Whose heart hasn’t bled this week for Felicia Boots, the 35-year-old mother who became so delusional after stopping her medication for post-natal depression that she smothered her two children, 14-month-old Lily and nine-week-old Mason?
The wisest words, surprisingly, have come from the Old Bailey judge who heard her case: one doesn’t expect High Court Justices to show such sympathy and understanding. Speaking on Tuesday, Mr Justice Fulford said: “I unreservedly accept that what the defendant did to the two children she and her husband so loved and nurtured was solely the result of psychiatric and bio-physiological factors truly beyond her control.”
My tears for Mrs Boots, her husband and two children have been partly hormonal, because I’m six months pregnant, and partly empathetic: I never sank to the level of depression that Mrs Boots suffered, but after the birth of my first child two and a half years ago, I, like many other women, had post-natal depression (PND).
The tears are also of relief, at the acknowledgement from someone, particularly a man in a professional capacity, that post-natal depression is “beyond the control” of the person suffering it.
My depression after my son’s birth was horrific but mercifully short-lived. I suffered a tricky pregnancy: I’d already had two miscarriages, then bled heavily during the first trimester. I was told I was miscarrying again, then, mistakenly, that the foetus had a severe chromosonal abnormality and I would have to have a termination. That diagnosis was wrong, but a combined screening test showed up a one-in-six risk of Down’s syndrome. A subsequent amniocentesis test then confirmed that the baby wasn’t Down’s, after all, but later he and I both bled internally and delivery from 26 weeks was mooted.
In the end, I carried my child almost to full term and gave birth to a healthy baby, but the psychological damage was done. I’d spent most of the pregnancy trying not to get emotionally attached to my son in case I lost him. It was impossible, as he was placed in my arms, to feel anything other than a blankness in my heart where I knew a warm glow should be. It was a nothingness, dulled by drugs but worrying to me, even then, on that hospital bed, through the haze of painkillers.
Of course, I now love him with all my heart and feel a total maternal pride that grows each day. My husband and I say a prayer of thanks in church every Sunday for our healthy boy.
But the first three months after Josh was born were so hard I can’t remember much about them, other than a drowning sensation. When we got home from hospital, my husband and my mother rushed around the house while I sat there numb, staring at the wall. Every time my son cried, I cried, and his daddy or a grandparent would pick him up and beam the smiles at him that I didn’t have.
Most new mothers suffer from chronic tiredness, of course, and I can hear, as I write this, the cries from many readers of “You just have to get on with it”. Believe me, I would have been among your number had I not also experienced such depths of misery. After a week or so, there was no chink of light from behind the clouds, and after three weeks I had a real feeling of panic as I gazed out of the window at “normal” people heading off to work. My mother sent me to the doctor’s to get help.
I was lucky. My GP was fantastic. I had to tick boxes in a questionnaire designed, I imagine, to give the doctor an immediate glimpse of just how bad I was. One question asked: “Do you feel like harming yourself?” Humiliated, but distraught, I ticked “Yes”. My GP asked why, and she looked relieved when I explained that if I could just fall down the stairs and break my leg, I would be absolved from looking after the baby.
I also asked her why, after all my problems leading up to my son’s birth, I wasn’t feeling grateful to have him alive and well in my arms. I hated myself for acting like a spoilt brat, I said, for rejecting the very thing I most wanted. I felt I was just behaving badly, and that everyone around me, although supportive, was quietly mystified by my response. I was sure that the angry “Pull yourself together” chastisements were not far away, and I was desperate to do just that, before they arrived like slaps on my already red face. I sat in that doctor’s room, panicky, confused, full of self-loathing and utterly hopeless and helpless.
My doctor smiled warmly, said she was glad I’d sought help, that PND was common and – those magic words – beyond my control. She advised a low dose of anti-depressants to see if that would help. (I was also offered counselling, which I think would have worked better, but I would have to have waited several weeks for a referral, which was too long.)
And so, gradually, over two to three weeks, I began to rise to the surface of my despair, and surveyed the scene. There was my son, gurgling at anyone who looked his way and waiting patiently for his mother to join him on his little cloud of happiness.
NHS health visitors, who should have disappeared from the scene a couple of weeks after I brought my son home, were still making house calls every couple of days to check up on me, while grandparents, husband and new friends from my National Childbirth Trust course were there most days. The various aches and pains from giving birth began to subside, and I saw that my son was interesting, soft, warm and different every day.
At the suggestion of the health visitors, I joined a baby massage group to get the hands-on experience with my baby that had been sadly lacking. I learnt that his little legs and arms would withstand my clumsy grasp, and our time together in the company of strangers helped us bond.
Now I’m pregnant again, and of course I’m worried I’ll slide down that dark tunnel after the birth of my second son. It doesn’t help that I’ve already had a call from healthcare professionals working in the same office as the social workers who rang me when my son fell off his bed and broke his arm in the summer. They said they have me on record as suffering from depression during my last pregnancy, and how am I?
The phone call worries me: first, the records are wrong as I wasn’t depressed during my pregnancy, but after it, as many mothers are. Secondly, I feel that I’m now being scrutinised by social workers from afar and that, if they already have the wrong information about me, wrong conclusions could be drawn. I know social workers have a difficult job, but I don’t want to be wrongly labelled.
The statistics suggest that you are more likely to suffer PND if you’ve had it previously, but a number of factors have changed for me: I’ve had experience with a small baby and I’m more used to sleep deprivation. I also have a robust toddler waiting at home who deserves a sentient mother. Should I feel myself slipping again, my mother or husband will push me back to the doctor’s.
If any good can come from Felicia Boots’s story, it is that women will be more likely to seek help quickly should a few post-partum tears turn into a torrent they can’t stop.
There is also more the health service could do: it can’t be right that, according to Office of National Statistics figures (2001), the single biggest cause of death in women who are pregnant or have recently given birth is suicide. Thankfully, many maternity units have begun employing psychiatrists to diagnose and treat conditions such as post-natal depression. And according to the psychiatrist and Telegraph columnist Dr Max Pemberton, ''Perinatal psychiatry is now a recognised speciality in medicine. There has also been better training for midwives and health visitors.”
Still, I believe the people best placed to help women are other women who’ve been through it, and are happy to admit that the first three months with a baby can be the hardest they’ll ever face.
For support and advice call 0800 043 2031 or visit pndsupport.co.uk