Book Review of You Are Not Alone – An anthology of perinatal mental health stories from conception to postpartum
You Are Not Alone By the Canadian Perinatal Mental Health Collaborative
2022, Wintertickle Press , Barrie, Ontario
Revised by Suyin Jordan CPD, CCCE, CNPE
I heard about this book from the 2 parents who started a movement in Canada to improve perinatal mental health for parents in Canada. I can’t remember where I heard about their journey but it inspired me to get their book and what a great book it is. This collaboration is by Patricia Tomasi is the co-founder and executive director of the Canadian Perinatal Mental Health Collaborative (CPMHC) along with registered nurse and perinatal mood disorder coordinator, Jaime Charlebois.
“This anthology is extremely timely,” says editor and anthology creator, Patricia Tomasi. “Social isolation is a major contributing factor of postpartum depression and our hope is that these stories and this book will help moms know and feel that they are not alone, especially in light of the ongoing pandemic.” (Press release for the book on CPMHC.)
This book aims to dispel stigma around prenatal and postnatal mental health and illness, providing hope and resources to expectant and new moms, and their families. Whereas pre-pandemic, one in five women suffered from prenatal or postpartum anxiety and depression, that number is now one in three.
The book contains 49 true stories from parents who have gone through perinatal mental health illness from conception to the postpartum period. The contributors openly share their feelings, their struggles and triumphs through their perinatal journey. Each author bravely tells their story of their own lived experience in their own words and many of them have gone on to become fierce advocates themselves.
There are also chapters written by top perinatal mental health experts who contributed their knowledge, expertise and advice.
Before delving into the book, there is an important mention about content and trigger warning which is beneficial to those who may have experienced issues mentioned in the book and serves as a reminder to be mindful that the writings may trigger some unwanted feelings and cause distress. I will be sharing some passages from the book and so am also warning that the content of this review may be triggering for some.
There is also a disclaimer mentioning that this book is not meant to provide medical advice for individuals.
The book is divided into five parts: 1) Preconception, pregnancy and birth; 2) Postpartum depression and anxiety; 3) Postpartum anger; 4) Postpartum bipolar disorder and psychosis; and 5) The pandemic.
Each part has several stories that cover subjects like tokophobia; which is the fear of pregnancy, infertility, post-adoption depression, motherhood, anxiety and scary thoughts, postpartum bipolar disorder , postpartum anger , paternal depression experienced by partners and fathers and more.
Renowned perinatal mental health advocates Karen Kleiman and Dr. Nichole Fairbrother collaborate on a chapter about postpartum anxiety and intrusive thoughts.
There are also chapters written by many more incredible health-care professionals including: Dr. Simone Vigod, Dr. Ariel Dalfen, Dr. Ryan Van Lieshout, Dr. Verinder Sharma, Dr. Anja Wittkowski, Dr. Gail Erlick Robertson, Dr. Jodi Pawluski, Dr. Lesley Tarasoff, Dr. Christine Ou, and Mark Williams, founder of International Fathers Mental Health Day and the #HowAreYouDad campaign.
The authors hope the stories in the book help people realise that people experiencing Perinatal Mood Disorders (PMADs) are not alone and that there is a growing movement of advocates dedicated to bringing about change to the perinatal mental health services available to Canadians.
They just want people in Canada to have what people in the U.K., Australia, and parts of the U.S. already have—universal screening and timely access to the best evidence-based treatment for the most common complication of pregnancy and postpartum.
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I would like to share some passages from the book.
Suicide is a leading cause of maternal death and rates of perinatal mental illness are higher for BIPOC and LGBTQ+ people. These are some thoughts from writers from the BIPOC, LGBTQ+ and native community.
In ‘Sweet Baby Ada’, Black mom, Candice Thomas of Barrie, Ontario shares her story of how she suffered from postpartum depression following the birth of her daughter during the pandemic:
I’ve had days where I don’t get out of bed. I cry for a few hours, and sometimes just putting my coat on to go outside for a walk seems like too much for me. I have to be strong for my daughters, but as the days go by, it’s getting harder and harder.
Sweet Baby Ada by Candice Thomas, pg. 279
In ‘Worthy of Love’, Indigenous mom, Stephanie George shares her story of postpartum anxiety and intergenerational trauma.
We, as Indigenous women, are afraid to speak. Society, while making advances, still doesn’t like hearing from us. Racism is rampant. We don’t feel like we matter because we are told that. That also drives perinatal mental illness in our communities.’
Worth of Love by Stephanie George, pg. 126
On Postpartum Anger, Christine Ou talks about Perinatal anger and rage – the neglected mood problems of the PMADs (Ou and Hall, 2018). She shares a quote from Emily Flake, New Yorker cartoonist and illustrator.
People say you don’t know what love is until you’ve had a child. BS. The emotion you really don’t understand until you have kids isn’t love. It’s rage.
There are also some poems in each chapter, I will share one here
WELL, I’M NOT
“How are you feeling, love?” they say.
But, I don’t know how to reply.
There’s a liquid fear sliding down my throat
And I’m being suffocated inside.
“How are you coping, love?”, they ask.
When I know I’m obviously not.
Why’s there an assumption that I must cope?
I’m learning to deal with an awful lot.
I haven’t had a full night’s sleep, My mind has turned to mush.
I feel I’m always on high alert.
This mum thing’s really tough.
“How can I help you, love?”, they say.
Just pop over for a friendly chat.
Let me feel like I’m not alone in this;
It’s overwhelming from where I’m sat.
“What do you need, love?”, they ask.
Take the reins for just one morning.
Let me not cope ‘til I’ve figured it out,
Without making me feel like I’m not coping.
Leander Moore @postpartumpoet – pg 208
At the end of most of the stories, the contributors left a way that you could connect with them which is also a nice touch. Similarly, at the end of the chapters written by the health professionals, they also left their contact details. This will be a useful resource for readers should you want to connect with them in the future. These chapters also provided valuable resources for referral and what to do if you suspect someone is going through PMADs.
The book is very well referenced with all references grouped into the 5 chapters where they were quoted.
I found the book very easy to read and the contributors’ stories were compelling and gave me an insight into the many different perinatal mood disorders (PMADs) . It helped me understand and have some knowledge on how the different PMADs may present and what people may feel when they have these PMADs. I myself could relate to the postpartum depression and anger chapters, having experienced these feelings after I had my babies. Although I was never formally diagnosed, I think I suffered with prenatal anxiety and depression with my first pregnancy and postpartum anger and depression with my second.
I feel book is a must read for doulas and perinatal educators. PMADs affects so many people and their families. Being aware of how common and normal it is, normalises and reduces the stigma that is still attached to this day of mental health challenges in the perinatal arena. Having the knowledge of how PMADs may present will help us recognise when our clients need to be referred to their health care professionals for assessment. The sooner it’s diagnosed, the sooner support can be sought and treatment if necessary can begin and the sooner parents and their families can start to get better and have more positive transitions to parenthood.
From the resource chapter, I am sharing some of the resources here:
- Postpartum Support International
Text : 1-503-894-9453
- World Maternal Mental Health Day
- Canadian Perinatal Mental Health Collaborative
- Pacific Post Partum Support Society
- Women’s College Hospital, Reproductive Life Stages Program
- Mount Sinai Hopsital, Perinatal Mental Health Program
Phone: 416-586-4800 ext. 8325
- Postpartum Stress Center
- 2020 Mom
Phone: 310 -955-1081
- Maternal Mental Health Leadership Alliance
- Action on Postpartum Psychosis
- Maternal Mental Health Alliance
- PANDA, Perinatal Anxiety and Depression Australia
National Helpline: 1300-726-306
About the Author/Reviewer
Suyin Jordan RGN, RM, CPD, is a CAPPA trained and certified postpartum doula, a CAPPA trained birth doula, lactation educator and childbirth educator. She joined CAPPA faculty as a postpartum doula trainer 4 years ago.
Suyin left Malaysia at the age of 23 to do nursing and midwifery training in the UK and worked as a nurse and midwife in England for over 20 years. She has been a Doula in Canada for over 9 years working in and around Toronto and the GTA.
Suyin has two adult of her own and is passionate about supporting individuals and families holistically and to ensure healthier outcomes, both mentally and physically. Respectful of all cultures and traditions, Suyin believes that the role of a doula should be adaptable to help those with little or no extended family as well as those who have an established network.
Suyin believes in a strong and supportive organization that promotes the view of Doulas as professionals in the Doula field. Her background is evidence-based and her aim is to encourage Doulas to reach their potential, supporting and mentoring Doulas who want to achieve certification and engage in continual professional development (CPD), helping them set and achieve their goals.
Suyin speaks several languages including English, Malay, Hokkien, Cantonese and some Mandarin. Her hobbies include Knitting & crochet, scrabble on-line, cooking and healthy eating, yoga, fitness and looking after the family pets. Her mission is to feed the world and make everyone happy (her doula work and her devotion to her family help her achieve this in some small part!). If Suyin could have her life over again she would be a farmer; growing all kinds of produce while looking after the farm and all the farm animals.