Perinatal Mental Health Hero

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Perinatal Mental Health Hero

I recently was introduced to a Labor & Delivery nurse who is making a huge impact on the state of perinatal mental health care pathways. I could feel the passion come through in her voice as we spoke a few weeks ago on the phone for nearly two hours about what she was doing to raise awareness and increase access to quality care in our local area (Washington, DC metro area) for women who desperately need it.

I asked Kisha to share her story in a few paragraphs, and this is what she sent me to share with you:

“I grew up in the small southern town of Crowley, Louisiana. After graduating High School, I enlisted in the Coast Guard to see the world. I was stationed in Hawaii for 3 years at a small boat station, then became a USCG Dental Technician Petty Officer 3rd Class. My final duty station was at the Department of Transportation in Washington, DC. Prior to leaving the USCG, I became a Massage Therapist. It was during my 5 year stint as a Massage Therapist, that I rediscovered my heart for nursing. I graduated college, became a Registered Nurse, and a mom at 30 years old. After working as a Mother-Baby and Pediatric RN, I took a chance on Labor & Delivery and found my niche in nursing!  Eight years later, I am still working as a full-time night shift L&D RN.

Being a Labor & Delivery RN is one of the most exhilarating & frustrating experiences. Over the years, I have gained invaluable frontline skills, instincts, and knowledge about calming a woman’s fear in the throes of labor and empowering her to embrace motherhood. I am proud of these abilities and love sharing the birth experience with women and their families, but in all honesty the realization of perinatal mood and anxiety disorders (PMADs) prevalence among mothers and its detrimental impact on families has dramatically shifted my perception and purpose. My heart breaks knowing that over 8 years and countless births, 1 in 7 of those pregnant women and new mothers that I cared for inevitably went home suffering in silence from a PMAD. Maybe some of them already knew they were high risk and had support in place, but for many they went home with an infant and the expectation that their mental health was secondary in motherhood. As I continue to bear witness to the subtle shifts that seem ‘normal’ after childbirth (lack of sleep, lack of self-care, lack of support) that directly contributes to this needless suffering, I have found my life’s work is to destigmatize PMADs, while alleviating the unnecessary suffering of these women and their families.

As a frontline nurse, I believe that we as a profession are key to a long overdue paradigm shift in perinatal mental health. We are well-positioned and equipped to assess the mental health of pregnant women and mothers in the acute care setting, provide them with the first aid emotional support they need, and connect them to the appropriate perinatal mental healthcare providers and resources in their community.”Kisha Semenuk is a mama to two young boys. And as a night shift nurse who recently obtained her Masters of Science in Nursing, Kisha completed her Nursing Capstone Project on the knowledge gap she identified when researching perinatal mood and anxiety disorders and effective postpartum depression screening using the Edinburgh Postnatal Depression Scale (EPDS) among frontline perinatal care providers (OBs,Perinatal RNs, & Mother-Baby RNs).Through her deeper research, Kisha became acutely aware that as a frontline RN she was bearing witness to the silent suffering of so many women and families. Nothing was being done about it on the frontline and Kisha wanted to take action to make lifesaving changes.

She began actively networking with frontline OBs and built a team of fellow perinatal mental health champions who helped her to compile and organize an online resource which will allow women and their families to easily locate specialized, local professionals, support groups and treatment facilities. This resource will be kept at the fingertips of frontline nurses who are often the first healthcare professional to recognize the emergence of a perinatal mood disorder.Kisha’s mission with the DMV (DC-Maryland-VA) Perinatal Mental Health Resource Guide is to develop, disseminate, and maintain a comprehensive, up-to-date, regional directory of specialized mental health providers, support groups, advocacy organizations, and other relevant clinical resources pertaining to perinatal mental health. This directory will assist providers, patients, and their families with obtaining specialized mental health evaluation and treatment during pregnancy and postpartum.

How amazing would it be if we could create a guide like this for every city in our country? I am so energized and extremely appreciative of all the blood, sweat and tears she has poured into this project and I cannot wait to see it take off and bring help and relief to so many families who in the past did not know where to turn.

I applaud Kisha’s dedication and drive for instituting change in an area all of us here at Postpartum Progress care deeply about.

{The DC-MD-VA (DMV) Perinatal Mental Health (PMH) Resource Guide is launching online by November 1 and is a result of an ongoing collaboration between the DMV PMH Resource Guide Team and existing DMV-based PMH Professionals and Perinatal Mood and Anxiety Disorders (PMADs) survivor support network. Team members include: Kisha Semenuk, L&D RN and MSN; Aimee Danielson, Director of MedStar’s Georgetown University Hospital Women’s Mental Health Program; Lynne McIntyre, the Mid-Atlantic Postpartum Support International Coordinator/Mary’s Center Maternal Mental Health Program Coordinator; Helen Conway, Psychology Major (C’15) Summer Intern; and Dina Karellas, L&D RN and Nurse Informatics Graduate Student; in addition to Adrienne Griffen, Founder of Postpartum Support Virginia (PSVa), and Nadia Monroe, Founder of Postpartum Support Maryland (PSMd).}

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Arm Yourself with Information

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footprints-sand

A guest post by Kristin Shaw

When I was going through a divorce in 2004, I was sad, hurt, angry, and I cried a lot. A whole lot. I prayed to make the pain stop, and I would call my mother sobbing.

“I can’t take this, Mom,” I would say. I’m sure her heart was breaking for me.

I refused antidepressants and I was determined to beat the pain on my own. I went out with friends, I self-medicated with wine, and I went to the gym for an hour or two a day. My journal was my closest confidante, and I created a mantra: “I will not be bitter. I am strong. I can do this.”

Five years later, with a new life under my belt, I took a hit that was even harder than that one.

In the face of postpartum anxiety and terrible sleep deprivation, I knew I had to beat the creature taking over my existence, but I could not get past it. I tried taking walks with my baby and took deep gulps of air, trying to calm my heart, beating out of control. I told myself that I was stronger than this thing; that I must get past this for our son.

I prayed for my life.

Dear God, I am asking for your help. Please lift me into your arms and help me get through this, the toughest time of my life, so I can enjoy every moment with our precious baby boy. Please continue to give my husband strength to carry all three of us. Help him remember to eat so that he can take care of us. He is my rock here on Earth and I thank you for bringing us together. Thank you for bringing our son into our lives and giving us such a little miracle.

He is such an amazing baby. He is happy and smiling every day, and he rarely cries. Right now he is talking to the animals in his mobile and laughing as he bats at them. He does not notice the tears in my eyes or the deep, dark circles on my face.  We will get through this together, as a family.

Prayer alone did not help, as much as I wanted it to. The anxiety was building and building, and by the time I saw my obstetrician, I had full-out insomnia, was sleeping two hours a night, and was shaking like a vibrating bouncy seat. I could not focus long enough to read one page of a magazine. I hovered over the crib, checking my son’s breathing.

The doctor took one look at my face and could see I was floundering; she diagnosed me with postpartum anxiety, the close cousin to PPD. She prescribed Zoloft to regulate my sleep and anxiety, and it took two excruciating, terrifying weeks for it to kick in.

I nursed and took great care of my son, but I could not figure out how to take care of myself in the meantime. I lost all of my baby weight by the time my son was a few weeks old, which meant I was worrying myself through more calories than I was eating. I entertained the idea of showing up at the ER and begging for a room in which I could just rest.

Even as the Zoloft was working its way into my system, I took Ambien – with great hesitation – to help me sleep. I started with a half of a tablet and slept for three hours in a row. Reading about the side effects of Ambien, I started having nightmares about sleepwalking and trying to care for my son as a zombie. In desperation, I alternated between Tylenol PM, which made me worry about my milk supply since it included an antihistamine, and Ambien, which scared me. I nearly asked my husband to lock me in the garage one night so I could sleep in the car to ensure that I would not sleepwalk.

The light of the mornings saved me, even after a desperate night. I called a friend who had been through similar trials and she listened patiently. Finally, I got back on track. The sun came out. I could see how beautiful my life was again and it was even shinier and more gorgeous than I remembered it. My son smiled through it all – although he’s never been a great sleeper, he was consistent and mellow through his first couple of months.

Every new mother should arm herself with information on postpartum depression and postpartum anxiety, just in case. It’s scary, it’s real, and she may not even know she is afflicted. I’m thankful my husband was there. I don’t know how a single mom could get through that without help, because having someone to lean on meant that I made it through to the other side. Asking for help is hard, and surrounding yourself with people who can help and will help you without question means the world.

Kristin Shaw is a freelance writer, 2014 BlogHer Voice of the Year, and co-producer of the Listen to Your Mother show in Austin, where she is the mother of a mini Texan. You can reach her via Twitter @AustinKVS, Facebook, or her bloghttp://www.twocannoli.com, where she writes about relationships, motherhood and love.

Image credit: Unsplash

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Let’s Talk About Sex (and PPD)

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postpartum depression helpSex after baby. We all know the cliche about its nonexistance – after all, the sleepless nights, the leaky breasts, and the lack of personal space that accompany a newborn aren’t exactly aphrodisiacs.

But sex after postpartum depression? Is a uniquely difficult experience for many mothers.

With my husband’s permission, I wanted to take the time this week to share my own experiences with sex, depression, anxiety, and medications. I know I’m not alone – and I want you to know you’re not alone either.


At first, relations with my husband were slowed only by the physical limitations that follow a vaginal birth: pain, scar tissue, and sleep deprivation. You see, I started my first weeks as a mother with postpartum anxiety and it wasn’t until months later that the depression took hold. But as it slowly invaded my brain, my interest in sex waned. This is a common symptom of depression and, for me, the numbness I felt toward my child and my life spread into my marriage.

It took months for me to accept that I was suffering from postpartum OCD and postpartum depression and to seek help. When my doctors put into place both talk therapy and medication plans, I finally began to feel just the smallest bit like myself again. But as my happiness returned, my libido only diminished. And though I knew that couples typically experience a temporary drop in marital satisfaction after the birth of a baby, I couldn’t help but feel concerned. It was more than just a decrease in desire.  I found the thought of having sex completely repulsive.

After some research, I learned that the antidepressant I was using (an SSRI) is linked to sexual dysfunction in a high percentage of patients. I nodded my head as I read about the symptoms, including loss of desire and inability to climax. It felt like I was being punished for treating my depression, and I wondered how a marriage is supposed to survive both mental illness and celibacy.

So as hard as it was, I brought up my concerns with my psychiatrist. Over the two years that followed, we worked through a series of medication trials, finally settling on a mood stabilizer that seemed to alleviate the depression without such a severe impact on my sex life. When I became pregnant with my second child, however, I chose to return to my SSRI, knowing there was more research to support its safe use during pregnancy. I made that decision knowing I would be sacrificing my libido, but fully aware of the risks untreated depression carry for both baby and mother during pregnancy.

I wish I could tell you that the sexual side effects were limited to my first postpartum period. But, sure enough, they returned as the medication took hold and I felt the depression and anxiety lift. I also wish I could tell you that this is a story written entirely in the past tense, but almost 3 years postpartum, I still take the SSRI daily, and it continues to impact my desire and performance.

At times, it feels as if I have to choose between sanity and marriage. I hate that the medication that works so well — that allows me to feel like a calmer, more rational version of myself — takes something so important away from both me and my husband. But I am also grateful for the life it allows me to lead. My doctors and I speak about the sexual side effects of my medications at each appointment and are constantly balancing them with the therapeutic benefits – and we have tweaked dosages and timings to help as much as possible. (I won’t get into the details – that is something for you and your doctors to discuss.) For now, we’ve found a plan that, while far from ideal, allows me to continue treatment for my medical condition.

I hope that if nothing else, these last 6 years negotiating the world of antidepressants, mental illness, and sex allow me to help someone who may be suffering in the same way:

I want you to know that if you are experiencing sexual side effects from your anxiety, depression, or medications that you are not alone.

It’s important to be honest and open with your doctors about all side effects and symptoms you are experiencing, including loss of libido and lack of performance.

Finding the right medication and other treatments for postpartum depression (and other mood and anxiety disorders) can be a complicated process, but there are many options out there and probably one that will fit your needs.  Don’t give up.

photo credit: fotolia.com

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