Here’s what I wish I had known, and what you can do to prevent it from happening to you.

As I write this, it’s the night before Mother’s Day, a day I dread each year.

I dread it because my wife — the mother of my 6-year-old daughter — is gone.

Each year, I fight back tears as my daughter lies in my bed asking questions about why her mommy is in heaven. It’s a question that, quite frankly, offers no sensible answer for a child. She can’t wrap her head around it.

Nighttime is usually full of fear for my beautiful daughter Adriana. It’s the time of day that she’s not a normal 6 year old.

Every night, after tickle attacks and belly laughs, Adriana complains of a stomachache, sore throat, or headache. She becomes restless and her breathing becomes heavy. The symptoms she’s experiencing are from anxiety.

Adriana lost so much at such a young age. Her mom died when she was just 5 1/2 weeks old. Going to school each day, seeing other parents, and hearing teachers refer to moms at home are all constant reminders of what she doesn’t have.

My daughter fears losing me, and all the other adults in her life. She’s afraid that she’ll be all alone in this world — a child fending for herself, missing everyone she loves. While this fear might be irrational for most kids, it’s very real for her.

But this year, for the first time ever, my daughter quietly said, “I don’t feel scared anymore. I feel more relaxed than I’ve ever felt.” My heart fluttered. I asked her why she felt so calm.

“My heart is full of love and joy tonight. You see, Daddy, when people are sad it’s because their heart is too small to hold lots of love and joy. The only way to make others’ hearts bigger is to give them some of yours.”

On August 30, 2013, my beautiful, healthy, and smart daughter Adriana was born. My wife and I were both 30 years old and had everything a young couple could dream of in this world. We felt invincible and unstoppable.

Together we had a connection that brought out the best in each other. Our love gave us the courage to step out of our comfort zones and grow as people and professionals.

We had a once-in-a-lifetime kind of love — a love that never dies.

On October 8, 2013 our perfect world changed forever. On that October morning, I awoke to find my wife Alexis lifeless in our basement. It’s a sight that still sucks the air out of my lungs.

Our daughter’s birth

It all started with a term I had never heard: traumatic birth.

In our case, Adriana came into the world in a code blue birth with no doctor in the room.

Just 12 minutes prior to Adriana’s arrival, my wife was screaming that she needed to start pushing. The doctor matter-of-factly dismissed her; there were other births that were a higher priority than ours. We were told that since Alexis was a first-time mother, it would be at least 2 more hours.

Twelve minutes later, Adriana was coming, fast and furious. I remember the panic like it was yesterday. The only nurse in the room told me to grab one leg while she grabbed the other, and started coaching Alexis in breathing exercises.

Alexis and I stared at each other in fear, wondering when a doctor would arrive. In the midst of the screaming and pushing we realized something was wrong. The baby was stuck. She had no slack — the umbilical cord was wrapped around her neck.

The nurse tried to remain calm but soon screamed for somebody, anybody, to find scissors and cut the cord. Lights were flashing and alarms were blasting. Finally, what seemed like a dozen or more doctors rushed into the room.

I’ll never forget looking at my daughter’s blue body, anxiously waiting to hear a cry or a gasp for air. When that cry finally came, it was a relief unlike anything I can explain.

I looked at Alexis, exhausted and scared, and knew something was wrong. The thing that made her so special was gone. Her energy had been sucked away and replaced with confusion and self-doubt.

Little did I know what the next 5 1/2 weeks would be like.

The first weeks home

The first sign that told me there was something wrong came about 2 1/2 weeks postpartum. Alexis had been struggling with debilitating anxiety and called her OB-GYN to express her worries.

They referred Alexis to a licensed clinical social worker with a masters in psychology. In her first appointment, Alexis was diagnosed with post-traumatic stress disorder (PTSD) from the delivery.

PTSD led Alexis to believe that her very first act of motherhood was hurting her child. She believed that Adriana had brain damage and it was her fault because she couldn’t wait the 2 hours the doctor said.

Alexis was so convinced that Adriana had brain damage that we had neurological testing done. The testing proved Adriana was fine. Alexis refused to believe it.

The next two weeks can only be described as complete and utter chaos.

It was 13 sleepless nights with a baby that cried incessantly. Meanwhile, I watched my wife’s depression spiral out of control so quickly it’s hard to put into words.

Each day started the same. We called crisis centers, hospitals, her OB-GYN, our pediatrician… anybody that would listen, to try to get help. Alexis, unlike most women, did not suffer in silence. She knew she was in trouble.

We asked for help 7 times in the last 13 days of her life. At each and every appointment, Alexis filled out screening questionnaires. Each time, we left with nothing — no resources, no information to seek help, and no hope.

It was only after she died that I was able to read some of her answers to the screening questions. They were horrifying, to put it mildly. But because of HIPAA laws, no one could tell me just how dire the situation was.

Signs and symptoms of postpartum depression

  • excessive sadness that lasts for more than 2 weeks
  • excessive crying
  • a feeling of hopelessness
  • overwhelming fatigue
  • loss of appetite
  • excessive fear or worry
  • intense irritability, anger, or rage
  • inability to sleep
  • loss of sex drive
  • feeling shameful, inadequate, or like a burden
  • changes in mood
  • withdrawing from family and friends
  • trouble making decisions, or confusion
  • trouble bonding with baby
  • intrusive thoughts of harming self or baby
  • hallucinations, hearing voices, or paranoia (these are signs of postpartum psychosis and should be treated urgently)

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Escalating emergency

I didn’t realize how bad it was until one night when Alexis looked me in the eyes and said, “I know what we have to do. We should find a great family for Adriana and give her up for adoption. We had the most perfect life before we had a baby. We could go back to that same perfect life.”

That night was the first of multiple trips to psychiatric emergency rooms.

Each time, Alexis pleaded to be admitted. She was always told she was “not crazy.”

Each appointment was spent finding reasons why she was “not like them,” — the other admitted patients: you have a master’s degree, you’re the daughter of a minister, you’re pretty and well-spoken, you’re financially secure, you have a supportive husband, you have family and friends…

None of them listened to her say, “I don’t know how to make the anxiety stop. I can’t control the voices. I haven’t eaten in 5 weeks. I haven’t slept more than an hour a day. I can’t stop crying. I have a plan to hurt myself. I don’t deserve my husband or my baby. I can’t bond with my baby. I don’t care about anything anymore. I can’t make even the smallest decisions. I don’t want to have my baby taken from me. I’m a burden on everyone that loves me. I’m a failure as a mother.”

Imagine how hard it is to suffer from mental illness, reach out for help, find the courage to admit all of these things, and still be turned away each and every time.

Her desperate pleas for help were met with, “You’re fine, you’re not really going to harm yourself.”

After each appointment, Alexis would get in the car and say, “Nobody is going to help me. Nobody cares about me.”

On our 4th wedding anniversary, we sat in the psych ward, in a glass room that locked from the outside. While my wife was pleading with a social worker to be admitted, I pulled the emergency room psychiatric doctor aside and tearfully asked him how I was supposed to protect her.

His response was that women like her never attempt suicide in a sloppy way. Women like her would never want to be remembered not looking their best. Women like her only do it in 2 ways: asphyxiating themselves in their garages with a vehicle or overdosing on pills.

I left with instructions to remove car keys and prescription pills from our house.

“Not cut out for motherhood”

My wife’s main concern was the suicidal thoughts she started having after her OB-GYN prescribed Zoloft.

About a week after starting Zoloft and telling her OB that she was having intrusive thoughts, the doctor (the same doctor who told Alexis not to push during delivery) doubled her dose.

Alexis started researching alternate treatment options and made an appointment to review them with her OB. She also wanted to level with the doctor — Alexis wanted to say she felt abandoned in the delivery room, and tell her about the PTSD diagnosis.

It didn’t go well. The doctor was so offended that she told Alexis to go on birth control and not have any more babies. She told Alexis, “You’re not cut out for motherhood.”

When Alexis came out of the exam room, it was as if all the anxiety and stress was gone. I asked Alexis why she was so relaxed. She said she knew what she had to do.

Alexis told me she needed to take everything one day at a time. That night I took a picture of her looking at our perfect baby girl. They were looking into each other’s eyes. Alexis was smiling with her perfect smile.

I sent the picture to her parents to let them know that I thought she had turned a corner. I thought she was going to be alright.

Adriana cried and cried that night. I sat in the nursery rocking her and singing Coldplay songs to her. Alexis came into the nursery at about 3:30 in the morning and said “Pop, you’re so good with her. I don’t know how you do it. You’re going to be the best dad. When she falls asleep will you please come snuggle with me?”

Adriana fell asleep almost immediately. I crept into bed and snuggled next to the love of my life thinking the medication had finally started working. I was so exhausted and whispered to Alexis, “Promise me you won’t do anything to hurt yourself. I can’t do this alone. I need you.”

She said, “Yes.” Then Alexis looked at me over her right shoulder and said “I love you, Pop.”

The next morning, Alexis took her life.

After I found her, my heart became so small. Just like Adriana said — it seemed incapable of feeling love and joy.

Thank God for my beautiful daughter’s huge heart full of love and joy. Over time she’s spread that joy, and my heart has started to heal.

I’ve realized that during my lowest points when it feels impossible to smile, I can still make other people feel joy. In turn, it puts a smile on my face — if even just for a second. These small moments of joy have slowly built me back up. I now see that helping others find their joy is my life’s calling.

After Alexis’ death, I decided I needed to do something to make sure this didn’t happen to other mothers. I wanted to memorialize my wife with a legacy that my daughter could be proud of.

I established the Alexis Joy D’Achille Foundation with the help of family, friends, the Allegheny Health Network, and Highmark Health insurance company — two of the most compassionate healthcare organizations in operation today.

I’m proud to say that in December 2018, our foundation opened a state of the art, 7,300 square foot center for maternal mental health at West Penn Hospital in Pittsburgh, Pennsylvania.

Over 3,000 women received treatment at The Alexis Joy D’Achille Center for Perinatal Mental Health in 2019.

We want to make sure that moms never feel alone, so we’ve encouraged moms and families everywhere to share their stories using the hashtag #mywishformoms.

The campaign is a social cause initiative focused on breaking the silence around postpartum depression and has been nothing short of amazing. More than 19 million people from almost every country on earth have participated.

Like most fathers in this country, I was ill-prepared for the reality of childbirth and pregnancy. I want to share what I know now, so hopefully no other mother, father, or child has to walk in my shoes.

Partners should be present at doctor’s appointments

We need to show the women we love that we support them. Also, it’s crucial to establish relationships with the OB-GYN team before the baby is born.

The relationships built with doctors over the course of 40 weeks give partners a point of contact to reach out to if something seems wrong with mom during pregnancy and postpartum.

Become educated and feel confident in asking questions

Be an advocate for mama. As partners, it’s the least we can do considering we don’t endure labor or push out a child.

Nobody, not even a doctor, will ever know your partner the way you do

If something seems off, speak up. I wish I had.

Pay attention to mom’s eating habits

Alexis lost nearly 50 pounds in just 5 1/2 weeks postpartum. She was 10 pounds under her prepregnancy weight. Her loss of appetite was a big red flag.

Make a postpartum plan

Postpartum depression is the number one undiagnosed complication of childbirth in this country. Making a plan for support can be extremely effective in minimizing risk.

Don’t be afraid to ask friends and family if they’ll be willing to help out once the baby arrives.

Anyone who has had a baby and has the time will happily help. “It takes a village” is true, so find yours before the baby comes.

Let mom know she’s needed

Always let mom know how much she’s appreciated and needed. I always say marriage is 100/100 not 50/50. If both of you give 100 percent all the time, everything is going to be fine.

After delivering a baby, mom’s 100 percent might not be her usual. That’s when we as partners need to step up and give her our all.

Let her know how much she means to you and the baby. Make sure she knows that there’s never a situation where you’re better off without her. Although she might require extra help during this time, tell her she’s never a burden.

A fed baby is a healthy baby

Please, please, please stress this to her. The pressures around breastfeeding are enormous triggers for some women.

Breastfeeding may be ideal for baby, but not if it compromises mom’s mental health.

Take note of what she’s saying and doing

If she talks about phantom baby cries or hearing voices, don’t brush it off.

Alexis became scared of taking the baby out in the dark. She would crank the heat to 85 degrees on summer nights, worried that it was too cold. She became obsessed with talking about how our diets needed to change.

All of these fears and compulsions were signs of her postpartum anxiety.

Recognize when simple decisions are debilitating

If your partner is having trouble making the simplest of decisions, there’s probably something wrong.

The simplest of tasks might become burdensome. For example, Alexis would say, “I don’t know how I can make it to my appointment this afternoon. I have to get out of bed, brush my teeth, wash my face, comb my hair, change the baby, dress the baby, burp the baby, put on socks, put on shoes, tie my shoes, put the baby into the car seat…”

You get the point. She’d go through the list of everything she had to do, to the smallest detail. It became paralyzing.

Pay attention to her sleep

If she’s not sleeping enough, sleeping too much, has trouble falling asleep or staying asleep, she may need help.

Listen to her when she talks about harming herself or the baby

If she says these things, take it seriously. Women are more likely to attempt suicide during the postpartum period than any other time in their life.

It’s estimated that suicide and drug overdose may be responsible for up to 30 percent of maternal deaths. According to the Centers for Disease Control and Prevention (CDC), suicide is the leading cause of death in nonhispanic, white women during the postpartum period.

Remember that postpartum depression isn’t the only issue to look out for

Many women experience other symptoms or conditions like:

Know that dads are at risk, too

It’s important to note that postpartum depression isn’t exclusive to women.

As many as 10 percent of dads may also get postpartum depression. If a dad is dealing with a mother that has untreated postpartum depression, often they themselves will end up experiencing a mental health episode too.

Watching this area of medicine change so quickly over the past 6 1/2 years has inspired me to keep fighting for family health. God willing, I plan to use my story to help women and families get the care they deserve.

I won’t stop until women everywhere in this country have access to the same kind of care that we’ve brought to women in Pittsburgh.

Help for postpartum mood disorders

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Steven D’Achille is the founder and president of the Alexis Joy D’Achille Foundation for Postpartum Depression. He’s active with other women’s mental health organizations, sits on the board of Postpartum Support International, and has spoken at events and conferences all over the world to share his story. Steven’s a proud born-and-bred Pittsburgher, hailing from McCandless Township. He and his family own and operate the Pizza Roma and Pomodoro Italian restaurants in the North Hills, and he’s often found warmly welcoming customers to both establishments.