In the video: A 28-year-old woman and her toddler son were found without signs of life in a house in Haifa (Photo: Shlomi Gabay, Yoav Etiel)
The tragic case of the mother who murdered her baby and committed suicide in Haifa shocked her, especially in circumstances of postpartum depression. One in ten women will suffer from postpartum depression to varying degrees, but shame and stigma still cause many women to be left alone with their distress and not seek help.
Judy Stander, a midwife at Shaare Zedek and a representative of the Midwives Association, talks about the depression she faced at the birth of her first child: "I have a bachelor's degree in psychology and I'm a midwife, I had to be as aware as possible – and yet I suffered from postpartum depression. I'm a new immigrant and I gave birth to my eldest son without family support, and I didn't have many friends in Israel. I spent a lot of time alone with my son. I felt tired and didn't feel like anything, everything was very hard for me. I had no appetite, I ate and drank just to have milk, not to feed myself. I took care of my son, he gained weight and developed. I functioned, but only outwardly was I depressed."
ZAKA North commander Hezeki Farkas exhumes the body of the toddler, the scene of finding the body of a mother and son, Haifa, May 4, 2023 (Photo: Shlomi Gabay)
The first time she realized a pickup truck was wrong was when her son was three months old. "I expected the difficulty and fatigue from childbirth to pass and I would start enjoying motherhood," she tells Walla!. "But I felt like I was still tired and I had to drag myself out of bed. At night, when I had to get out of bed to feed him, I felt that my whole body was made of stones. I felt like I had lost myself, there were days when I would look in the mirror and not recognize the woman in front of me," Judy says through tears.
The typical symptoms of postpartum depression can be low mood, sadness, and a feeling of despair most of the day. Irritability, anger and rage. Lack of appetite or overeating almost every day. Insomnia or excessive sleep. Low self-esteem or feelings of guilt. Non-stop crying, a sense of distance from the baby and negative feelings towards the baby to the point of thoughts of hurting the baby. Repetitive thoughts of death or self-harm' anxiety for the baby's well-being and loss of interest or pleasure in things that used to be enjoyable.
The sense of relief comes after talking about the difficult feelings, often with a close friend, as happened with Judy. "I was talking to a good friend, and she told me I was in a difficult situation and maybe I should talk to someone. I went to a psychologist who gave me recommendations about her, at first I went to her thinking maybe I shouldn't be here and maybe I was okay. I didn't go to her wholeheartedly, and I wasn't sure I needed outside help. I'm a sporty person, so in therapy I realized I had to make room for it and it brought me back to myself."
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Judy Stander, midwife at Shaare Zedek and representative of the Israel Midwives Association (Photo: courtesy of those photographed)
Today, Shtender is already after three births. "I understand it's not the same connection." It is possible to undergo treatment and rebuild a connection with the children," she stresses. "Today my eldest son and I have an amazing relationship and I really don't think my situation when he was born hurt him, on the contrary - because there was difficulty at first since I am constantly working on building a strong and good and healthy relationship between us. After hearing about the incident in Haifa, I felt so much pain for her and how alone she felt. She didn't have a single friend to reach out to her like I had. We need to be sensitive to our neighbors or mothers on a playground. Even a small word can make a difference."
Roni Cohen Lazar, a member of the Israel Midwives Association and a midwife at Assuta Ashdod, had similar feelings: "I have three children and already at the first birth I felt slightly depressed. For my second birth, I made a number of someone who could help me with this after the birth, but I didn't use it. In the third child, just when I didn't expect it, it came, she recalls.
"When my little one was about two months old, a good friend of mine and my husband told me I wasn't doing well," she said. I didn't understand what they wanted because everything seemed fine to me. I already had two children at home and I know what maternity leave is. I didn't feel like I wanted to hurt me or my baby, nor did I cry all day, but I didn't feel anything. I didn't feel anything but something gray, I didn't sleep or eat. I was afraid to leave the house. I was very scared to drive. I didn't feel joy or sadness, but I went into a place that wasn't emotionally involved."
Postpartum depression can occur at any birth, either first birth or after multiple births. Ronnie describes depression as an experienced mother that can be difficult for veteran mothers: "My relationship with Ethan was more difficult than my two older children and it overwhelms complex feelings because I looked at myself as an experienced mother. I know what breastfeeding is and what it's like to be awake until the middle of the night, but he wasn't like his brothers and did things differently. I didn't have the strength to deal with him, things that were simple for me in the first children were harder for me with him."
Roni Cohen Lazar (Photo: courtesy of the subjects, courtesy of the subject)
Eventually, Ronnie was also able to free herself from her depression. "I realized that my loved ones were suffering. My family doctor suggested antidepressants and I started treatment. She said I needed to see a mental health doctor, where I changed medication. Taking medication doesn't mean she's psychic or going crazy. It's a hormonal imbalance," she explains.
Ilana Gans, a national supervisory nurse in the Public Health Division of the Ministry of Health, describes the ministry's coping with the phenomenon: "Close to 10% of mothers develop postpartum depression in the first weeks after giving birth. A larger percentage of mothers feel despondent after giving birth that passes after a few weeks, a small percentage continue with it more to more difficult situations. Psychosis is attended by very few women, and it comes only a few months after birth and can endanger the mother and baby - and maybe that's what probably happened in Haifa."
The feeling of many women who come to Tipat Halav is that nurses are not an address to talk about the difficult feelings. How do you at the Ministry of Health deal with this?
"Women come to milk drops with the feeling that they came for the baby, but our view is also of the circle of family, woman and baby."
According to Gens, 97 percent of women answer the questionnaire to detect postpartum depression, so that at least half of women can be identified. "It's the same figure as other countries. Every nurse knows how to identify a woman suffering from postpartum depression. We try to promote a non-judgmental and culturally sensitive therapeutic approach. For example, in the Negev, a quarter of the women come from the Bedouin sector, so in most stations most of the nurses come from the sector. It's the same in the ultra-Orthodox and Arab sectors."
The Israel Midwives Association is the representative professional association of 1,400 midwives in Israel's public hospitals, home and community midwives. The organization works in accordance with the zeitgeist to promote midwives, deepen their training and expand their powers. These are professional women, licensed as a certified midwife, which was granted to them by the Ministry of Health after six years of training, after four years of nursing studies for the title of registered nurse and an additional two years for the position of midwife.
Yifat Hadar Rubenko, a midwife at Beilinson and chairman of the Midwives Association, notes that women who have experienced depression in the past are at increased risk of developing depression during pregnancy. "Usually, depression in pregnancy does not go away alone and requires treatment even before the date of birth. In many of the women who suffered from postpartum depression, it turned out that it began during pregnancy, but was not diagnosed or treated," Rubenko notes. "We are currently leading the organization's model of continuous pregnancy accompaniment, together with the Ministry of Health, the HMOs and the Israeli Association of Obstetricians and Gynecologists, with an emphasis on a personal protocol, for each woman from the beginning of the pregnancy and throughout it, including about six weeks after birth. The model of continuous pregnancy accompaniment by a midwife also touches on the issue of depression. Research has proven that the connection between the woman and the midwife already at the stage of pregnancy enables deep acquaintance and building trust between the woman and the midwife, so that we can identify women with depression at an early stage of pregnancy and refer them for diagnosis and treatment by other professionals."
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