May is National Maternal Mental Health Awareness Month. Perinatal mood disorders (depression, anxiety and more) are the most common complication of pregnancy and/or postpartum.  It is estimated that one in five pregnant people are dealing with the challenges of pregnancy mood disorders.  One in seven people transitions to life with a new baby while also suffering from a postpartum mood disorder. 

Childbirth educators would be remiss if they did not allocate time during classes, from the very first moment of connection onward, to discuss this topic.  Based on the above estimates, 20% of the people sitting in your classes preparing for their labor and birth are already dealing with a mood disorder but may not have the information or the bandwidth necessary to receive the support they need during this vulnerable time.

It is not uncommon for pregnant and postpartum people to have a bad day here and there, the kind of day where nothing seems to go right, where everything feels out of whack.  It would be simple to dismiss those times as “just a bad day.”

But what happens when the bad days keep coming?  Are there more bad days than good? If that is the case, the pregnant or postpartum person might be downplaying or dismissing symptoms of a mental health disorder. Mental health is critical, and most importantly, treatable.

The types of mental health illness that folks may face during the childbearing year include depression, anxiety, OCD, bipolar disorder, and psychosis.  It is not uncommon for people to downplay the symptoms, after all, this is supposed to be a “happy” time. According to Postpartum.net, it is estimated that up to 70% of people hide or downplay their symptoms during this time.  This is a big problem.  When people minimize symptoms, by definition, they feel small or unimportant, and when they are considered unimportant, there’s no reason to get support or treatment.

The truth is, mental health is just like physical health. If someone had a high fever and/or trouble breathing, they would seek medical attention. If they have recurring, troubling thoughts or feelings that won't go away and impact their everyday well-being, it's equally important to get medical treatment.

When not treated, mental health disorders can impact a person’s ability to function, as well as impact the health, growth, and development of their child -- during pregnancy and childhood. The first step to getting help for perinatal mental health is to recognize the symptoms. Symptoms of mental health issues include:

• Anger, sadness, irritability, guilt, lack of interest in the baby, changes in eating and sleeping habits, trouble concentrating, thoughts of hopelessness and sometimes even thoughts of harming the baby or self
• Extreme worries and fears, often over the health and safety of baby, panic attacks, shortness of breath, chest pain, dizziness, a feeling of losing control, and numbness and tingling
• Repetitive, upsetting and unwanted thoughts or mental images (obsessions), and sometimes need to do certain things over and over (compulsions) to reduce the anxiety caused by those thoughts
• Flashbacks of the trauma with feelings of anxiety and the need to avoid things related to that event
• Bipolar mood disorder includes "low" phases and "high" phases. The low time is called depression and can appear as severe depression. The high time is called mania or hypomania and shows symptoms of euphoric, elevated, expansive or irritable mood with increased energy; racing thoughts; frenzied speech/speaking; decreased need for sleep; grandiose thoughts; restlessness; quickly changing topics in conversation to things that don't relate; impulsivity or poor judgment.
• Seeing and hearing voices or images that others can't -- hallucinations; believing things that aren't true and distrust those around them; confusion and memory loss; seem manic. Immediate help and care is needed immediately for these symptoms.

Once the symptoms are recognized, the impacted person should seek out professional support. This includes an appointment or discussion with:

• Licensed mental health professional, including counselor, psychologist, psychiatrist
• Call into the free PSI helpline: 1-800-944-4773 (or text: 503-894-9453)
• Family physician
• OB/Gyn

Childbirth educators can be sure that they are sharing information with families from the very start.  Resources can and should include local support groups, postpartum doulas, hotlines and more.  Spiraling the topic throughout the course is critical so that people leave with the message that perinatal mood disorders are both normal and treatable.  How do you cover and normalize the topic of perinatal mood disorders in your classes?

image source: https://wmmhday.postpartum.net/

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