Maria’s Letter to Her Younger Self

Maria’s younger self in 2009

A note of thanks to my friend and fellow PPD survivor/advocate, Maria, who was gracious in letting me share this letter she wrote last week during Maternal Mental Health Week, and I happened to see it on my feed and totally loved it.  This letter has inspired me to write my own letter to my younger self, which I hope to share soon.

If you are suffering from a postpartum mood disorder right now, please be comforted in knowing there are so many more moms like Maria and me that have suffered and overcome PPD only to become much stronger and empowered women.  You will down the road be able to write–and perhaps even share–your own letters to your younger selves as well.

*  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *

Dear Younger Maria (2009):

You are going to be okay.

You’re in hell now,
but you’re going to plug along
and find your way out.

It isn’t going to be easy
and it isn’t going to be pretty,
but soon after this photo was taken
you will summon the courage to reach out for help.

You will call the nurse manager in your obstetrician’s office
and in between sobs and heaving breaths,
you will slowly and fully tell her how you think something is wrong.

How you feel nothing when you hold your daughter
and you cry all the time.
How you only want to hide in a locked closet or a locked bathroom,
and in fact that is often what you do
once the kids are asleep or with a babysitter.

You are barely functioning but you are doing it.
You are doing it mama.

And those babies love you.
And you are an amazing mother.
And you are going to shine so brightly.

I promise.

Just hold on,
trust in yourself,
lean on your trusted friends,
and always remember that
you are worthy of more than this feeling.

More than this heart-wrenching,
gut-punching pain
and stifling loneliness.

This emptiness that consumes you will subside,
and soon you will find
a version of yourself that will set you free.

Be brave sweet mama.
I am so proud you.

Love,
Older Maria (2019)

Free Screening of Not Carol and Panel Discussion – Scotch Plains, NJ on May 29, 2019

If you live in New Jersey, please consider attending this screening of Not Carol, a feature-length documentary about the Carol Coronado case from 2014.  I’d blogged about it here and here.  And in searching for her current status just now (I was hoping there’d be news that would be more positive than that she was spending the rest of her life in prison without parole), I found this article featuring Joy Burkhard of 2020Mom  and her advocacy for Carol and other moms.  Carol’s case is another example of a tragic loss resulting from a postpartum mood disorder, in this case postpartum psychosis.

What:  Free Screening of Not Carol

Why:  Learn about postpartum depression (PPD), its symptoms and how to support mothers (and even fathers) suffering from it.  Public awareness initiatives like this one can help reduce stigma and ensure mothers suffering from a postpartum mood disorder, like PPD or postpartum psychosis, get the help they need.  We must ensure future cases like Carol’s will never happen again.  Note: this screening is not just intended for doctors/psychiatrists/social workers that work with new moms.  You can be a survivor, advocate, or simply a concerned citizen who may or may not know someone in your life that has suffered/is currently suffering from a postpartum mood disorder.

When: Wednesday, May 29 at 7:30 p.m.

Where: Scotch Plains JCC, 1391 Martine Avenue, Scotch Plains, NJ 07076

RSVP: Courtney Teicher via cteicher@jccng.org or 908-889-8800 x227

After the film there will be a panel discussion comprised of the following individuals (note that Dr Birndorf and Dr. Levine were on The Today Show on August 3, 2018, which focused on Dr. Levine’s experience as a new father with PPD.  Click here for my blog post about that):

  • Film Executive Producers: Eamon Harrington and Veronica Brady
  • David Levine, MD:  Summit Medical Group physician
  • Catherine Birndorf, MD – Clinical Associate Professor of Psychiatry and Obstetrics/Gynecology and founding director of the Payne Whitney Women’s Program at The New York Presbyterian Hospital – Weill Cornell Medical Center in Manhattan.  She is also a co-founder of The Motherhood Center).  I’d met her previously at a Postpartum Support International (PSI) conference.

Speaking of PSI, there will be information and individuals on-hand to provide information about the non-profit international organization.

 

 

Sounds of Silence 11th Annual Run/Walk – May 11, 2019

Join the Sounds of Silence, Friends of the Postpartum Resource Center of New York’s 11th annual run/walk in memory and celebration of Lisa Mary Reilly and help raise funds in the effort to increase awareness of perinatal mood disorders, such as postpartum depression (PPD), postpartum OCD, and postpartum psychosis.   Not only is this for an excellent cause, it will be a nice opportunity to race (or walk) a beautiful 5K boardwalk along the Atlantic Ocean.

Here’s a video of last year’s run/walk:

I have posted about this annual run/walk every year since 2009.  That year, I was one of the two top fundraisers, bringing in over $1,000 (as an individual).  This annual fundraiser was started back in 2008 by sisters Erin Mascaro and Lisa Reilly. It was Lisa’s experience with PPD after the birth of her daughter–an experience so deeply painful and full of suffering (a suffering that many others like her feel forced to endure in silence) that was witnessed by Erin and other loved ones–that motivated Erin and Lisa to break the silence of PPD with the Sounds of Silence annual run/walk .

All proceeds will go towards supporting the important services the Postpartum Resource Center of New York, Inc., a 501(c)3 non-profit organization (tax ID #11-3449880), provides to new mothers and their families.  To learn more about its services, go to:  http://postpartumny.org.

Please help spread the word about this fundraiser by blogging or sharing the flyer on Facebook/Twitter.

Sponsors Needed:  They are looking for sponsors, so companies looking for opportunities to support a wonderful cause that benefits mothers and their families should seriously consider this opportunity!  Click here for more info.

All New York State schools and colleges are invited to participate!  Click here to find out more.

Date:  Saturday, May 11, 2019

Time:  Registration from 8:00-9:00; race/walk begins at 9:15 AM.  There will be a Kids Fun Run, Raffles, Pre- and post-prace refreshments.

Place:   Jones Beach State Park, Wantagh, Long Island (Field 5)

Run/Walk Registration:  $30 (adults); $20 (ages 11-18); $5 (ages 10 and under); register here.  Registration price increases after May 4th.

Virtual Participation:  For those of you who can’t make it in person, you can participate virtually by registering via this link.  $30 to participate; you get a t-shirt for participation.

What first 250 entrants and first 500 registrants will receive:  First 250 entrants will receive commemorative t-shirts, and first 500 registrants (on day of) will receive race swag bags.  There will be a post-race raffle for prizes that include gift baskets, gift certificates, etc (you need to be present to win).  All who raise $200+ will receive a Sounds of Silence beach towel.

50/50 Fundraiser:  There will be a 50/50 Fundraiser to benefit the Postpartum Resource Center of New York.  Only 300 raffle tickets will be sold.   Grand prize: $10,000; 2nd prize: $3,500; 3rd prize: $1000; 4th prize: $500.  All proceeds from this raffle will be shared equally between the winner of each prize and the Postpartum Resource Center of New York, Inc.  Click here for more info.  Click here to purchase your ticket(s) while they last. Click here to order.  NOTE: Your ticket(s) will be mailed to you. You do not need to be present to win. All prize awards noted here are based on a sale of all 300 available tickets. Actual prize award(s) is based on total number of tickets sold.

 

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.

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!

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!

Why Screening of Postpartum Moms is Important and Who Can and Should Do the Screening

Today’s post was inspired by a March 19, 2018 NPR article by April Dembosky titled “Lawmakers Weigh Pros and Cons of Mandatory Screening for Postpartum Depression,” as well as a June 2018 Romper article by Karen Fratti titled “Moms Should be Screened for Postpartum Depression in the ER, New Study Suggests, & It Makes Perfect Sense,” a June 30, 2018 News Medical article titled “Screening mothers for PPD in emergency setting,” and a June 29, 2018 Austin360 article by Nicole Villalpando titled “Who should be screening moms for postpartum depression? More doctors now can.

Screening moms for postpartum depression (PPD) serves multiple purposes.  Screening will help ensure moms get the help they need and avoid suffering unnecessarily.  In case you weren’t aware, screening educates women on what PPD is, why it happens and just how common it is (1 in 7 new moms experience it), and helps them avoid what I and so many other mothers have gone through (PPD makes you feel alone, like you’re losing your mind and will never return to your previous self).  It will ensure fewer moms will ultimately fall through the cracks.  It will ensure fewer tragedies involving mothers and their babies.  And I’ve said this many times before, but a mother who is not well cannot care for her baby the way a healthy mother can.  This is pure logic.  Unfortunately, logic takes a back seat because our capitalist society places more priority on what benefits the pocket over what benefits the people’s well-being.

So…..question is WHO should screen new moms for PPD?

Her OB/GYN?  This should be a given, period, hands down, no questions asked!  In May 2018 the American College of Obstetricians and Gynecologists recommended that, in addition to the standard 6-week postpartum visit, OB/GYNs perform a follow-up visit within the first three weeks postpartum.  This new recommendation is due to the fact that symptoms of PPD often begin before the 6-week appointment.   See second half of my blog post on the issues many OB/GYNs are faced with in terms of screening.

Her baby’s pediatrician (but here the patient is the baby, not the mother)?  The American Academy of Pediatrics (click here and here) recommends doctors screen mothers for PPD when they bring their newborns in for wellness visits, since they occur numerous times in the baby’s first year; whereas, the mother only gets the one wellness check at postpartum week six.  Pediatricians who realize that the baby’s development can be negatively impacted when the mother is ill with PPD will try to screen the mom for PPD.  Problem is, most pediatricians as far as I’m aware are not prepared to screen and refer mothers since the mother is not a patient.

An ER physician?  While you will no doubt raise your eyebrows, doctors like Dr. Lenore Jarvis, an emergency medicine specialist with the Children’s National Emergency Department at United Medical Center in Washington, DC, have been seeing moms bring their babies to the ER, and it turns out the baby is fine but it’s the mother who is highly anxious and feeling overwhelmed.  In these cases, it’s logical to try to determine if it’s the mother who needs help.  In fact, Dr. Jarvis and several colleagues conducted a research study with several colleagues on screening moms for PPD in an ER setting.  A Eureka Alert release dated June 29, 2018 explains the results of the research study. Moms who participated were screened using the Edinburgh Postnatal Depression Scale supplemented by other questions.  The great thing about the research study is that, when moms scored positive for PPD, they received information about PPD and were offered–or if they had a strong positive score from screening, they were required to have–a consultation with a social worker.  Additionally, the researchers followed up with mothers who screened positive one month later to see how they were doing.  This is akin to case management programs we have in place when patients check out of hospitals (I explain all this in my post below). Now THIS is the way it SHOULD be!

Dr. Jarvis refers to the ER as a “safety net  for people who are not routinely accessing regular checkups for themselves and their children. If a mother is having an acute crisis in the middle of the night and feeling anxious and depressed, they often come to the emergency department for help.”  Because American policymakers have been so resistant to instituting policies that would require insurance companies to work with doctors to ensure PPD is caught early through screening and subsequent referrals–researchers/subject matter experts on PPD are left to make recommendations for what Dr. Jarvis referred to as a “safety net” approach of having emergency rooms screen for PPD when moms come in either for their babies (for colic, fevers, etc.) or even for themselves (symptoms of a postpartum mood disorder).

While I agree we need to cover all bases and try to screen a new mother wherever and whenever possible, why do we even need to resort to waiting until a mom comes into the ER to screen them?  Why do we have to have such a safety-net, fall-back, beats-nothing-at-all, better-late-than-never approach in the first place?  Answer:  our society continues to place too much priority on conception and childbirth but once the baby is born, everyone forgets the mother.  Once the baby is born, the mother’s health falls by the wayside.  I’ve blogged about this before, but the attention from that point on will be on the baby from visitors who coo at the baby and treat the mother as invisible.  Same thing with doctor visits; the mother only gets one postpartum wellness check at 6 weeks.  That’s it.  It’s like the mother ceases to exist.  Whereas, other cultures have customs to honor and mother the mother (click here and here for past posts).  The birth of the baby is synonymous in these cultures with the birth of the new mother and they are honored for bringing new life into the world.  This, my friends, is why maternal mental health advocacy is so important.  Until American policymakers institute policies to demonstrate the importance of mothers and their health, we advocates must continue to act as “squeaky wheels to get the grease.”

The following section is an excerpt from my book.

New mothers, especially the ones at high risk for PPD, should be screened during their six-week postpartum visit, 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 six-week screen doesn’t indicate PPD, she should be assessed once more at the twelve-week point—or when she weans or when her period returns, whichever comes first, 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 two 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 anxiety about the baby
  • Restlessness/irritability
  • Detachment from and inability to bond with the baby
  • Difficulty thinking, concentrating or making decisions
  • Feelings of guilt, inadequacy, failure and/or worthlessness
  • Urge to run away
  • Onset of panic attacks
  • Sense of despair and/or hopelessness leading to thoughts of death/suicide
  1. How have you been feeling physically and emotionally?
  2. Are you feeling particularly stressed, and, if so, is it due to a major change you are experiencing, such as marital problems, death of a loved one, financial problems, a recent move, or a job change?
  3. How do you feel about the baby? Are your feelings in line with your expectations of how you’d feel about the baby?
  4. Do you feel you have adequate emotional and practical support from your partner? Do you have any relatives or any other help, like a doula, to help you with the baby during the day?
  5. Are you breast-feeding and, if so, how is it going?
  6. How do you feel the labor and delivery went? Do you feel you experienced any sort of trauma during the delivery?
  7. Do you feel your childbirth and motherhood experience are meeting your expectations?
  8. Do you feel particularly anxious about your baby’s health (colic, SIDS)?
  9. How is your appetite?
  10. How are you sleeping? Have you been able to get at least four, if not five, hours of sleep a night?
  11. Have you had any recurring thoughts/images that are disturbing?
  12. How have you been adapting to motherhood, in general?
  13. Have you returned, or will you return, to work?

I believe these types of questions should be incorporated by all OB/GYNs throughout the country. This all theoretically sounds good and fine, but in most cases, OB/GYNs are not prepared to implement. Why not? At the very least, it would require training on perinatal mood disorders (recognition of symptoms and treatment), as well as ability to provide the right referrals as needed.

This last paragraph from my book excerpt remains true to this day.  Sad because I published my book in 2011.  Seven years later, things have not really changed.

California’s screening bill, AB 2193, has yet to pass the Senate and get signed into law.  Once passed, it would be an exciting development for mothers, as it doesn’t just require screening for PPD.  It requires health insurance companies to set up case management programs (same way my mother was assigned a case manager each time she had to stay overnight at a hospital to ensure she had a plan in place to address the issues that landed her in the hospital–i.e., physical therapy in a rehab center, visiting nurse to change her bandaging, etc.) to help connect moms who screen positive for PPD with a mental health practitioner.

Case management is set up to ensure there is a treatment/referral plan in place.  I sincerely hope that this means health insurance companies are prepared and able to carry out the new requirements.   And I sincerely hope that California will lead the way for other states to follow suit in setting up similar screening bills that will actually require health insurance companies to set up case management programs.

It goes without saying that screening moms for PPD serves no purpose if you can’t help those who test positive for PPD.  So far, as the first state that put mandatory screening in place, New Jersey has not had any reason to be excited ever since its initial groundbreaking “first-state-to-mandate-screening” announcement.  New Jersey, as well as 3 other states— Illinois, Massachusetts, and West Virginia — have tried mandated screening, and it did not result in more women getting treatment, according to a study published in Psychiatric Services in 2015.

A whopping 78% of those who screen positive don’t end up getting mental health treatment per a 2015 research review published in the journal Obstetrics & Gynecology.  Why have women in these states with mandatory screening not been getting treatment?  Well, for starters:

  1. Some obstetricians and pediatricians are afraid to screen for PPD because they are not equipped to refer.  But why is that?   Why is it hard for them to all rely on the resources available via 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.
  2. The resources to whom doctors (obstetricians, pediatricians, general practitioners, etc.) can refer mothers are limited, especially in more rural areas.  And in more rural areas, it’s harder to find mental health practitioners trained in prescribing meds to pregnant/breastfeeding women, let alone trained in treating moms with PPD.
  3. All too many mental health practitioners don’t take the woman’s insurance or there are significant limitations from an insurance coverage perspective.
  4. There’s a very long wait (several months) to see most mental health practitioners, especially for the first time….a woman in the throes of PPD can’t afford to–both literally (from a cost perspective) and figuratively (from a life & death perspective).
  5. There’s little incentive financially, thanks to insurance companies’ lack of adequate coverage for doctors who do such screening…..in my opinion, screening should be done at the standard 6-week postpartum checkup and therefore covered as part of that checkup.

Attention, American policymakers….our mothers are worth it.  I mean, we make such a big stink about fetuses and unborn babies in this country, let’s start thinking bigger picture, shall we?  Without mothers, there would be no babies to conceive and bring into this world.  Let’s start treating mothers less like second-class citizens and more like human beings who deserve to be able to give birth to and care for their babies without getting sick with PPD and possibly dying in the process!