Keys to Empowering New/Expectant Moms and Maternal Mental Health

I was talking to someone 2 days ago who mentioned that for millenials, images are the way to go to attract attention to important messages.  In this day and age of limited-word media like Twitter and other social media forums, sound bytes and visuals tend to grab people’s attentions more.  Print media — like magazines and books (like mine) and all the other books I devoured in my quest for knowledge on why postpartum depression (PPD) occurs in certain women — are going more and more by the wayside.  Just today, I stumbled across an email from Karen Kleiman, MSW, LCSW, (founder of The Postpartum Stress Center and author of numerous books on perinatal mood disorders)1 yr and 9 months ago giving me permission to use the below image on my blog.  This image grabbed my attention and I want to help circulate it.   You should too if you care about mothers.  We need images and information like this to reach more expectant mothers.  We need to ensure they are informed before they even give birth so they aren’t blindsided with PPD.

Why do I feel this information is important? My experience with PPD happened back in 2005, and I blogged about the ignorance of my OB/GYN in February 2009, just shy of 10 years ago.  It was one of my first blog posts. Unfortunately, not much has changed between then and now except for the advent of Facebook and other social media to spread the word via organizations such as Postpartum Support International (PSI), PPD survivors/advocates, social workers, therapists and others who treat perinatal mood disorders (PMDs).  I know this from the stories that come across my feed on Facebook.  I know this from talking to others whose job is to care for mothers who struggle with PMDs.  The general population doesn’t know the difference between postpartum blues and PPD because all too many doctors don’t even know the difference.  Karen Kleiman would not have needed to create the above image if she didn’t see the problem still existing with doctors misinforming PPD moms.

The care model for OB/GYNs should be mandated to include:

  1. adequate training in medical schools/residency programs to ensure doctors know how to recognize symptoms of and treat perinatal mood disorders and know the difference between the baby blues versus PPD
  2.  a 15-minute time slot in every hospital baby care/childbirth training session to go over the basics of perinatal mood disorders (PPD, postpartum anxiety, postpartum OCD, and postpartum psychosis), difference between the postpartum blues and PPD, breastfeeding realities, risk factors, importance of lining up practical/social support before baby’s arrival, insomnia as a common first symptom, etc.)
  3. being prepared to offer referrals to organizations like PSI (which has coordinators in every state that can try to help the mother find local help), maternal mental health facilities and mother/baby units (which are starting to pop up more & more around the country), PPD support groups, therapists/social workers who specialize in helping PPD moms, and even websites / blogs / Facebook groups that can provide online support
  4. screening patients for risk of perinatal mood disorders
    • prior to pregnancy – to establish a baseline of hormone levels before pregnancy and determine if the woman has a history of PMDD  or other risk factors for PPD
    • during pregnancy – consultation comprised of questions to try to detect pre-natal depression and review of a standard small booklet with images and bullet points covering the basics of perinatal mood disorders (PPD, postpartum anxiety, postpartum OCD, and postpartum psychosis), difference between the postpartum blues and PPD, breastfeeding realities, risk factors, importance of lining up practical/social support before baby’s arrival, insomnia as a common first symptom, etc.)
    • during 6-week postpartum visit – including blood work to detect iron/thyroid deficiencies and measure hormone/neurotransmitter levels, thyroid panel, Adrenal Stress Index

Click here to see my Onboarding Questionnaire, Pregnancy Questionnaire, and Postpartum Questionnaire.

As you can see, I am continuing to use my PPD experience to come up with ideas to effect change in the reproductive health care arena.  I will continue to find ways to contribute toward public awareness campaigns, as well as resource development and distribution.

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Happy 10th Blogiversary and Happy Chinese New Year!

Struggling with long and endless days at work, so just briefly checking in to acknowledge these 2 significant events.

Ivy’s PPD Blog’s 10th blogiversary!

Can’t believe that it’s been TEN YEARS since I started my blog on February 5, 2009!

And what better way to kick off the lunar new year than with such a milestone!

Whether you celebrate Chinese New Year or the Lunar New Year…..I sincerely wish you the very best!

More later this week…stay tuned, and thanks for stopping by my blog!

New mothers with babies in the NICU are at increased risk of PPD – Part 2

Continuing on the topic I started on January 13th titled “New mothers with babies in the NICU are at increased risk of PPD,” I wanted to add a few points I missed earlier, inspired by a post that came across my feed recently from the Emerald Doulas website titled Preemies Parents and PMADs.  The post was authored by Carrie Banks, an Emerald Doula and one of the North Carolina state coordinators for Postpartum Support International.

Finally home from the NICU with the baby, it is natural for parents to feel anxious, now that they are responsible for their baby’s care and there are no nurses, doctors and machines tending to their baby’s care any longer.  The feeling of being fully responsible and the fear that something may go wrong can cause the parents to feel overwhelmed, especially if there are still medications, feeding and weight gain challenges, as well as physical (e.g., vision, hearing, motor skills) and cognitive development concerns.

I can recall feeling overwhelmed with having to deal with colic, cradle cap and eczema all at once.  My baby was not even a preemie, and my postpartum depression (PPD) starting once the one-week colic period ended.  So, yes, factors that cause stress during the first postpartum weeks while a new mom is still healing from childbirth can indeed lead to PPD.

The Emerald Doulas article contains great tips on addressing:

  • impaired/delayed bonding due to inability to hold the baby/feelings of fear/awkwardness of holding the baby in the NICU
  • transitioning to life at home after the NICU
  • feelings of isolation, guilt and shame
  • why getting help is important

Parents of preemies may also feel ungrateful or even guilty for seeking help for themselves, since everyone’s focus has been on the preemie baby for days, weeks or even months.  While these parents may feel like the only thing that matters is their baby to be okay, they need to remember that they need to stay strong and healthy, both mentally and physically, in order to be there for their baby!  Weeks if not months of having to stay strong for their NICU baby and for other children they may have can chip away until suddenly they find themselves unable to keep it together any longer.  Being anxious and sleep-deprived over an extended period can lead to a postpartum mood and anxiety disorder (PMAD) to set in.

Another contributing factor to the development of a PMAD is the feeling of isolation that occurs from staying home with the baby and keeping visitors away to protect the baby against germs, especially during the winter when colds and the flu abound.  The disappointment that comes from not having friends and family around like they would’ve wanted to have can also contribute toward the development of a PMAD.  Finding a community and support in the form of a NICU support group in-person and/or online can be invaluable, as it can help them feel less alone and more hopeful knowing they are not along in their experience both inside and outside of the NICU having to deal with physical/cognitive development concerns/challenges in addition to the seemingly endless visits with doctors, speech therapists, occupational therapists and/or physical therapists.

There should be no doubt as to whether seeking help is an option.  If you need help, do not hesitate to get it.  Reach out to friends and relatives.  See if you can get a friend and/or relative to help coordinate the search for specific kinds of help.  I’ve seen many situations where a friend sets up a Meal Train account and shares it on social media or email to get friends/relatives/neighbors/colleagues to pitch in money or orders from local restaurants/delis to be sent directly to the family.  If you need help with overnight care and you can afford to hire a postpartum doula, then see if you can locate one through referral from a friend/relative or by searching for one on the Doulas of North America (DONA) website.

You, my dear mother (and father), need to remember self care!

Traditional Postpartum Practices Workshop – Jan, Feb, Mar 2019

Come check out this special 2-day workshop that will teach you what a holistic after-birth recovery plan–one that is based on Malaysian traditions that have led to the lowest rates of postpartum mood and anxiety disorders (PMAD) in the world at 3%–should look like that is based on the world’s #1 postpartum healing practices.  In the United States PMADs occur in as many as 1 in 7, or 14% of new mothers. By the end of the training, you will know how to create an effective daily plan encompassing specialized nutrition, body massages, abdominal wraps, herbs, and other treatments to help a new mother’s body to recover in a stronger, faster and more balanced manner during the first 6 weeks postpartum.

During her many years living abroad in Malaysia, Valerie Lynn conducted extensive research on postpartum practices via the Ministry of Health, Traditional Complementary Medicine Department of the Malaysian government, as well as via interviews in hospitals and in the field.  She learned that the detailed and thorough care that is provided to new mothers during the first 44-days postpartum is unrivaled.  She witnessed firsthand how quickly mothers recovered from childbirth from the postpartum care they were provided.

Learn for yourself and/or to help other mothers reduce the amount of time needed to recover from childbirth!

A Note to Corporations re: maternity leave and how to maximize employee potential:  Click here for more info.  She can do corporate lunch seminars..just reach out to her via valerie@postpregnacywellness.com for more information on how to coordinate this!

When:
January 24-25, 2019
February 21-22, 2019
March 21-22, 2019
Options are to attend day 1 or both day 1 and day 2 (contact Valerie Lynn at valerie@postpregnacywellness.com for latest rates.

Where:  (Photo ID is required to enter)
Consulate General of Malaysia
313 E 43rd St
New York, New York 10017

To Register:
Please email valerie@postpregnacywellness.com for payment link.  Your full name, company name, address, and telephone are required.  Click here for more info.

About Valerie Lynn:
Author of The Mommy Plan (endorsed by many childbirth educational organizations and is listed as a choice of required reading for Postpartum Doula certification by the Childbirth and Postpartum Professionals Association (CAPPA)Valerie Lynn is an expert on employing a blend of the most effective eastern and western postpartum recovery practices to help new mothers through their physical and hormonal recovery from childbirth.  These practices have been proven to greatly reduce the amount of time needed for new moms to heal.  It was during her own 15-month experience with postpartum anxiety and OCD (obsessive compulsive disorder) after the birth of her son in 2007 that Valerie turned to traditional feminine healthcare to re-balance her post-baby hormones and heal herself naturally through herbs, massage and diet.  She was living in Malaysia at the time. Valerie has held positions such as Executive Director of the American Malaysian Chamber of Commerce and Principal of VLM Consultancy where she was provided strategic consultancy services for foreign companies entering the Malaysian and APEC markets.  She is part of the Board of Directors of the distinguished Malaysian NGO YASNITA, “Women’s Pathway to Success” where she serves as an International Advisor on Postpartum Recovery Practices. She is International Country (PSI) Volunteer Co-coordinator for Malaysia of Postpartum Support International, a global organization in 138 countries. She is a Board Member of the International Maternity Institute and the After Birth Project in the U.S. Valerie regularly contributes to articles, books, and training programs. She aspires to improve the healing-care of new mothers in the United States and globally which, she believes, will reduce the high rates of postpartum depression. She is an approved speaker for Johnson & Johnson.

New mothers with babies in the NICU are at increased risk of PPD

The motivation for this blog post is a Huffpost article that popped up in my Facebook feed yesterday titled “NICU Moms Are Struggling With Mental Health Problems–And They Aren’t Getting Help” by Catherine Pearson.  It happens to be from 4/13/2018, but I’m only seeing it now for the first time.

I have blogged about the many risk factors for PPD before.  One of the risk factors happens to be premature births.  Last time I blogged about premature births being one of the risk factors for PPD was 9 years ago.  So, I’m way overdue blogging about this topic again!

A new mother who was pregnant one minute–and expecting several more weeks of pregnancy–and suddenly giving birth and seeing your baby hooked up to machines is an overwhelmingly anxiety-provoking experience.  All new mothers are not only hormonal, exhausted and trying to recover from childbirth, but NICU mothers are also anxious about their babies, unwilling to leave their babies’ sides, and find it hard to eat, sleep or even talk to friends and family members who don’t fully understand what it’s like to have a baby in the NICU. Unable to touch, hold and feed her baby and instead seeing her tiny, precious baby hooked up to so many wires, it is natural for a NICU mother to be consumed with feelings of helplessness, distress and fear.  Each day, the NICU mother spends many hours each day at their baby’s side, pumping every few hours, and on high alert with respect to her baby’s breathing and the noises of the machines keeping her baby alive.

In the daily hustle and bustle of the nurses and doctors in the NICU, having them stop and ask the mother (and/or father) how they are holding up and making sure they are taking care of themselves and getting enough rest are not going to be at the forefront of their priorities, though you’d think it should be second nature for them to do so.  In fact, they are seldom trained to know what to ask.  Even if they did ask, there is an inadequate referral system in place to get help for a mother with a postpartum mood disorder.

“…[Studies have suggested that up to 70 percent of women whose babies spend time in the NICU experience some degree of postpartum depression, while up to one-quarter may experience symptoms of post-traumatic stress disorder.”  Simply put, a new mother’s risk of experiencing a postpartum mood disorder is very high.  And that is not surprising in the least.”

What should the screening entail?

I’ve previously blogged about and will repeat here that mothers should be assessed for postpartum depression (PPD) between 4-12 weeks postpartum.   She should be encouraged to have her six-week follow-up visit with her OB/GYN, provided she doesn’t complain about symptoms up to that point.  If she is symptomatic before the six-week visit, she should be screened right then.  If the 6-week screen doesn’t indicate PPD, she should be assessed once more at the 12-week point and also when she weans and when her period returns, since these events can trigger PPD in some women.

The following—in addition to screening tools like the Edinburgh Postnatal Depression Scale or Cheryl Beck’s Postpartum Depression Screening Scale—should be asked at the six-week follow-up visit with the OB/GYN, which can help diagnose PPD:

1. Have you been feeling any of the following for the past 2 weeks:

  • Persistent and mostly inexplicable sadness/tearfulness and feeling empty inside
  • Loss of interest/pleasure in hobbies/activities you once enjoyed; inability to laugh
  • Overall impaired functioning
  • Sleep difficulties (either insomnia or sleeping too much)
  • Weight loss (usually fairly quick) associated with a decrease in appetite
  • Weight gain associated with an increase in appetite
  • Excessive worrying/anxiety/concern about the baby
  • Restlessness/irritability
  • Difficulty thinking, concentrating or making decisions
  • Onset of panic attacks
  • Sense of despair and/or hopelessness leading to thoughts of death/suicide

2. How have you been feeling physically and emotionally?

3.  How is your appetite?

4.  How are you sleeping?  Have you been able to get at least 4, if not 5, hours of sleep a night?

5.  Have you had any recurring thoughts/images that are disturbing?

 

If local resources for PPD are not readily available (though all hospitals around the country should have a list of local psychologists, psychiatrists, social workers, registered nurses, PPD support groups on hand), the least they can do is provide a pamphlet for Postpartum Support International. Its website lists resources in every state.  And many states have already formed, or are in the process of forming, chapters to focus on state-specific efforts at advocacy, training, and other improvements.

If you are a new mom with a baby in the NICU, please, please, please remember that, though your attention is preoccupied with your baby, if you let your own strength and health go by the wayside, it is possible to succumb to a postpartum mood disorder.  Not everyone will succumb, but just remember the increased risk and higher occurrence among NICU moms.  Don’t forget to take care of yourself.  When your baby comes out of the NICU, you need to be strong and healthy to care for your baby.

 

 

Be the One Person Who Makes a Difference for Someone Else

My first blog post in over 4 months was only 2 days ago.  As you can see, I meant it when I said I would focus more on blogging!

Today’s post is inspired by a Scary Mommy article that appeared in my feed yesterday. The title of the article is “Am I Invisible? One Mom’s Pain-Relieving Response to Being Excluded” by Rachel Macy Stafford.  The title itself triggered my mind to flash back to many experiences of trying to befriend other mothers, only to have my attempts stopped dead in their tracks with the same kind of cold reaction mentioned in the first few paragraphs of this article.   I’ve hated–no, DESPISED– the feeling of being excluded since I was repeatedly excluded as a teen by these 3 C’s:  cliques, classmates and even fellow churchgoers.  Exclusions by teens is one thing.  But exclusions by adults?  Totally unacceptable, unnecessary, immature, inexcusable …..and quite simply, crappy.

As an adult, I have never had any problems striking up conversations with strangers I’ve never met before.  I have done that fairly often during the past 29 years of commuting into the city.  Usually, we are able to have these conversations due to our shared commuting woes.  That is our common bond.

In 2018, I made more new friends in my area in the one year than I have in the past 17 years combined.  As I’ve said in prior posts, I’ve found it challenging making friends in my area.  The friends I made last year arose from shared objectives of ensuring a #BlueWave this past November.  That was our common bond.

In 2016, I made more friends with classmates at my college reunion than when I was in college!  Being alums (without the stress of getting passing grades) was our common bond.

In 2006, I became a member of Postpartum Support International (PSI).  I blogged about our common bond previously in this blog post.

These are just some examples of how a common bond encourages friendships to form and conversations to be had even between strangers.  But that leads me to ask why a common bond of motherhood does not encourage friendships to form and conversations to be had even between strangers?  Why did the author of the Scary Mommy article experience the cold and mean exclusion that she experienced?  Why did I experience numerous cold and mean exclusions of countless mothers, even ADULT mothers of newborns, when we share a common bond of wading through unfamiliar territory together?

Doesn’t matter what the reason is, now does it?  Regardless of the reason–whether it be insecurity, pride or just plain nastiness–I would never do this to someone else.  It’s taken me a long time to piece it all together….the realization that such nasty behavior was actually a favor, as it instantly warned me not to waste any time.  In keeping with my philosophy “Life is too short for BS,” when I see people who–whether they know me or don’t know me yet–behave in a manner that is suggesting exclusion, I won’t waste my valuable time or energy on them.

In keeping with my philosophy of “Love, laugh and live a life with no regrets” I will take my experiences of people turning their backs on me and make sure I DO NOT treat others the way I DO NOT want to be treated myself.   I would NOT turn my back on someone who needed help, a listening ear and/or support.  I am not in the business of being on this earth to earn negative points in the karma area, TYVM.

I would:

  1. Help others who need help because, if the situation were reversed, I would want someone to offer me help
  2. Listen and provide comfort to others who need comforting because, if the situation were reversed, I would want someone to comfort me
  3. Support others who need support because, if the situation were reversed, I would want someone to support me

You know what they say about motherhood?  IT TAKES A VILLAGE.  Do what the Scary Mommy article suggests, which is to be the one person that makes a difference for someone else.  Imagine if everyone did that?  We would truly have a village!

The article urges us to each be the one that makes a difference for another, because all it takes is one person to help, listen/provide comfort to, and support someone else and help them realize they aren’t totally alone in this very-populated-and-yet-quite-lonely-at-times world.  How do we know the other person who’s coming to you for help, comfort or support isn’t in a dire situation?  How would you feel if you found out you could have made a difference by helping them, but was cold to them and there was a tragic outcome?

New mothers who are experiencing, or have experienced, a postpartum mood disorder share a common bond of loneliness, of feeling alone in our experience.  All it takes is one person to help another to not feel alone.  This is why so many new mothers have dedicated their lives to providing help/listening to/providing comfort to/supporting mothers suffering from postpartum mood disorders.  They want to give to someone what they did not receive while they were sick themselves.  Many, like me, did not get help, comfort or support.  Too many new mothers feel alone and for no reason at all.  There is no reason for a new mother to feel alone and at the end of their rope.

I will end with this beautifully-written poem in the Scary Mommy article:

With one invitation, we can take someone
From outsider to insider
From outcast to beloved member
From unknown neighbor to coffee companion
From wallflower to life-of-the-party
From shortened life expectancy to 80 years of joy.

I DO NOT want to have any regrets for not doing something when I had the opportunity.  Do you?

A New Year and Returning to Blogging

“Tomorrow, is the first blank page of a 365 page book. Write a good one.”
– Brad Paisley

I’ve seen this quote many new years past, but for some reason, it’s sticking with me more so now than ever before.  I haven’t blogged for over 4 months….the longest break since I started blogging in February 2009.  If you’ve been following my blog for some time, you may have noticed it’s been quiet over here and may have wondered if I’ve decided to call it quits.   Well, I’ve previously vowed I would never completely stop.  Blogging about maternal mental health will always be a passion of mine, as my experience 14 years ago has shaped me into the person I am now.  Blogging has also been a huge outlet for my thoughts and anger when I hear about our society’s shortcomings when it comes to maternal mental health.  As I’ve mentioned before, the anger that has fueled my passion has fizzled, and my anger has been directed toward the state of our government instead.  With my district’s Democratic nominee winning on November 6th and now with the House flipping blue (wooooot!!!!) this past Thursday,  I can breathe a sigh of relief and let go of some of my anger.

I’ve also been so busy at work that each day merges into the next and into the next with 10-hour days with no stops and often no lunch breaks……to the point that I’m feeling like my life is flashing before my eyes….and my daughter’s growing up so fast, she’s heading to HIGH SCHOOL this fall!  Plus, my parents and their health and other issues have been weighing heavily on my mind.

And so it comes to my latest philosophies, which are spin-offs of my long-time philosophy of “Just do it” and “Work hard, play hard.”

“Love, laugh and live life with no regrets”

and

“Life is too short for BS”

I don’t really take crap from anyone anymore.  I speak my mind.  I try to maintain work/life balance.  I’ve been trying to achieve more down time on weekends and each evening, trying to to sleep earlier and even squeezing in before bedtime a chapter or two of the bestseller “A Discovery of Witches” by my fellow Mt. Holyoke classmate, Deborah Harkness.   What more motivation do I have than the fact that the show is premiering in two weeks on Sundance Now?!  I’ve tried to see my parents more often.  I’m trying to do more with my daughter before she goes off to college and I <gulp> become an empty-nester. I’m trying to clean out loads of stuff I’ve been holding onto and just try to keep it simpler and less cluttered.  Cuz what am I going to do with stuff I’ve been hanging onto for years and don’t really need anymore?

Finally, as the new year begins, I would like to start up my blogging once more.  After all, I’m not used to not having my blog be one of the first blog resources that comes up when you search the terms “postpartum insomnia,” “can’t sleep when the baby sleeps,” etc.  Time to get to work and get to blogging again!