In the last few years there has been a significant push to screen pregnant and postpartum women for symptoms of depression. In fact, in 2015 the American College of Obstetrics and Gynecologists (ACOG) recommended screening at least once during the perinatal period for symptoms of anxiety and depression using a clinically validated assessment tool such as the EDPS (Edinburgh Postnatal Depression Scale) or the PHQ-9 (Patient Health Questionnaire-9). Several states have followed suit in mandating depression screenings for perinatal populations.
I encourage all my pregnant and postpartum clients to draft a list of ways they would like their medical care providers to interact with them which are supportive of their emotional needs and bolster their mental health. I refer to this as their Pregnancy/Postpartum Bill of Rights. Yes, it’s strong rhetoric but the language is intentional as I often see women who are reluctant to advocate for themselves. They don’t want to be difficult, they don’t want to offend, they want to be “good patients.” Consequently, they feel disempowered and their emotional wellbeing suffers.
A few weeks ago, ProPublica published a sobering article entitled The Last Person You’d Expect to Die in Childbirth. The article addressed the extremely high maternal mortality rates in the United States, which are contrasted significantly with low infant mortality rates.
In trying to understand this enormous discrepancy, the authors note numerous examples in which our medical system: from medical education, to Medicaid spending, to hospital credentialing, to routine obstetric and postpartum care protocols; privileges the health of babies while ignoring the health of moms.
Parenting, and particularly parenting a baby, requires an enormous amount of mental and physical effort. There are the logistical challenges of making sure everyone is fed, clothed, and bathed. And that everyone gets to where they need to be on time. There are intense physical demands such as healing a postpartum body, nursing, and getting very little sleep. And of course, there are significant emotional challenges. Adjusting to the significant shift in identity (great piece on this here,) struggling with the very real problem of mommy guilt, and managing the emotional labor of a family can take a real toll on one’s emotional wellbeing.
June marks Pride month, with cities around the world marking the occasion with marches, parades, family carnivals, and all kinds of great events. This past weekend we celebrated pride right here in the nation’s capital. Pride is of course about celebrating and supporting our GLBTQI family members, friends, and community. But it’s also a reminder to take stock of and consider the numerous ways our country’s policies, laws, and protections continue to marginalize and discriminate against GLBTQI people. This is especially true for those of us whose identities and various points of privilege affords us the space to not think about this daily.
Over the past few weeks, you’ve learned about perinatal mood and anxiety factors, how to find support, and how to support a friend or partner. This week I wanted to speak to the importance of social support, and specifically, how essential it is to connect with other moms and parents with kids of the same age. There is incredible value in this. Indeed, countless studies have shown that lack of social support during pregnancy and the postpartum period puts women at higher risk for developing a perinatal mood or anxiety disorder (PMAD).
In last week’s post, I ended with a promise to feature more information and more first first person accounts of women and men who have experienced perinatal mood and anxiety disorders whose voices are underrepresented. With that goal in mind, I am thrilled to have had the opportunity to interview Divya B. Kumar, ScM, CPD, CLC; a co-founder of the Perinatal Mental Health Alliance for Women of Color (PMHA-WOC).
In last week’s post, I spoke about what to do and where to turn if you are concerned you are experiencing a perinatal mood or anxiety disorder. A question I get asked frequently is how to be helpful if you have a friend or partner who is suffering, or if you are concerned about someone. I wanted to spend this week’s post addressing this.
Postpartum depression is getting a lot of press these days. Sparked in part by Chrissy Tiegans’s touching article in Glamour Magazine about her own struggles with postpartum depression, there have been a lot of celebrities opening up about their experiences with PPD, and a lot more mainstream articles written about the subject. Additionally two documentaries (When the Bough Breaks and Dark Side of the Full Moon) were recently released which focus on the topic.
Today is Mother’s day. Many of you may be celebrating with breakfast in bed, brunch with family, or some well deserved R&R. It’s an important day of recognition for all the incredible mamas out there who do so much for their families and it is worth celebrating. And yet, Mother’s day is an extremely difficult day for so many women and their families and we do not do enough to acknowledge that.
Postpartum Depression has been getting a lot of media attention this days. Thanks in large part to an incredibly brave article in Glamour Magazine written by model, television host, and author Chrissy Tiegan about her struggles with postpartum depression, there has been a slew of coverage about the disorder. Ranging from personal narratives, to descriptions of signs and symptoms, these articles are incredibly important in reducing stigma and bringing attention to a problem that affects an estimated 10-20% of woman.
But here’s the thing. It’s so much more than depression. When we speak to pregnant and postpartum women about their emotional health, we need to focus on the whole spectrum of perinatal mood and anxiety disorder, commonly known as PMADs.
A few weeks back, I wrote about stillbirth This week I wanted to delve a little bit deeper into what emotions and coping looks like following this devastating loss.While there is certainly some overlap with the feelings and strategies that I wrote about in my pieces on miscarriage , there are aspects specific to losses that occur later in pregnancy that I wanted to highlight.
The reality is that pregnancy is a time of incredible psychological vulnerability. In fact, the majority of women who experience mental health symptoms postpartum note that their symptoms began during pregnancy, with 14-25% of pregnant women experiencing depression, anxiety, or another perinatal mood or anxiety disorder (PMAD). This is especially true if you have a history of depression, anxiety, or another mental health concern.
I'd like to take another break this week from my series on loss to feature an important piece by the incredible Lori Mihalich-Levin, founder of Mindful Return. Lori's new and amazing book Back to Work After Baby: How to Plan and Navigate a Mindful Return from Maternity Leave is coming out on April 11th.