Editor’s Note: The following is part of a class project originally initiated in the classroom of Ball State University professor Adam Kuban in fall 2021. Kuban continued the project this spring semester, challenging his students to find sustainability efforts in the Muncie area and pitch their ideas to Ron Wilkins, interim editor of The Star Press, Journal & Courier and Palladium-Item. This spring, stories related to health care will be featured.
Cora Brown, a first-time mother to her 8-month-old daughter, Rayleigh, was diagnosed with depression and anxiety before she was pregnant, but Brown said her depression became worse during her pregnancy.
“I felt so isolated and so alone during the whole pregnancy,” the first-time mother said, explaining that she did not want to be alive and she felt horrible every second of the day.
She talked with her doctor, who is woman, about her feelings, but she felt the doctor brushed off her depression as “normal” for a pregnant woman.
Two months after having her daughter, Brown felt like she was the only parent.
Brown, 20, lives with three other people: Taylor, who is her significant other and Rayleigh’s dad, Taylor’s brother and his mother.
Brown said she did not get a lot of help from those around her until she explained to them that she needed help.
“I started to feel alone and like I was the only one doing any of the work,” Brown said. “My mood started tanking again, and I still haven’t fully recovered from it.”
Brown said she loved being pregnant with her daughter, but she also does not want to do it ever again.
Licensed mental health counselor Mandalyn Castanon said the most common issues are postpartum depression and postpartum anxiety, while on the more severe side of the spectrum is postpartum psychosis. This is where a mother is extremely confused, has lost touch with reality and sometimes plans to hurt the child, according to the Cleveland Clinic.
Study finds more cases of postpartum depression
According to a 2020 study by Rada Daghar published in the 2021 “Archives of Women’s Mental Health,” out of a sample of 1,573 women, approximately 61.7% of the mothers met the threshold for minor or major depressive symptoms. This is higher than found in previous studies. About 19% sought mental health consultation, while the majority went to the follow-up maternity care visits that occur at three to eight weeks after birth.
If postpartum mental health goes untreated, it can become significantly worse, Castanon said.
For the family of the mother, it is important to understand that the mother is going through the emotions of being alone and that they need to pay attention to the mother to be able to recognize increased symptoms of depression or anxiety, Castanon said. Family members can help by making sure the mother attends all her postpartum check-up appointments because the doctor’s office will use a postpartum mental health screener to help indicate if the mother is suffering from some type of issue.
“Mothers might feel detached from their children, feel like bad parents, and they might feel isolated and alone from the rest of the world,” Castanon said.
Sandra Hobson, a nurse midwife for 23 years, said the experience after birth is different for everyone. The mom’s hormones are everywhere, and that is normal for a period of time. However, if the feelings are longer than the two weeks that are considered “baby blues,” it is time to consider mental help.
“If you can’t do what you need to do with life (and) with your baby, then it is a whole different matter,” Hobson said. “If it impacts your daily life in a negative way, you might need to be seen about it.”
Mental health can change after giving birth
A 2020 study by Desiree Phua, published in “Front Psychiatry,” talks about how maternal mental health can develop prenatally and predict postpartum mental health. The findings indicate that out of the 1,150 women who were studied, their symptoms of depression and anxiety were different between being pregnant and postpartum.
Their symptoms were mainly related to feeling worthless or useless. After the pregnancy, they felt like they were being punished and felt overwhelmed. This study suggested that anxiety symptoms may precede the feeling of maternal depression and that public health policies should be tailored to specific pre and post-partum symptoms.
“When a person comes in for labor, they do the Edinburgh survey, and that gives us a little view on how they are doing mentally, and it can put up some red flags,” Hobson said.
The Edinburgh Postnatal Depression Scale is a self-reporting survey.
According to the American College of Obstetricians and Gynecologists, screening for antepartum and postpartum depression is suggested, however, there is not enough evidence to suggest a universal screening.
The Edinburgh survey asks 10 questions, including one involving suicide ideation or thoughts of suicide. With a score above 12 out of 30, mothers are suggested to gain help either through medication or therapy.
According to an article written by Dr. Kathryn Hirst about postpartum depression, she found that up to 60% of women with postpartum major depression may have obsessive thoughts focusing on aggression toward their infant. Therefore, it is important to recognize the symptoms and signs of postpartum mental health issues.
How to help
Castanon said that those around the mother can help her by paying attention to her, letting her take care of her basic needs, and letting her take time for herself so that she is able to be fully present with the baby and the rest of the family. She also mentions that most community mental health centers have some type of program specialist or therapist to help those with postpartum mental health.
The Pregnancy Promise, an Indiana-funded program which connects individuals to prenatal and postpartum care, also offers cares for other physical or mental health care and treatments for opioid-use disorder.
This program provides support during the prenatal, or pregnancy period, and for 12 months after the end of the pregnancy. There is also an Indiana catalog of resources for mothers who are searching for help, including maternal mental health support groups, mental health virtual support, community and family programs, and more.
