It’s not just the blues

Mom looks to help moms share postpartum troubles
By Casey Farrar
Sentinel Staff
Published: Wednesday, May 27, 2009
The day she went home from the hospital with her newborn daughter Adlay Rose, a weight settled heavily on Caitlin R. League.

She had already been battling physical illness and depression throughout her pregnancy and coming home made the new Keene mother feel even more overwhelmed and anxious.

“I felt the earth go out from under me pretty much,” League said. “I was just panicking about panicking, panicking about being alone with her. I almost would say it was performance anxiety.”

Fortunately, she’d already met with Amanda R. Houle during prenatal visits and knew she could turn to her for help. Houle is a behavioral health consultant for Monadnock Family Services at Cheshire Medical Center/Dartmouth-Hitchcock Keene. She works with pregnant women and new mothers through a pregnancy wellness program at the hospital.

Part of her work involves teaching women how to deal with depression, anxiety and other mental health issues associated with pregnancy and offering resources for support.

For League, taking advantage of the available resources in the community for new mothers, getting counseling and taking medication helped her deal with the postpartum depression she was facing. It’s been nearly a year since Adlay was born, and now her mother’s starting a peer support group for mothers grappling with feelings of anxiety and depression during and after pregnancy.

“It’s hard to talk to other moms that don’t feel that way and they don’t know how to empathize with what you’re going through,” League said. “They say, ‘Oh it’s normal, it’s just baby blues.’ ”

Between six and 13 percent of women suffer from minor or major depression after childbirth, according to Postpartum Support International, a California-based organization.

But that is just one of a spectrum of what are known as “perinatal mood disorders” — ranging from depression and anxiety during pregnancy to postpartum depression, panic disorders, obsessive-compulsive disorders, post-traumatic stress disorder and psychosis.

Because there has been growing awareness of pregnancy-related depression, new mothers may overlook symptoms of other disorders, Houle said, which can begin before delivery or be delayed days or even months after.

They can include sadness, loss of appetite, sleep disturbances, lack of interest in the baby, anger and fear. Postpartum psychosis, the rarest and most severe of pregnancy-related mood disorders, can include delusions and hallucinations.

League said exhaustion added to her anxiety and she eventually decided to go on medication and stop breast feeding.

Along with League’s husband, Rob, other members of her family helped take care of the baby when she needed to rest.

“I almost knew, intuitively, that I needed to stop breast feeding for myself to remain sane because when I wasn’t breast-feeding it allowed other people to come in and take care of her more easily,” League said. “It took a lot of anxiety off of me. But it was still hard, there’s still a lot of guilt around that.”

There is also a misconception, says Houle, that taking medication to treat depression will mean mothers have to stop breast-feeding.

“There are medications that are perfectly safe to take while breast feeding,” Houle said. “We know that breast-feeding is very helpful for mom and baby, but we also know that it can cause more distress. It’s important to look at safe options for moms related to medication or natural options.”

Along with the hospital’s program, which includes check-ups with new mothers immediately after giving birth and six weeks later to identify any possible risks, a handful of other agencies in Keene provide support for mothers.

Sophia’s Hearth Family Center, which is hosting League’s new support group (see related box for information), hosts play groups where parents have a chance to chat and children can socialize, according to Nancy E. Macalaster, director of family programs.

The groups allow parents a chance to build relationships and share tips and ideas, Macalaster says.

“What we have noticed in terms of the postpartum challenges is that the parenting groups, particularly the littlest ones, afford a place where a woman can voice her experiences,” Macalaster said. “The first task is to build a relationship and since many of the same moms come regularly, it provides a safe place to say they’re having a hard time.”

Monadnock Family Services, a Keene-based mental health organization, also runs several support programs, including Baby Time, a program that provides health, parenting information, support and visits from a nurse.

Mary E. Mullen-LaValley, an early childhood and family educator at the agency, says new mothers are often relieved to hear that their feelings are normal.

“It serves as a reassurance to know that if you’re eating too much or too little or crying a lot, can’t wake up or can’t fall asleep these are very shared experiences and beyond your control,” Mullen-LaValley said.

The agency also hosts free play groups where parents can meet each other and talk about challenges they’re facing.

Parents can also get support through a maternal and child health program at Home Healthcare, Hospice and Community Services.

In addition to starting the support group, League has also taken on an initiative to increase collaboration between the local agencies that work with new mothers.

She’s heading up a task force that includes representatives from local agencies to compile information about what’s out there — and what needs to be.

The group has already discussed starting a program where local volunteers can visit new mothers and help with child care to allow mothers time to relax or sleep, she said.

Another idea League hopes to build on is having volunteers call to check in with mothers and look for early warning signs of a problem.

“There’s already a system where lactation specialists call to check on how breast-feeding is going,” League said. “This would be like that, but it would be about the moms. Just someone asking, ‘How are you doing, mom?’ ”

While she knows that she can’t stop other new mothers from going through what she experienced, League said her goal is to help them understand they’re not alone.

“It’s a lot easier if you know that this happens to other people too and you don’t have to feel bad about it,” she said.

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