By Annette Cycon, founder, MotherWoman
"I'm feeling paralyzed by anxiety and fear. I can't cope. I don't want to take care of the baby - I want someone to care for me. I don't want to touch her. My life is over, I'm numb. I wish I'd never gotten pregnant. Something is wrong with me..."
Ten years ago Meghan (not her real name) became suicidal eight months after the birth of her daughter. She had been feeling anxious and depressed since pregnancy. In the following postpartum weeks and months, things got worse. She could not sleep or leave the house, she cried all the time, and she could not care for herself or her daughter. She went to the ER several times, thinking that her panic attacks were heart attacks. No one screened her for depression, either during pregnancy or postpartum. By the time her baby was eight months old, she was despondent, and felt that her daughter would be better off without her. She was hospitalized in a psychiatric hospital and separated from her daughter. Eventually she was referred to the one psychiatrist who understood postpartum mood disorders, and she got well in a few months. Now she and her daughter are very close and she has not had a mental health relapse since.
"I never thought I would recover from postpartum depression and feel like my old vibrant self again. A year ago, I could barely get out of bed, but now, because I got the help I needed, I'm able to function. I love my daughter. I really do. I'm so grateful to feel normal again. I'm alive. It's all over - those dark days are really over. I hold her close to me and kiss her madly!"
The U.S. Preventive Services Task Force, an independent group of experts appointed by the Department of Health and Human Services, recently recommended that all pregnant and postpartum mothers be screened for postpartum depression and other mental health concerns. Moms need special recognition at this time, the task force says, because of evidence showing that they can be accurately diagnosed and successfully treated, and because untreated depression harms not only the mother, but her child as well.
While this recommendation came out only last month, MotherWoman has been educating health care providers about perinatal emotional complications for over ten years. (Perinatal emotional complications are feelings and behaviors that cause mothers distress and interfere with their functioning during pregnancy and the postpartum period; they can include depression, anxiety and other symptoms across a spectrum of severity.) Meghan's story was the catalyst for MotherWoman's advocacy in the area of maternal mental health. Over the past ten years, MotherWoman has educated thousands of providers about perinatal emotional complications such as depression, anxiety and psychosis, and has worked with communities across the state of Massachusetts to conduct universal screening for all pregnant and postpartum mothers, and strengthen community resources, so that no mother falls through the cracks like Meghan did.
MotherWoman, located in Hadley MA, has been successfully addressing this issue in Western Massachusetts and across the state for years. MotherWoman's Community-based Perinatal Support Model (CPSM) is a community intervention which brings multidisciplinary providers together to increase community awareness, professional education, and community resources, and implement universal screening in OB and pediatric settings for pregnant and postpartum moms.
"Before we started this program, we were not screening women and didn't have any connection to local resources. Now, six years later, women are screened at regular intervals throughout pregnancy and through the first year of the baby's life in the pediatric setting. Providers have standardized protocols for referral to local resources, and we have two MotherWoman Support Groups in Greenfield. The community has worked together to create a safety net, and moms are getting the help they need." Linda Jablonski, Assistant Nurse Manager at Baystate Franklin Medical Center Greenfield MA
Annette Cycon, Founder, and Director of Training at MotherWoman says,
"Unaddressed postpartum mental health issues can affect babies, children, and families, and universal screening will help identify these women. But screening does not necessarily get women to treatment. There are many barriers to care for a pregnant or postpartum mom who is struggling with mental health issues such as depression or anxiety. The number one barrier is stigma. It's still not socially acceptable for a mom to admit that having a baby is not the best time in her life or to seek help for mental health concerns. One in seven women will suffer with postpartum depression, and yet very few facilities screen for it, or educate or prepare her for it, let alone offer specialized mental health and community resources for her."
Jacqueline Kates, MD and obstetrician with Women's Health Associates in Westfield, MA adds, "Another barrier to care is the lack of provider education and training about how to deal with a mom who has a mental health issue. Furthermore, providers are reluctant to screen for postpartum emotional complications if there are no services in the community where they can refer her confidently. We not only screen all women regularly in our OB practice, but we know where we can send her when she needs help."
"We also have to address the lack of cultural understanding about how maternal mental health is viewed among diverse populations. Most communities do not have adequate medical and mental health providers who understand cultural strengths and challenges from the inside," says Shannon Rudder, Executive Director of MotherWoman
With support from MA Department of Mental Health and MCPAP (Massachusetts Child Psychiatry Access Project) for Moms, MotherWoman's Community-based Perinatal Support Model is being replicated in 10 communities across the Commonwealth, including four communities in Western MA: Springfield, Holyoke, Westfield, and Franklin County. The Association for Maternal and Child Health Programs has awarded MotherWoman with a 2016 BEST Practices Award for this Community-based Perinatal Support Model.
"We have formed a Postpartum Depression Coalition here at Baystate where we come together monthly with mental health providers, childbirth educators, doctors, nurses, and everyone who comes in contact with pregnant and postpartum moms to solve this problem. Because of our work with MotherWoman over the years, we are now screening moms for postpartum depression and we have places to send moms who need help." Dr. Frank Robinson, Vice President, Public Health and Community Relations, Baystate Health, Springfield, MA.
At MotherWoman, we are very proud of being ahead of this national discussion on postpartum mental health and are working with leaders in this field nationally to bring this important issue to light. As a founding member of The National Coalition for Maternal Mental Health we are working together to support a federal bill -- "Bringing Postpartum Depression Out of the Shadows Act of 2015" which will support state efforts for screening and treatment for moms who are suffering.
For more information: email@example.com
Annette Cycon is the founder of MotherWoman, a non-profit dedicated to supporting and empowering mothers to create personal and social change. She develops and offers professional trainings on perinatal emotional complications to build community-based perinatal safety nets for moms and families. She has been leading mothers' support groups for over 20 years, and believes that speaking the truth about motherhood is revolutionary! She is the mother of two adult daughters.