Receiving professional-guided self-care for six months

Author： Mirui

With a pounding heart, I pressed the phone number.

"Hello?”

“Um, I'm wondering if I can still use this home nursing service thing. Well, I found your website and came across this service. I'm interested in this, but it's been about two years since I gave birth. Am I still  qualified?"

As a 40-year-old, my hesitant debut into using home nursing for mental care began with this bit of nervous inquiry.

As I look back, even during my pregnancy, I experienced mild depression.

I was taken by surprise by the unexpected pregnancy, and my mind was filled with confusion. However, I was able to manage my daily life, and at that time, I had a partner.

We decided to have a non-marital birth by mutual agreement.

Although I couldn't bring myself to make the significant decision of submitting a marriage certificate, I thought this was a "normal childbirth" in my own way.

However, the situation totally changed after giving birth.

With my aging body, lacking sleep time became a big and constant struggle. Taking care of my first baby brought me intense feelings of anxiety. To make things worse, under the state of emergency due to the COVID-19 pandemic, I couldn't rely on babysitting for others casually.

As I continued to endure, my condition got worse.

I found myself experiencing what is commonly known as postpartum depression.

After I got this disease, harmless comments like, "Your baby is adorable," killed me, just like stabbing a knife into my heart. I could NOT feel "Oh my baby is cute" anymore. It felt like I was labeled  "failed mom"

I took sleeping pills to fall asleep. I wake up during the nighttime feeding my baby and go back to sleep with more sleeping pills. Food had no taste. Being alone with my child was difficult. I endured intense frustration. This cycle repeated over and over again. What kind of torture was this?

As a self-employed freelancer, I didn't have the option of taking childcare leave. I brought my laptop to the maternity hospital to get my work done. I didn't have a real maternity leave. 

Naturally, I had no capacity to consider my partner's needs, and our misunderstandings piled up, leading to a postpartum crisis.

 "Isn't this neglect?"
"You're not prepared enough as a mother."
"Why can't you just endure it?"
"Get out of here! "
"I can't stay here anymore so I've signed a contract for another apartment."
"This isn't a family."

These hurtful words were thrown at me by my ex. I didn't have the energy to argue back. I couldn't understand what was happening to me.

My condition got worse even further.

After discussions, I decided to move to a different place with my child, away from my partner. I just wanted to regain my own rhythm, away from this relationship.

The new life which I thought would be a recovery period turned out to be way harder than expected.

It was painful to be asked "What happened?" by friends or coworkers, I struggled to get to know the neighborhood, relying on Google Maps for finding supermarkets and convenience stores. Everyday life became a big challenge, and my capacity quickly reached my limit.

This is not good.

I had been thinking, "This is not good" since I gave birth, but now, "THIS IS NOT GOOD AT ALL.  What should I do?  Oh….I'm in trouble..."

When I was in such a state of crisis, I came across "home nursing with a focus on maternal and child support" on Twitter.

I have been receiving treatment for depression since my pregnancy. I have also received counseling and connected with the local public health nurse. I also had parenting counseling as well. Despite my efforts to find someone who could provide the support I needed and accompany me through this painful journey, I haven't been able to find someone who truly understands and supports me.

Although every supporter listened to my story attentively, it was just fragmented. That didn't make parenting easier. What I really needed, was more specific support in terms of "lines" and "squares", more like concrete and practical assistance provided in various aspects of parenting.

My former partner, who I had hoped to support and accompany me, had already gone.

For me, who was at a loss, the "home nursing care" that could be provided several times a week felt very appealing. So I took a chance to research “my living city name +  Mother and Child Support + Home Nursing Care” and Ta-da! I FOUND IT! I also found a local news article during my research as well. This might be the kind of support  I need!

After a week of hesitation, I took the courage and picked up the phone.

That nervous inquiry became a turning point in restoring my well-being.

And now, six months later, I receive home nursing care three times a week, with each one-hour visit.

I continued to share my struggles, joys, and what I found out in my daily life, which are kind of tiny little things and hesitate to discuss with my parents or friends even with my counselor.  Although my physical condition would rise and fall, I was able to learn about my thinking habits through this counseling.

This "home visiting nursing*1" system, in fact, can be covered by health insurance. Just like when visiting a hospital, you show your insurance card and pay only the copayment. (In Japan, if you show your health insurance card, generally your copayment is 30% of your medical expenses.)

It is just like that. If your doctor requests it, you can receive the service and they will come to your home.

For mental health care, if you have a "self-support recipient certificate," you only need to pay 10% of the cost*3*4 and the maximum amount per month is also set low. However, I was "the first one" to inquire on their own. *2  That is what I was told. Many users begin receiving this service through a referral from the hospital where they gave birth or a public health nurse.

I have used this system and felt that self-care with a professional eye is very effective and that this approach may help many people in need.

There is a professional nearby who can take care of you with calm judgment. Even if you are not fortunate enough to have someone you can talk to in your neighborhood, you can still reach out to a safety net like this. I think this is a great thing.

But I have only been able to tell close friends that I am receiving "home nursing service" because it sounds too serious. That's why I want to say this. I wish using "home nursing service" would become more accessible.　

I hope this message reaches those who are suffering.

Here is some additional information for reference:
Notes:
The information below is based on the Japanese social insurance system. If you don't hold a Japanese health care certificate, support might differ. But still, if you are in need, please ask local government officials, they might tell you what you can get. Hope this info will be a clue to finding a solution.
*1 For those who want to know about home nursing　
Home nursing is a service where nurses and healthcare professionals with specialized medical and nursing knowledge visit patients' home or facilities to provide medical care. You can see more details in Japanese from this link.  
*2 How to request home nursing for mental health care
Call the chosen home nursing station to inquire about availability. If they are available, get a "Home Nursing Referral" from your psychiatrist at the mental health clinic. After submitting the referral to the home nursing station, you are able to start using their services from that day onwards.
*If you don’t have a history of visiting a mental health clinic, it is possible to receive care through self-payment. If you have a newborn infant shortly after childbirth, it may be possible to receive home visits based on a referral from your obstetrician. Ask a home nursing station first. When you look for a nursing station on the internet, keywords such as "care for the whole family" or "support for mothers and children" are good clues for what you are looking for. This is because home nursing for mom has not been very common in Japan so far and people tend to think home nursing is something for elderly person.
*3 What is a Certificate of Recipient for Independent Living Support?
It’s a document issued to almost all individuals who have been receiving mental health care services for a certain period of time.If you have this certificate, you can reduce the burden of mental care related medical expenses. In my case, the total cost for medication, clinic visits, and home nursing services combined is around 10,000 yen per month. Please note that this amount can vary depending on income. I used to pay around 5,000 yen per month when I didn’t earn much money.
*4 How to get a Certificate of Independence Support 
Please search this key words “ local government name where you live ＋Certificate of Independence Support”  You can check the procedure. Then contact the welfare office of your local government. If you have a small child and have a connection with the local public health nurse, you can also inquire through that nurse. In my case, I prepared the documents with guidance at the local public health center because I was going through a very hush and difficult time and my brain didn’t work that much.

I sincerely think this information may help someone in need.

Call for Donations
Thank you for taking the time to read our essay. This essay was written by a single mother Mirui for the Mother's Day Campaign 2023. The Japanese non profit Single Mothers Sisterhood is an organization dedicated to supporting the mental and physical well-being of single mothers. Every year in May, we conduct a campaign to promote the importance of self-care and celebrate the diversity of families. Reading the essays written by single mothers allows us to appreciate the diverse qualities and characteristics that make each and every one of them special and unique. We would greatly appreciate your support. You can visit our donation page by clicking here.

Single Mothers' Sisterhood

Mother's Dayキャンペーン2023｜特定非営利活動法人シングルマザーズシスターフッド