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CHAPTER 34 Cheryl Tatano Beck 683

Kim recalls that she began motherhood believ- Kim once remarked that she loved being preg-
ing this would be the event that would turn her life nant, loved giving birth, and loved the idea of
around. It did for several weeks, but slowly Kim being a mother. She said, “It would be great in
became involved in her old life. She received the beginning, but after a couple of months I’d
money to buy clothes and food for her baby. In start feeling bad. It seems like with both my babies
spite of that help, however, Kim had no place to that around 6 or 7 months, I just couldn’t handle
live and no money to support herself. She never anything.”
held a legal job in her life. She qualified for post- Although Kim took the baby to a pediatrician
partum medical care for 6 weeks, but after that she for follow-up care, none of those care providers
was on her own. knew her or knew her history—they were pri-
When the baby was 7 months old, Kim called a marily concerned with her son’s health. Kim’s
nurse who had once cared for her during her preg- affect is usually very upbeat; she smiles easily.
nancy and asked for help to give her daughter up It is not likely that anyone ever asked her any
for adoption. She believed she would simply never important questions about her life or her experi-
be able to give her baby the life she knew all babies ence of being a mother. Kim was, for all intents
deserved. Kim was using drugs again, and the baby and purposes, “lost to follow-up.”
was being kept by whoever was in the mood to do Kim’s story illustrates the kinds of complexi-
so. Kim absolutely loved this baby, and the choice ties that can make postpartum depression espe-
for adoption came from this love. Kim chose a local cially challenging for women who live amid
Christian adoption agency. Staff there gave her the drugs and chaos. In the midst of this life, women
opportunity to read the profiles of potential fami- still want to be good mothers and have the same
lies, see pictures of them, and actually choose the hopes and same dreams we all have. Drugs, alco-
family who would raise her baby. Though she did hol, crimes, and all the other ways Kim’s life
not know the family’s name or address, the family was chaotic were the only avenues by which she
and the agency committed to regular photographs received services—after-the-fact services.
and updates about her daughter. Interventions by others could have made a
Without resources or support, and without her difference at many points in Kim’s life. One of
baby, Kim returned to the only life she had ever these points was during her prenatal period. She
known among the only people she really knew. clearly evidenced most of the risk factors for
Eighteen months later, Kim gave birth to another postpartum depression, despite her cheerful atti-
baby. This time, she swore things would be differ- tude toward the pregnancy. If you had been a
ent. When this new baby was also about 7 months nurse caring for Kim during her prenatal care
old, Kim found herself deeply involved in crack and identified her to be at risk for postpartum
use, with her baby being passed around from rela- depression, what kind of care plan would you
tive to relative and from friend to friend. Unfortu- have developed before or after her baby’s birth?
nately, Kim was present during the commission of Would you have been willing to intervene on
a violent crime with a predictably tragic outcome. behalf of Kim or her baby, even though their
Although Kim did not actually commit this crime, needs occurred within the community and not in
she was present and was ultimately sent to prison. the confines of a hospital or office?

CRITICAL THINKING ACTIVITIES

1. Interview a friend or family member about her 3. Were any of her experiences suggestive of risk for
prenatal and postnatal experiences. postpartum depression?
2. Did she have feelings that you expected? Did she 4. Explore the resources available in your community
have any that surprised you? for women with postpartum depression.