Area organization works to educate on maternal mental health.
Liz A. Friedman experienced a perinatal mental health crisis with her first child more than 10 years ago. She had classic risk factors for a maternal mental health issue, including complicated pregnancy, preeclampsia, recent loss of a loved one and lack of sleep for five days or nights following the birth.
“And yet no one screened me, educated me, asked me about my risk factors, informed me about the frequency of postpartum depression (10 to 20 percent of mothers), or the frequency of perinatal emotional complications during pregnancy (15 percent),” said the program director and founder of the Postpartum Support Initiative of MotherWoman, and member of the Massachusetts Postpartum Depression Commission.
“Even though I had significant risk factors, the system failed to identify me as at risk, and because of that I had no ability to prepare myself or my family and put safeguards in place, know what to look for and get myself the support and help that I might need to handle the situation.”
Friedman said that while her medical providers were well qualified, “they were all functioning within a system that does not have the proper protocols in place to care for mothers" when it came to issues like postpartum depression.
The state commission she serves on was established by law in 2010, and tasked with addressing postpartum depression statewide, and assisting the Department of Public Health Commission. Members met recently in Boston to discuss screening recommendations, and new initiatives to address perinatal mental health in the Commonwealth.
MotherWoman supports and empowers mothers to create personal and social change by building community safety nets, impacting family policy and promoting the leadership and resilience of mothers through support group development, community-based perinatal mental health response and professional training for providers.
Services for mothers include support groups, mental health clinicians and centers, prescribers, supports for young mothers, early intervention and other supports, crisis resources and online resources.
MotherWoman partners with community partners and leaders to work with providers to create a comprehensive perinatal mental health support system so that all mothers are screened, supported and connected with resources when they most need them, Friedman said.
Anxiety, intrusive thoughts, compulsive worry about the infant, constant crying, inability to leave the house and inability to sleep even when the baby sleeps can be symptoms of perinatal emotional complications and deserve to be taken seriously, Friedman said.
“Any mother who is experiencing additional stresses during pregnancy and the postpartum time, such as a difficult pregnancy, traumatic birth, premature baby or infant health complications, breast feeding complications, financial stresses and family crisis, such as death and loss of job, can have an impact on maternal mental health," Friedman said.
"Poverty and isolation are the highest risk factors for perinatal emotional complications.”
Any mother who has these risk factors, or is experiencing these types of symptoms, should seek from a qualified provider, Friedman added.
“Help is available, and can make a significant difference to a mother’s experiences, her recovery and getting on her feet,” she said, adding that parental mental health can have a significant impact on infant's mental and physical health, school readiness and behavioral development.
For her, the worst part of perinatal emotional complications was the fear that she would not recover, that there was something irreparably wrong with her, that she was crazy.
“This is a very common fear of mothers who are experiencing perinatal emotional complications and one of the first fears that we help assuage when educating providers, mothers and in our support groups,” Friedman said.
“When a mother is reassured that she will recover, that there is help available and that many other mothers have experienced just what she is experiencing, then the feelings of ‘losing one’s mind’ diminish and the ability to find her own resilience and identify resources to help can increase.”
There are several perinatal mood and anxiety disorders including postpartum depression, postpartum anxiety, postpartum panic disorder, postpartum psychosis and antenatal depression.
“Women can recover, heal, be excellent mothers with PPD and PPA and other perinatal emotional complications,” Friedman said.
“Perinatal emotional complications do not define how you are as a parent. And if you're having difficulty parenting, because of intense emotional complications, it's a good time to ask for help from friends, family, religious community, professionals.”
The best way for a mother to be able to disclose her struggles is for friends, family members and providers to be the first one to broach the subject, Friedman said.
Friedman encourages simple statements from supportive individuals such as: “Did you know that one in eight mothers experiences depression and/or anxiety during their pregnancy, and after the baby is born?” or “It’s really common for you to feel overwhelmed and fragile after a new baby is born. If you are feeling really intense feelings, there are supports available to help you with the adjustment to motherhood,”
If you are concerned about a mother or about yourself, Friedman offers this advice:
+ Support her: Help her with the basics--baby care, food support, sleep and recovery from birth, breastfeeding and sleep deprivation.
+ Educate her: Give her information about perinatal emotional complications.
+ Empower her: Help her get more resources and support her to utilize resources that are good for her--mental health, community and family support, complementary therapies, early intervention support.
+ Normalize her experience: Tell her that there’s nothing wrong with her, that she will recover, that she is just the right person to be her child’s mother.
“The one reality of postpartum emotional complications is that in no way does our own mental health challenges keep us from fully loving our children,” Friedman said.
“Many, many mothers--in the heart of their darkest days with perinatal emotional complications--have unending and bottomless love for our child/ren and do the very best that we can for them given our own struggles.”
For more information, go to www.MotherWoman.org.
On Nov. 20 from 5:30 to 9 p.m., there will be an educational opportunity for providers offered by MotherWoman, in coordination with Mercy Medical Center, entitled “Promoting Perinatal Emotional Health: Best Practices for Perinatal Depression Universal Screening.” Registration required by via email to alice.hodge@sphs.org. Cost is $75 and CEU's are available. The session will take place in the center's Deliso Conference Center.