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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Warrior Moms Are Key to Fighting Stigma

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Susan and Tiny BeanI had the thrill and honor recently to attend the recent Special Legislative Commission on PPD meeting with Representative Ellen Story this month.  My new friend (and fierce advocate and mental health professional) Mara Acel-Green extended an invitation to the open meeting – and upon walking in, I was floored by the feeling that Postpartum Progress belonged in the room.

The Commission invited Deborah Wachenheim to speak about her sister Cindy, whose story was featured in The New York Times earlier this year. Listening to Deb speak about the events leading up to her sister’s postpartum psychosis and death, I was struck by the genuine interest and concern of the room.  This was a meeting full of top tier mental health and birth professionals, legislators, and non-profit leaders.  Their heartfelt appreciation for Deb’s willingness to share something so personal (and freshly raw) and thoughtful questions gave me hope that the meeting was not just government lip service.

As the meeting progressed, organizations checked in with progress reports, included MCPAP for Moms, the Department of Public Health and the Community Health Center pilot programs.  Throughout each of their discussions, time and time again, the question that kept resurfacing was “How do we make sure screened mothers are being supported after their diagnosis?”

What these doctors are really concerned about is How do we get moms to follow through with their diagnosis and treatment?  The Commission has been focused up until this point primarily on training primary care physicians, pediatricians, and birth care workers on screening for postpartum mood and anxiety disorders.  But as any survivor can tell you, screening and diagnosis (though absolutely essential) are only the first of many hurdles on the path to wellness.  As suggestions were shared, I noticed that their solutions all focused on actionable items for healthcare workers.  And it seemed to me they were missing a piece of the puzzle.

Postpartum Progress doesn’t just “drop kick despair.”  It kicks stigma in the teeth.

After my own diagnosis, 5 months postpartum, I continued to struggle for almost 6 months with treatment compliance.  It wasn’t that I refused treatment, but instead that I was still struggling with so much shame that I just couldn’t comply.  Depression and anxiety rob a person of their sense of truth and rationality.  Psychosis steals reality itself.  How anyone could expect me to take responsibility for my own mental health treatment in 2009 still leaves me in disbelief.

I attended therapy regularly but fought against taking medications.  And though I knew the right answers to my therapist’s questions and believed them on some level, deep down I still carried such stigma about mental illness that I couldn’t separate myself from my disorders.  Not until I found Postpartum Progress.

Reading stories of other mothers just like me, I found my own courage reflected back to me.  Here were women who had battled the same terrible thoughts, who had raged at their babies, and who had felt worthless in their roles as mothers – and I looked up to every. single. one.  Postpartum Progress doesn’t just “drop kick despair.”  It kicks stigma in the teeth.

This is why I credit Postpartum Progress and #PPDCHAT with saving my life.  Not because Katherine Stone or Lauren Hale treated my anxiety and depression, but because they showed me I was worth saving – that I could and would get better.

This is what legislators, healthcare professionals, and non-profit organizations need to know: the key to getting mothers to follow through with treatment?  Is to disintegrate the stigma.  No one does that better than the Warrior Moms.

I’ll be meeting with the Commission staff and other Massachusetts organizations in the coming months to make sure Postpartum Progress is a part of the important conversations they are having about treating and supporting mothers during and after pregnancy – because the patient community?  Is that final piece of the puzzle.

 

Author’s Note: Postpartum Progress recently collected survey data from its Warrior Mom community and FaceBook fan page.  75% of respondents indicated that Postpartum Progress increased their likelihood to seek professional help for their condition.  You can read the entire report HERE.

photo credit: Susan Petcher

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Authenticity Instead of Perfection

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decoy momAuthenticity is defined as real, not false or imitation. Original. Genuine. This is what we should strive for as women, as mothers, as people. To be that which we are deep down instead of cookie cutter copies of those around us. It’s only when we dare to step out of our comfort zone that we will boldly begin to live our lives. Strive for authenticity instead of perfection. Dare to be you, even if that means walking around with spit up on your shoulder and gummy bears stuck to your shirt. Motherhood isn’t glamourous but it’s one of the best jobs in the whole world.

Colorful jars sit atop a shelf in a misty and humid room. Running water slides down her skin as she lathers up with the latest in moisturizing body wash which promises to make her skin glow with youth. She washes her hair with shampoo and conditioner to make it thick, silky, and soft.

As she exits the shower, the drying process begins – softly – so as not to leave any red marks or heaven forbid, pull skin in the wrong direction. Pat the face dry then move down to her toes. She folds the towel in thirds and places it neatly back on the rod before she wraps her hair in a smaller towel.

Grabbing a toothbrush, she measures out the whitening toothpaste and gets to work. Rinses, then gargles with mouthwash to ensure bad breath stays at bay. Then, moisturizer. While that soaks in, she puts on her undergarments. A bra with an underwire and underwear that promises to hold in her stomach which has nurtured the lives of her children close for the past few years. She frowns. Back to the bathroom.

She reaches for the first layer of glow, then dots on concealer. Waits for it to dry before applying an overall foundation and gently blending it together to hide the exhaustion and stress marching across her face. Next up, eye liner and eye shadow. They make the eyes more open and energetic. Mascara goes on next, gently, the kind that lengthens the lashes because again, more awake and conscious. Less tired.

Then she puts on blush to cheer her cheeks up, smiling as she carefully brushes up, not down – happy, not sad, she whispers to herself.

She takes down her hair and gives it a tousle. Plugs in the hair dryer and gives her hair a once over, then pulls it into a messy bun and pokes a pretty bobby pin with a gorgeous flower on it into the base of the bun. Walks into the closet and chooses whatever isn’t wrinkled or covered in baby food stains. Grabs a pretty pair of heels then over to the jewelry box to select accessories.

A small hand tugs on her silk skirt and she looks down.

“Mama? You look beee-yooo-tea-fahllll. Hug?” her middle daughter asks, covered in chocolate from whatever snack she just finished devouring.

So the mother leans down and gives the child a hug, knowing she will have to change her clothes. She sends her daughter on her way, and walks back into the closet, stripping as she goes. A new outfit selected, she makes it to the car with no child-induced stains on her pretty clothes.

She turns the key, unlocks the door, and slides into the driver’s seat, throwing her miniature purse on the passenger seat beside her. Exhaling, she checks her makeup one last time to be sure she looks human and not like some exhausted creature just waking up from hibernation. She doesn’t. She turns the key, starts the music, and backs out of the driveway.

Transformation into Decoy Mom complete.

Decoy Mom is a mom who goes through great lengths to hide how her life is really going, to hide the authenticity of her fight. Every stitch must be perfect, every thing in it’s place, nothing negative to be found anywhere. And yet, inside, everything is falling apart. Her heart, her life, her soul – it’s all cracked and crumbling.

I’m not saying that a Mom who has it all pulled together is definitively falling apart. Nor am I saying that a Mom who doesn’t have it all pulled together is authentically herself. What I am saying is that we are all “covers” when we are with people and some of us are even “covers” when we are alone. As the previous post by Katherine pointed out, you can’t tell when a mom has a Perinatal Mood & Anxiety Disorder just by looking. We are good at hiding it.

We choose what pieces of ourselves to share and what pieces of ourselves to hide. We are not expected to be fully authentic with anyone unless WE choose to do so. But we should absolutely be at least fully sharing ourselves with ourselves. In order to be authentic with anyone at all, you have to first be authentic with yourself. Being authentic with yourself is a difficult practice but a necessary one. As Brene Brown says,

“Authenticity is a daily practice.”

Stop hiding behind a mask, telling yourself lies about who or what you are inside and outside. Take a hard look inside. Explore. Make a list of everything that is there whether it is good or bad. Work to improve or re-frame the bad (sometimes, negative traits can be utilized for positive things – are you firm & harsh? Figure out how to rein that in by using compassion and understanding). Expand the good, let go of the negative. Focus on flipping the script.

Figure out what you want out of life this year, make a list, then break it down into smaller goals. Don’t let the big things overwhelm you and don’t let yourself become Decoy Mom.

Be the authentic Mom, wife, sister, cousin, aunt, and YOU that you were meant to be. Stop hiding her under layers of crap. You might find that you have more time (and energy) to BE you if you give up all the hiding.

(photo sourced from: https://flic.kr/p/dy8tQr)

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