Tully and Postpartum Care- A Doula's Perspective

The postpartum doula world was a buzz when previews were released for Diablo Cody’s newest film, Tully. Having loved Juno, also written by Cody, for its realistic slice-of-life depiction of a supported teen pregnancy, we had high expectations that Tully would show how postpartum doulas aide the transition into parenthood. 

The movie opens with actress Charlize Theron, playing a very pregnant Marlo, lumbering down the hall to wake her son. You can feel the exhaustion of the third trimester as Marlo sets into motion the cascading responsibilities of the day. Quickly you are introduced to the struggles that she has been through, from caring for a ‘quirky’ son to struggling with a previous perinatal mood disorder. In an attempt to stave off a resurgence of Marlo’s ‘hard time,’ her brother Craig, played by Mark Duplass, offers to pay for a night nanny. Taken aback with mild offense and slight trepidation, Marlo reluctantly takes down a number to call “in case [she changes] her mind”.

After the baby is born, the movie goes on to portray the early postpartum period in a way that may feel all too real to recent parents: a repetitive whirring of never-ending, circular tasks done on little sleep, minimal energy, and dwindling patience. Director Jason Reitman catches shots that make us as parents laugh, gasp, and nod empathetically. After weeks of feeling alone, empty, and exhausted, Marlo decides to take Craig up on his offer. Enter Tully, a twenty-something night nanny played by actress Mackenzie Davis. Early on in their working relationship, Tully reiterates to Marlo that she is ‘[there] to take care of [Marlo]’. Feeling both apprehensive and relieved, Marlo welcomes Tully into her home, accepting the kind of helpful support that a postpartum doula might typically provide - support with breastfeeding, emotional processing, baby care, and household tasks.

Marlo’s journey with Tully takes some unconventional turns as Tully steps out of the role of a postpartum doula (imagine a wine-fueled hot tub conversation and sexual fantasy, adolescent makeup parties, and a night of bar-hopping together in the big city). Much to our dismay, the film’s end reveals Tully to be a delusion-- a symptom of postpartum psychosis. A psychosis that went unnoticed by Marlo’s husband and family.

Yikes! And let's pause for a reality check. While this movie demonstrates a real issue that affects a very small portion of the population (statistics tell us that .001% of childbearing women will develop postpartum psychosis), there is a larger - and quite serious - story to tell. Postpartum psychosis, though rare, is an extremely concerning ailment that requires immediate medical support: among the women who develop postpartum psychosis, approximately 5% will commit suicide; there is a 4% infanticide rate associated with the illness. And while postpartum psychosis is uncommon, other perinatal mood disorders are more prevalent:

  • 80% of postpartum parents experience the baby blues-- feelings of sadness, stress, and/or difficulty bonding with baby;

  • 14% of women suffer from postpartum depression;

  • 4-10% of new mothers experience postpartum anxiety/panic disorder; and

  • 3-5% of childbearing women are affected by postpartum obsessive compulsive disorder.

Any of these perinatal mood disorders (which can affect partners, as well, though at different rates of prevalence) can make the postpartum period more challenging - and less magical - than families often expect it to be. A perinatal mood disorder can interrupt bonding between parent and child, which can have impacts over the longer term. The statistics - and the story of "Tully" - demonstrate the importance of awareness surrounding perinatal mood disorders, their symptoms, and where families can go for help.

Perhaps the most important message of "Tully" is that every family deserves support in the postpartum period, a period that encompasses all pregnancy outcomes including miscarriage, abortion, and fetal/infant loss. If you are struggling with your perinatal experience, or even if you are simply preparing yourself and your family for a new addition, you don’t have to go it alone - I encourage you to explore (and use) the resource list that follows.

Camilla Rae is a Bridgetown Baby Postpartum Doula and INNATE Postpartum Care- Certified Provider. With loving compassion, Camilla enjoys caring for the expanding family, sharing baby rearing wisdom, and holding space for the transition into parenthood. When she isn’t caring for her clients, she can be found snuggling her 4 month-old, Maverick, volunteering at the Moreland Farmers Market, traveling the world, and homesteading.

*Statistics are provided by the CDC and Baby Blues Connection.
 

Postpartum Resources

Crisis Lines

Emergency: 911

Multnomah County Crisis Line: 503.988.4888

National Suicide Prevention Lifeline: 1.800.273.8255

National Hopeline Network, Suicide & Crisis Hotline: 1.800.442.4673.

Community Information and Referral Services: 211

Portland Area Mental Health Crisis Line: 800.716.9769

 

Perinatal Mood Disorder Support

Doula Support

ABC Doula :: 503.752.1691 :: abcdoula.com

Birthingway College of Midwifery :: 503.760.3131 :: birthingway.edu

Birthing Stone :: 503.718.7574 :: birthingstone.com

Bridgetown Baby :: 503.970.9554 :: bridgetownbaby.com

Doula Love :: 503.766.3495 :: portlanddoulalove.com

Doula Match :: A website to help you find birth and/or postpartum doulas in your area. :: doulamatch.net

Doula My Soul. :: 360.545.3356 :: doulamysoul.com

It’s a Belly :: 503.493.7390 :: itsabelly.com

Kindred Mother Care :: Sejal Fichadia :: kindredmothercare.com

Groups

Baby Blues Connection :: Baby Blues Connection is a parent-to-parent support service based in Portland. :: 800.557.8375

Brief Encounters :: A safe place for parents whose babies have died before, during, or after birth. Brief Encounters provides nonsectarian group meetings for bereaved families. :: 503. 699.8006 :: http://briefencounters.org

Postpartum Support International :: Postpartum Support International is dedicated to helping women suffering from perinatal mood and anxiety disorders, including postpartum depression, the most common complication of childbirth. :: 1.800.944.4773 :: http://www.postpartum.net

Providers

The Postpartum Stress Center :: The Postpartum Stress Center, LLC, is a premier treatment and professional training center for prenatal and postpartum depression and anxiety.

WellPDX :: WellPDX is a collective of Portland metro area acupuncturists, chiropractors, massage therapists and naturopathic doctors.

Camilla Rae is a Postpartum Doula and INNATE Postpartum Care-Certified Provider at Bridgetown Baby. This article first ran in NW Kids Magazine July 2018. http://www.nwkidsmagazine.com/2018/06/july-2018/

Until That Moment In The Kitchen: More on Mother's Day

Mothering is a collection of stories. In honor of Mother’s Day, we celebrate our collective journey— and acknowledge that within that collective journey, our individual experiences of mothering can differ widely. Some stories of mothering are threaded through with sadness, making Mother’s Day a complex sort of celebration. Bridgetown Baby client Saranna’s full story will be featured later this year in our Client Stories, but, in this snippet, she shares a moment of healing in the aftermath of loss, part of the arc of her growing family’s story.

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After we lost our son Spencer at 20 weeks gestation, I felt I was stuck for a long time at a certain point in my grief—grief support groups didn’t feel welcoming; the things people said, however well-meaning, made me feel more alone, as if there weren’t room for the grief I was experiencing. And when our daughter Neha was born a year and half later, the way people spoke of her (“now you have your baby,” as if that could fill the hole left by Spencer’s death) made me feel fiercely protective of her; I didn’t want her to bear the burden of feeling like a replacement for the older brother none of us ever got to know. So I took that burden on, too—and felt even more alone.

But perspective and healing came in an unexpected moment in the kitchen one afternoon. Neha ran up to me, bursting with news.

“Guess what, Mommy? Mocha (our dog who had passed about three months earlier) and big brother Spencer are driving around in a big red car in heaven together.”

“Oh, wow, Neha—that’s neat. Can you tell me more?”

“No, it was just in my dream.”

“Oh, I see. Do you miss them?”

“Yeah.”

I asked her if she had more she wanted to share with me; she said no, and went running out of the kitchen as fast as she’d come in. 

And I thought, ‘wow, just…wow. Here I am just cutting vegetables for dinner and, in a conversation that must have seemed so simple to her, she allowed me to experience my grief in a different way.’

In that moment, I suddenly felt that I didn’t have to hold all of the weight and responsibility of remembering this person, and honoring this person, and missing this person…Neha has integrated it seamlessly and lovingly into her story; the weight can be shared. It was as if my heart said, “I don’t have to bear this burden alone. And everyone’s going to be okay.”

~as told to Bridgetown Baby doula Brita Johnson