The 32nd Annual Postpartum Support International Conference

I think everyone has friends that you can go a while without seeing and when you do see each other again, it’s like you’d never really been apart.  I have a few friends like this in the perinatal mood disorder (PMAD) world.   And that circle keeps growing each time I attend the annual Postpartum Support International (PSI) conference.

In the past 13 years, I have attended 7 of what my dear friend, Pec Indman (co-author with Shoshana Bennett, PhD, of Beyond the Blues: Understanding and Treating Prenatal and Postpartum Depression & Anxiety), refers to as “family reunions” and with good reason!  We are like family.  For me, it’s my tribe.  My very first conference was in New Jersey back in 2006, followed by Kansas City (KS) in 2007, Pittsburgh in 2010, Seattle in 2011, Minneapolis in 2013, Philadelphia in 2017, and Portland (OR) four weeks ago.  I generally feel a natural affinity to other PSI members because we are all for the most part postpartum mood disorder (PMD) survivors and/or are PMD advocates.  Nearly all work with PMD moms/families as a medical or mental healthcare practitioners, and that’s where I’m different from them.  But my mind keeps going back to it as a possibility of switching gears one day down the road.

The 32nd annual PSI conference took place June 26-30 this year in Portland, Oregon.  At this conference, I heard some of what I already learned about previously and some new things I hadn’t heard much about previously–e.g., EMDR (eye movement desensitization and reprocessing) and brainspotting.  One of the keynote speakers was Lee Cohen, MD, director of the Ammon-Pinozzotto Center for Women’s Mental Health, Massachusetts General Hospital, as well as Professor of Psychiatry at Harvard Medical School. Dr. Cohen is a national and international leader in the field of women’s mental health, and is widely published with over 200 original research articles and book chapters in the area of perinatal and reproductive psychiatry.

The fact that there were over 700 attendees over the course of the 4-day conference was awesome!  It gave me the goosebumps!  We were excited to see an unprecedented increase in the number of attendees, which can only mean one thing:   more people than ever before know about PSI and its mission and share the mission to effect change when it comes to postpartum outcomes.  This is awesome!  Now, if only we can get more OB/GYNs and nurses to attend!  Find a way to give them some sort of continuing ed credits….an additional bit of motivation to come to these conferences!  Being able to properly recognize, diagnose, and treat PMDs is still an unnecessarily huge hurdle for all too many doctors around the country.

At this conference, I sat side by side at the bookstore at 7:30 am on each of the first 2 days of the conference with a young man from Zimbabwe.  We were both volunteers for that early morning shift.  Linos was one of only a handful of men who attended the conference, the first representative from that country to ever attend a PSI conference, and one of the ones who traveled farthest to get to Portland.  You can tell he was on a mission to effect change in his country.  One of his top missions this year is to help raise funds for Zimbabwe’s first PSI Climb Out of the Darkness event.  Climb Out of the Darkness is the world’s largest event for raising awareness of perinatal mood and anxiety disorders, while raising money and building community.

I just donated to Team Zimbabwe.
Go Team Zimbabwe!

Funds from this Climb Out will go towards the 2nd international Society for Pre and Post Natal Services (SPANS) conference on Maternal Mental Health in Africa in September 2019.  The conference theme this year is “Incorporating Mental Health into Maternal, Paternal and Child Health to improve outcomes.”  Linos and Team Zimbabwe hope to bring participants from many parts of the continent to further African awareness and to improve the accessibility, affordability, timely and essential maternal and paternal services, as well as assist in the raising of awareness of Infant, perinatal and paternal to improve the health of mothers, children and the families at large.  Every penny of your generosity will ultimately make a huge impact on the welfare of families impacted by maternal mental health issues.  Thank you very much.

You are not alone. You are not to blame. With help, you will be well.
If you or someone you know is suffering, PSI can help.
Call 1.800.994.4773 or
Text 503.894.9453

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!

 

I Can Understand How the Despair from PPD Can Cause a Mother to Want to End Her Life

As a preface to this post, I’d like to share an excerpt from my book that reflects how the pain from postpartum depression (PPD) can fill a mother with so much despair and hopelessness–especially when she doesn’t know what is happening and why, and that there is a cure for whatever it was that is causing her to feel/behave/think the way she is feeling/behaving/thinking–that she would want to end her life.

One too many times, I gave Ed a miserable look and told him how scared I was that I didn’t know what was going on with me and I was afraid that I’d never get better. There would be tears in my eyes but I couldn’t cry. Most of the time, he didn’t know what to say. It was way after I had fully recovered from PPD that Ed finally admitted that he had feared I would never get well, never return to my old self, and never appreciate watching [our daughter] grow up.

Each day, I’d stand by a window, staring out at the snow and pleading for God to help me get through all this. I’d say over and over again, “Please, God, please help me get through this. My baby and husband need me … help me to be strong!” It was difficult for me to focus on any tasks. Often I’d sit there in the kitchen by myself or stand in the middle of a room, unsure of what to do next or not wanting to do anything at all. I felt like staying in bed all day long or in a tight ball hiding in a corner, rocking myself for comfort, but I couldn’t because I had to take care of [my baby]. During that time, I tried my best to interact with [my baby], to play with her, and talk to her.

…….. I thought I was never going to get better, I wasn’t going to be able to go back to work, and I wasn’t going to ever be well enough to take care of the baby. I just wanted to shrivel up into a tiny ball and disappear. I couldn’t bear the thought I was going to be like this for the rest of my life.

Although I never thought about actually ending my life, I constantly thought about disappearing because I just wanted all the misery to end.  And I most certainly couldn’t imagine staying in my PPD state for the rest of my life.  So it’s a good thing my PPD was cured when it was, as I’m not sure how much longer I would have lasted.  I have heard many other mothers who suffered from PPD that thought about disappearing as well.  I have also heard a few instances of mothers thinking about taking their own lives and/or actually attempting suicide.  Each time I hear these stories, it makes me feel more committed than ever to continue blogging and trying to reach people who are struggling with PPD.

I’ve been wanting to share a couple of important articles about suicide as the second leading cause of death for women in the postpartum period….one article is from last June and the other is from 3 months ago.

The one from 3 months ago (5/2/2018) was written by Catherine Pearson on Huffington Post titled “Suicide is a leading cause of suicide for new moms but awareness is low.”  The article focuses on the story of Kari who died by suicide back June 2010.  Kari’s sister, Karla, shared the story to try to educate other mothers on how deadly PPD can be. Like some of the other stories I’ve shared on this blog, Kari’s family was unaware of how bad her PPD was until it was too late.  Her family was getting her ready to move in with them to help her out until she felt better, but never had a chance to do so.   Within 4 weeks of giving birth, she died by suicide.  Her condition had quickly gone from giving birth to not being able to sleep (what happened to me) to feeling super anxious to wanting to harm herself.  The day before she was going to see a doctor about her condition, she died by suicide.

The one from last June (6/5/2017) was written by Gina Louis for Medium titled “The Night Postpartum Depression Almost Killed Me.” This is the story of a new mother who, after struggling with feelings of inadequacy and feeling a failure of a mother and wife that her children and husband would be better off without, she planned to take her own life one night.  She was going to let the dark hole of despair swallow her up.  But she thankfully didn’t carry it out that night.  She got help.  She is now, like me, a survivor speaking up and trying to help others realize that PPD can be overcome with the right help.  As my experience has made me feel stronger and more confident than before, her experience has made her feel stronger and more confident than before.

What Kari’s sister and Gina Louis are trying to do by sharing these stories is to educate folks on how deadly PPD can be and how quickly things can become deadly.  PPD is a serious condition that can lead to tragic consequences quickly.  If you or someone you know is suffering from PPD, please seek/get them to seek treatment asap.

For a country that is so advanced in medicine and technology, we must ask ourselves why American mothers don’t have enough access to, or education about, maternal mental health treatment and why American policy makers can’t do more to address the stubbornly high rates of pregnancy-related death and pregnancy-related suicides, which account for one in five postpartum deaths.

If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline.
You can also text HOME to 741-741 for free, 
24-hour support from the Crisis Text Line.
Outside of the U.S., please 
visit the International Association for Suicide Prevention for a database of resources.

A Must for All New Jersey Medical/Mental Maternal Healthcare Practitioners, Doulas, Midwives, etc.

After a two-month dry spell in posting on my blog due to lots going on at home and at work, here I am briefly to help spread the word for the Postpartum Support International 2-day training on November 15-16, 2018 in Fort Lee, New Jersey:  Perinatal Mood Disorders: Components of Care. 

Led by PSI’s very own Birdie Gunyon Meyer, RN, MA (whom I’ve known since I became a member in 2006), Lisa Tremayne, RN, CPPD, CBC, and Joanna Cole, PHD, it is a critical training intended not just for mental health care practitioners but anyone and everyone who would ever need to care for an expectant or new mother.  That includes obstetricians/gynecologists, general practitioners, pediatricians, doulas, midwives, nurses, ER doctors and their staff, etc.

You can visit the site that goes over the training objectives, location, and cost via the above link, but the training will cover the basics in identifying/treating perinatal mood and anxiety disorders (PMADs)–which include antepartum depression, postpartum depression, postpartum anxiety, postpartum panic disorder, postpartum OCD, postpartum PTSD, and postpartum psychosis–as well as understanding risk factors, treatment options, breastfeeding, consequences of untreated conditions, impact on loved ones, importance of social support, cultural differences, spirituality, etc.

Please attend and/or help spread the word about this training.  It is so, so critical that we ensure as many people as possible are trained so that fewer mothers suffer unnecessarily (like I did) and even worse, fall through the cracks and become another tragic outcome of a perinatal mood disorder.

 

The Robin Study is Looking for New Mothers to Participate in a Research Study

The Robin Study is a research study evaluating an investigational oral medication in women with postpartum depression (PPD).  An investigational medication is a study drug that will be tested during a study to see if it is safe and effective for a specific condition and/or group of people.

To be eligible for the study, you must:
  • Be 18 to 45 years of age
  • Have given birth within the last 6 months
  • Feel any of these symptoms associated with PPD for 2 weeks or longer:  insomnia, crying/sadness, lack of appetite, sudden weight loss, hopelessness, lack of interest in baby, loss of interest in things you used to enjoy, intrusive/disturbing thoughts
  • Have symptoms that began no earlier than the third trimester and no later than the first four weeks following delivery (I know that many mothers don’t develop PPD until 6 weeks or later, but this is a specific requirement for this particular research study)

If you qualify and decide to participate:

  • Your PPD symptoms will be continually monitored by qualified study staff (nurses and clinicians), under the guidance of the study doctor.
  • You will receive study-related medical care and the assigned study drug at no cost.
  • You will be required to take the assigned study drug at home every night for 14 days. You’ll have nightly phone calls with the study coordinator and will come into the study site three times while on the medication and two times as follow-up. Your total participation will last about 76 days.
  • Transportation may be provided for those who require assistance.

To learn more about the study, review frequently asked questions, and see if/how you may qualify, please visit www.TheRobinStudy.com, call (844) 901-0101 to speak with a study representative, or fill out the contact form and a study representative will follow up with you.

Go See Tully, and Let’s Talk

Just a quick post tonight with a movie review of “Tully” written by a friend of mine, Mrs. W.

Initially, Mrs. W was annoyed like I was about the movie’s apparent failures based on a couple of negative movie reviews she and I both read this past weekend.  Like me, she did not want to see the movie.  That is, until I sent her the review from a postpartum psychosis survivor, Melissa Bangs, who happens to be the star of her own one-woman show “Playing Monopoly with God” that’s been on tour for the past couple of years and is headed to New York City next week!  Reading this positive review of someone who is a PPP survivor peaked Mrs. W’s interest, and so she went to see “Tully” yesterday.  Please take a moment to read Melissa’s personal thoughts from the perspective of an actual PPP survivor!

Without further ado, here’s Mrs. W’s movie review:

“Ok. So I saw it tonight………….

  1. There are a couple triggering scenes.  One of them was in the first half of the movie, which almost caused me to leave because my whole body got amped up like I was going to have an anxiety attack.  But I calmed myself down and was able to sit through the last half of the movie, which was less emotionally jarring.
  2. I don’t want to spoil the movie, but I will say that the main character definitely has postpartum psychosis but no one ever says it outright.  There are a few things said (like when her husband told the doc she was depressed with their second child) that might mislead people to think she has postpartum depression (PPD), but I think the movie left out the actual diagnosis on purpose because it wants the audience to figure it out on their own.  However, I do think the movie shines a light on postpartum mental health and how a struggling mother could slip through the cracks …to the point that even a husband who doesn’t pay close attention would fail to notice his wife’s condition.
  3. It is a shame that the doctor in the movie doesn’t say it outright that she has PPP.  It was definitely a missed opportunity to shed light on the subject no one talks about.
  4. Also, Charlize Theron played the heck out of that role.”

Hmmmm, it’s interesting that Mrs. W thinks the film makers deliberately left out the diagnosis of PPP to cause the audience to want to figure it out on their own.  I, on the other hand, don’t have such an optimistic perspective and in this case would not give the film makers such credit for the reasons stated in my blog post about Tully.  What the movie and the subsequent posts on social media has done, at least in the maternal mental health circle, is promote discussion about maternal mental health.  But that’s within the already existing circles of advocates, mental healthcare practitioners, and survivors.  I haven’t really heard much about discussions going on among the general public, which is why first and foremost we must capture the proper message about maternal mental health conditions (and bust stigmas associated with them) to educate people, share widely and DISCUSS!  THIS is why I am still annoyed about the lost opportunity to educate the public.  The film makers could have easily inserted a diagnosis into the screenplay.  But they didn’t.

Anyway, the whole point of this post is to weigh different perspectives and not let a couple of negative movie reviews completely shut off all interest in seeing a movie.  Just as Mrs. W had done, she started out with an opinion that was formed based on a couple of negative reviews of people (not really clear if they themselves were PPD or PPP survivors) who did see the movie.  Because of these negative reviews, she was annoyed and had zero interest in seeing the movie.  After I showed her Melissa’s review, she went to see it and was able to form her own opinion after seeing it.  Then she shared with me her thoughts about the movie.

Mrs. W did confirm that the movie:

  1. Puts a light on maternal mental health in terms of mothers’ struggles being real and women like Tully falling through the cracks due to lack of awareness and lack of support from significant others and loved ones.  Motherhood is not easy.  A mother who is struggling will fall through the cracks if she doesn’t get the help she needs.  New mothers need practical/emotional help during the first couple of months.  Forget about the whole supermom thing.
  2. Falls short in raising awareness that postpartum mood disorders are experienced by 1 out of 7 mothers and definitely not anything to be ashamed of.  They are very real, serious, painful to experience, and life-changing.

And yes, Charlize Theron plays the heck out of ANY role she plays.  But for me, even if Charlize earns an Oscar nom, I still can’t set aside my annoyance (that I blogged about previously) to see it.  As a person of principle, I would not want to pay even $1 to watch a movie that fails an opportunity to educate the population properly by sending unclear signals on the condition Tully really suffered from.  To each his/her own, as they say…..

 

Recent PPD Successes and Failures in the Media

I went from blogging once in two months to 8 times so far this month!  With Maternal Mental Health Month a little less than a week away, a lot of fundraising, training and public awareness events are being prepped to happen throughout May.  Another reason to love this time of year….hello spring!

Okay, so the title of my post is “Recent PPD Successes and Failures in the Media.”  There were 2 things in the media that caught my attention on my Facebook feed today that motivated me to blog once again. One is a success and one is a failure.  If you’ve been following my blog for some time, you would know that one of my favorite things to blog about are successful and failed attempts at depicting new mothers suffering from a mood disorder in the media, like my recent post about “Black-ish.”

Let’s start with the SUCCESS……
On this morning’s Megyn Kelly TODAY a postpartum mood and anxiety disorder (PMAD) survivor, Ashley Abeles, shared her experience.  The segment also included brief appearances by Dr. Catherine Birndorf and Paige Bellembaum who are the Medical Director and Program Director, respectively, of The Motherhood Center of New York. The Motherhood Center provides support services for new/expectant moms and treatment for PMADs. I met these ladies from the Motherhood Center at previous Postpartum Support International conferences.  If you missed the show, you can watch it here.  We need more moms sharing their PMAD experiences on shows like this!  Experiences kind of like my own that, as her husband explains, isn’t “headline-grabbing” material involving the tragic death of the mother and/or baby.  Because guess what, the vast majority of PMADs experienced by new mothers are NOT headline-grabbing material.  They’re mothers suffering from anxiety, panic attacks, insomnia, weight loss and/or intrusive/obsessive thoughts who need medication and/or therapy to recover.  Yes, severe postpartum depression (PPD) can cause a mother to feel so depressed that she just wants to disappear or her baby would be better off without her since she can’t feel joyous like a new mother should, but postpartum psychosis is too-often confused with and lumped under PPD (as a catch-all term) by both the general public and doctors alike.  Yes, doctors!  Also, PPD is not the same as the baby blues and even today, doctors still mix up the two!  We’ve come a long way since I had PPD when it comes to information in the news, in publications, on the Internet and in social media.  But we still have a LONG way to go.

And here’s the FAILURE……
The movie “Tully” starring Charlize Theron.  A Motherly post by Diana Spalding titled “We’ve seen Tully– and we’ve got some real concerns” it seems yet another movie director/producer has failed to do their homework about PPD before coming up with the screenplay and releasing it.  What every movie director/producer or TV show director/producer needs to do before even contemplating a movie or TV show about PPD is consult with Postpartum Support International.  This organization is the leading authority on maternal mental health matters and should ALWAYS be consulted to ensure the right information is incorporated into the movie/show plot.  “Tully” attributes the bizarre experiences of Tully (i.e., hallucinations she has of Marlo, frantic baking and cleaning late into the night, impulsive behavior that leads to her car crash, suicidal ideation) to PPD.  However, her behavior is actually attributable to postpartum psychosis, hence this movie spreads misinformation about what PPD really is.  Her talk of suicide is brushed off by her husband, which I can see happening in the real world when loved ones fail to “get it” and ignore the mother’s serious need for help.  While this is a movie and movies don’t necessarily have to educate–after all, this is not a documentary–it should at least get terms right (postpartum psychosis, NOT PPD!)  and it should try to mention at some point that yes, the new mother who’s obviously not well and diagnosed, albeit incorrectly, with PPD needs help!  Maybe put some kind of disclaimer at the beginning or end of the movie like you sometimes see at the beginning or end of a TV show.  Something along the lines of:

“Approximately one out of seven new mothers suffers from a postpartum mood disorder.  If you are a new mother that is experiencing any of the following symptoms: insomnia, crying/sadness for more than 2 weeks, lack of appetite, sudden weight loss, rage, hopelessness, lack of interest in the baby, loss of interest in things you used to enjoy, thoughts of harming the baby or yourself, please know that you are not alone, what you are experiencing is not your fault, and you will recover if you get the right treatment.  Contact Postpartum Support International at 800-944-4773 or visit http://www.postpartum.net

Sounds of Silence 10th Annual Run/Walk – May 12, 2018

Piggybacking off my last post from 4 days ago in which I blogged about the Lisa Mary Reilly Visioning Education Series, today I would like to invite folks who live in the Tri-State area to join the Sounds of Silence, Friends of the Postpartum Resource Center of New York’s 10th 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.

I have posted about this annual run/walk every year since the first fundraiser back in 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 2009 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 .

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.

Date:  Saturday, May 12, 2018

Time:  Registration from 8:00-9:00; race/walk begins at 9:30 AM.  There will be a Kids Fun Run, Raffles, Food and more.

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

Registration:  $25 (adults); $15 (ages 11-18); $5 (ages 10 and under); register here.  Registration price increases after May 5th.

Virtual Participation:  For those of you who can’t make it in person, you can participate virtually by registering via this link.

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.  All who raise $200+ will receive a Sounds of Silence beach towel.

50/50 Fundraiser:  For the first time, there will be a 50/50 Fundraiser to benefit the Postpartum Resource Center of New York.  The drawing will take place during the After Party at Fatfish Wine Bar and Bistro, Bay Shore, NY.  Only 300 raffle tickets will be sold.   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. 

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.

Traumatic Childbirth: The Ever-Widening Ripple Effect

Piggybacking off of my last blog post “Mother May I?” – An Important Documentary About Childbirth Trauma 2 days ago, I wanted to make folks aware about a childbirth-trauma-related event that I spotted on my Facebook feed today.

LMR Visioning Educational Series 2017

Sonia Murdoch, Jane Honikman, and me

The Lisa Mary Reilly Visioning Educational Series hosts an annual event in collaboration with the Postpartum Resource Center of New York.  Last year, I attended the event that took place in Manhattan and featured Jane Honikman, founder of Postpartum Support International.

This year’s event will be co-hosted by The Rochester Postpartum Wellness Coalition and will take place on Thursday, May 3, 2018, from 11:00 am-2:00 pm, at the Rochester Academy of Medicine, Rochester, NY.  The guest speaker of this event will be Cheryl Tatano Beck, DNSc, CNM, FAAN. She a Distinguished Professor at the University of Connecticut School of Nursing.  Dr. Beck serves on the editorial boards of 4 journals and has published over 150 scientific articles as well as 4 books.  The title of her presentation is Traumatic Childbirth: The Ever Widening Ripple Effect.   Click here to find out more about the event and to buy tickets, which are $50 each and includes lunch.

My wish is for every medical professional that treats mothers–from OB/GYN doctors and their staff to maternity ward staff, emergency room staff, midwives, doulas, and family doctors/general practitioners, as well as mental healthcare practitioners–were required to take this kind of training regardless of where they are located. This means this kind of training should be replicated and hosted in every major city in every state.  Until then, we are going to continue to have medical/mental healthcare professionals fail to realize the connection between traumatic childbirth and postpartum mood disorders.

We need to emphasize the importance of care for mothers just as much as people emphasize the importance of care for babies.  As I’ve said before, it just seems so obvious that, once a mother gives birth to a baby, all the attention goes to the baby and its care and the mother falls by the wayside.  Hello, she just carried a child for 9 months and had to give birth! Her body goes through extreme physical changes, including hormonal upheaval.   Any complications that occur during childbirth can increase the chance of a postpartum mood disorder to occur.  The ONLY view that matters on how a childbirth went should be is the new mother’s view on her childbirth experience.  If she feels like it was a God-awful experience, we need to respect, acknowledge and try to understand her feelings.  We should never pooh pooh her experience.  We should never assume her feelings are what you think they ought to be.  A new mother’s experience is her experience, period.

Let’s care more about how a mother views her childbirth experiences.
Let’s care about the kind of care she receives during childbirth.
Let’s care about how she envisions her childbirth to go.
Let’s care about how she feels about breastfeeding.
Let’s care about how anxious she feels about taking care of the baby.
Let’s care about her enough that when she seems to not be herself, we get her the help she needs.
Let’s care enough to realize that about 20% of new mothers experience a postpartum mood disorder that usually starts within the first 4-6 weeks postpartum but can happen up to a year and may be triggered by weaning.
Let’s care about her feelings, bottom line.

 

 

 

“Mother May I?” – An Important Documentary About Childbirth Trauma

A couple of days ago, a link to the Kickstarter project for the documentary “Mother May I” popped up on my Facebook feed, and it instantly caught my eye (and yes, I am one of the many backers and sincerely hope they meet their financial goal in 30 days, so please consider backing too….even $10 would help!).  Why did it catch my eye?  Because I had a traumatic childbirth experience that was the beginning of an agonizing postpartum depression (PPD) journey.  I didn’t have the awareness needed for me to advocate for myself.  There were no patient advocates anywhere along my PPD journey.  I didn’t have anyone to talk to about my experience.  I didn’t have a means of validating what I experienced.  I was in the dark.  I had to learn the hard way.  This is why I blog, why I wrote my book, and why I look for ways to help others and to try to get the word out and raise awareness so fewer mothers will be blindsided the way I was.

About one-third of new mothers describe their childbirth experiences as traumatic, but you hardly ever hear about negative experiences because everyone wants to be like “everyone else” and happily announce that “mother and baby are doing well.”  No one wants to admit to having a negative childbirth experience, just like no one wants to hear about a negative childbirth experience.  And that is why everyone thinks childbirth experiences aren’t that big a deal.

I had previously blogged about negative childbirth experiences via my blog post titled “Forget the Myths, Here are the Realities of Pregnancy, Childbirth and Postpartum Experiences.” It was one of my first blog posts.   The difference between my traumatic childbirth experience and the ones that are the focus of this film is that the ones in the film, like the one experienced by Caroline Malatesta, involve obstetric assault that resulted in both physical and emotional harm to the mother.  That is much, much worse than what I experienced.

What has been completed thus far is 20 hours of footage of interviews of more than 15 experts (including a birth doula, a labor & delivery nurse and psychologist who specializes in posttraumatic stress disorder (PTSD) and survivors of birth trauma.  My plan is to reach out to the Birth Monopoly Foundation folks behind this documentary–including Caroline Malatesta, President, whose own birth trauma story is the impetus behind and featured in this film–and make sure they include the connection between negative childbirth experiences and maternal mental health disorders like PPD.

If you’ve been following my blog for some time, you know that passion for public awareness is one of my focal points.  I am particularly excited to see that funds from the Kickstarter project will help fund online campaigns to provide free information about birth trauma, resources, and legal rights. It will also help fund college outreach initiatives to help get the film (plus guided discussion) into 1,000 college classrooms around the country.  I believe there is no better time to present such information to teens than in colleges.   Colleges are a great way to reach numerous young people at once.  Speaking of which, I had envisioned doing a book reading of my book at my alma mater when it first came out, but I didn’t get very far.  My school is an all-women’s school and what better place to reach so many women at once about PPD!  But my idea didn’t get much interest.  Perhaps I wasn’t reaching out to the right people.   Perhaps I will try again there….and in other colleges as well.

To follow Birth Monopoly on Facebook: http://www.facebook.com/birthmonopoly 

 

Playing Monopoly with God – New York City Performances!

I am super excited to share the news that “Playing Monopoly With God” is coming to New York City! (Unfortunately, I won’t be able to make it due to prior commitments).

“Playing Monopoly With God” is an amazing, one-woman play.  Melissa Bangs is the talented and passionate actress behind this play.

Her mission is to share her experience and in so doing, spread awareness on what it’s like to be one of the 20% of new mothers who suffer from postpartum mood disorders and encourage mothers to share their experiences.

Melissa has been touring for 4 years putting on 37 shows—including sold-out shows in Seattle and Los Angeles– reaching nearly 5000 people

♦♦♦♦♦♦♦♦♦♦♦♦♦

Postpartum Support International presents:

Playing Monopoly with God & Other True Stories
Hilarious. Heart-wrenching. Human. 
A true tale of childbirth, madness and the journey home.
LIVE. NONFICTION. STORYTELLING. PERFORMANCE.
 
TICKETS ON SALE NOW!!! MAY 17th – 20th

Evening
 Performances – 6PM Doors – 7PM Performance
THE RATTLESTICK THEATRE @ 224 Waverly Place, New York, New York
Thursday, May 17th – Live Performance followed by a PSI Gala Event at Bobo NYC ($175)
Friday, May 18th – Live Performance w Wine, Cheese and Panel Discussion ($75)
Saturday, May 19th – Live Performance (also to be webcast) ($45 in-person)
and a Mimosa Matinee…
Sunday, May 20th – 1PM Doors/2PM Show ($45)
 
In September 2012, at 40 years old, Melissa Bangs gave birth to her beautiful daughter Adelaide.  A month later, dramatically hormone depleted and sleep deprived, Melissa is admitted to the Providence Psychiatric Facilities in a complete manic state.  After nearly a month, she is sent home with a bipolar diagnosis and on lithium.  What comes next is an extraordinary journey.
 
On her path back to wholeness, one of the things Bangs did was read her entire 100 plus page hospital record.  Somewhere, around page 87, there is a nurse’s note that looks as if it were scribbled late at night after a long shift.  It reads, “Patient says she will do comedy on this experience.”  Upon reading this, Bangs laughed out loud.  
 
The psych team couldn’t have possibly known that Bangs has been a storyteller her entire life and did comedy for a stint, as a student, at the Upright Citizens’ Brigade in New York City.  They couldn’t have known that transforming details from the most painful experience of her life into a room full of laughter would prove healing for so many.
 

Join Postpartum Support International for an evening of storytelling full of bewilderment, chaos and hilarity.  Bangs has a knack for telling true stories that cut to the bone of our shared, vulnerable human condition. Her true gift, however, comes in the moments in which she’s able to strip away the shame or agony of an experience and transform the room into an uproar of laughter.

Postpartum Pain – by Stacy M.

Thank you, Stacy, for once again sharing your gift of poetry on my blog.

Just eight months old
Lost and confused
Mommy had to go

As tears flowed
From tired eyes
I drove

Clenched the wheel
Held on tight
The most important
Ride of my life

Surrendered all my
Postpartum pain
I told them all
To please go on
Without me

I just couldn’t
Breathe
Or eat
Or see
Anything
In front of me
I felt like
Disappearing

I wasn’t sure
If I could go on
I was drifting
So far
And sinking
So fast

Fearing
Everything
And everyone
Blindsided
By the panic
And the pain
I thought for sure
The old me
Was gone
Long gone and
For good

All the fear
Abruptly
Turned my world
Pitch black

I wasn’t sure
If I could
Ever find
My way back
Or my old self
I was desperate
For help

Postpartum pain
Makes you lose
Your way
And your grip
Makes reality
Start to slip

It can rob you
Of your dreams
It’s deceiving
Gets you believing
That nobody
Not even yourself
Or your new baby
Or this life
Needs you

In all the darkness
That surrounded me
I was a tiny shadow
Of myself
Not even

Did anyone see
I was not okay
Did I really hide it
All too well
Who was in denial more
Me or my community
Why do we pretend
It will never make
Any sense

Just those few years ago
I stood at the edge
Ready to give up
The fight
Of a life I worked
So hard for
I had a home
With a husband
And children I adore
In a moment
I could have lost it all

My knees were buckling
In a flash I suddenly
Could not understand
What it was I was living for

Prisoner of my own mind
Paranoid of the judgment
Overwhelmed
Run down
Unsteady from
The incision that
Still felt so raw
Stitches barely
Holding me together
The healing felt like
Forever

Postpartum pain
Postpartum pain

Oh how thankful
Of where we are now
My little girl sleeping on me
All snugly and sound
As I still pick up all the pieces
Of that horrific transition

Postpartum pain
Postpartum pain

Will make you never the same

Postpartum Depression Doesn’t Look the Same Across the Board

I always try to keep up with the multitude of articles that feature Karen Kleiman, MSW, LCSW, founder of The Postpartum Stress Center and author of numerous books on perinatal mood disorders.  This particular article from October 4, 2017, titled “Postpartum Depression May Look More Like Anxiety Than Sadness” that appeared on Well and Good, by Annaliese Griffin,  caught my attention.  It caught my attention because it’s because when my doctor told me 13 years ago that I had postpartum depression (PPD), I didn’t believe him.  I thought “How could I be depressed if I’m not even sad?”  He explained that depression could manifest as anxiety, but did I understand that at the time?  Nope. Little did I know that I was about to embark on a journey to discovering what PPD really was….that it’s a catch-all term that encompasses all postpartum mood disorders, which includes postpartum anxiety, postpartum OCD, and postpartum psychosis.  That my PPD caused insomnia, weight loss, loss of appetite, and being a shell of a person unable to enjoy anything, and unable to pretty much do anything.  I was so concerned about my baby’s cradle cap and eczema and her bowel movement/feeding schedules that, by the time her colic came and went at my 6th week postpartum, PPD set in and I had no idea what was happening to me.

This article is very important because the number of women suffering from postpartum mood and anxiety disorders (PMADs) is pretty common.  And I should know because of the number of hits I get on my blog for the symptoms that I experienced.  So, if it’s been over 3-4 weeks since you had your baby and if you are feeling anxious, unable to sleep even when the baby sleeps and unable to function and enjoy things you’re normally able to enjoy (like listening to music), having moments of rage, having panic attacks, and/or having obsessive and even scary thoughts, please go the Postpartum Support International (PSI) website to seek help near you.  You are not alone, there is nothing to feel ashamed of, and you will get better with the right help.  Do not be afraid to ask for and accept help.

Jessica Porten’s story went viral a week ago because she admitted to the nurse at her OB/GYN office that she was experiencing feelings of anger, and that admission was unfortunately not handled correctly.  This, my friends, is why I have been blogging for the past nearly 9 years.  My mission is to help spread awareness and in so doing dissipate the stubborn stigma that refuses to go away because there is still so much ignorance about PPD.  My mission is to also help mothers as much as I can to get the help they need.  Anger/rage is another way that PPD can manifest for some mothers.  Everyone’s PPD experience is unique to that person because we are all complex people that– when emotions, temperaments, hormones, heredity, childbirth experience, and history come together–symptoms manifest differently from one person to the next.  Symptoms can range from feelings of sadness to anxiety, anger and even rage to insomnia, sleeping too much, lack of appetite, eating too much, obsessive/intrusive thoughts, etc.  As such, treatment of these moms will vary from one mother to the next.  Some moms need medication. Some moms need therapy.  Some moms need a combination of medication and therapy.  The duration of treatment will vary as well.  But there is one thing in common among all mothers suffering from PPD:  they need help.  They don’t need to be treated the way Jessica Porten was treated.  They don’t need to be treated like I was treated 13 years ago.

Erica Chidi Cohen, a doula and co-founder and CEO of  Loom in Los Angeles attributes postpartum anxiety to first-time mothers feeling uncertain and anxious about going through childbirth and taking care of a baby for the first time. It is more common than you think for first-time mother to feel anxious but when the anxiety morphs beyond worry to insomnia, lack of appetite, etc. is when medical attention is needed.  A traumatic childbirth experience increases the chances for a new mother to experience PPD.

Click here to visit Kleiman’s The Postpartum Pact. It is an important postpartum toolkit for expectant mothers and their partners and loved ones to review before baby’s arrival.  It truly pays to be prepared, regardless of whether you think you may be at risk for PPD or not.  One never knows, as I have said in prior blog posts and in my book, whether something may happen during pregnancy/childbirth that could lead to PPD.  It can’t hurt to review the pact and prepare to have folks lined up to help once baby arrives to ensure the new mother has adequate practical support, especially if this is her first baby or if she has another little one(s) to take care of already.

Speaking of adequate support, it’s organizations like Loom in Los Angeles and Whole Mother Village  in W. Orange, NJ — two examples of many childbirth, pregnancy, and reproductive wellness communities that have sprouted around the country to provide support, information, referrals and services from preconception to parenthood– that are critical because it takes a village when it comes to a family’s well-being.  Going it alone is not a viable option nowadays, especially when the significant other needs to work to support the family and the new mother is not well and family members are not close by and/or are too busy to provide emotional and practical support.  It really is no wonder there are so many cases of PPD.  Please see my past posts about the importance of mothering the mother and how it takes a village to minimize the occurrence of PPD here and here.

 

 

Is This the Way A Doctor’s Office Should Treat a New Mom with PPD? Heck No!

Before you read this post, please read this: 
If either you or a loved one gave birth in the last few weeks or months and you are having problems with insomnia, don’t feel like yourself, experiencing a great deal of anxiety and/or rage and/or are scary thoughts, please call Postpartum Support International (PSI) at 800-944-4773 where trained individuals (many of whom are survivors themselves) will listen to you and connect you with informed providers.

Note that the story you are about to read is an example of what may happen if you and your loved ones are not informed about mood disorders that occur during pregnancy and after childbirth, and your OB/GYN and staff are not properly trained to detect, diagnose, treat and/or refer patients with perinatal mood disorders.  It does not mean that the same thing will happen to you.  If you have any concerns about your own situation, please leave me a message and I will get back to you asap.  Or give that PSI number a call.

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

 

This is the Facebook post that went viral right after it was posted this past Friday, January 19, 2018. Instead of taking legal action (which I most certainly would have done), Jessica is paying it forward by sharing her story so the public can see how broken the healthcare system is when it comes to postpartum care for new mothers.  She also turned down the numerous offers for help she has received since her post went viral and instead asks that everyone who has reached out to her offer their service for a woman of color.

Following is her experience in a nutshell.

  1. Usually, new moms have their first postpartum visit with their OB at 6 weeks. Her first appointment wasn’t scheduled until the 3rd Her OB kept cancelling her appointments for a month, so by the time she went she was 4 months postpartum. That’s not good.
  2. At the doctor’s office, Jessica told the nurse practitioner that she had postpartum depression, which included fits of anger and violent thoughts. She also said she wanted to discuss medication options, needed medication and therapy to get through this, had a strong support system at home, and she would never hurt herself or her baby.  If she’d spoken to me or anyone with experience diagnosing and treating PPD, I would think “Okay, this is a woman who is informed and knows what she is talking about. I have no reason to doubt that she knows what she’s saying, so I will have the doctor see her now so they can talk about treatment options and/or referral to someone experienced with treating PPD.”
  3. But instead of telling the doctor so he could properly assess her condition and discuss treatment and/or referral options, they called the police! In exchange for her honesty and being knowledgeable enough about PPD to advocate for herself, she was treated like a criminal!   A grueling 10-hour ordeal ensued, with her infant in tow.  No medication. Never once speaking with a doctor. No follow-up appointment. She drove with her baby to the ER with 2 police cars escorting them. They took her blood and she had to give a urine sample.  A security guard stood guard.  She had to remove all her clothes, which they took away and locked up.

Like Jessica, I would want to effect change but I would want to give the nurse practitioner and doctor a piece of my mind.  I would’ve been so pissed by this overreaction to a mother knowledgeably informing her doctor’s office of her PPD and the ensuing humiliating experience that ensued, plus I don’t forget bad experiences that easily and who would?  When a mother is suffering from PPD, she is already in an emotionally vulnerable state and this kind overreaction can be the tip of an already unstable iceberg.

Everyone who comes in contact with new mothers should ABSOLUTELY be trained to recognize symptoms of a perinatal mood disorder, to understand that a new mother with a perinatal mood disorder needs support and treatment.  This would apply to nurses, OB/GYNs, general practitioners, pediatricians, doulas, and midwives.  At this point, there shouldn’t be a single OB/GYN doctor and nurse that doesn’t know how to recognize symptoms of a perinatal mood disorder and either treat her or refer her right away to someone who can.  This kind of training should not be optional.   IT MUST BE MANDATORY….i.e., you can’t practice as an OB/GYN doctor or nurse without the mandatory training that Postpartum Support International offers. Let’s advocate for change at the American College of Obstetrics and Gynecology (ACOG) and American Board of Obstetrics and Gynecology (ABOG) level, as I’ve been saying for years.

At the end of her post, Jessica proposes crowd sourcing as a way of coming up with solutions to fix this broken healthcare system. She poses very thoughtful and key questions that should prompt immediate discussions among everyone who has anything to do with maternal mental health (e.g., advocates, mental healthcare practitioners, doctors, nurses).  These are her questions, which I’m putting here to help get the word out, as not everyone is on Facebook.

  • Why is the way I was treated standard procedure?
  • What can we do to improve standard procedures for all postpartum mothers, but also specifically those at higher risk for developing PPD and presenting with signs of PPD.
  • Who is most qualified to make suggestions for improvements?
  • Who is actually capable of making the changes to standard procedures, and how can we can contact them?
  • Why was I let go, when so many others would have been put on a mandatory 72 hour psychiatric hold, and had their children taken away?
  • Why do a disproportionate number of women of color who have PPD not receive the services they need, even when they initiate treatment?
  • Why are a disproportionate number of women of color who have PPD misdiagnosed?
  • Why are black women half as likely to receive mental health treatment and counseling as white women?
  • What can we do as a community to lift up our marginalized members and make sure they receive the quality care that we ALL have a right to?!?

I am hopeful that we will make some headway, since this post has gone viral as she’d hope it would be.  I am already hearing that advocacy groups like 2020Mom reach out to Jessica, who is going to join 2020Mom in a rally in Sacramento, California state capital, which just so happens to be where Jessica’s story took place.  2020Mom is in the process of introducing 4 bills in California.

I have previously shared how my PPD experience was a critical steppingstone to becoming the person I am today, and do not regret it except for the time that I lost during the weeks I was not myself. My PPD experience changed the course of my life.  I believe I had PPD for a reason, as it has given me the courage to speak up, blog, publish a book, and change my career path.

I somehow get this feeling that Jessica’s PPD experience is a steppingstone to advocacy and change when it comes to maternal mental health matters.  I am pretty sure this is just the beginning of her involvement in maternal mental health advocacy.

Thank you, Jessica, for sharing your experience!

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

Update to post: 
Jessica Porten’s story has gone viral and made it into various news media, which is what I’d hoped would happen.  The more ways her story gets shared, the more people she reaches (including folks in the medical field). Here are just some of the places her story has popped up:

Sacramento CBS news: “Mom Shocked After Doctor’s Visit For Postpartum Depression Leads To Police Escort To ER” by Steve Large.

NowThis Her video

Medium: “Address Postpartum Depression with Training and Treatment, Not Police” by Ann Smith, current President of PSI.

Slate: “She Asked for Help for Postpartum Depression. The Nurse Called the Cops.” by Darby Saxbe.

Upworthy: “A mom told her OB she might have postpartum depression. Then they called the cops.” by Evan Porter.

Romper: “This Mom Had The Cops Called On Her After Seeking Help For PPD, & Her Story Is A Must-Read” by Karen Fratti.

Romper: “Why Are We Letting Our Mothers Die?” A Conversation About Postpartum Treatment” by Ashley Stoney.

Research4Moms: “No More Excuses: Providers Are Accountable for Their Lack of Knowledge About Moms’ Mental Health” by Shannon Hennig.

Dearly: “Mom Says She Needs Help for Postpartum Depression. Nurse Leaves the Room…to Call the Police” by Prudence Hill.

Huffpo Canada: “A Mom With Postpartum Depression Asked For Help. Her Nurse Called The Cops” by Patricia Tomasi.