Supporting Maternal Mental Health: 6 Things Everyone Should Know

Statistically, only 25% of women get the perinatal mental health support they need. It’s going to take a village for us to change that. Every single one of us either knows someone or will know someone who is trying to conceive, pregnant or in the postpartum period. 

That’s why Partum Health and the YMCA of Metropolitan Chicago came together to host experts in the postpartum and perinatal mental health field to discuss the facts everyone should know about Perinatal Mood and Anxiety Disorders and how to combat them. Here are six key takeaways from our program with panelists Partum Chief Medical Officer Dr. Melissa Dennis, Perinatal Clinical Psychologist Dr. Nicole Tefera, and Chief Economic Inclusion and Equity Officer of the YMCA of Metropolitan Chicago Martina Hone:

1. 3 out of 4 women experience the baby blues(!). But Postpartum Mood and Anxiety Disorders (PMADs) extend beyond the baby blues–and their consequences can be lethal. The perinatal period is defined as during pregnancy through 12 months after giving birth. During that time, lots of changes take place–not just within your body, but adjustments to work, and family and financial dynamics. Because the baby blues are so common, it’s become easy to normalize conditions beyond that. Those conditions can include panic symptoms disorder, panic episodes, obsessive compulsive disorder, perinatal bi-polar, psychosis (which requires immediate intervention) and PTSD–particularly if they’ve experienced a traumatic birth or a history of trauma.
   
   It’s critical that we all become aware of the spectrum of conditions so we can support and advocate on behalf of the parents in our lives.

2. Preventative and interdisciplinary care does help. You can get started with a therapist preventatively. By establishing that relationship in advance, it’ll be much easier to reach out for help if you start to struggle postpartum. And it’s even better if that person can reach out to you during critical junctures to see how you’re doing. It’s also important to remember how interconnected your mental health is with all the other facets of the postpartum period. Breastfeeding and sleep struggles are proven to put a mother at risk for postpartum depression. It’s a novel idea for your lactation consultant and postpartum doula care to be connected to your mental health provider–but it’s also what the standard of care should be.
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3. It’s okay to not be okay–and trust your gut on when it’s time to take action. It doesn’t matter how much you wanted to have a baby or how long and hard you tried to get pregnant. You’re still allowed to feel blue. Almost everyone sheds some tears during the newborn period or feels frustrated, worried that they’re not doing this right. It’s unrealistic to expect that you’ll be over-the-moon all the time. But, knowing the warning signs in advance can help you figure out when it’s time to seek help.
   
   Treatment can extend beyond therapy to include medications that are safe during the perinatal period. Remember: No one knows you better than you. Don't let someone else tell you that you are OK when you know that you are not.
   
   
4. It may sound cliche, but connect with others: Talk to your friends. Talk to your family. Talk to your postpartum doula or other care providers. Talk to other mothers or join a support group–and don’t be afraid to talk about the struggles that you’re having. The worst thing you can do is isolate yourself and suffer in silence, because that’s when your mind can start to spiral: Thinking you’re not good enough or not doing this right. Wondering why you can’t do this or if your baby even loves you. These are the times when it’s more important than ever to talk to someone.

5. Race-based health disparities persist. The maternal health crisis negatively affects Black women more than any other community. Black women experienced 49.5 deaths per 100,000 people–that’s over 2.5 times the rate experienced by white women.  That's compared to 19 per 100,000 for white women, 16 per 100,000 for Latinas, and 13.2 per 100,000 for Asian women. For some, these stats aren’t new, but until we see meaningful change in the system, it’s important for us to repeat them every time.
   
   
6. Pregnancy can be risky–and that’s why whole-person care is so important. Dr. Dennis shared three key reasons we need to shift our thinking towards whole-person care during pregnancy:
   - It’s important to identify any chronic conditions the mother is dealing with, as pregnancy can often add to or exacerbate those. It’s better to catch problems before new ones can begin.
   - Pregnancy is a captive audience. It’s a time in life when everyone has access to health insurance and most people do access prenatal care. If during this time, we don’t act upon diagnoses that are present or work on preventative health, we’re missing a huge opportunity
   - Things change a lot after you deliver–and you typically only have one appointment with your OB or midwife postpartum. But what about getting back to you, again? That’s where whole-person care, whether it’s working on mental health care or physical therapy, working with other specialists is so important.
   

Dr. Tefera also shared a list of resources to keep on hand if you don’t have a care team in place or need additional support:

1. Postpartum Support International Helpline: 1-800-944-4733 / Text in English: 800-944-4773 / Text en Espanol: 971-203-7733
2. The National Maternal Mental Health Hotline: Call 1-833-TLC-MAMA (1-833-852-6262). This free, confidential service provides access to trained counselors and resources 24 hours a day, 7 days a week in English, Spanish, and more than 60 other languages. They can offer support and information related to before, during, and after pregnancy.
3. Text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org
4. National Maternal Mental Health Hotline (HRSA): 1-833-943-5746