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.

 

 

 

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

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

About one-third of new mothers describe their childbirth experiences as traumatic, but you hardly ever hear about negative experiences because everyone wants to be like “everyone else” and happily announce that “mother and baby are doing well.”  No one wants to admit to having a negative childbirth experience, just like no one wants to hear about a negative childbirth experience.  And that is why everyone thinks childbirth experiences aren’t that big a deal. I had previously blogged about negative childbirth experiences via my blog post titled “Forget the Myths, Here are the Realities of Pregnancy, Childbirth and Postpartum Experiences.” It was one of my first blog posts.   The difference between my traumatic childbirth experience and the ones that are the focus of this film is that the ones in the film, like the one experienced by Caroline Malatesta, involve obstetric assault that resulted in both physical and emotional harm to the mother.  That is much, much worse than what I experienced.

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

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

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

 

Playing Monopoly with God – New York City Performances!

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

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

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

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

♦♦♦♦♦♦♦♦♦♦♦♦♦

Postpartum Support International presents:

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

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

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

Postpartum Pain – by Stacy M.

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

Just eight months old
Lost and confused
Mommy had to go

As tears flowed
From tired eyes
I drove

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

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

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

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

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

All the fear
Abruptly
Turned my world
Pitch black

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

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

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

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

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

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

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

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

Postpartum pain
Postpartum pain

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

Postpartum pain
Postpartum pain

Will make you never the same

Postpartum Depression Doesn’t Look the Same Across the Board

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

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

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

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

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

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

 

 

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

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

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

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

 

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

Following is her experience in a nutshell.

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

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

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

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

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

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

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

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

Thank you, Jessica, for sharing your experience!

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

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

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

NowThis Her video

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

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

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

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

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

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

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

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

Journey of a PPD Survivor – Q/A Series – #2

Welcome to the second of my Journey of a PPD Survivor Series!

Laura Winters, LCSW, whom I’ve had the pleasure of knowing since we met at this year’s Postpartum Support International conference in Philadelphia, is a therapist specializing in infertility and prenatal/postpartum stress.  We are both members of the recently-established PSI-New Jersey chapter.  Laura is passionate about helping women on their journeys through motherhood, offering individual and group support.  Her practice, Postpartum Health & Harmony, is located in Chatham and Mountain Lakes, NJ.  For more information or to contact Laura, please visit www.postpartumhh.com.

Thank you, Laura, for taking the time to provide my blog readers some insight into your journey as a PPD survivor!

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

Question 1:
Can you please describe your journey to becoming a Licensed Clinical Social Worker and what motivated your passion to help women with infertility issues (which I experienced) and mothers suffering from a perinatal mood disorder? How long have you been helping women experiencing infertility and perinatal mood disorder?

 When I was considering careers, I wasn’t totally sure what I wanted to do, but I knew that I wanted a career that would enable me to make a difference in people’s lives.   Social work was suggested to me and it was a perfect fit!  I started out my career working with children and teens and I really enjoyed helping them through various challenges.  In 2007, I started working in private practice, primarily focusing on families.  It wasn’t until about 2011 that I first started seeing some women who were struggling with perinatal mood disorders.  At that time, it wasn’t a specialty of mine, so I only saw a few new mothers.

In 2013, I became a mother and had an entirely new appreciation for parenthood.  It was incredibly difficult in ways I never imagined.  Breastfeeding was not going well, which caused me a lot of anxiety, sadness, and added to my exhaustion.  My husband and I both felt more like roommates and our relationship was strained.  This experience inspired me to make some career changes, most notably acquiring more advanced training in perinatal mood disorders and developing this specialty in my practice.

As I began to work with more pregnant and postpartum moms, I also started getting referrals for women experiencing infertility and postpartum moms who had gone through fertility treatments.  Once again, I felt a need to learn more and was interested in adding this focus to my practice.  I see these times in women’s lives, when you’re trying to conceive or newly postpartum, as being so precious and yet such a vulnerable period.  For the most part, everyone assumes that they will get pregnant easily and that motherhood will be challenging but amazing.  When things don’t go as planned, it can completely turn your world upside down and have you questioning everything about your life.  My personal experience definitely fueled my passion for supporting moms as well as couples trying to conceive.

 

Question 2:
In your practice, have you seen a correlation between infertility and a perinatal mood disorder? Do you treat mothers who you’d also seen while they were struggling with infertility issues and ended up suffering from a perinatal mood disorder?  Have you treated women suffering from infertility issues who ended up not suffering from a perinatal mood disorder?

 Infertility treatment is a risk factor for a perinatal mood disorder and I do see this correlation in my practice, though not across the board.  There are so many factors that influence whether a mother will develop a perinatal mood disorder.  I’ve seen women who have been through infertility treatment and did not end up experiencing any perinatal mood disorders.  Support and early intervention are very helpful in protecting a mom’s mental health.

  

Question 3:
Can you provide an overview of the services you provide? I see that you help patients in person, online, and even in a support group setting. Do you find one way of seeing your patients is more helpful? 

 I offer individual, couples, and group counseling.  I see almost all of my clients in person.  I offer online and phone sessions for times when clients may not be able to come to the office, such as not having child care available or in the first few weeks after childbirth.  Online and phone sessions are a great way of continuing sessions when life gets in the way.  The support group is open, meaning that you don’t have to register and can come as often as you need.  The moms that come to the group tend to be looking for different support than those who come for individual counseling.  The group moms are often looking to connect more with other moms going through similar experiences.

  

Question 4:
In your practice, what kinds of treatments for postpartum depression do you recommend?

In addition to therapy, I will recommend medication for those that are open to it or who have tried other things and are still struggling.  I also encourage my clients to try to incorporate exercise and a healthy diet into their routine.  For clients that are interested, I may recommend meditation or teach them an acupressure technique called Emotional Freedom Technique (EFT).

 

Question 5:
Have any medical healthcare practitioners–like IVF doctors, general practitioners, OB/GYNs or pediatricians–ever refer their patients to you?

 Yes, medical healthcare practitioners are great referral sources.  I definitely get more referrals from those healthcare professionals who take the time to talk to their patients about mental health.

 

Question 6:
What do you think medical health practitioners who come in contact with new mothers, like OB/GYNs, GPs and pediatricians, can do to help prevent, detect and treat perinatal mood disorders?

I would encourage medical health practitioners to take time to talk to moms about mental health.  Ask them about their mood and stress level.  Look their patients in the eyes and ask them how they are really doing.  Normalize how challenging being a mother is.  Making comments such as “motherhood is tough” or “you have a lot on your plate now” can go a long way in helping a mother feel comfortable to open up to you.  And having referral sources on hand when their patients need more support is extremely important.  Don’t leave it up to a new mom to have to find help herself.

 

Question 7:
Is there one key piece of advice you would offer to an expecting or new mom?

For expecting moms, I would tell them to make a postpartum plan that outlines things such as who they can count on for specific types of support (baby/childcare, cooking, advice, etc), how they will protect their sleep, and where they can turn if they need support.  For new moms, I would advise them to take breaks, ask for and accept help, and know that challenges come in phases but do eventually end.

 

Question 8:
What would you want to say to women currently suffering with a postpartum mood disorder?

This is the most common complication of childbirth and not an indication of who you are as a mother.  There is a lot of support available out there including counseling, support groups, and other moms who have been there and are happy to offer encouraging words.  You will feel better once you get the support that’s right for you.  Other moms have recovered and you will too.

 

Question 9:
What advice would you offer to friends/family members of a woman who is currently suffering with a postpartum mood disorder?

Reach out to her often – call, text, stop over.  Be there for her when she’s ready to talk.  Try to listen and validate her feelings.  Consider what support you can offer her—including cooked meals, childcare, cleaning, keeping her company—and rather than asking if she wants that help, tell her that this is how you’d like to help.  Tell her when you’re available to provide that support and then let her decide when you can come over.  Most moms will turn down help initially, but when you are very specific with what you can do and when you can do it, it’s harder to turn that down.  Also, it may help you better understand what she’s going through by researching information on perinatal mood and anxiety disorders.

 

Question 10:
What do you see as the biggest challenge in helping a mother recover from a postpartum mood disorder?

Lack of support and lack of insurance coverage are big obstacles.  It’s hard enough finding a therapist or psychiatrist, let alone when you have an infant and aren’t feeling like yourself.  Whether you have insurance coverage or not can help or hinder the process.   I find that the more support a mother has around her (people who can help with certain tasks and give her breaks), the easier recovery is.  It’s really challenging when you don’t have enough support at home and are expected to do a lot of the childcare and household tasks.  It doesn’t allow enough time for moms to tend to their needs.