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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Tri-State Area Resources for New Mothers and Professionals Who Care for Them

I will be adding to this post as I think of other resources…

Postpartum Support International (PSI)

I’ve been a member of PSI since 2006 and have met many wonderful, dedicated and caring social workers, therapists, peer-to-peer support group leaders, etc. at its conferences over the years.  The PSI website, as I’ve mentioned in numerous previous posts, provides a listing of resources by state. There is also a warm line for those who need telephone support.

I’m happy to mention that more and more PSI chapters are forming. For example, in the tri-state area the PSI-CT chapter just recently formed https://psictchapter.com/ and NJ is in the process of forming a PSI-NJ chapter.  Click here for the article  published on February 20th that highlights the purpose of the PSI-CT chapter.  The PSI-NJ chapter is in the early stages of development, but the officers are now in place and ramping up plans with monthly calls to establish committees. The chapter has a Facebook page and a website is in the works as well.

If you would like to get involved with either chapter, please let me know and I can put you in touch with them.

Maternal Mental Healthcare Centers

When it comes to mothers’ centers, there are 2 on my mind in New York City:

Seleni Institute
The Motherhood Center of New York

I will be adding NJ and CT ones in the next few days.

Workshops for Professionals, Peer Support Group Leaders, and Advocates

The Partnership for Maternal & Child Health of Northern New Jersey will be hosting training events featuring Cheryl Tatano Beck, DNSc, CNM, FAAN, Distinguished Professor at the University of Connecticut, School of Nursing.

Click here for more information about the workshop scheduled for April 26th in New Providence.
Click here for information about the workshop scheduled for April 27th in Englewood.

The target audience for these workshops includes physicians, nurses, social workers and others (like peer-to-peer support group leaders) working with perinatal women.  Advocates and others concerned about maternal mental health (like me) are also welcome to sign up.

I will be sure to post information about events intended for new mothers and for those who are dedicating their lives in helping new mothers.

 

 

24th Annual Postpartum Support International Conference

Last week, I spent 3 days (October 27-30) at the annual Postpartum Support International conference.  This year, it was held in conjunction with the biennial (every 2 year) Marce Society conference, which is traditionally held in the city of the current President of the Marce Society.  With the current President of the Marce Society being Katherine Wisner of the Western Psychiatric Institute & Clinic, University of Pittsburgh Medical Center, this year’s conference took place in Pittsburgh.

Past PSI conferences I attended were in Jersey City, NJ and Kansas City, KS.    With this year’s conference being held in conjunction with the Marce Society, there were over 400 people in attendance, including leading researchers and experts in postpartum depression (PPD).  I was honored to be in the presence of so many individuals who have made such a huge difference on behalf of so many women who have suffered perinatal mood disorders.

Individuals like (note that there are too many to list here, but here are the ones that are most notable to me because I have read their research in the years I have been doing tons of reading on PPD):

  • John Cox, DM, FRCPsych, FRCP, who, along with colleagues J.M. Holden and R. Sagovsky, developed the Edinburgh Postnatal Depression Scale (EPDS) in the 1980s.  Dr. Cox was awarded the Louis Victor Marce Medal in 1986 for his pioneer research and clinical work in perinatal Psychiatry carried out in Uganda, Scotland and Staffordshire.  In 2002 he was elected Secretary General of the World Psychiatric Association.
  • Lee Cohen, MD, director of the Perinatal and Reproductive Psychiatry Clinical Research Program within the Clinical Psychopharmacology Unit of the Massachusetts General Hospital, as well as an associate 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.
  • David Rubinow, MD, Chair of Psychiatry and Professor of Medicine at UNC Chapel Hill.  Dr. Rubinow is currently President of the American Neuroendocrine Society and the Society of Biological Psychiatry, has won numerous awards for his research, his clinical supervision and training, and his scientific administration, and serves on the editorial boards of six journals and has authored more than 300 scientific publications.
  • Cheryl Tatano Beck, DNSc, CNM, FAAN, is 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 125 scientific articles as well as 4 books.

I was one of the minority there who was not a mental, medical or public health professional, or social worker.  There were 3 other young ladies there who, like me, are simply moms who want to learn more about perinatal mood disorders and find ways to help spread awareness, as well as to advocate on behalf of and provide support to other mothers.   These young ladies were Katherine Stone, Lauren Hale and Amber Koter-Puline.  This was my 2nd time meeting Katherine and 1st time meeting both Lauren and Amber.  This was the first time all 4 of us PPD bloggers were together in one place.

Here we are:

Amber Koter-Puline, Katherine Stone, Lauren Hale, and me

Another highlight of the conference was the appearance of Former First Lady Mr. Rosalynn Carter as the keynote speaker and book signing of the book “WITHIN OUR REACH: Ending the Mental Health Crisis,”  which she co-authored along with Susan K. Golant and Kathryn E. Cade.

There was so much information provided at the conference, but I was able to take away these 2 really important points that I would like to share with you:

  1. It is critical that we integrate behavioral health with medical care that is provided by those charged with the reproductive health of women.  I learned there is a multi-disciplinary approach to treating women with perinatal depression comprised of a psychiatrist, obstetrician, obstetrical nurse practitioner, and psychiatric social worker at Kaiser Permanente Medical Center in San Francisco.  We REALLY need more of these throughout the country!  In certain other countries, it’s the midwives and early childhood nurses–in addition to GPs–that are the front line of screeners.
  2. There was a presentation about the proposed changes being made regarding the treatment and screening of PPD for the DSM-5 due to be published in May 2013.  During this presentation, the ballroom grew noticeably hotter as one by one members of the audience took to the microphone to state their questions and concerns.  Most of them centered around the announcement that 4 weeks is the cut-off date for onset.  I mean, have you heard of a more ridiculous thing than that?!   That means that any screening that may occur (as not all OB/GYNs or other health professionals screen today) would only occur in the first 4 weeks postpartum, since a postpartum mood disorder (PPMD) would’ve had to rear its ugly head by then.   Why, then, you ask would they propose such an outlandish thing?  Well, it’s because all these years the DSM-IV and all its predecessors are based purely on statistics obtained directly from research.  Not doctor’s offices or hospitals or clinics.  Not from data obtained from the EPDS given to the thousands of moms that give birth each year.   Sounds like typical political, ahem, B.S. if you ask me….

Okay, so what does this all mean?  This means that moms will not only continue to have their OB/GYNs dismiss their PPMD symptoms, but now in addition, there will be a specific cutoff of 4 weeks.  Anything after 4 weeks will risk being shrugged off, as doctors will be referring to the handy dandy DSM-5 as the Bible and complacently inform these moms that they couldn’t have a PPMD because they were more than 4 weeks postpartum.

There is still opportunity to improve on the DSM-5 as it is being proposed.  You can help make a positive difference.  How?  Well, starting in May 2011 and ending midnight of June 30, 2011, the public will be able to submit comments on the draft of the DSM-5 on the American Psychiatric Association’s DSM Development website.   I will be signing up to do so, and I hope you will too.   The more women who do, the better chance we have of convincing the powers that be that they need to extend the onset period to 1 year (or even 3 months would be far better than 4 weeks)!  Voice your concern.  Tell them why.  Share your story.  I know numerous women whose symptoms of PPD didn’t begin until after the 6th week.  Like me, for one.   Other countries who have had ancient social support customs in place for centuries have had 6-8 weeks as the period in which the new mom must be cared for.  There is a reason behind that….just as there is a reason behind the Swedish model of the primary care physician (or general practitioner) performing postnatal screening between 8 and 21 weeks postpartum, with 13 weeks as peak prevalence.

To think that women who are sick with PPD will continue to be shrugged off and go untreated and allowed to suffer unnecessarily angers me to no end.    We are supposed to make progress, but instead, we are more concerned about statistics obtained during very limited studies.   Folks on the DSM-5 committee, this is a blatant example of not being able to see the forest for the trees.