The events in this story as well as the reporting occurred prior to the coronavirus pandemic.
Graham often felt sad and overwhelmed.
“It was so scary,” she said.
“The whole weekend I was bawling my eyes out, feeling so hopeless.”
That evening, she crawled into her husband’s lap and he held her while she cried.
Graham finally decided to call her doctor.
When her OBGYN’s office opened Monday morning, she made an appointment for that afternoon.
Drink a big cup full of sickly-sweet liquid, get your blood tested. It’s routine at any OBGYN office.
“They affect upward of 1 in 5 mothers, and that’s an average,” she said.
“There are some populations at much higher risk.”
And yet doctors are less likely to recognize and treat depression in pregnant and postpartum women than in the general population, according to a study published in the American Medical Association’s peer-reviewed journal JAMA Psychiatry.
In recent years, more OBGYNs are screening for pregnancy and childbirth-related mood disorders like postpartum depression. But women fall through the cracks because continuing education on how to diagnose those disorders hasn’t caught up with the need, said Moore Simas.
“The vast majority of obstetric providers have not been adequately trained to address (pregnancy and postpartum mood disorders),” she said. Training guidelines are relatively new, she said, “so we have generations of providers who didn’t necessarily get trained to do it.
“We’re in a watershed moment where we have to catch up.”
The doctor’s visit
Graham arrived at her obstetrician’s Birmingham office with her daughter strapped to her chest in a flower-print baby carrier.
Her daughter Beverly, age 2 months, was exclusively breastfed and Graham wasn’t sure how long the appointment would last.
Graham was nervous as she sat in the waiting room.
She hoped her OB would be able to give her answers and a treatment plan.
A nurse called her back to the exam room.
According to Graham, that’s when her doctor stood up, told her she needed to make a few calls, and left the room.
com’s calls requesting comment.
com show the doctor sent Graham to the hospital with a preliminary diagnosis of suicidal ideation, which is thought or plans of suicide. The doctor’s notes in Graham’s hospital records note that Graham “states she has a plan of shooting herself.
There is a name in the mental health community for a specific kind of disturbing thought that’s common among postpartum women: an “intrusive thought.” It is frightening and unwanted, but up to 70 percent of pregnant or postpartum women experience intrusive thoughts, said Moore Simas.
“Often (doctors) will hear about scary thoughts about hurting self or harming baby, and they immediately jump to worry,” she said. “But what I don’t think most providers appreciate yet is that unwanted or intrusive thoughts are really common.
Those thoughts are symptoms of something much more serious when they are welcoming or calming to a patient, she said.
After the ER, Graham was admitted temporarily as a psych patient at St. Vincent’s.
She learned she would have to stay overnight because the psychiatrist wouldn’t be available until the morning.
He found his wife teary-eyed, he recalled, but she seemed mostly upset that she would need to stay overnight.
“You know you’re not legally detained,” he told her.
“You can leave.”
Hayden told the staff she would like to leave, thinking she could come back the next day when the psychiatrist was available.
But staff told her she couldn’t leave, she said. Hudson asked the staff if she was legally detained.
The doctor said that could be arranged, they both recalled. Hayden’s heart sank.
Once she and baby Bev were settled into their room, a sitter arrived. The sitter’s job was to stay in the room and monitor her around the clock.
In a hospital wing designed for celebrations, joyous new parents and drowsy newborns, Hayden felt embarrassed. She was ashamed that some of the nurses, who’d attended her high school, knew why she was there.
Later that evening, Hudson went home to be with their toddler.
She awoke shortly after 5 a.
The psychiatrist asked Graham questions about whether she planned to hurt or kill herself or anybody else. No, no, Graham said.
When they were finished, the psychiatrist said she was going to admit Hayden to the psych ward for evaluation.
“I told her the same thing I’d told the ER doctor, that I can’t because my baby is exclusively breastfed,” Hayden recalled. “She said she’d come up with a separate plan and for me to have a blessed day.
The whole thing didn’t take more than five minutes.”
“I definitely took it seriously,” he said.
“But I’ve known Hayden for years, and I could tell she didn’t plan on acting on it.”
A nurse came in and asked Hayden to stay until the psychiatrist approved a treatment plan.
The Grahams waited.
Then the attending physician came in and said while she and the psychiatrist recommended Hayden be admitted as a psych patient, there was another option: Hayden could leave the hospital that day with a plan for outpatient treatment with a psychiatrist, a prescription for an anti-depressant and the understanding that Hudson would monitor her 24/7 around the children.
Hudson works from home and said it wouldn’t be a problem; Hayden said she was happy with that plan.
But two hours went by and they didn’t hear anything.
Hudson and his mother, Leslie Haynes, asked the staff to get the discharge papers ready to sign. Hayden felt ready to go home, happy with what she thought was the treatment plan – Zoloft, outpatient psychiatry treatment and observation by her husband.
But papers never came.
com tell a similar story, except that nurses were also trying to contact the doctors about Hayden’s desire to be discharged. While the treatment plan she wanted is mentioned more than once in doctors’ notes, it appears her family’s increasingly adamant desires to leave raised staff suspicions.
“It was a lot of confusion on our end and seemed like confusion on their end,” Hudson said. “We were very uncertain about why they kept trying to drag out the situation and keep her there longer.
But by then it was too late. The elevator doors closed and she was gone.
She drove to the exit, paid the exit fee, and passed police officers and security guards on her way out.
After they reached Haynes’ home, Hayden’s phone rang.
It was the neighbor: “Why are there police at your house?”
“What?” Graham asked, not sure she’d heard right.
“There are police and unmarked cars all over your house.
Hudson said at that point he felt like he was in a Harrison Ford movie, unjustly accused of a crime.
“I was like, what have we done to be chased around by police?” he said.
The Grahams met the police and a case worker from the Alabama Department of Human Resources at a relative’s house. The case worker handed them a notice requiring them to show up at court the next morning at 8:30 a.
“They were petrified,” Haynes recalled of Hayden and Hudson.
“It was the most horrific experience. I’m 55 years old and I have never in my life gone through anything like that.
“It was surreal,” Hayden said.
“I felt like I was melting into the floor, I couldn’t breathe, my heart was pounding.
They were both required to attend 12 parenting classes.
Every morning, Hayden awoke in her house at 5 a.
She got dressed quickly so she could drive to the cousin’s house and arrive by 6 a.
She didn’t leave until 10 p.m.
, when she was legally required to leave.
” She and Hudson completed the required parenting classes in record time, she said.
“Our marriage was hanging by a thread because of this,” she said.
In mid-December, nearly two months after the hospital stay, the court allowed the family to move back home together if Hudson’s grandmother moved in with them and constantly monitored Hayden with the children.
Hayden said she couldn’t walk to the mailbox while carrying her baby without Hudson’s grandmother having to come out to the porch to watch them.
On the way home from court, they stopped and got a Christmas tree.
In February, the Grahams arrived at the courthouse for another hearing, having completed their parenting classes and other requirements.
She felt prepared but didn’t want to get her hopes up.
Her attorneys, DHR workers and court services representatives met with the judge and the case was dismissed.
“I was at a loss for words,” she said. “I couldn’t believe it.
I started clapping and everyone in the room started clapping. I was so happy.
It’s been a month since the Grahams regained full custody, and things are starting to return to normal. Hayden was diagnosed with postpartum depression by a psychologist and psychiatrist and is doing well in outpatient treatment, she said.
And yet Hudson is still processing the emotional and financial toll the last five months have taken.
He still feels anger at the professionals and the systems he believes failed his wife and family.
“It was very scary,” he said.
But now that we’re finally through it, it’s something we’re trying to put in the past.”
She’s volunteering with the Alabama chapter of Postpartum Support International, a nonprofit that recently started monthly support meetings for postpartum mothers in the Birmingham area, and also holds meetings in Huntsville.
The organization also offers a free helpline women can call to get connected to counseling and other resources, and a psychiatric consultation line for doctors to get help diagnosing pregnancy-related mood disorders.
Hayden doesn’t want women reading her story to be afraid to seek help for pregnancy or postpartum mood disorders. She believes the breakdown in her care came from being misdiagnosed and from poor communication about her treatment options, but feels strongly that women should always try to seek professional help.
“If I were talking to my friend, I’d tell her don’t be afraid to get help,” she said. “Just make sure you trust your doctor.
(Special to Al.com)