1 / 48

Everyone Wants to Hold the Baby, Who Will Hold the Mother?

Everyone Wants to Hold the Baby, Who Will Hold the Mother?. Jabina Coleman, LSW,MSW,CLC,IBCLC. Owner & Founder, LIFE HOUSE Lactation & Perinatal Services, LLC Co-Founder, Perinatal Mental Health Alliance for Women of Color. Objectives:.

bluma
Download Presentation

Everyone Wants to Hold the Baby, Who Will Hold the Mother?

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Everyone Wants to Hold the Baby, Who Will Hold the Mother? Jabina Coleman, LSW,MSW,CLC,IBCLC Owner & Founder, LIFE HOUSE Lactation & Perinatal Services, LLC Co-Founder, Perinatal Mental Health Alliance for Women of Color

  2. Objectives: • Describe the continuum of Perinatal Mood & Anxiety Disorders • Understand who’s on the frontline supporting women and families • Understand the importance of assessing, diagnosing and referring

  3. This hurts I’m scared

  4. Universal Needs of all Mothers Companion or Spokesperson Universal Needs of all Mothers Supportive or trained professionals Time & space to share experiences Jane Honikman

  5. We are all on the frontline

  6. What is Postpartum Depression?

  7. isolated • scary Intense worry paranoia • afraid • lack of appetite • insomnia • alone • killing oneself

  8. PERINATAL MOOD ANXIETY DISORDERS PMAD NOT PPD

  9. Why Should We Care About PMADS? • #1 Medical complication related to childbearing women • Detectable • Treatable

  10. 1 in 7 Women will suffer from Perinatal Depression within one year postpartum

  11. 1 in 3 Women of Color experience postpartum depression during the first year postpartum.

  12. 50% In the most recent study conducted by the Philadelphia Maternal Mortality Review board 50% of women who died within one year postpartum between 2010-2012 had a mental health diagnoses...

  13. Depression/Anxiety Panic OCD PTSD Psychosis PMADs consists of...

  14. Theories of PMAD Etiology • Biological Sensitivities • Vulnerability • Psychological • Social/Environment • Spiritual beliefs

  15. Postpartum Blues or Depression? Severity Timing Duration

  16. Baby Blues: The Non-Disorder • Affects 60-80% of new moms • Symptoms include crying, feeling overwhelmed with motherhood, being uncertain, MILD • Due to extreme hormone fluctuation at the time of the birth • Lasts no more than 2 days to 2 weeks • Acute sleep deprivation and fatigue

  17. Sadness, crying • Unexplained physical complaints • Suicidal thoughts • Appetite changes • Sleep disturbances • Poor concentration/focus • Hopelessness and helplessness Postpartum Depression Symptoms

  18. Agitated • Inability to sit still • Excessive concern about baby’s or her own health • High alert • Appetite changes Postpartum Anxiety

  19. Episodes of extreme anxiety • Shortness of breath, chest pain • Rapid heart rate, trembling, hot flashes • Restlessness, agitation or irritability Postpartum Panic

  20. Intrusive, repetitive thoughts • Tremendous guilt and shame • Horrified by thoughts • Hypervigilance • Moms engage in behaviors to avoid harm or minimize triggers Perinatal OCD

  21. Things to Note about Perinatal OCD... • Often occurs along with depression • Because women with OCD will not discuss thoughts, providers MUST ask about scary thoughts

  22. What is Trauma? • Direct or indirect experiences with the traumatic event • Witnesses the traumatic event in person • First-hand, repeated or extreme exposure to aversive details of the traumatic event

  23. Postpartum PTSD Symptoms • Re-experiencing the traumatic event • Isolation from family & friends • Emotional numbing • Hyperarousal or hypervigilance • Avoidance

  24. Perinatal Trauma • Emergency C-section • Postpartum hemorrhage • Premature birth • Infant in NICU

  25. PTSD Due to Birth Trauma • Avoidance of aftercare • Impaired mother-infant bonding • PTSD in partner who witnessed birth • Sexual dysfunction

  26. PTSD in NICU Parents • Neonatal complications • Lower gestational age • Greater length of stay in NICU • Stillbirth • Intrusive memories of infant’s hospitalization • Avoidance of reminders of childbirth

  27. Delusions Hallucinations Insomnia Confusion/disorientation Rapid mood swings Waxing and waning Postpartum Psychosis (PPP)

  28. PPP Prevention • Remain on medication • Immediate postpartum treatment • Good sleep is essential (Bergink et al. Am Psychiatry. 2012 Jun;169(6):609-15)

  29. Postpartum OCD vs. Postpartum Psychosis • Women recognize thoughts images are unhealthy • Extreme anxiety related to thoughts/images • Overly concerned about “becoming crazy” • Women do not recognize actions • Thoughts are unhealthy • May seem to have less anxiety with indulging in thoughts and behaviors

  30. Postpartum Mood Disorders in Dads/Partners • Initial high after birth may give way to depression • Rather than sadness, men may be more likely to be irritable, aggressive and sometimes hostile when depressed • Distancing “checking out” • Distractions and habits

  31. Barriers to Perinatal Mental Health Care nt dkkdkl

  32. Which came first, breastfeeding issues or PMAD?

  33. Three Choices... • Expose the baby to medication through the breast milk • Expose the baby to the adverse effects of untreated depression in the mother • Take antidepressant medication and wean from breastfeeding the baby

  34. Ask the Question: You Can’t Tell By Looking

  35. I ‘m making it work I’ve been having headaches. I’ve been snap[in”

  36. Responding to suicide risk • Assess whether she has a plan or is describing an intrusive thought or non-lethal wish • Gather history of any personal or family suicide attempts to assess risk factor • Educate regarding phases of recovery; reassure her that her acute symptoms will pass • Acknowledge her wisdom in being honest

  37. Screening Vs. Diagnosis Screening tools ARE NOT diagnostic

  38. Barriers to Screening

  39. Responsible Screening • Preconception • Screen at the first prenatal contact • Every trimester • Postnatal visit • Well baby visits • Intervene early • Refer rapidly • Follow up • Mobilize support: family, community, professional

  40. You are not alone • You are not to blame for what you are feeling • You will be well and feel like yourself again- this is treatable. Universal Message

  41. Who’s holding the mother? Ashley Lukashevsky

  42. Trust that clients are the experts in their own lives. Listen what clients are saying about their priorities, concerns, and needs; challenge ourselves to hear what clients may and may not be saying. Support clients’ decisions about how to care for their families and support them to reach their goals. Trust Listen Support

  43. Thank You Jabina Coleman Life House Lactation & Perinatal Servicesjabina.coleman@gmail.com Perinatal Mental Health Alliance for Women of Colorwww.pmhawoc.org

More Related