Maternal Mental Health: An Advocate’s Call-to-Action

May 9th, 2014

by Katherine Stone
Postpartum Progress

Postpartum depression (PPD) is real. It doesn’t go away with a 10-day course of antibiotics. It doesn’t reward those who exercise the best, or eat the best or pray the best. It’s not a thing that wanders off without incident when it gets bored with you eventually.

Moms don’t know this. Hundreds of thousands of them every single year either don’t recognize they have a real illness or do recognize it but believe it will just go away on its own. No harm, no foul.

That’s not true. Women with moderate to severe PPD need professional help to fully recover, and yet one study found that only 15% of the three-quarters of a million or so women who get this illness every year ever get treated. Can you imagine?

We don’t talk about the cost our nation’s families are paying, even though the evidence is everywhere.  Just ask the National Center for Children in Poverty, which states that “Maternal depression and anxiety is a stronger risk factor for child behavior problems than smoking, binge drinking and emotional or physical domestic abuse.” When moms with PPD go untreated, their children are more likely to have cognitive and behavioral problems, poorer school performance, aggression issues, and future psychiatric illness themselves. Not to mention that suicide is a leading cause of death of women in the first year postpartum.

It’s tough to talk about the downstream consequences of untreated PPD because it makes it appear as though I’m blaming the victim, when that couldn’t be further from the truth. Moms who experience perinatal mood and anxiety disorders – we call them Warrior Moms at Postpartum Progress – are my life’s work. I am absolutely dedicated to them in every way. I know as a survivor myself that we don’t ask for these illnesses, didn’t cause them, feel terrible guilt and shame because of them, and would get rid of them in a hot second if we could.

So the only possible explanation for all the damage maternal mental illness is doing to hundreds of thousands of children and families in the US each year is not that moms are at fault, it’s that moms don’t even know. They don’t know how to recognize the difference between normal new mom stress and maternal mental illness. They don’t know that if they have moderate to severe PPD it’s very likely going to take more than exercise or healthy food or a boot-strap mentality to address their symptoms. They don’t know that by asking for and getting help they are honoring their own value, which is certainly important, but they are also providing an exponentially greater benefit to their children.

There’s a lot of finger pointing and deflection in maternal mental health. We haven’t been properly trained. We don’t have effective referral networks.  There’s no clear process. We’re not sure who is supposed to do what and when. There’s no budget. There’s no time. All of that is absolutely true. I understand. But as the leader of a patient-centered nonprofit I can tell you that none of that matters to the moms. We will work with you to do whatever it takes to prevent suffering. We don’t care much about barriers.  The health of our nation’s families is at stake.

To me the heroes in all of this are the moms who figure out how to get past the stigma and fear and plentiful barriers and ask for help. The healthcare providers who, by hook or by crook, do everything they can to watch out for these illnesses and help their patients even when there is no mandate or referral network or time or clear process.  We owe these people – the moms and the providers – better.

The work has already started. In the last decade I have seen more pediatricians, OBs, midwives, doulas, visiting nurses and others individually take on this issue. I have seen more specialists popping up around the country. More mothers speaking openly about their experience so that someone else might benefit. Organizations (including HMHB!) starting to come together to form the National Maternal Mental Health Coalition. I’m thrilled to see this movement. But I also know that it’s just the teeniest, tiniest tip of the proverbial iceberg. It’s time to kick it up a notch. There is no doubt in my mind that we can do this