Friday, December 23, 2016

When Something Isn't Right

Heather Wilson, Early Childhood Support Team Leader at NCSS, notes that many expectant mothers feel thrilled about the upcoming birth of their child; they expect motherhood will be fulfilling and sublime, but when the baby is born, they might not feel that way at all. Mothers may experience depression, anxiety, Obsessive Compulsive Disorder or Post Traumatic Stress Disorder following a traumatic birthing experience. Feelings of depression, compulsion, or anxiety do not mean someone is a bad mother and they do not mean she doesn’t love her baby. Every mother has her own story, says Heather. “We want [expectant and postpartum mothers] to know we’re here to help. We want to be a source of light during a time of darkness and provide comfort to unsettling distress.”   

Anna Gabaree knew throughout her pregnancy that she was at risk for postpartum depression and anxiety, and she knew what signs to look for. As soon as her baby was born, she felt a change instantly, like something wasn’t right. For Anna, the symptoms didn’t manifest in depression—as most people might associate with struggling new mothers—rather, she feared for her baby’s safety to a degree that was harmful. She would sit awake and stare at her daughter through the night fearing that something would go wrong and her baby would die. After feeding, Anna wouldn’t allow herself to leave her baby’s side for even a moment, worrying that something terrible would occur in her absence. As her daughter grew a bit older, she felt intense anxiety that she was doing everything wrong: she hadn’t read to her daughter enough; she hadn’t cleaned up enough; she hadn’t completed enough puzzles with her child. Like many mothers, Anna held it together at work and with her friends—people who saw her every day didn’t even know anything was wrong—but on the inside, she was bubbling over with anxiety. On the day she found herself screaming into a pillow to release, she knew she needed to seek help.

As supervisor of the Northwestern Medical Center Birthing Center, Anna was in a knowledgeable position; she knew she was at risk and she also had an understanding of symptoms and the kinds of resources that could help. For expectant or postpartum mothers who are not as familiar, there are screening tools to help identify troubling feelings, like the Edinburgh Postnatal Depression Scale (EPDS) that is used at Northwestern Medical Center (NMC). The EPDS is a 10-question screening tool that asks mothers to consider their feelings over the week leading up to the test. It is intended to be administered with the mother privately; this way the mother has the best opportunity to feel comfortable being honest. The EPDS can reveal results that are then reviewed with the mother’s provider, and referrals can be made from there.
While referrals can come from anywhere, a majority of the referrals to the NCSS Perinatal Mental Health Counseling program come from NMC do to their thorough screening process. The EPDS is conducted after delivery; in the two-three days that a mother stays in the NMC Birthing Center; two weeks after delivery; and again six weeks postpartum.

Sometimes a mother in the birthing unit might feel like something is wrong, but she can’t identify it. These upsetting thoughts or emotions can start during pregnancy. “It can be easy to brush off,” Anna says. “But it’s okay to say that. It’s okay to say ‘something isn’t right. I’m not okay.’” When a woman does say this, Anna and the other nurses in the Birthing center might follow up with questions like, “Can you tell me more about that?” “What are you afraid of?” “What does it look like?” Expectant or postpartum mothers can speak with any of the nurses in the Birthing Center; the nurses can help attach vocabulary and understanding to feelings and also connect mothers with programming at NCSS that can offer further supports. It’s important to have quick access to programs and support, says Anna. A mother experiencing these unsettling and forbidding feelings does not want to wait days to hear from a provider. Within hours, a mother can be referred to the Perinatal Mental Health Counseling program and feel like support is on the way.

The Perinatal Mental Health Counseling program is a unique one at NCSS. Expectant mothers or new mothers who may be experiencing troubling symptoms can receive counseling in their homes from a traveling counselor:  Jessica Dewes, Early Childhood Specialist. Packing up the car and driving to NCSS might not feel feasible for new mothers just adopting a routine at home. Jessica will sit amidst a pile of laundry, or push aside diapers and rattles to engage in a conversation. “Messes don’t matter,” she says, laughing, as though she is recalling messes in her own home that might invite judgement. Jessica can work with families and mothers to reduce symptoms so motherhood can feel enjoyable and fulfilling. Jessica is also able to make referrals to other programs for the family while she works with the mother; as can be expected, the entire family can be affected when one is struggling with a mental health issue. Jessica loves the work she does with mothers, and she is moved by how many community members and mothers are open to the program. It can be difficult to seek treatment; some mothers are experiencing these feelings for the first time, and unfortunately, like many mental health issues, there is stigma attached to postpartum depression and anxiety.

Part of that stigma might come from the media’s portrayal of mothers experiencing depression or anxiety. Often, in movies, TV, and even the news, stories are sensationalized and depict mothers as dangerous to their babies. Within NCSS’s program, counselors and other staff try to break the cycles of stigma. Every mother has her own story and her own journey, and for each of those mothers NCSS can help them to develop some strategies for success. Prior to a diagnosis of symptoms, everything can feel strange, misunderstood, and weird. Jessica says she can tell a mother’s situation is improving when the mother begins to be honest with herself about her feelings. Surrendering can lead to important understanding and reduction of symptoms.

Finding a solid support system that encourages open, honest communication can make all the difference for expectant and postpartum mothers.  For Anna, that meant talking to her family and her doctor. For other mothers, maybe that support person is a sister or a spouse, a partner or a neighbor; maybe it’s the person who delivers the paper in the morning.

The Perinatal Mental Health Counseling program at NCSS is intended for expectant or postpartum mothers in Franklin and Grand Isle counties. If you know of someone who is experiencing any of these troubling symptoms, please reach out. There is no wrong door at NCSS; if you are looking to make a referral to the Perinatal Mental Health Counseling program, please call our main number, 802-524-6554 and someone will be happy to assist you.
Please click on the link to watch the NCSS Here for You episode on Perinatal Mental Health Counseling. In this episode, you can hear Heather Wilson, Jessica Dewes, and Anna Gabaree talk about this unique program.

we’re here for you.

Written by Meredith Vaughn


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