To tell the mothers' stories after childbirth, I draw from my first-hand experiences with mothers, and I use the media that best fits that particular story. The stories of depression and PTSD after childbirth are sensitive, and countless mothers often tell the same story, proving the authenticity of their shared experiences.
Hearing these heart-wrenching stories imprints itself in my mind, and the vision of the story/stories float in my head for months or years, like ripples of waves on the ocean, and not satisfied until they splash themselves on the media I am painting on. The stories do not belong to me and must be retold in paint to advocate for the mothers. I am frequently working on many projects and many media at once. For the mothers' postpartum depression and PTSD stories project, I often choose large format canvases or boards to draw the viewer into the postpartum world of the mother. The mothers who have previewed my painting universally identify with the subject matter. They often become tearful and want to contribute to the stories by adding their voices. My mothers, in the paintings, are often alone, inviting the viewer to join them for their shared stories. The mothers and the viewers work together in silence through various healing stages. Chronicling mothers' postpartum depression and PTSD journey is not a responsibility I have taken lightly. Each painting is carefully thought through to fulfill its role in advocating for the mothers.
The current painting series encompasses 30+ paintings representing 26 postpartum depression grief resolution stages. The series was developed from almost 30 years of listening to my patient's emotional distress. Looking back, I feel relatively ignorant about how I did not understand my patients for so many years. From childhood, we were hard-wired to view childbirth as a positive event, which was no different for me. 30% of women have some degree of postpartum depression after childbirth, and 3-6% are traumatized to the degree that they qualify as Post Traumatic Stress Disorder victims. Patients' distress is frequently attributed to hormonal changes, postpartum blues, or the mother's inability to cope. Medical school and residency did not prepare me for postpartum maternal issues. I saw difficult deliveries and noticed that if the baby did well, it was a successful delivery, and if the baby did not do well, it was a bad delivery. The mother was a vessel that carried the child. But the vessels break, and sometimes not even the mothers notice it. Besides the visible injury to the perineum and the anal sphincter, the invisible damage to the pelvic floor levator ani muscles is the basis for developing pelvic floor disorders for which 30% of women undergo surgery during their lifetime.
I could not connect the psychological symptoms of mothers to physical injury for the longest time until I pioneered a bedside ultrasound methodology that could be used to screen a large number of patients for hidden muscle injuries. The dilemma was that the ultrasound's observed level of damage did not correlate with patients' stages of distress. As I saw more and more of these injured mothers, I realized I witnessed mothers at different stages of exacerbation or resolution of the PTSD cycle. The literature on postpartum PTSD is in its infancy. Postpartum PTSD can be anything that the patient perceives as traumatic. Over the years, I realized postpartum PTSD healing was similar to recovery from losing a loved one as the patients mourned capacities and functionalities that were now "dead" to them. Trauma to the pelvic floor structures and muscles can manifest as pelvic pressure, pain, discomfort, sexual dysfunction, or loss of bladder and bowel function that rubs the patient of the capacity to function as before.
In this series, I have taken the typical statements and sentiments that the patients have expressed over the years and matched them with stages of recovery from grief. Although postpartum/postnatal PTSD is common, it is rarely diagnosed. The patients feel alone and as if they do not have an advocate and their voices are not heard. I advocate for mothers to have their stories told by painting their emotions.