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.

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Things Your OB/GYN Won’t Tell You But Should

Lately, I’ve been having a hard time picking what topic to blog about in the little time that I have to blog.  Nowadays, something I read in my Facebook feed has to really spark my interest in a big way.  Today, I stumbled across this HuffPo article “6 Things Your Ob-Gyn Won’t Tell You But Should.”  The article is meant to provide guidance to women who are thinking about becoming ,or are already, pregnant and need to find an OB/GYN that is right for them.

Here’s the comment I left:

I can tell you what my OB/GYN didn’t tell me about….postpartum depression…or treat me in an understanding/sympathetic fashion….or know who to refer me to for help. It’s pitiful and inexcusable that they are supposed to be charged for the care of women’s reproductive health matters, and yet perinatal mood disorders are still so far off their radars! They must get up to speed and be prepared to inform, detect (this includes screening pregnant and new moms with basic questions), and treat and/or refer to a specialist for treatment!

Here’s my advice for you that is coming from someone who has been down the road of having to find an OB/GYN (because I had just moved to the area) and was merely relying on the fact that so many women in town have the same one, without really feeling the doctor out ahead of time by asking questions and really determining if he was the right fit for me.  I didn’t allow any chance for my gut instinct–usually very fine-tuned–to really kick in.  How was I supposed to know he was going to have such poor bedside manner at the first hint of things not going as planned, and then drop kick me when he realized I had PPD?

In addition to the questions the Huffpo article lists, be sure to ask the following:

  1. How much about PPD and other perinatal mood disorders do you know, and can you tell me about them?
  2. Do you screen all your patients during, at minimum, the postpartum period for any postpartum mood disorder (PMD)–both via basic questions asked (see sample questions here) and via bloodwork?
  3. Do you treat PMDs, and if not, do you have referrals to healthcare providers who specialize in treating PMDs?

Please note that I am not limiting this advice to those with a history of depression.  I never had depression prior to my pregnancy and yet managed to get hit from left field with PPD and was thus left feeling sad, scared, alone, helpless and hopeless.

Please do not follow in my footsteps.

Be in the know and choose your OB/GYN wisely.