Group Approach to Prenatal Care…Start of A New Trend, Hopefully

I realize its been 2-1/2 weeks since my last post. …yikes!  Time flies…as we know all too well!  I’ve been caught up with a lot of things going on at work, home, editing my manuscript, celebrating Chinese New Year, etc.  Yes, Chinese New Year….the Year of the Rabbit.  For all those who observe, may it be a year of good fortune, happiness, and above all, good health!    The Chinese New Year festivities period began on February 3rd and lasts 15 days, until February 17th.  新年快樂! 恭禧發財!

I have been out of the loop for the past couple of weeks and only stumbled across a tweet from Amber Koter-Puline regarding a article titled “Building A Sisterhood Among Moms-To-Be” that caught my attention.  Why did it catch my attention?  Well, specifically, the word “Sisterhood” caught my attention.   This is, I feel, so lacking in this society.  A society that used to be more about social support of new moms and their families during pregnancy and postpartum and is now based on a model of competitiveness, do-it-yourself, and the ever prevalent supermom myth.  And let’s not forget the 2-minute visits with the OB/GYN too.   The model upon which society and women’s healthcare are now based is, quite frankly, pitiful.

So, take a few minutes to read through that article and see if you agree with me that we need to have more of this type of approach in not just prenatal care, but postnatal care as well!   The article tells us about the Christiana Care’s Smyrna Health & Wellness Center and its group approach to prenatal care and how its patients feel.   It’s important for a woman who’s pregnant, especially for the first time, to feel empowered, confident and prepared, rather than apprehensive and feeling like she’s all alone in that apprehension.  To be able to participate in a group setting where advice and thoughts/feelings/concerns of other pregnant women are shared is extremely valuable and reflects the way it used to be when society was more social support-oriented.

They refer to their approach as Centering Pregnancy, which focuses on not just medical care but education and support…again, what you would’ve found back in the days of social support in days gone by (and in other cultures today).   This program, which is optional to patients of the Center, is limited to about a dozen women at a time and is comprised of 10 visits altogether.  These women would begin at around 4 months into their pregnancies.    Each appointment in the program takes about 1.5 to 2 hours.  In addition to the one-on-one time with the healthcare provider going over test results and other concerns, patients spend the majority of their time in the program with other pregnant mothers, listening to and sharing experiences with each other.  Healthcare providers also provide presentations to the group of women on topics related to pregnancy and wellness, including breastfeeding, nutrition, and postpartum depression (PPD).  Yes, even PPD!   

The benefits to such a program are many, including the fact that healthcare providers don’t need to repeatedly go over pregnancy and wellness topics individually with each patient because the information is provided all at once to the group of women in the program.  It’s important to note that there has been a reduction in the number of pre-term births for mothers enrolled in the program….I’m sure due to the lower anxiety levels in these mothers, as there is a correlation between high anxiety levels and pre-term births.   Additionally, many of the women become friends with each other during the program and stay in touch–even arranging playdates for their babies– after the program ends for them.   What I’d be interested in finding out is if there has been a reduction in the number of mothers with PPD as well…..though,  I have to say that I wouldn’t be a least bit surprised, since there is a correlation between high anxiety levels and PPD.

We DEFINITELY need more of these prenatal programs across the country IN ADDITION TO postnatal programs like Santa Barbara Postpartum Education and Support (SBPEP).

Pain, Sadness Hiding Behind Smiles…Never Assume and Think That All is Blissful for the New Mom

Never assume….never take for granted that everyone always has smooth deliveries and postpartum experiences…..never think that just because she’s smiling that everything is fine and blissful, as it always has to be after the birth of a baby.

I just got through reading a touching letter on Susan Stone’s blog written by a father who lost his daughter to postpartum depression (PPD) and is encouraging people to petition for the Melanie Blocker Stokes MOTHERS Act.   His daughter seemed fine though people realized too late that she appeared to be more consumed with worry in the days leading up to her suicide.    Touched and with tears in my eyes, I started to write this post.

Something has to be done to stop the silent suffering of so many new mothers, bring more public awareness on PPD, and more healthcare professionals (GPs, OB/GYNs) up to speed on detecting PPD before it spirals out of control and leads to sometimes disastrous consequences.  What we need to do is prevent these situations from happening in the first place.  The only way we can make progress is through public awareness, which includes dispelling the myths of motherhood.  Now, if you happen to be one of the proponents of those ridiculous myths because you feel threatened or whatever the reason might be, then take a reality pill and get with the program.  Jump off that la-la train that you’ve been riding.  You cannot possibly ignore the fact that PPD is the #1 complication of childbirth, with 1 out of 8 women suffering from it.  If you still want to ignore it, then that’s YOUR problem.  Don’t make it anyone else’s. 

How many more lives should be torn apart from an illness most people still think is a make-believe illness?  Some marriages do not survive.  Children of women with untreated PPD may end up with cognitive, social, emotional and behavioral delays and potentially anti-social issues down the road.  For God’s sake, some women whose illnesses spiral out of control don’t even make it through alive. 

Sure, mothers have been giving birth for thousands and thousands of years. Just because most women with PPD don’t speak up doesn’t mean it doesn’t exist. And you mothers out there….if you don’t speak up, people will continue to go on scoffing at the idea that PPD does exist.

Why the fear?  Why the secrecy?  Why not speak up?

You may be wondering why the heck, then, doesn’t a mother who’s not feeling herself get help in the first place, then think about this.  

  • Many (like me) don’t even know what is happening to them in the first place. 
  • Many go see their doctor about why they’re feeling the way they’re feeling, but are told that what they’re feeling (baby blues) is normal and should go away by itself; yes, doctors still misdiagnose even today (more on this in my next post – stay tuned). 
  • Many are afraid of what their family/friends may think. 
  • Many are afraid others will look down at them and call them weak/bad mothers. 
  • Many may even fear that if they speak up, their children will be taken away.  After all, media is doing a great job in painting the wrong picture about PPD  (see earlier post on ABC’s Private Practice) and the public seems to think, ever since the Andrea Yates case, that everyone who has PPD is at minimum a bad mother or will turn into an Andrea Yates.    Well, Andrea Yates had postpartum psychosis (PPP)–which occurs in 1 in 500 to 1,000 mothers– and was never successfully diagnosed and treated, and look at the disastrous consequences that resulted.   The healthcare system failed her and those around her didn’t help her.  Instead, the public chooses to put the blame squarely on her shoulders. This is why public awareness and education are CRITICAL!

Basically, with the exception that the birth of a child is a life-changing experience for all women, though in different ways and to different degrees, no one woman’s motherhood experience is the same as any other. The only experiences you will hear are the mothers who have positive experiences gushing to everyone they know and run across “I love being a mother. Being a mother is such a fulfilling, wonderful experience that I wouldn’t trade it for the world. I couldn’t ask for anything more. It’s all I ever dreamed motherhood to be.” Since you only ever hear about the positive experiences, women whose experiences aren’t as positive will tend to keep their feelings to themselves.  It takes courage and a desire to empower other women to speak up.  Slowly, the numbers of women who speak up are growing until hopefully, one day, this suffering in silence nonsense will finally come to an end.  I’m hoping this momentum continues to the point until the motherhood myths disappear and mother-centered programs (mental/physical health and practical/social support) during the postpartum period become the norm rather than the exception.

Don’t compare yourself to other mothers that appear to be coping extremely well with motherhood–those who never look tired, always look happy and seem to do it all without needing any help at all. I know how tempting and almost second nature it is, but you must resist doing so.  Don’t assume that, just because other new mothers around you seem to have a picture-perfect motherhood experience, they’re natural mothers because they seem to know what to do and do everything right, and even look great  even immediately after having given birth. It could also be that some of these women have hired help in the form of a doula/nanny/housekeeper, which does in fact help new mothers get the rest they need to recover (see previous post on social support).  Unfortunately, however, not everyone has the ability to hire such help. 

You don’t know what truly goes on behind closed doors.   Just like others won’t know something’s wrong unless you open up, you’ll never know whether these seemingly perfect mothers are just putting up a façade. It’s scary how common it is for a woman to disguise how she’s truly feeling–it’s called make-up and good acting–all so others won’t know she’s not coping as well as she thinks she should.  She wants to give the impression that she’s handling it like the supermom that other mothers give the impression they are and how she wants to be viewed as.  This is one of the reasons why even today people are surprised to hear that PPD is the #1 complication of childbirth.  

No one’s life is perfect, despite appearances.

Please see a doctor if you don’t feel yourself even after 2-3 weeks postpartum, and you’re feeling down, unable to smile, unable to enjoy anything and/or unable to sleep even when the baby sleeps.