Join Your Sisters & Raise Your Voice for Maternal Mental Health

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We’re getting closer ladies! It’s almost time for our 3rd annual Climb Out of the Darkness®. We already have more than 150 teams in 44 states and 3 countries. More than 1,000 Climbers, many of them mothers just like you who know what it’s like to be in the deep darkness of postpartum depression, postpartum anxiety and more.

Please join us this June. We can only succeed if we work together to eliminate stigma and make sure all mothers get the information and support they need. It’s time to Climb Out!

Registration is free. You are not required to fundraise, but those of you who raise $100 or more by June 30th will receive our awesome official 2015 Climb Out tee. Here’s what it looks like:

climb tee 2015

You’re going to want to be wearing that t-shirt, I’m pretty sure. I know I’ll be wearing mine proudly!! (Note: those who have joined the Climb early and already raised $100 by May 15 will receive their shirt to wear at the Climb. Otherwise, your shirt will be sent in August.)

To find a Climb in your area and learn how to register, click here.

To get answers to frequently asked questions about the Climb, click here.

Can’t wait to Climb with you!

~ Katherine, CEO & Founder, Postpartum Progress

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Pregnancy Anxiety and Family History of Miscarriage

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Pregnant BellyFirst-time mothers can find many things to be anxious about when they become pregnant. What will pregnancy be like? Will my baby be healthy? Did I start taking my prenatal vitamins early enough? Am I really ready for this? But some women may have an additional fear that seems more relevant than it might to other pregnant women: Will I be able to stay pregnant, knowing that my mom had a history of miscarriage?

This anxiety was something that I had to deal with when I discovered I was pregnant with my son shortly after beginning infertility testing. After a year of trying to conceive, I had been getting rather depressed about failing each month, and the beginning of that year of trying may or may not have started with a miscarriage I was too afraid to see my doctor about. I know now that that was a bad decision, not telling my OB/GYN about the three weeks of heavy bleeding that had forced me to reschedule my initial annual exam where I’d intended to ask for a prenatal vitamin prescription, but I didn’t bring it up because I didn’t want to know for sure. My mom had suffered three miscarriages when I was a kid – the reason why there ended up being eight years between the births of my two younger brothers – and I was trying to shield myself from the emotional aftermath of knowing for sure whether it was a miscarriage or just an exceptionally heavy period. My periods were awful and unpredictable when I went off the Pill. I still have plausible deniability.

So there I was with a positive pregnancy test around Christmastime 2004, overjoyed that I was finally pregnant, but haunted by the shadow of a possible miscarriage. Some of these things are genetic. Some are due to environmental factors. Some don’t seem to have any reason whatsoever. Were those genes passed on to me?

These fears led to a tearful call to my OB/GYN just after New Year’s. I was spotting. They tried to reassure me over the phone as they set up the appointment for me to come in. Spotting can happen in a normal pregnancy. It doesn’t mean anything is wrong. But predisposed as I was to anxiety, this was no consolation. I saw the CNM I liked at my OB/GYN’s office for a pelvic exam and a urine test. The blood was brown, though, old blood, and my pregnancy test was positive. My cervix was inflamed, though, so they sent me to the local women’s hospital for an internal ultrasound because they didn’t have any ultrasound techs in the office. I was only five weeks along, so all they could see what the egg sac and yolk sac, which was good enough for them to reassure me my pregnancy was fine. Only if I started seeing red blood along with cramping should I worry and give them a call.

I didn’t have to make another call like that, but my anxiety didn’t go away.

My inflamed cervix ended up needing to be treated, and I was prescribed MetroGel for it. MetroGel is considered Category B for pregnancy risk, but I was still in my first trimester, and I was terrified that something bad would happen if I introduced this foreign substance so close to where my baby was developing at such a crucial period. I ended up waiting until the first day of my second trimester to actually use the MetroGel. That decision in itself was risky, as an untreated infection can also potentially harm a developing fetus, but it was what I considered the safest route at the time.

Thankfully, my anxiety levels decreased appreciably once I reached 24 weeks. That was the magic number in my head where I felt I could stop worrying about a miscarriage, because about 50% of babies born prematurely at that fetal age survive. And with each passing day, I knew my son’s chances of surviving and being born relatively healthy were just getting better and better.

Unfortunately, my anxiety came back with a vengeance after my son was born, alongside my undiagnosed postpartum depression. If I’d known then what I know now, 10 years later, I would have talked to my doctor. I would have tried to get help. I know I would have avoided taken any medication during my first trimester, but I might have considered some of the lowest-risk medications during my second and third trimesters according to the best available information at the time. I certainly wouldn’t have waited until my son was three before finally seeking treatment from a psychiatrist.

I know I couldn’t have stopped worrying about losing my son, but I could have had someone to talk to about it if I’d looked into therapy. But that’s why I think Postpartum Progress is so important – so people like me can encourage other women to get the support we never had.

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Toxic Expectations for Birth

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What if every expectant mother could rely on her community to celebrate and protect her?  [Photo Credit: Rachel Wilder]

What if every expectant mother could rely on her community to celebrate and protect her?
[Photo Credit: Rachel Wilder]

We build our expectations for birth and pregnancy from childhood; birth stories pervade our culture, from TV and movies to baby dolls. My own life always included lovely retellings of my birth, at home, peaceful and perfect. The trouble is that fear pervades our birth culture, and more often than not, the only stories we hear and the only images we see depict dramatic “success” and dramatic “failure.” The media’s close attention to how celebrity mothers look while pregnant and just after giving birth places enormous pressure on all moms to seem as though pregnancy is effortless and birth leaves us unchanged, physically, emotionally, and mentally. Glossy magazines give the impression that bringing new life into the world is as simple as adopting a kitten. At the same time, this culture that fails to celebrate the enormous strength a mother displays, no matter what her story holds, exaggerates the risks and pain of pregnancy and birth. Even the most conservative of studies shows that there are too many interventions during birth, with no apparent medical reason. A woman’s care provider is likely to question her ability to carry and birth her baby safely, even when she shows no signs of any risk for any complication. What a powerful message!

We are afraid–the stakes are too high. Failure is everywhere in medical language around birth and infancy. How can we begin our journey as mothers with any confidence, when culture and medical authority combine to express their anxieties that we will fail? It’s everywhere: “failure to progress” is an official medical diagnosis during labor, and a baby who does not fit on a growth chart may be diagnosed with “failure to thrive.” We might find comfort and faith in the everyday, commonplace, health most moms and babies clearly display, but even the doctors who know better warn us about every risk and danger. Friends, family, the media, our own care providers, all nervously question a mother’s ability to safely carry, birth, and nurture her baby. We have to fight much too hard to avoid internalizing their doubts as proof our of our inadequacy.

We must work hard, if we want to find positive birth stories and images, while terrifying scenes assault us without our permission. The images of birth that are most common actually depict extremes or pure fiction. Strangers seem somehow compelled to share the most horrifying birth story they have ever heard. Meanwhile, photographs that manage to capture a birthing mother’s inner strength are removed from social media for depicting nudity, even when “the rules” claim that nude photographs are taken down only to protect us from pornography. This applies to images of the postpartum body, as well, unless it reveals no trace of a pregnancy. The perfect mother does not exist, but to know that and to feel it, deeply, are very different things. Effortless perfection is a toxic standard, even when our armor is up and strong. The vulnerability of pregnancy and new motherhood deserve our protection. We could make a shield out of our collective experience, offer reminders to each other, “I know that you are strong, even when you don’t feel strong.” Why doesn’t every mother heard that message loudly and clearly?

“Fear can only be overcome only by Faith” — this is my favorite quote. It comes from an extraordinary doctor and veteran of World War I, who dared to write about “the dignity of motherhood” in his book, Childbirth Without Fear, published in the first part of the twentieth century, as fears about birth rose exponentially every year, and faith in mothers plummeted.others who cherish their memories of birth, like me, work against the same culture of silence around the realities of birth and new motherhood that threatens to overwhelm mothers who feel that they failed, somehow. That culture does not hear any mention of the real and difficult work that a mother does during pregnancy and birth, and that silence breeds fear. My own life seems defined by silence and fear, since my first anxiety attack, around age eight. During my pregnancy and birth preparation, I desperately sought an escape for me, my baby, and my husband. We found it, in the tools provided by HypnoBirthing, a movement partly inspired by Childbirth Without Fear. After a lifetime of feeling that my anxiety could to invade every moment, I moved into pure faith, during my birth, and experienced precious hours with no fear. What a gift I gave myself! A childbirth class did not instill a lifetime of faith in myself as a mother or just in me, but those hours of freedom from fear remain a potent reminder of my own strength, even in my darkest moments. I teach HypnoBirthing now, because the tools I learned from my teacher, while I was pregnant, helped me and my partner overcome our fears, until we were both filled with faith in me. I hope to help other moms have that same confident beginning.

I often wonder what would happen to perinatal mental health, if our culture asked for and listened to our birth stories. What if birth stories were as commonly shared as our newborns babies’ statistics? What if we combed birth stories for a mother’s strength, instead of asking about pain and complications? What if we told a new mother, “Look how you acted as advocate for your health, and your baby’s best interests, even when you thought you were too exhausted!” What if we congratulated new parents on the way they partnered during birth to welcome their newest family member, together? We can always find moments that highlight beauty, strength, advocacy, power, because giving birth requires all of these things! What a gift we could offer new mothers, if we refused fear and chose faith, instead! What a start we could provide, if we truly listened to every mom?

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Help Save Massachusetts Program Helping Moms with PPD

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I am twice blessed. Not only do I get to be on the board of directors of Postpartum Progress, Inc. and have the honor to work with Katherine, our other directors and an army of Warrior Mom volunteers to help educate and encourage moms suffering from postpartum depression, anxiety and other mood disorders to get the help they need, but I get to live in one of the few places in the world where a government has taken active steps to recognize the seriousness and treatability of these diseases: Massachusetts.

A great new program in Massachusetts started last year to promote the mental health of new mothers by building the capacity of providers serving pregnant and postpartum women to effectively prevent, identify and manage depression and anxiety during pregnancy and after birth. This program for mothers was actually the child of an earlier and very successful program called MCPAP, which was founded in 2005 to develop a similar capacity for primary care physicians to effectively diagnose and treat children with mental health concerns. MCPAP gives primary care doctors ready access to a team of regional experts (each with a child psychiatrist, a social worker, and a care coordinator) who are on call for telephone consultations.

Recognizing that there is a direct correlation between a mother’s mental health and the mental and physical health of her children, Massachusetts legislators had the wisdom to try to similarly treat mothers.  In just a small state like this where there were 72,000 births last year and when at least 1 in 7 mothers suffers from a pregnancy related mood disorders such as anxiety or depression, at least 10,000 children and families are at risk when their mothers don’t get the critical postpartum support they need.

MCPAP for Moms was launched in July 2014 is now a model on the national stage for ensuring healthy families. In many areas of my state, especially rural ones where I live, there is a glaring lack of health care providers who understand the diagnosis and treatment for mothers suffering from pregnancy related mood disorders. All obstetrical providers who come into contact with new mothers can now call a warmline and receive guidance from psychiatric experts as well as referrals in their community. In addition, the program provides capacity building training from another great advocate and leader, MotherWoman, for support groups and professional coalitions across the state to strengthen the skills of the medical community in each unique county of our state. Already, more than 400 mothers and their families have been directly impacted by this program.

Unfortunately, in the world of governments which are always looking at budget shortfalls, the MCPAP Program is presently not being funded at a level that would allow it to keep the Moms portion. Truly, we all understand that there are many, many worthy programs and not enough budget funds to go around, but in this case there is already in place a requirement for commercial insurers to cover the cost of serving their members. This revenue stream is expected to add $1.6M to the state operating fund, which will more than offset the $500,000 in funding required to keep MCPAP for moms alive and growing.

As we see play out in various crises all over the world, untreated mental health issues can have disastrous consequences. Massachusetts must continue to be, and I’m not exaggerating here, a world leader in providing mental health screening and treatment for our children and their mothers. If you live here in this great Commonwealth with me, please contact your state Senator and tell them this:

Our mothers deserve quality professional care to treat postpartum related mood disorders. 10,000 children’s live will be directly impacted if we fail to ensure the MCPAP for Moms project stays in place, so please make sure that MCPAP (Massachusetts Child Psychiatry Access Project) funding is increased to $3.6 million on line item 5042-5000.

Alternatively, any mom can sign the online petition at Change.org asking for the program to be funded by clicking the link.

~ Deborah Rimmler

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