Tully and Postpartum Care: A Doula's Perspective
by Camilla Rae
The postpartum doula world was abuzz 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 new 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.
This article first ran in NW Kids Magazine in July 2018.