A Voice of Strength I Didn't Know I Possessed: Part II of An Interview with Ivy Shih Leung

A Voice of Strength I Didn't Know I Possessed: An Interview with Ivy Shih Leung, author of One Mom's Journey to Motherhood: Infertility, Childbirth Complications, and Postpartum Depression, Oh My!

In this second part of my interview with Ivy, she shares insight into her Chinese culture and pregnancy and postpartum. Secondly, she delves into her experience with infertility and complications during pregnancy. Finally, Ivy shares wonderful thoughts as to how writing, blogging, and communication can help to end stigma about PPD and create the causes for healing. You can read the first part of our interview here.

How has culture affected your writing about your experience?

I don't feel that my culture really affected my writing about my PPD experience. Though, I have to say that I am one of the few Asian bloggers I'm aware of. Unlike most of my Asian friends and acquaintances, I am very outspoken and opinionated. The Chinese tend to keep their emotions bottled up and thoughts and experiences to themselves. In general, they are a very proud people. Everything is pretty much about saving face, which means not putting oneself out there when it comes to personal experiences, especially if there is anything in the least bit negative. As we know from the Western culture, pregnancy and motherhood are supposed to be blissful experiences. I, on the other hand, have a book that shares ALL my thoughts and experiences while suffering from PPD. It's a fairly big deal for any woman to share her PPD story, let alone publish a book about it. It's an even bigger deal for a Chinese woman to do either.

What would you like mainstream culture to know about your culture regarding pregnancy and postpartum?

Although I am Chinese and even speak Mandarin fluently, I was born and raised here in the U.S. As a result, I am very Westernized and do not observe many of the traditions my parents and the generations before them may have observed. Actually, my mother gave birth here and was not privy to the custom of Zou Yue. She gave birth in a foreign country with no loved ones around her. She received less help with taking care of me when I was a newborn than I had when I had my own daughter. At least when I had my daughter, my husband helped, and my mother and mother-in-law each stayed a week to help.

Zou Yue is like some of the other mother-nurturing customs observed by other cultures (la cuarentena in Mexico, sarantisma in Greece, Jaappa in India) in terms of observing a 30 or 40 day period of taking care of the mother, so she can take care of her baby and get adequate sleep to recover from childbirth. Forty seems to be a magical number, a number that has survived through the centuries and therefore has special significance. No doubt it has something to do with the fact that 40 days is the average length of time for a new mother's body to recover from childbirth and return to a pre-pregnant state. It's also why an OB/GYN will tell the new mother, once she's given birth, that he will see her in 6 weeks. Each of these traditions involves female family members and friends of the new mother providing her and her baby with care, so that the new mother's only focus is on getting rest and bonding with/feeding her baby. They also help around the house and prepare meals. Certain rituals are observed in which food is prepared a certain way to help keep her body/system warm. She is protected from feeling overwhelmed; hence, visitors are kept away (or kept at a very minimum) during this time. She is told to avoid bathing for fear of catching cold. All these rituals have the mother's well-being in mind. In terms of breastfeeding, female family members are on hand to teach her how to do it. In these other cultures, there is no expectation that the new mother know how to breastfeed instinctively and easily. There is a reason behind the phrase it takes a village.

I have blogged about the importance of social support and how, through the years, we seem to have lost perspective on things when it comes to the community coming together to help a new mother who has just had a baby. Getting adequate social support comprised of both emotional support (e.g., shoulder to cry on, listening non-judgmentally) and practical support (e.g., help with breastfeeding, cleaning, errands, laundry, taking care of the baby for a few hours so mom can take a nap or shower) is critical for new moms. Having enough support during the first 4-6 weeks until a new mom's body recovers from childbirth and her hormone levels return to their pre-pregnancy state can help keep anxiety levels down, help her get the rest she needs from all the changes her body has gone through with childbirth.

When you were pregnant, how was your culture addressed by care providers in ways that were helpful? And what about during your recovery from PPD?

I don't remember if my OB/GYN and hospital staff asked me any questions, either orally or via a written questionnaire, as to whether I had any cultural preferences that needed to be taken into consideration during or after childbirth. There definitely was no attempt on the part of my OB/GYN to ask me if I had any preferences for the duration of my pregnancy. Fortunately, I didn't have any preferences, anyway. I just wanted to be treated with respect and care, both of which my doctor ended up failing at. Now, in terms of the GP who treated me during my PPD, he was the ultimate example of a doctor with extremely poor bedside manner. The way I was treated by him and my OB/GYN angered me so much that I wrote them both letters during my recovery from PPD, telling them that their treatment of me aggravated my already extremely painful experience, they should get with the program when it comes to PPD, and I was dropping them and moving on to doctors who didn't lack bedside manner the way they did.

Infertility and Complications

Can you share a little about your experiences with both?

Without getting into the details as covered in my book about my infertility experience and childbirth complications, I'll just say that, like more and more women these days, I got married late (at age 36 ), had a dermoid cyst removed a year later to increase the likelihood of getting pregnant and not having it get in the way of a developing fetus, tried to conceive naturally for over a year before being referred to an IVF center where we failed our first cycle (it was such less than optimal experience mostly because the staff and environmental overall were cold and disorganized), and got pregnant successfully via my 2^nd IVF cycle at a different center. What started off as 2 fetuses became only one after a car accident I had about 2 months into the pregnancy. Other than nausea that lasted my entire pregnancy, some spotting, and overall anxiety that I would carry to term, my pregnancy went well. I delivered vaginally (with an epidural and episiotomy), but ended up having my uterus removed 3 days afterwards due to placenta accreta. During my entire 7-day stay, I was constantly woken up for blood work and extremely exhausted as a result. On top of that, I was starved for nearly the whole time I was there. Due to my surgical procedure, I was kept in an entirely different wing from my daughter for over a day, and whenever I called for a nurse, no one came. Some nurses were not nice to me at all. It was like a living hell for me most of the time I was in the hospital. To get the full details of my infertility, childbirth complications, and PPD experiences, you can read my book.

How can your experience help the readers of Giving Birth with Confidence?

My hope is that those who read about my experience in my book which covers a lot, including key statistics and information on the biopsychosocial factors behind PPD (infertility and childbirth complications are risk factors) will become more knowledgeable about perinatal mood disorders. I hope that they will also read the growing numbers of blogs of mothers who are speaking up about their struggles with perinatal mood disorders. Why? Well, knowledge is power. With more knowledge, there would be less ignorance and stigma, and motherhood myths will have less of a negative impact on mothers than they do today. I want to see fewer mothers being caught off guard and not knowing what is happening to them, should PPD strike. Being ignorant and unprepared for it causes unnecessary fear, anxiety, guilt, and inability to appreciate one's baby. For example, insomnia after the third week postpartum is a common first symptom of PPD.

My blog is hit numerous times each day via Google and other search engines using words like postpartum insomnia, new mom insomnia, insomnia four weeks after childbirth, can't sleep when the baby sleeps, can't sleep six weeks postpartum, and so on, which means that there are many moms out there who are going through what I went through, in terms of insomnia as a symptom of PPD, beginning at around 40 days. That's right, there's that magical number again! Had I known about PPD before my daughter was born, I would not have been as scared as I was as to why I had insomnia and couldn't sleep even though I was exhausted beyond words and even during the times she slept. My fear would not have escalated to full-blown anxiety attacks. I would've recognized other symptoms like loss of appetite (I lost so much weight so fast that within a couple of weeks I weighed less than I did before I got pregnant!). As soon as I started to have insomnia, instead of merely taking the Ambien prescribed to me by my OB/GYN, I would've immediately known to question it as a sign of PPD and gotten the right treatment then. As they say, hindsight is 20/20...

I would like to thank Ivy for her wonderful work and sharing her experiences and knowledge with Giving Birth with Confidence. To learn more about Ivy, visit her blog at http://ivysppdblog.wordpress.com/.