cellphone was, like, giving me weird messages.

DEMBOSKY: Lisa waited for the police to come in and take her. But the next morning, she woke up in her own bed. The cops had arrested their nanny instead. Lisa told her husband it wasn't fair. She said she was going to jump off the Golden Gate Bridge. And that's when her husband told her he was going to drive her to the police station.

L ABRAMSON: I was like, oh, OK. He's taking me in. And I guess I'm getting arrested.

DAVID ABRAMSON: It was probably one of the worst days of my life, bringing my wife to the hospital and then eventually checking her into an inpatient unit. It was really, really challenging.

DEMBOSKY: This is David Abramson. He explains there was no crime, no helicopters. And the nanny wasn't arrested. He took Lisa not to jail, but to the psychiatric ward at California Pacific Medical Center in San Francisco.

D ABRAMSON: You could see in her eyes and her body language that she was panicked all of a sudden that we were leaving.

DEMBOSKY: About a week in, Lisa remembers her husband showing her a printout from the Internet on postpartum psychosis. It said hormones going wild plus sleep deprivation can trigger the confusion and paranoia.

L ABRAMSON: I really was just like, no. Like, I've heard of postpartum depression. No. Like, I've never heard that, like, there's postpartum crazy. I was like, mm-mm (ph).

DEMBOSKY: Postpartum psychosis is real. It's rare, but experts believe more women are affected than previously thought. Psychiatrist Nirmaljit Dhami says a lot of doctors don't recognize the symptoms.

NIRMALJIT DHAMI: Clinicians can think that the patient is normal and probably suffering from sleep deprivation and discharge them home.

DEMBOSKY: In the U.S., mental health problems are one of the leading causes of death among new moms. California just finished its first big study on this, looking at the cases of 99 new moms who died by suicide over a 10-year period. It's not published yet, but a data preview revealed that of those 99 suicides, doctors said 98 of them were preventable.

DHAMI: The work that we do here is less than 10 percent of what needs to be done.

DEMBOSKY: For example, when Lisa Abramson first arrived at the psych ward, her husband told the resident who admitted her that he thought Lisa had postpartum psychosis. The resident said, postpartum what?

L ABRAMSON: They weren't equipped for me by any means.

DEMBOSKY: Three days in, Lisa's breasts became engorged. They were so painful.

L ABRAMSON: Because I stopped breastfeeding instantly.

DEMBOSKY: Her husband had to negotiate to bring in Lisa's breast pump from home. And she was put in a padded room to use it.

L ABRAMSON: What you would imagine from, like, a terror movie.

DEMBOSKY: But the worst thing of all was not being allowed to see her baby. The hospital says this is a safety measure for everybody. Her family argued with the staff.

L ABRAMSON: They said, you know, she needs - like, she's a new mom. And, like, she needs to see her baby. Like, that's - keeping this bond going is, like, really - it's important. Yeah. That was the hard part - was not getting to see her.

DEMBOSKY: Lisa's family was eventually able to negotiate short visits with her daughter.

L ABRAMSON: Yeah. For, like, an hour or something. It was tough.

(SOUNDBITE OF BEEPING)

DEMBOSKY: On the other side of the country from San Francisco, there's a place with a very different approach - the hospital at the University of North Carolina in Chapel Hill.

UNIDENTIFIED PERSON: Four - neuroscience, perinatal unit - how can I help you?

DEMBOSKY: This is a psychiatric unit that is reserved exclusively for pregnant women and new moms. Every room has a hospital-grade breast pump. Moms can store breast milk in a special fridge. But head psychiatrist Mary Kimmel says the most distinctive feature is the visitor policy.

MARY KIMMEL: Babies can come to the unit, and we really encourage that. We encourage, actually, older kids to also come to the unit.

DEMBOSKY: Right now, UNC is the only hospital in the country that has a designated psych unit just for pregnant women and new moms. A hospital in New York has a women's-only unit. And El Camino Hospital, an hour south of San Francisco, will soon start construction on a women's-only psych unit with a special focus on new moms.

LUCY ABRAMSON: Ready?

L ABRAMSON: Yeah.

LUCY: Set? Go.

L ABRAMSON: Good job.

DEMBOSKY: Lisa's daughter, Lucy, is 5 now.

L ABRAMSON: One...

LUCY: Two...

L ABRAMSON: ...Two...

LUCY: ...Three.

L ABRAMSON: ...Three.

DEMBOSKY: And she has a second daughter, Vivian, who's a year and a half.

LUCY: Go, Vivi (ph). Go, Vivi.

DEMBOSKY: Lisa recovered fully from postpartum psychosis, and it did not come back after her second pregnancy, in part, because of all the precautions she took. She made sure she got enough sleep, and she gave herself permission to give up breastfeeding if it was too much.

L ABRAMSON: We've got so many messages of just self-sacrifice. Do anything for your kids. And that's what it means to be a good mom. And, for me, that's not what made me a good mom. That's what made me fall apart.

DEMBOSKY: She says she's trying to put herself first and know that that's what makes her a better mom. For NPR News, I'm April Dembosky in San Francisco.

(SOUNDBITE OF C.W. VRTACEK'S "WAR")

SIMON: And that story is part of a reporting partnership between NPR, KQED and Kaiser Health News.

(SOUNDBITE OF C.W. VRTACEK'S "WAR")

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