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The opening notes of String Quartet OCD are dark and menacing, tones that sound as violent as the violin, viola, and cello bows look swooping up and down the elegant instruments. The effect is intentional, a desperate effort for composer Loretta Notareschi to convey the intrusive thoughts she regularly grappled with after giving birth to her daughter in 2013. Although she immediately bonded with the infant, the Regis University professor also imagined throwing the baby down the stairs or stabbing her with a kitchen knife.
She was experiencing postpartum obsessive compulsive disorder (similar to OCD), a condition that’s rarely discussed due to the stigma associated with such thoughts—and the mother’s fear that social services might take the baby away from her. The mental illness falls into the sphere of pregnancy-related mood and anxiety issues, which 10 to 25 percent of women experience while carrying a child or in the several months after they give birth. The refrain from experts like Dr. Celeste St. John-Larkin, the medical director of the Healthy Expectations Perinatal Mental Health Program at Children’s Hospital Colorado, is that such problems are more common than gestational diabetes—which every expecting mother gets tested for—but postpartum depression screenings aren’t required. (Both the American Academy of Pediatrics and the U.S. Preventive Services Task Force have recommended otherwise for good reason: Local researchers recently found that suicide and accidental overdose are the most common cause of death for Colorado mothers in the first year after giving birth). “OBGYNs tend to be much more comfortable with addressing gestational diabetes, and that’s the provider pregnant women usually spend the most time with,” St. John-Larkin says.
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Notareschi, though, was struggling with more than just a severe case of the baby blues. She avoided staircases and sharp objects and began repeating certain bizarre phrases (for example, “You must think I’m made of candy glass”) and musical patterns in order to try and calm herself—the compulsion side of OCD. Fortunately, she’d casually mentioned the thoughts to a nurse while still in the hospital and was connected with Healthy Expectations staffers, who put her on medication and introduced her to a support group. Within a year, she’d fully recovered.
It’s appropriate then that Notareschi has now partnered with Healthy Expectations—thanks to a grant from Chamber Music America—to present her deeply personal string quartet, which explores the roiling emotions of fear, shame, despair, frustration, and ultimately peace she felt while experiencing postpartum OCD. Tonight, the Denver-based Playground Ensemble, for which Notareschi is essentially a composer-in-residence, will perform the piece for the public in the Mt. Oxford Auditorium at Children’s Hospital, with a panel beforehand featuring maternal mental health experts such as St. John-Larkin.
Although Notareschi was initially concerned about writing a piece that could be viewed as too feminine in an industry still dominated by men, she wanted to follow the tradition of composers using the string quartet as an outlet to write about their own lives, which goes all the way back to Beethoven (and adding more diverse voices to the canon never hurts). Plus, she thought her piece might illuminate some of the misconceptions about an oft-misunderstood disease. “I had such a pop culture understanding of OCD before I got it,” Notareschi says. “I thought it was washing dishes and folding socks.”
“I do feel like there’s the two ends of the spectrum with how perinatal mental health gets represented,” added Jenny Paul, the clinical director of Healthy Expectations. “We either see images of everything going well and blissfully, of a mother running through fields of flowers with her baby, or we see the other end, in which a mom has struggled with postpartum psychosis and killed her children. There’s no in between, and it’s a huge disservice to women.”
Find out more about postpartum OCD and depression at tonight’s 7 p.m. performance of String Quartet OCD, in the Mt. Oxford Auditorium at Children’s Hospital Colorado. (Take the glass elevators up to the second floor.)