THE LIFE AND DEATH OF RUTH RHODEN CRAVEN AND THE BIRTH OF POSTPARTUM SUPPORT CHARLESTON
The Life and Death of Ruth Rhoden Craven and the Birth of Postpartum Support Charleston
Editor's Note: This is part three of a four-part series, airing every Friday, that retells the origin of our organization. (Read part one here and part two here.) Some of the content may be disturbing, as it is a story of maternal mental illness, gun violence and suicide. If you find that you need to talk to someone about it, please reach out at email@example.com.
According to the discharge summary of the hospital’s psychiatrist, he wrote: “The patient is a 33-year-old white female with no previous psychiatric history admitted for depression and suicidal ideation. The patient had her first child on 9/20/99 after a normal pregnancy. Since then she has had a decreased mood, increased anxiety, and significantly reduced sleep. The patient took an overdose of 8 Ambien prior to admission. She denies psychosis, use of alcohol or drugs. She was started on Zoloft 50 mg two weeks prior to admission but that was recently increased to 100 mg. The patient’s medical history is significant for being postpartum, otherwise, unremarkable.”
Ruth Rhoden Craven was admitted on Oct. 10, 1999, to the adult psychiatric unit in Columbia, S.C. She continued to take Zoloft and was given medication to help her sleep, which seemed to improve her mood, according to the psychiatrist’s notes. “During the hospitalization,” the notes state, “she continued to deny any suicidal ideation and was noted to have brighter mood and affect. By 10/14/99, she had improved sufficiently for discharge home.”
But according to the records obtained by Ruth’s family, Ruth conveyed to her caretakers in the inpatient psychiatric unit that she was still unsure of her ability to be a mother.
On Monday, Oct. 11, the notes say that she was very tearful, saying that it was the first time she had really cried about her situation. She had feelings of guilt that others were having to take care of her baby. The staff offered reassurance, according to the notes, and talked with her about how to receive adequate sleep while rearing an infant. On Oct. 12, the notes indicate that Ruth vented feelings of incompetence about taking care of her son. Others thought it was “no big deal,” but she said she was left feeling insecure. Ruth said she was still stressed out about Andrew having to be re-hospitalized shortly after his birth due to jaundice. At that point, though, Ruth reported feeling more well-rested and more competent.
On Oct. 13, Ruth said she was feeling a little better about her competency as a mother, but she wasn’t sure she was ready to be discharged from the psychiatric unit. On Oct. 14, the day of her discharge, she received a dose of Ativan for anxiety and stated that she was not ready to leave the unit. She reported that she was still apprehensive about her ability to mother her child but acknowledged to the unit’s staff that she would have a lot of support at home.
Upon her discharge that day, Ruth’s mother said she and Joey Craven, Ruth’s husband, met with a hospital counselor on how best to support Ruth moving forward. Helena Bradford complained that the institution was ill-prepared on how best to help her daughter. “They didn’t know anything about postpartum depression,” she said. “Other people [in the psych unit] were just dealing with regular depression. And that’s what all their questions were about. And so I said, ‘You know, what can we do to help her with postpartum depression?’” Helena said the hospital’s staff could not find anything about postpartum depression in their library. Helena tried to do her own research online and was dismayed by what she found. “What I found [online] was stuff like, take her off on a vacation, let her go buy a new dress... And so, even after she died, I had no clue what postpartum depression was. What had killed my child?”
Knowledge and information about postpartum depression, and the rest that fall under the spectrum of perinatal mood and anxiety disorders (PMADs), has evolved greatly in the past 20 years. “Regular” depression can present at any time during a person’s lifespan. It’s more common in women, and the median onset is 32.
For PMADs, it is often linked to a woman’s hormones associated with pregnancy, childbirth and breastfeeding. A clinical diagnosis of perinatal depression is identical to “regular” depression, except she may be pregnant or has recently given birth. A PMAD like postpartum depression usually presents within four to six weeks of giving birth, although most women are not diagnosed until at least three months postpartum. Symptoms can occur even in pregnancy.
Diagnosing a PMAD can be difficult though. Moms may deny their feelings, in the hopes of waiting it out. They may fear that someone is going to take their child away. For women like Ruth, having a baby and suffering from a PMAD can be overwhelmingly challenging.
Two weeks after her discharge, on Oct. 28, she had her postpartum checkup with her OB. According to his notes, her postpartum exam was normal and that her “postpartum depression was under control.” Ruth had been experiencing high blood pressure throughout the month of October and was advised to keep an eye on it.
After this time, the family said that Ruth improved, but not enough to return to the job that she loved. Helena said that Ruth was triggered whenever her son cried, not knowing how to soothe him. The crying would send her into a panic.
It is common for women who are working toward recovery from PMADs to have bad days despite any progress that they’ve made. This is a time where family members should be vigilant, even when the mother seems to be doing well, and take precautions to remove potential weapons from the home and keep tabs on medications. Recovery from PMADs is measured in months or years, and not weeks or months. Moms who are struggling do not want to hurt themselves, but sometimes they convince themselves that it’s the only way to save themselves or their children when they experience a bad moment.
Unfortunately, suicide is one of the leading causes of death for postpartum women, according to a 2015 study in the Journal of Psychiatric Research. The authors determined that the women likely resorted to suicide because of the low rates of seeking mental health treatment and inadequate assessment by their health care providers of risk or illness severity for mood disorders.
When women have access to resources, are educated about their risk for PMADs, have proper medical management and guidance of their medication, if necessary, and know that they will be welcomed into a community, the chances of them resorting to self-harm or suicide will decrease.
On the night of Sunday, Dec. 5, Ruth’s best friend, Mary Anna Mullinax, was decorating her Christmas tree when she felt suddenly stricken by sadness.
“We had just moved into a new house, and I love Christmas,” she said. “I love Christmas more than anything. And while we were decorating, I just got so sad. And it was just overwhelming, and I went up to my room and cried. And there was no reason, but I was just so sad. I thought I just needed to get this out, whatever I’m feeling. And I came back down, and I got the phone call right after that.”
That day, while Joey was working and she was home alone with her 2.5-month-old infant, Andrew, Ruth fetched her handgun -- which her husband had given back to her because she had started to feel better -- from her car’s glove compartment. When Joey arrived home from work that day, he discovered his wife in her vehicle with a self-inflicted gunshot wound and his baby inside their home, alone. Joey then contacted the authorities and Ruth’s younger brother Mark, who also lived in Lexington. Word moved quickly to Ruth’s mother and her friends that she had committed suicide.
“I think she was having intrusive thoughts,” Helena said. “I think she was afraid she was going to do something to hurt [her son], and so she shot herself instead. She meant business, that last time.”
Helena said she and her second husband, Buzz, drove up to Lexington immediately to be with Joey and Andrew. Elaine Earl, a friend of Ruth’s, said she screamed when she received the news in a phone call. She said that, to this day, she still regrets trying to help Ruth with breastfeeding. Elaine said she had trouble dealing with her grief and knowing what to say or how to act in the days after Ruth’s death.
People who knew Ruth say that she would be the last person you would think would resort to suicide.
“We had a group friend who had committed suicide earlier in our lives,” said Mary Anna, who was a co-founder of the Ruth Rhoden Craven Foundation. “And I remember at his funeral, all the friends had gotten together sort of in a circle, and she was one of them. And everybody sort of made a vow that if anything were to be getting to us that bad that we would reach out to others. She never did. She would be the one that everyone would reach out to. You would never think that it would be her…
“She was very forward thinking,” Mary Anna recalled. “I remember there were times where she thought Joey might get a new job. ‘Well, when Joey gets this job, I’m going to do this, this, this and this, and then, you know, we’ll have it all worked out.’ And I remember thinking, you don’t do that with a baby. You can’t plan like that. And that’s what always struck me with her death. That I knew it had to be something instantaneous because had it been planned, she would’ve had that child’s life planned out. She would’ve had Joey’s life planned out...She would’ve had casseroles in the freezer for the next three months. That would’ve been her just preplanning everything.”
The next day, on Monday, Dec. 6, Joey called Ruth's OB. “Patient’s husband called today to state that Mrs. Craven took her life last night with a gun,” her OB records state. “She had an appointment today for an IUD placement. On her last discussion with me about how she was feeling, she stated that she was much improved and her psychiatrist had decreased her Zoloft to 50 mg. Her husband was disappointed with the psychiatric evaluation and care of his wife and wanted me to call her psychiatrist and let him know of the news. I expressed my condolences to Mr. Craven and told him that I would be in touch with her psychiatrist and let [him] know of her demise.”
The visitation for Ruth’s body was on Tuesday, Dec. 7, with the funeral taking place at the Cravens’ Lutheran church in Lexington the next morning. Family and friends would then travel to Mount Pleasant later on the 8th for entombment at Mount Pleasant Memorial Gardens on Mathis Ferry Road.
Read Part 4 here.
The Life and Death of Ruth Rhoden Craven and the Birth of Postpartum Support Charleston
Editor's Note: This is part two of a four-part series, airing every Friday, that retells the origin of our organization. (Read part one here.) Some of the content may be disturbing, as it is a story of maternal mental illness and suicide. If you find that you need to talk to someone about it, please reach out at firstname.lastname@example.org.
One in every five moms will experience a perinatal mood and anxiety disorder (PMAD), according to 2020 Mom, a national maternal mental health advocacy group. Of that 20 percent of women, only 15 percent will actually receive mental health assistance. Those women who are struggling can present with postpartum depression, anxiety, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), psychosis and/or adjustment disorder.
The reasons behind that shocking statistic are many. There is often a lack of communication or understanding about PMADs during OB appointments during and after pregnancy. The social stigma that surrounds mental health can make people uncomfortable. The shame a mom feels when she is struggling can sometimes be unbearable. The intrusive thoughts she may experience will repulse her and cause her to be fearful of reporting them to her family or medical provider. The options that are available to some women may be beyond their income and time capabilities. And she may not have supportive family members who recognize that she’s suffering.
Moms who are struggling with PMADs sometimes feel like there is nowhere to turn. They often flounder in the darkness.
Adjusting to having a newborn is rarely a smooth process, but Ruth Rhoden Craven’s family and friends picked up on troubling behavior right away. Breastfeeding was a struggle, and Ruth’s predisposition for structure and order may have shocked her once she became a mother.
Mary Anna Mullinax’s husband, who had once dated Ruth many years prior, spoke to Ruth on the phone when she was still in the hospital recovering from the birth. “He hung up the phone and he said, ‘Something is wrong,’” Mary Anna said. Ruth told Mary Anna’s husband that breastfeeding was not going well.
One week after Andrew’s birth, on Monday, Sept. 27, 1999, Ruth called her OB to let him know that she may be struggling with postpartum depression. He wrote her a prescription for Zoloft and advised her to call with an update in 30 days. But Ruth was back on the phone with her OB that same week, on Friday, Oct. 1, saying that she was “still depressed.” Both times, she told her OB that she wasn’t experiencing suicidal thoughts. He told Ruth to follow up again in one week to let him know how she was doing.
At 7:05 p.m. the next day, Saturday, Oct. 2, Ruth’s husband, Joey Craven, rushed her to the same Columbia, S.C., hospital at which she had given birth because she had taken three doses of Tylenol-Codeine to help her sleep. The Cravens’ pastor also joined them that evening. According to the physician’s assessment of her visit, “Patient denies being suicidal or wanting to harm self. Patient’s mother recently left and went back to Mount Pleasant. Patient expresses feeling overwhelmed with responsibility of new baby. Husband supportive/helpful [and] thinks she may need some outpatient counseling.” By 9:30 that evening, she was discharged and taken back home.
Family and friends slowly learned of Ruth’s brief hospitalization and realized that things were not going well. Joey did not want it known that Ruth had taken the pills purposefully, for fear of their son, Andrew, being taken away by the state’s child protective services.
Ruth’s outgoing personality had quickly changed to being withdrawn. Helena Bradford, Ruth’s mother, recalled a time when extended family members came to Ruth and Joey’s home in Lexington, S.C., to meet Andrew. “[Ruth] just sat on the couch and smiled and didn’t say a word,” Helena said. “And that was absolutely not her.”
Amid this, Ruth continued to struggle with breastfeeding. Well-meaning friends tried to help Ruth get over the hump of the newborn period, a time when many mothers and babies struggle to make breastfeeding work. A passionate breastfeeding advocate, Elaine Earl recalled calling Ruth several times, trying to help, and an occasion when she and another friend traveled to Lexington to see Ruth.
“[Ruth] was really withdrawn, and I tried to help. However, I can be loud, and I was way too pushy,” said Elaine, who was a co-founder of the Ruth Rhoden Craven Foundation. “I remember showing her how to sit with a pillow on her lap to hold the baby, and she didn’t want to do it, but I think I forced her to do it. She helped Andrew about a minute then gave him to Joey. Joey asked us to leave about five minutes later. I got huffy, saying things like, ‘Ruth doesn’t want us to leave. I want to ask her myself.’ So I pushed my way in to her room, and she said, ‘Yes, please leave.’ I felt horrible and apologized, and we left. That would be the last time I saw her.”
On another occasion, Mary Anna said she and another Charleston friend were also going to drive up to Lexington to visit Ruth, Joey and Andrew. “I remember Joey called us the night before and said, ‘Don’t come.’ And that was not Ruth.”
As Ruth continued to withdraw, Helena pleaded with Ruth to stop breastfeeding. “I finally said, ‘Ruth, give it up. There’s nothing wrong with formula.” Ruth had been producing plenty of breastmilk, but she and Andrew were having trouble figuring it out together. She tried for about two weeks, Helena remembers, and then tried to exclusively pump. That proved to be too stressful as well, and so she decided to use formula.
“I could see, in her perfection, that that might be a failure [for her],” Mary Anna said.
Being overwhelmed continued to haunt Ruth. In the dawn of the Internet age, Ruth communicated with another woman online who was selling baby clothes. Helena said she had asked the woman how she juggled being a mom with all of its responsibilities, like getting all of the bottles washed. Ruth thought that if she couldn’t figure out how to get organized, she was going to lose it.
Five days after Ruth’s first suicide attempt, on Thursday, Oct. 7, Helena called Ruth’s OB. She had traveled to Lexington to be with Ruth again, and Helena told the doctor that Ruth was still very depressed and was now having suicidal thoughts. According to the doctor’s notes, Helena told him that Ruth “wants to go to sleep forever and never wake up.” He advised Ruth to increase her dosage of Zoloft and referred her to a psychiatrist.
Helena lived in fear for her daughter. She was having trouble finding resources on postpartum depression, in medical literature and support online.
“I walked through the dining room to get to the kitchen, and I hated that house because it was dark,” she said. “[Ruth] was in this dark corner between a china cabinet and another piece of furniture. I said, ‘Ruth, what are you doing? Are you sitting there hiding from the cats?’ ‘No, ma’am. I’m just hiding.’ And that’s just when I really got terrified. I said, ‘You must be chilly, sitting there on the floor. Why don’t you go in the den on the sofa and get under some cover?’ So she did that. And that’s when I got online, and I was very, very new to the Internet. And I was trying to find anything I could on postpartum depression. I had no idea how to help her.”
On Sunday, Oct. 10, Joey woke up Helena in a panic, saying “Call 911. Ruth took a bottle of pills!”
Read Part 3 here.
The Life and Death of Ruth Rhoden Craven and the Birth of Postpartum Support Charleston
Editor's Note: This is a four-part series, airing every Friday, that retells the origin of our organization. Some of the content may be disturbing, as it is a story of maternal mental illness and suicide. If you find that you need to talk to someone about it, please reach out at email@example.com.
Mary Anna Mullinax sat across from another mom who was suffering. On the edge of her seat, Mary Anna listened intently as the other woman poured out her heart about her struggles with motherhood. Although she was listening and giving encouraging words, Mary Anna was working through her own grief. She was determined and driven by the desire to never lose another mom under her watch. Mary Anna sat in circles like that one, on that particular day, because she had lost one of her closest friends to postpartum depression. She and her collaborators were desperate to never let another mother suffer in silence.
“One of the things that really struck me was, postpartum depression was like something that took a piece of metal and twisted it into nothing,” Helena Bradford said. “And that’s what we couldn’t understand. What was this disease that just obliterated her?”
This is the story of Postpartum Support Charleston. More than that, though, it’s the story of the life and death of Ruth Rhoden Craven and all the other mothers who have found themselves in darkness, through no fault of their own, after the birth of their children. This organization, created initially as the Ruth Rhoden Craven Foundation, was born out of sorrow, but it lives on in love for the child that Ruth left behind, for mothers that are struggling and for the ones who have recovered.
Ruth would’ve turned 52 today. She was born on March 9, 1966, in Richland County, S.C., to Helena and the Rev. J. Marlon Rhoden Jr. Her mother and Ruth’s friends remember her as level-headed, friendly, talkative and organized. She grew up on Sullivan’s Island and later in Mount Pleasant, attending Wando High School and graduating from the College of Charleston with a bachelor’s degree in business administration. She loved music and was an avid concert-goer, Mary Anna said. Ruth attended concerts for Duran Duran, Tom Petty, the Eagles, Elton John and -- her favorite -- Billy Joel. Mary Anna, who was younger than Ruth and whose families had known each other for years, recalled that Ruth mentored her in high school and included her in her group of friends.
“She was the motherly one of the group,” Mary Anna said. “If anything needed to be taken care of, it was Ruth that did it. If you needed anything, she was the one. If you were interested in something, she was right there with you. If she ever dated someone, if they were interested in whatever, like fly fishing, she had the fly fishing hat. She had all the stuff. She was right in there with it.”
Ruth loved her job as an accountant at a family-owned business in Lexington, S.C., and she was wanting to move up the ladder. Helena said Ruth had taken the test twice to become a CPA but, frustratingly enough, hadn’t yet passed. Her co-workers were particularly fond of her, Mary Anna and Helena remembered.
“At lunch time, if she’d go out to get lunch, she’d say to the people in the office, ‘I’m going out to get some lunch. Do you want some?’” Helena recalled. “And she’d bring it back. Her coworker visited her a lot after she got sick. And at one point, she said, ‘You better hurry up and get back because you’ve got these people spoiled. They want me to go out and get their lunch for them. I said, No, that’s Ruth. That’s not me.’”
Ruth and Joey lived in a modest, one-story brick home on Vanderbilt Road, and Ruth was excited and nervous about becoming a mother. Elaine Earl, the third co-founder of the Ruth Rhoden Craven Foundation, met Ruth after marrying into Ruth’s circle of friends. Elaine recalled that Ruth was concerned that she wasn’t gaining as much weight in pregnancy as expected. She also remembered Ruth’s formality in approaching all things, especially when it came to naming her child.
“What I remember vividly is Ruth taking me and my then-husband Shawn out to lunch so she could ask us if it was OK to name their baby Andrew, since we had just used that name for our child,” Elaine said. “We said, Sure, of course it is! We were elated and a little confused that she felt the need to be so formal with us, but that was just how Ruth was.”
As the due date approached in September 1999, Mary Anna said that Ruth made three lists for who was going to be contacted when Andrew was born. She was so organized, Ruth asked Mary Anna which list she wanted to be on -- and Mary Anna chose the 6 a.m. list for a birth announcement call. “That was how she structured everything,” Mary Anna said.
According to Ruth’s medical records, Ruth was scheduled to be induced on Sept. 20, 1999. But her baby had other plans. On that day, when she was 41 weeks along in her pregnancy, her water broke spontaneously, and Ruth and Joey went to a hospital in Columbia for the birth. When she arrived, her cervix had already dilated 4-5 centimeters, and then rapidly went to 5-6 cm, progressing smoothly and quickly. Her obstetrician’s records state that the doctor was eventually summoned to the room due to fetal distress. He found that Ruth was ready to push, so he performed a second-degree midline episiotomy and unraveled Andrew’s umbilical cord, which had been wrapped around his neck four times.
Shortly thereafter, Andrew was born. His airway was suctioned, and his umbilical cord was clamped. He was a healthy baby boy, and he was transported to the nursery while Ruth birthed the placenta, and her episiotomy was repaired.
The Cravens were now a family of three.
Read Part 2 here.
Hi! My name is Mary, and for as long as I can remember, I had always wanted to be a mom. In the fall of 2010, just three months after my wedding day, my dreams became a reality when I became pregnant.
Nine months, an induction, 36 hours of labor, and a C-section later, my son Riley was born. I had become a mother! After the anesthetics had worn off and I was more alert, I remember sitting on my hospital bed, while my husband slept, with my little boy swaddled and propped on his Boppy. It was just the two of us, and it was pure bliss!
But a late night feeding turned into disaster when I discovered my son bleeding from his feet. Lots of pokes and prods on my baby boy and an accusation pointed at me from a medical professional turned my life upside down. I collapsed and cried on the bathroom floor, telling my husband to take him away from me. I didn’t deserve my son. Despite this, and a correct diagnosis, I unraveled. I feared during this time that someone would take my baby away.
Eventually, God sent me an angel in the form of a counselor who specialized in postpartum mood disorders. She very literally saved my life. Her name was Kathleen, and I met with her every week for a few months. Together we discovered that I was suffering from postpartum PTSD, anxiety, OCD, and depression. She also referred me to a psychiatrist for medication. My healing came from taking my daily dose of Celexa, along with a routine of self-care and positive affirmations. It was, and sometimes still is, a daily struggle to climb out of the darkness. But I did it, and I finally felt worthy. I finally felt like a mother.
Not long after, my little family of three relocated to Charleston from California for my husband’s work. I was nervous to make such a big change after everything I had overcome. I knew that in order to keep myself together, I would need to find a support system. As soon as we had internet access, I Googled “Postpartum support near me.” The first thing that popped up was an advertisement for Postpartum Support Charleston’s annual Moms’ Run! As soon as I clicked the link, I knew this was something that I needed to do. I made the decision that this was going to be my next self-care goal. The Moms’ Run was my motivation over the next 12 months to get my physical health under control. I worked my tail off and dropped over 100 pounds! Going from barely being able to walk to my mailbox without getting winded to crossing that 5k finish line with tears in my eyes was one of the most gratifying moments of my life!
Having Postpartum Support Charleston as a resource is what kept me afloat. I am finally in a place in my life where I feel like I am healed enough to help others, which is why I decided to be a volunteer. I am both humbled and honored to be a part of this organization.