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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Let’s Rewind: The Isolation of Motherhood pt. 2

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My family and I headed to a castle. No big deal.

My family and I headed to a castle. No big deal.

Parenthood is, in a lot of ways, just a bunch of sleepless nights bleeding into long days. That sounds kind of bleak, but I’m not sure there’s a more complex state of being than that of being a parent. You’re always being pulled in multiple directions and overcome with conflicting emotions. And, honestly, I’m not sure that it’s ever as hard as it is in the first gritty-eyed months of having a freshly baked baby.

Throughout Archer’s first year, inertia carried me. Once I went back to work, the force of my footsteps was the only thing that propelled me forward. Daycare. Work. Pump. Coffee. Pump. Lunch. Pump. Daycare. Home.

And through it all, I felt alone.

Physically, distance crushed me. I was half a continent away from my family. Emotionally, disconnect destroyed me. Most of my friends did not have children of their own. If I could have articulated how abandoned I felt, my words would have been scarcely a whisper.

But, again, let’s rewind.

Breastfeeding came easily to Archer and me. Despite his time in the NICU, he latched quickly and nursed like a champion. The emotional trauma of his tumultuous birth experience was healed by our outstanding nursing relationship.

Nursing sustained us. It bonded us. It provided just the right dose of feel-good hormones to shield me from the undercurrent of isolation that tried so insidiously to steal my joy. When we weaned, the loneliness reached up from the deep below and quietly pulled me down.

Without realizing it, my body and mind were being realigned as Archer nursed less. The chemicals in my brain like tectonic plates, slowly and imperceptibly shifting to create entirely new and unrecognizable continents within my psyche.

I left my job to pursue a freelance writing and marketing career and I spent each day deafeningly alone. Just me and my deadlines and – I know now – my depression.

Despite having solid support systems and amazing friends, I was borderline non-functional by the time I admitted that I needed help. Depression is a liar and she told me that no one knew my plight – that such loneliness was the result of being undesirable by friends and family alike.

In my first postpartum counseling session, I sat across from my psychiatrist and psychologist – both specially trained to work with mothers with mood disorders – and told them how impossibly isolating motherhood was. My doctor pushed up his glasses, looked me in the eye, and said, “Liz, I am not here to belittle your experience, but I want you to know that every mother who has ever sat in that chair has said those same words.”

Now, let’s fast forward.

With a diagnosis of “post-weaning depression,” I restarted on my Lamictal and recovered, once again, quickly. And, again, we reveled in my stability.

Archer became our co-pilot on a new adventure and we moved from Baltimore to Germany for a three year assignment with my husband’s job. In our time here, the isolation of motherhood combined with the isolation of ex-pat life to create a sort of mecha-loneliness that has tried to cut me down many times. If I’m being honest, sometimes, it has succeeded.

Enduring a rough pregnancy an ocean away from family and friends did little to quell the rising tide of lonesomeness. Late night nursing and long days working ignite sparks of heartache that occasionally rekindle the flames of alienation.

But, in my worst days, I rewind to my psychiatrist’s office and remember that my isolation is not a unique condition of my experience with motherhood.

You see, motherhood is a weird thing in that many mothers experience the same things, but in different ways. There are times when all of us feel alone. Motherhood, on some level, breeds some amount of isolation. But, in that isolation, we are – in a twisted way – brought together.

 

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Let’s Rewind: The Isolation of Motherhood

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Liz Bauman is an American wife, mom, and writer living in Weisbaden, Germany. When she’s not camped out behind her computer screen, she quests for castles, plays Dungeons and Dragons, and drinks a lot of tea. Earl Grey. Hot. She’s also one of my favorite people, and a woman who’s personhood and journey through motherhood while living with mental illness always leaves me inspired and hopeful. If you’re so inclined, you can learn about her, tweet at her, or hire her. I’m thrilled she’s sharing her experience with us here on Postpartum Progress this week. Here is part One of her story. 

 

Archer at 16 days old

Archer at 16 days old

If asked to describe my experience as a mother in a single word, I’d love to say something like “joyful” or “empowering.” There are certainly days where I feel like motherhood has made me a strong advocate, a better feminist, and a compassionate member of the cult of womanhood. Sometimes, I go weeks at a time feeling like my two children have made me a better, more resilient woman. Like all that breastfeeding and babywearing have somehow infused my very essence with radioactive awesomeness, transforming me into some kind of Hulked-up mama hero.

But, the truth is, my motherhood has been isolating.

Let’s rewind.

Back when my husband and I were young and wild college kids in the expansive plains of South Dakota, we decided we would get out. Get far, far away from small town life and farms and go have big experiences in big cities. Shortly after we got engaged, the husband got accepted to George Washington University and I – on uneasy terms with my family – agreed that we should set forth on our grand adventure.

After 7 years in DC/Baltimore sprawl, we welcomed our son, Archer, and my world got simultaneously brighter and darker.

Let’s rewind again.

I struggled with mental illness since my teens. My diagnosis was a fast-cycling flavor of bipolar disorder characterized by frequent, but largely harmless ups and downs that rarely affected my life profoundly. But, a miscarriage at 23 triggered some major shifts in my brain chemistry that twisted my “frequent, but largely harmless ups and downs” into a screaming spiral into the gnarly pit of mix-state madness that nearly shattered the foundations of the life my husband and I worked so hard to build.

It was my first dose of the vicious isolation of motherhood and I didn’t even get a baby out of the deal. We had told no one that we were expecting, so I grieved our lost child alone. I internalized it and the sadness wrapped sticky, black anger around my bones that eventually permeated my heart and mind.

Broken and desperate, I hit rock bottom and my husband made me promise that I’d seek help.

A new shrink and an RX for Lamictal later, I was better. That seems like an over-simplification, but it was a pretty uneventful period of recovery and we spent a couple years soaking in our baby-free life, just being young and married and loving life on the East Coast. We both had our dream jobs and, with time, overcame the anxieties of miscarriages and mental breakdowns and I weaned off my meds so we could try, once again, to bake ourselves the proverbial bun.

It took a while, but – after 8 months of trying – we discovered we were expecting Archer. And things were good. Pregnancy was wonderful to me. It was my renaissance. I was stable, productive, and happy-all while being unmedicated.

When Archer was born, via emergency c-section, his resultant NICU stay tested my mental fortitude in a way I couldn’t have expected. Without going into all the triggery details, he spent his first couple of days drifting down the “will he/won’t he” line and I wouldn’t wish that sort of terror on anyone.

As he and I recovered, I found myself alone in the hospital. I was discharged and my husband – an important dude with a high-pressure job – went back to work. The nurses, taking pity on me, let me camp out in their on-call room so I could nurse Archer through the night because they didn’t have on-site rooms available for discharged moms.

I cried a lot. I’d never felt so alone. “Is this what motherhood is supposed to look like?” I asked myself as I cradled him his next to his incubator, lights blinking and monitors blooping.

Now, as I sit on the cusp of my second child’s first birthday, I can say pretty definitively, that it may not be what motherhood is supposed to look like, but reality is Kryptonite to supposition.

 

to be continued…

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