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

Elly Taylor of Becoming Us and her 2019 Seed Planting Workshop U.S. Tour

My friend, Elly Taylor, is an Australian relationship counselor, author of the book Becoming Us, and founder of an organization of the same name, which she created to teach professionals and support mothers and their partners.  Both the book and organization’s mission is to help the mother and partner navigate the peaks and valleys of the parenting journey via 8 essential steps that Becoming Us as “map, compass and travel guide all in one.”

Elly and I have a bunch of things in common.  We are both postpartum depression (PPD) survivors and book authors (though hers is award winning).  We were both blindsided by PPD and the challenges of parenting.  We are both members of Postpartum Support International.  Elly loves NYC (where I’ve spent the last 30 years working) as much as if not more than I love Sydney (where she lives).  She is fortunate enough to be out here in NYC each year for the past 4 years on Becoming Us-related reasons; whereas, I’ve been back to Sydney 3x in the past 22 years (I so wish I could return more often!).

Elly will be here in the states for her “Seed Planting” workshop tour in Los Angeles, Denver, Chicago, and New York City.  For the complete schedule and how to register, click here.  If you live near those areas and are a couple or family therapist, birth professional, infant or child mental health professional, and anyone else who works with expecting, new or not so new parent, sign up for Elly’s 2-hour interactive seed-planting workshop.

The training will teach you:

  1. how the groundbreaking research- and evidence-based Becoming Us approach can support you to work with mothers/fathers/partners to navigate the different transitions to parenthood, reduce risks for postpartum mood disorders, and support families to thrive
  2. what the transitions are (there are more than 8!), how they can negatively impact mothers and their families
  3. how to plant Becoming Us “seeds” that reduce risk for the most common parenthood problems including perinatal mental health issues and relationship distress
  4. how you can apply the model to your work with parents at any stage of their family life cycle

Then, in Atlanta, Elly will also hold a breakout session/seminar at the CAPPA Conference taking place from June 21-23.  See the CAPPA website for more info and to register.

Additionally, she will hold a breakout session/seminar at this year’s Postpartum Support International conference in Portland, Oregon.  It will take place on June 30th from 9am-noon.  See the PSI Conference website for more details about the conference and how to register.

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.

 

 

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

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

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

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

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

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

What should the screening entail?

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

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

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

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

2. How have you been feeling physically and emotionally?

3.  How is your appetite?

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

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

 

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

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

 

 

Be the One Person Who Makes a Difference for Someone Else

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

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

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

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

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

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

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

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

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

I would:

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

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

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

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

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

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

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

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!

 

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.

 

World Maternal Mental Health Day: May 2, 2018

With just a few minutes left to World Maternal Mental Health Day, I wanted to do check one more thing off my TO DO list: Taking a picture with The Blue Dot Project sign with a very important message on it to do my part in spreading awareness about the statistics (1 in 7 new moms), common symptoms, who to call for support/where to find resources & info (Postpartum Support International or PSI), a positive message (the PSI mantra: You’re not alone, this is not your fault, you will get better with the right treatment), and the hashtag #RocktheBlueDot.

 

 

 

 

 

 

 

Earlier in the week, I did the whole Twibbon thing with the #WorldMMHDay on social media, I have been sharing the daily Facebook posts of The Blue Dot Project on both my personal and my author page, and I figured I would wrap up today with this blog post.

With May as Maternal Mental Health Month, keep your eyes open for all sorts of social media campaigns, fundraisers, news articles, and blog posts.  The wealth of information is satisfying to see, as it is 100 times–to say the very least–more than what I had when I found myself stuck all alone and scared on the very difficult postpartum depression (PPD) path I found myself forced to take over 13 years ago!   We need to keep the public awareness going to continue to chip away at the stigma and ignorance that still prevent moms suffering from PPD (and their loved ones) from knowing what to look out for, knowing how to get help, having all medical/mental healthcare professionals that work with moms knowing how to detect/diagnose/refer moms who need help.

Please, please, please do your part to spread awareness.

Click here to find out how you can take your very own #RocktheBlueDot picture with your own message, and share it with the ladies over at The Blue Dot Project so they can share it on their end as well.

Share Postpartum Support International, The Blue Dot Project, and posts by other maternal mental health organizations across the globe.

Join the movement!

 

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

Free Webinar: Bringing Light to Postpartum Depression and PMAD

ATTENTION:
OB/GYNs and their staff, general/family practitioners, therapists, social workers – basically, everyone who would ever treat a new mother. Also, new/expectant mothers and their loved ones!

Once again, I’m piggybacking off of my last 2 posts about the Postpartum Resource Center of New York by sharing this great opportunity I learned from this post I just spotted on my Facebook feed for all who care for / about new mothers and their postpartum well being to learn about PMADs, treatments, resources, and how loved ones can help.

PMADs are experienced by 1 in 5 mothers.  What better way to spread awareness than this FREE webinar!  We need more of these opportunities to combat stigma and ensure as many people are educated as possible, as there are still way too many people whose job it is to care for mothers that don’t accurately identify PMADs and get them the help they need.  With more awareness, we will chip away at stigma.  We will ensure fewer mothers suffer alone and in silence.  We will ensure fewer mothers and children suffer the consequences of undiagnosed/untreated PMADs.

When:  Wednesday, May 2, 2018 from 8:00pm – 9:00 pm
Who:  Sonia Murdock (Exec. Director of the Postpartum Resource Center of New York) and Bridget Croteau (St. Joseph’s College NY alumna; Mrs. Suffolk County America 2017-18)
Cost:  It’s absolutely free, and open to the public!
Registration:  Click here to sign up. If you can’t make it to the live session, no problem!  You can access a recording, provided you register.
For more info:  Contact Taryn Kutujian at tkutujian@sjcny.edu

Please spread the word about this!  Share WIDELY on social media!

 

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.

 

 

 

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 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.

Two Important PPD Studies

Since my last blog post, I thankfully haven’t been insane with work as I’d been in earlier weeks.  Truthfully, I’ve just been lazy.  It’s like my body is finally letting me be relaxed and not doing much, for once in who knows how long that I’ve honestly lost track.  I am still in the process of transitioning off of the laptop I’ve had for over 8 years, and with this blog post will be closer to my goal, since it will leave me with only 5 more tabs left open to blog about.  My last blog post included 4 stories of moms who died from severe cases of postpartum depression (PPD).  This blog post is about 2 PPD studies.

BREXANALONE / SAGE-547

This past June, I was beyond excited in reading an announcement from the UNC Health Care and UNC School of Medicine Newsroom titled “UNC researchers lead clinical trial evaluating potential treatment for postpartum depression” about a new treatment for PPD called brexanolone (or SAGE-547) currently in clinical trial phase 3.  The results of the clinical trials have been extremely promising thus far, with SAGE-547 providing a fairly rapid onset of relief for the participants, but it still needs to undergo further tests before the FDA would approve it for use by new moms….and how AMAZING would that be!  It would make a huge difference in the lives of so many mothers and their families–with 1 in 7 new moms experiencing PPD–not to mention save lives!

Brexanalone is also known as allopregnanolone, which is a steroid in the brain (neurosteroid) derived from progesterone that helps to regulate mood.  There is an increase before and a sudden decrease after childbirth when it comes to both allopregnanolone and progesterone, and it’s the sudden drop that seems to trigger PPD for some women. There are currently no medications specifically intended to treat PPD. Antidepressants like Paxil, which are supposed to increase levels of the neurotransmitter serotonin, can take several weeks to “kick in” (it took 4 weeks for me), if at all.  For some moms suffering from PPD, multiple antidepressants fail to do anything.  And if you’ve ever been through depression you know how a day spent depressed can feel like an eternity, so can you imagine what weeks, or even months, spent desperate for a relief from symptoms, while caring for a new baby, must be like?

On July 14th, I heard Samantha Meltzer-Brody, M.D., M.P.H., director of the Perinatal Psychiatry Program at the UNC School of Medicine, talk in person about the treatment and the study at the annual Postpartum Support International conference in Philadelphia.

You can participate in testing via the Hummingbird Study. The website includes information on how to find out if you can participate.  On the website, there is also a helpful guide on how to to identify the warning signs of PPD of and provide support to a new mom with PPD.

PPD ACT

In order to better understand why some women suffer from PPD or postpartum psychosis and some do not, what causes PPD, as well as how to detect, treat and even prevent PPD and postpartum psychosis, information from as many women as possible needs to be collected for analysis.  To help collect data from as many participants as possible, an app was created. Thank goodness for technology!

Last year, Dr. Samantha Meltzer-Brody–yes, her again–was part of a team (that included the National Institute of Mental Health, UNC Chapel Hill and Apple) to create the PPD ACT iOS app, which I’d previously blogged about. It is an app that is is free and available to download via iPhone (and now Android phone!) in English and in Spanish in Australia, Canada, and the United States, and is coming soon to the UK and to Denmark.  Any mom who suspects she has experienced symptoms of PPD or postpartum psychosis is encouraged to download the app and join the study.  Even if you think/know you had PPD, you can participate in order to help advance the study to benefit moms in the future.  It only takes 10 minutes of your time.  I just did it myself, and it took less than 10 minutes, including the time to download the app to my iPhone.  Part 1 of the app is a short survey to get feedback on whether you have/had PPD and receive mental health resources if you are currently experiencing PPD. Part 2 involves participation by those who have/had PPD in a DNA study using a spit kit.

Click here for access to articles in the New York Times, Buzzfeed, CNN, Huffington Post, and the Lancet on PPD ACT.

Wake-up call for new moms who feel “off” for days after childbirth (and family members of these moms)

I’m finally blogging again after a slight reprieve from being unbelievably busy for weeks with work and then vacation and then feverishly cleaning my house for guests coming over (if I had more time to clean regularly cleaning wouldn’t be such a big deal).  Also, I am in the process of slowly transitioning off of the laptop I’ve had for over 8 years, so every single tab I’ve had open (which is a lot) need to be closed, obviously.  These tabs have been open for months for me to blog about and/or read but just haven’t had the time to do.  So, here I am trying to get through as many articles as possible.

Many of the tabs had stories about moms who died from severe postpartum depression (PPD), so I decided to blog about the deaths of FOUR moms who suffered from severe postpartum depression (PPD).  These are just four of the deaths from a postpartum mood disorder that have occurred since 2016.  There have been others, but these are the only ones other than the D’Achilles story (which I mentioned back in May) that I have come across in my daily news feeds because loved ones of these women have spoken up  and shared their stories so that others would not suffer such experiences.

In a Good Housekeeping article published on May 19, 2017 by Andrea Stanley titled “The Voice That Said ‘I’m a Bad Mom’ Killed My Wife,” Greg Ludlam opens up about the severe postpartum depression that took the life of his wife Elizabeth on June 1, 2016.  When their second child was around one year old, something about Elizabeth seemed off.  She wasn’t herself.  Little things set her off.  She withdrew from friends and neighbors.  She started saying and believing she was a bad mom.  There was no longer any joy or enthusiasm in things that used to make her happy. She got angry over things at work when she was never previously that way.  These are all trademark symptoms of PPD but Greg had no idea that his wife was suffering from it.  He has had to cope with the guilt of not picking up on what was going on and getting professional help.

Greg Ludlam urges the significant others of new mothers to do the following:

“….[If] you see something not right with your wife or partner, you need to get help right away from a medical professional who specializes in mental health care.  I’m not talking about tomorrow or next week — now.”

He also urges new moms to do the following:

“For anyone who is reading this and you’re feeling overwhelmed or you’re feeling like a bad mom or you’re feeling like a lousy wife, or just feeling unloved and alone — you’re not. You’re not a bad mom. You’re not a lousy wife. You’re not unloved and alone. There’s help. You need to reach out to a qualified mental health doctor right now.”

In a CTV News article published on January 18, 2017 titled “B.C. widower urges moms suffering postpartum depression: ‘Please seek help ‘” Kim Chen opens up about the severe PPD that took the life of his wife, Florence Leung shortly after she gave birth to their son in October 2016.   She had gone missing shortly after giving birth to her son and her body was pulled from the water near an island close to Vancouver, British Columbia.  Florence was being treated for PPD before her disappearance.  Chen urges new moms who feel anxious and/or experiencing low mood to seek help and share their feelings.  He mentions there is a too much pressure and too many misconceptions regarding breastfeeding, as the hospital where they delivered the baby had Breast is Best materials that reiterated over & over how breast milk should be the only food for babies for the first six months.  He realizes the benefits of breast milk but at the same time believes formula is totally fine as either a supplement or replacement for breast milk.  It should be a personal choice and dependent on circumstances.

Chen wants new mothers to know:

“Do not EVER feel bad or guilty about not being able to “exclusively breastfeed”, even though you may feel the pressure to do so based on posters in maternity wards, brochures in prenatal classes, and teachings at breastfeeding classes.”

In a Her View from Home article published in September 2016 titled “New Mom Takes Her Own Life After Silent Battle With Postpartum Depression: Why All of Us Must Share Her Friend’s Plea,” author Julie Anne Waterfield  opens up about the severe PPD that took the life of her friend Allison on June 28, 2016.  Allison leaves behind her husband and daughter.  Julie wants people to know that there is nothing shameful about PPD.  The transition to being a mother can be very difficult and it is important to get help from your husband/partner, friends, relatives (and if you’re not feeling yourself, seek help from a counselor and/or support group).  The road to motherhood is not always smooth or peachy.  For some new mothers (like me), the road is very difficult–not to mention lonely and for first-time moms uncertain, guilt-ridden and downright scary.  For these mothers, not having a birth and postpartum experience as they envisioned it *should* be makes them feel ashamed.

Julie wants new mothers to know:

“To all those mothers out there experiencing some of these same feelings: you are not alone, and you are not a bad mother!  PPD is lying to you.  It is twisting your memories, feelings, and beliefs and reshaping them into an overwhelming falsehood.  You will not be judged, only loved, as you seek help.  To those breast-feeding mothers taking Reglan (metoclopramide) to increase milk supply: stop and do research. Reglan has detrimental side effects such as new or worsening depression, suicidal ideation and suicide.  Supplement with formula if needed.  Your baby will be just as perfect and healthy with or without the breast milk.  Having more breast milk is not worth sacrificing your mental health or possibly your life.”

And finally in a The Hour article published by Kaitlyn Krasselt on September 8, 2017 titled “Norwalk sisters raising awareness about postpartum depression, suicide,” the sisters of Kara Kovlakas open up about the severe PPD that took Kara’s life (one day before she was to turn 33) on October 13, 2016, nine months after giving birth to her 2nd child.  Kara’s family created the Light for Kara website in her memory and to help raise awareness about postpartum mood disorders.  Kara had suffered from depression and anxiety before she had children.  Within 7 months after giving birth, her thoughts started to become jumbled and she couldn’t think clearly. She had doubts that she was a good parent.  A dark cloud followed her everywhere. She couldn’t see the positives, only the negatives each day. She had been seeking outpatient treatment for her depression and anxiety, and kept insisting to her family that she was getting better.  From the outside, she looked fine to everyone.  But taking her own life was something that her family and friends never expected.

Kara’s sister, Lauren Shrage, wants people to know:

“This is a real mental illness. The shame new moms feel about needing to reach out for help is real. As a new mom, you’re expected to have it all together. We’re all new moms too and the only thing anyone ever mentioned to me about postpartum depression was a pamphlet in the folder I took home from the hospital. That’s not enough.”

Please take these experiences to heart. Share them with others. We need to de-stigmatize PPD by being open about it and avoid being judgmental. Remember that not all postpartum experiences are peachy, and that one in seven new mothers experience a postpartum mood disorder. Let’s keep a close eye on the new moms in our lives.  Offer them help, not criticism. Don’t help push a new mom over the edge with Breast is Best or other one-size-fits-all tactics.  ONE SIZE DOES NOT FIT ALL.  Everyone is different.  Everyone’s childbirth and postpartum experiences are different. We want mothers AND babies to thrive, not die.

If you or a loved one doesn’t seem to be herself for days after childbirth, reach out and ask her to share about her postpartum experience with you and/or a health practitioner.  Getting help can mean life or death, as you can see from this blog post.  Postpartum Support International has a warmline (800-944-4773) and a listing of local resources to help with finding local help.  Reach out to me by leaving a comment below and I can respond via email.

Did you know that you can text 741741 when you are feeling really depressed or suicidal? A crisis worker will text you.  It’s a free service by The Crisis Text Hotline! (Only in the US).  Texting has proven to be a more preferred way of reaching out for and getting help.

The National Suicide Prevention Hotline is available 24/7. If you or a loved one needs help right now, call 1-800-273-8255.  It’s confidential and provides a network of over 140 crisis centers nationwide.    You can also visit www.suicidepreventionlifeline.org.

You have to break through the uncomfortable…Why? Because mothers are dying from postpartum mood disorders

You have to break through the uncomfortable…..We are losing a silent battle that no one wants to talk about.

Amen!  These are the words Brian Gaydos utters when people ask what happened to his beloved wife, Shelane, and his answer “She died from a disease called postpartum depression” makes them uncomfortable.  Discomfort from stigma is what keeps suffering mothers quiet and getting the treatment they need and deserve.

When I read the August 4, 2017 article by Michael Alison Chandler in the Washington Post titled “Maternal depression is getting more attention – but still not enough” and I saw Brian’s words at the end of  the article, I decided I needed to blog about these words and about the tragic death of his wife.  Shelane Gaydos, a 35-year-old mother with 3 daughters, lost a baby in utero at 12 weeks and within 3 weeks died by suicide.  Family members did not realize until a while after her death that she had suffered from postpartum psychosis.  The article mentions, and as statistics have always indicated, women are more likely to attempt suicide during the first year after childbirth than during any other time in their lives.  It is important to note that a woman doesn’t need to give birth to experience any one of the various postpartum mood disorders, including postpartum depression (PPD), postpartum OCD and postpartum psychosis.  She can suffer from these disorders after having a miscarriage as well.

The article mentions certain things I’ve mentioned all along in my blog and in my book:

  • 1 in 7 new mothers experience a perinatal (during pregnancy and after birth) mood disorder, and yet these disorders continue to be under-diagnosed and under-treated
  • A relatively small percentage seek professional help either because they don’t know what they are experiencing deserves and needs  professional help and/or they don’t know where to go to get help and/or they are ashamed to seek help
  • More obstetricians and pediatricians lack than possess the training needed to diagnose and treat perinatal mood disorders
  • Certain risk factors are the reason why certain mothers develop PPD and others don’t: genetic predisposition to biological factors (some mothers are affected by hormonal fluctuations during/after childbirth and after weaning more than others) versus environmental factors (poverty, poor/abusive relationships, premature birth or miscarriage, inadequate support, inadequate paid leave from work)
  • It’s thanks to advocates with platforms with a broad reach to members of the government and media that there has been progress in recent years.  Brooke Shields is one of the first of the advocates to start the trend of sharing their own experiences, spreading awareness, and trying to effect change.
  • There are still stubborn societal myths (thank you to the patriarchal and quite misogynistic forces and views still in place here in the 21st century) that only serve to put unnecessary, additional stress on women, encouraging the false notion that all mothers can not only care for their babies without any sleep or support, but also be able to breastfeed without any issues and return to their pre-baby bodies and weight quickly.  Unbeknownst to many of us stateside, societies around the world (and in olden days here in the good ol’ USA) have customs in place that provide new mothers with the support they need to recover from childbirth and care for their newborn baby.  Instead, because we are a strictly capitalistic society, more and more mothers now work and have anywhere between 0-13 weeks of paid leave and are expected to recover and jump right back to their jobs before having babies, as if they’d never given birth in the first place!  If only men who think “Women have been giving birth for centuries should just up and go back to the way they were” can experience childbirth firsthand sometime!

Certain states, like Massachusetts, New Jersey, and Illinois have passed laws that mandate screening for PPD, and thanks to recommendations by the American Congress of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP), healthcare providers are screening for PPD more routinely.  What I would like to know is whether these screenings are even happening (I am dubious):

  • In 2015, ACOG recommended that OB/GYNs screen women for PPD at least once during pregnancy and once after childbirth.
  • In 2010, the AAP recommended that pediatricians screen mothers for PPD at well-baby visits during the first 6 months.

Says Adrienne Griffen, founder and executive director of Postpartum Support Virginia, whom I have the honor of knowing through my affiliation with Postpartum Support International:

Postpartum depression is where breast cancer was 30 years ago.

I truly and sincerely hope and pray that it’s NOT going to be ANOTHER 30 years for us to see a significant change in the way we view PPD as a society and reduce the numbers of women suffering–and even dying–from perinatal mood disorders!

 

 

Colic, Sleep Deprivation, Inadequate Support as Risk Factors for PPD

Just a quick post about colic, sleep deprivation, and inadequate support for the new mom as key risk factors for postpartum depression (PPD). There are many topics I want to blog about, but it’s another case of too many ideas, not enough time.  Since these risk factors make up some of the crucial pieces of the puzzle of my PPD experience, and since the Babble post titled “DR. HARVEY KARP ON WHY HE BELIEVES PPD IS MORE COMMON THAN EVER BEFORE” by Wendy Wisner showed up on my Facebook feed today, I decided to do a quick blog post about it. This blog post joins my previous post about Dr. Karp and his 5S technique “Baby Fussy or Colicky? Try the Amazing 5 S’s!“, a technique that helps babies sleep and parents cope with colic.  Colic causes sleep deprivation and feelings of incompetence from not being able to calm your crying baby (due to lack of prior baby care experience and lack of adequate support/guidance provided by someone with experience).  I basically said the same things in my book.

Dr. Karp also believes the following, which are also points that I mention throughout my book:

  1. Sleep deprivation can change brain physiology in the amygdala by causing it to become more hypervigilant and a triggering of the body’s fight or flight mechanism.  This state can cause a new mother to feel anxious and remain in a constant state of alertness, fearful that something bad may happen to her baby.
  2. Self care is as important as caring for the baby…it takes a village….a health mom means a healthy baby
  3. A mother’s getting enough sleep and support = key to reducing the occurrence of postpartum mood disorders

The bottom line is new mothers MUST get adequate support.  But with many parents struggling financially and not being able to afford help (via resources like doulas) and family members experienced with baby care not living close by and/or are too busy to help, it’s no wonder there are so many cases of PPD.  Please see my past posts about the critical role social support plays in minimizing the occurrence of PPD here and here.