intensely trivial



KC Birth Network conference: Perinatal Mood Disorders

This is the second in a series of posts about what I learned at the KC Birth Network conference Apr. 23-24. As a birth doula, I specialize in helping the mother prepare for her birth in the prenatal period, and I’m there to support her at the birth. I feel less competent at the follow-through aspects in the postpartum period, even though I try. But it’s the postpartum period where the largest chunk of transition must take place, that grand transition to mothering a real live baby and figuring out what it means to be a family. So I really tried to learn as much as possible from the presentation about perinatal mood disorders.
Meeka Centimano, LSCSW, founded the Postpartum Resource Center of Kansas, in Kansas City, after struggling through her own postpartum depression. Here are some of the highlights from her talk about perinatal mood disorders:
— perinatal mood disorders affect not just the mom, but the whole family
— in attachment and bonding, baby teaches mom how to interact with him/her
— “from birth, mom socially engages baby while feeding, diapering & bathing”; when baby withdraws, mom engages baby, and baby responds: baby is teaching mom his communication system
— depression interrupts this system, disrupting baby’s ability to bond
— 63% of mothers experience some level of depression or anxiety 2-12 mos. postpartum (childbirthconnection.org)
— estrogen, progesterone reach peak levels during pregnancy; as soon as placenta is delivered, these levels plunge –> vulnerability to mood disorders
— medical risk factors that are “dead ringers” for perinatal mood disorders: personal or family history of mental illness, history of severe PMS or PMDD, prior incidence of perinatal mood disorder, difficulty tolerating birth control, family member self-medicating through alcoholism or chain smoking
— emotional risk factors: #1 risk factor is high partner conflict; also loss, early childhood experiences, and birth trauma
— social risk factors: isolation, lack of understanding, absence of partner or family, early discharge from hospital, financial strain
— having a baby cranks up the heat on all the old problems
— we have a cultural taboo against mothers having mixed feelings
— 1 in 5 women suffer postpartum mood disorders in a way that requires extra help

Types of postpartum mood disorders
1. postpartum depression
2. postpartum anxiety — symptoms: insomnia, sweating, can’t turn brain off, hot/cold flashes, restlessness, fears around baby, seemingly disinterested in baby
3. post-trauma (PTSD) — 1 in 3 women, upon birth; trauma is in the eye of the beholder; gap between what’s expected & what happens; birth can be traumatic because she didn’t have a voice and played the good patient; often has a history of rape or childhood sexual abuse; derealization; insomnia, racing thoughts, racing heart
4. postpartum OCD — intrusive thoughts, images of accidentally-purposely hurting baby; these women least likely to talk about their problem, going inward with these thoughts; highest risk of suicide; get obsessed with an image and then obsess about how to prevent it

How to help women with perinatal mood disorders
— “normalize” postpartum mood disorders (take away the taboo)
— get comfortable with being uncomfortable
— ask the scary questions (she wants you to)
— assure her you can be helpful!
— **assure her that you will be with her**

Treatment
Medical care rules out thyroid imbalances; could be pharmacological or nonpharmacological
Can a mother take medication during pregnancy or while breastfeeding?
— there is no such thing as non-exposure; either medical or through mother’s “natural” hormones
— highly anxious mother is bathing her baby in cortisol
Social support for healing:
— telling the story, diminishing the power of the negative experience
— empowerment
— connection
— safety & comfort in sharing negative feelings
— spiritual guidance
— practical support
— encouragement for parenting

For further information:
Puryear, Lucy. Understanding Your Moods When You Are Expecting.
The Postpartum Resource Center of Kansas. http://www.kansasppd.org/
Postpartum Support International. Cheryl Tatano Beck. www.postpartum.net
Meeka Centimano’s website. www.centimano.com

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Comments

  1. * Shelley C says:

    These are such informational posts. Thanks you for sharing what you learned, and I hope you were able to speak with St. Ina!

    Posted 7 years, 6 months ago


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