By MGH Center for Women's Mental Health | May 5, 2021
"At this point, nine states and Washington, DC have legalized the use of recreational marijuana. Another 30 states have legalized medical marijuana. The downstream effect of these changes has been a significant uptick in the use of cannabis among women of childbearing age. According to data collected from the National Survey on Drug Use and Health, the use of cannabis in pregnant women rose from 2.37% in 2002 to 3.85% in 2014 in the United States, noting that 21.1% of pregnant women who used cannabis reported doing so on a daily basis.
While we have data to indicate that the use of cannabis during pregnancy may negatively affect fetal growth and brain development, we have less information on how the cannabis and its byproducts, which are secreted into the breast milk, may affect the nursing infant. Here are some important things we do know:
Can cannabis be found in the breast milk?
No matter how marijuana/cannabis is consumed (smoking, vaping, or ingesting), its byproducts can be found in the breast milk. Figuring out how much is passed into the breast milk is complicated because how women use cannabis varies considerably. For example, the kinetics of smoking vary considerably from ingesting. Both cannabidiol (CBD) and the psychoactive component, delta-9-tetrahydrocannabinol or THC, have been detected in breast milk.
In the largest study to date, which included eight breastfeeding women, the amount of THC detected in pumped breast milk ranged from 0.4%-8.7% of the maternal dose, with an estimated mean of 2.5%. Using these data, the average absolute infant dose was estimated to be 8 micrograms per kilogram per day.
If cannabis is consumed, how long does it persist in the breast milk?
Cannabis concentrations in the breast milk are variable and are related to maternal dose and the frequency of dosing. However, there are some things that make cannabis a little different than alcohol or other recreational drugs. Cannabis and its byproducts are very fat-soluble or lipophilic. Because in women the percentage of body fat is 25-30%, there is a large reservoir for the storage of cannabis. What this means is that it takes much longer for cannabis to leave one’s system, compared to substances like alcohol. Furthermore, there is an especially long washout period in those who have been daily users. Long after the psychoactive effects have faded, THC and its metabolites can be detected in blood, urine, and breast milk.
Studies focusing on the detection of THC in milk have yielded variable results, with duration of detection ranging from 6 days to greater than 6 weeks in various studies. The most recent study from Wymore and colleagues In a recent study, Wymore and colleagues collected data on self-reported marijuana usage and measured levels of THC in maternal plasma and breast milk samples several times a week. In all 25 participants, THC was detectable in breast milk throughout the six week duration of the study.
The researchers estimated the mean half-life of THC in breast milk to be 17 days (SD 3.3). Based on this estimate, they calculated that it would be possible to detect THC in breast milk for longer than 6 weeks. In addition, the researchers were able to calculate a milk:plasma partition coefficient for THC which was approximately 6:1 (IQR, 3.8:1 – 8.1:1). Milk:plasma ratios give us a sense of how easily a compound passes from the mother’s bloodstream into the breast milk and can be used to estimate the amount of exposure through breast milk. Most M:P ratios for drugs commonly used in breastfeeding women are around 1 or less than 1; thus, an M:P ratio for THC of 6 is high and suggests that levels of THC in the breast milk may be higher than in the mother’s bloodstream.
The findings of the Wymore study are consistent with previous studies measuring THC in breast milk which observed a duration of detection ranging from 6 days to greater than 6 weeks after using cannabis. The longevity of THC in the breast milk may be related, in part, to the extremely high fat content of breast milk and the lipophilic nature of THC, so that the breast milk “traps” the THC, in a sense acting like a reservoir for THC storage.
What are the effects of exposure to cannabis in the nursing infant?
The bioavailability of cannabis and its metabolites ingested by neonates in the breast milk has not been well-characterized. There are conflicting data regarding the outcomes of infants exposed to cannabis during breastfeeding and very few studies assessing outcomes in this population. These studies are not easy to conduct. First of all, recreational use of cannabis continues to be illegal in many states. Furthermore, it is difficult to disentangle the direct effects of cannabis delivered in the breast milk from the indirect effects of cannabis on the quality of childcare and parenting, especially in heavy, chronic users or when cannabis is combined with other substances.
In one study, 136 breastfeeding infants were assessed at one year of age. In the 68 infants exposed to cannabis during the first month of life, there was evidence of decreased motor development at one year, when compared with matched infants who were not exposed to cannabis. Specifically, there was a 1465-point decrease in the Bayley index of infant motor development. However, the authors of this study cannot conclude that these findings were entirely due to exposure via breastfeeding, as many of the women also used marijuana during pregnancy.
In another study, 27 breastfed infants exposed to cannabis were compared to 35 unexposed breastfed infants. At one year, no differences were noted for motor and mental development using the Bayley Scales of Infant Development. However, the small size of this study limited statistical analysis.
So the jury is still out regarding the effects of cannabis on the nursing infant.
All women should be screened for drug use as a component of standard prenatal care. Screening for substance use should occur during the course of pregnancy with the goal of providing information regarding the potential adverse effects of cannabis and to ensure referral to appropriate resources for treatment as needed. Because many women are able to abstain from substances during pregnancy but resume use after delivery, screening must be repeated during the postpartum period.
Both the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics recommend that women refrain from using cannabis during pregnancy and while breastfeeding. Because of the persistence of cannabis and its byproducts in the breast milk for days to weeks, using cannabis and waiting for it to clear out of the breast milk is not a viable option. For women who use cannabis for medical indications, alternative therapies with more safety data during breastfeeding should be considered."
-Ruta Nonacs, MD PhD
By: Becky Vieira
"Dear Husband-I see you. Then and now. You might not think I did.
I try to imagine what you endured. The pain, fear. While the primary focus was on me, my health and recovery, I know you were suffering also. Silently. Never saying a word of complaint.
I recognize all you did to get me where I am today. To get us here.
We thought we’d just be tired. That exhaustion would be the biggest of our problems once our son was born. Neither of us expected that I’d be gripped – no, controlled – by my postpartum depression. It was supposed to be the happiest time of our lives, not the living nightmare it soon became.
It started slowly, do you remember? We thought I was tired. That my hormones were adjusting yet again. But before we knew it I was underwater. The progression from healthy to dangerous transpired within days once that beast took hold of me.
How did you do it? We had a newborn. No idea what to do with him. You carried that aspirator in your back pocket at all times “just in case.” And while we watched him sleep for fear something would happen if one of us closed our eyes, I began losing my fight.
Yet you continued on.
I started to slip away. I wanted to leave, convinced you both would be better off without me. You held me when I needed it. Let me run into the street to scream, then greeted me at the door with a warm blanket and tea when I returned. Researched treatment. Medications. Called my doctor and hid my car keys when things got dark.
You also got up every morning and went to work. Held things together for us financially. All while receiving frantic calls from me. Coming home between meetings, at lunch. To check on us.
There was no guidebook for you. No one you could call to ask questions on how to handle the situation. I was wrapped in the support I found online from other mom’s with postpartum depression. But what did you have? No men on social media were presenting themselves as the husbands of women with PPD. You had nowhere to turn.
There are resources for PPD. Help. But no one can really tell you how to live through it. It felt as if we were thrust into a new universe, one that spoke an entirely different language. My mind started lying to me and my will to live was faltering. Our coping skills were stripped away and we had to find a way to survive. I needed to be healthy again.
You kept going, for all of us. Trusted your instincts and did the best you could. Yes, there were moments when I was angry over the things you said or did. But today I see that it was in my best interest. You always tried to help.
Even when I screamed at you and said horrible things. Threatened to walk out of your life because I was convinced you deserved better than a sick wife. You never gave up.
You should be proud of yourself and recognize all you did. I’m proud of you. And grateful you stayed by my side. I’ll never forget sitting on the kitchen floor, crying to you as I said, “I’m crazy.” You kissed me and said, “then I guess I’m crazy, too.” Our tears turned to laughter and I knew I’d never be alone.
We survived and our marriage is actually stronger today because of all we endured. You held it together so that I could fall apart safely. And then build myself back up again.
Yes, I spoke up. Got help. Worked on myself, started taking medication. But it would have been much harder without you by my side.
I know you suffered. Were scared. And probably angry, frustrated and hopeless at times. But I never saw that. I only felt loved and supported.
Thank you for everything. I see you and what you did for me and our family. And I’ll never forget."
"If you think you may be suffering from postpartum depression, don’t wonder. Speak up. Talk to you doctor, partner, family and friends. If you are scared or worried about the stigma (I get it… we shouldn’t be concerned about that but of course we often are) and would rather talk to someone outside of your circle, you can call Postpartum Support International at 1.800.944.4773. If you just need a fellow mom to validate you and listen to your fears, find me on Instagram and reach out.
Anxious, overwhelmed, unhappy, or scared by how you feel? If you’re struggling emotionally, you could be depressed. Take this 10-question quiz to find out."
By: Melissa Willets
"If you're like me, your answer to the question: "Should I have another baby?" changes by the hour. I gaze at my sleeping, angelic children, snug in their beds at night, and think, YES! Definitely, the sooner the better, NOW. Then my kids are screaming, fighting over a single, blue crayon, and it's, NO! NO! NO! No more kids, ever.So how do you cut through those everyday moments of indecision, to get to the real answer of whether you should have another baby? Try asking yourself these six things:
1. How do you feel when you get your period?
Is it, relief or sadness? Last month my period was a welcome relief. I have a 10-month-old baby, a three-year-old, and an almost six-year-old. We've got enough going on! But this month it was different. I felt a little sad, and began to think, what if? What if our family is not quite complete yet? What if we had another baby?
2. How do you feel when you see a newborn?
Do you feel love sick, or just sick? I see an infant, and my heart swells. An involuntary, "aww," escapes my lips. I can't help it! I love how a newborn smells, I love her soft, delicious skin. Babies are heaven, pure and simple. And having another one is starting to feel like the greatest idea ever!
3. What do you picture your life to be like with another child?
Is life overwhelmingly hectic or charmingly challenging? I don't picture a scenario replete with loud crashes, screaming children, me trembling, gripping a too-full glass of wine, crying in frustration, as little people slowly take over my house, and my life. Instead, I see happiness. I picture smiles, hugs, cuddles, love and giggles. Oh, there's craziness too, believe you me. But mainly I hear The Beatles' song "All You Need Is Love," playing in my head when I imagine being a mom to four kids.
4. What would life be like if you didn't have another baby?
Arrow straight through the heart. Ouch. No, the truth is I've felt conflicted about having another baby for a while. Life is great the way it is. Life is full. We are parents to three, beautiful, funny, silly, smart, wonderful girls. Why mess with what is working pretty darn well for us? When I think this way, another baby seems like a bad idea...
5. What is your biggest reason for wanting another baby?
Is something still missing? Or, is it just hard to imagine closing that door yet? There are so many reasons I want another baby. I still long to feel a baby kick inside of me. I yearn to hold a newborn in my arms, knowing that I did that; I made that. I have also loved, loved seeing how my children love, and care about each other. Being witness to their sisterly bond has been the greatest privilege of my life. I know that adding to our family would just bring more love, and joy.
6. What is your biggest fear about having another baby?
I worry about tempting fate if we have another baby. Can I really be lucky enough to bring four healthy babies into the world? No one could be that lucky; it just isn't fair. Right? Sigh. I don't know."
By Uma Naidoo | December 07, 2018 | Updated March 27, 2019
"The human microbiome, or gut environment, is a community of different bacteria that has co-evolved with humans to be beneficial to both a person and the bacteria. Researchers agree that a person’s unique microbiome is created within the first 1,000 days of life, but there are things you can do to alter your gut environment throughout your life.
Ultra-processed foods and gut health
What we eat, especially foods that contain chemical additives and ultra-processed foods, affects our gut environment and increases our risk of diseases. Ultra-processed foods contain substances extracted from food (such as sugar and starch), added from food constituents (hydrogenated fats), or made in a laboratory (flavor enhancers, food colorings). It’s important to know that ultra-processed foods such as fast foods are manufactured to be extra tasty by the use of such ingredients or additives, and are cost effective to the consumer. These foods are very common in the typical Western diet. Some examples of processed foods are canned foods, sugar-coated dried fruits, and salted meat products. Some examples of ultra-processed foods are soda, sugary or savory packaged snack foods, packaged breads, buns and pastries, fish or chicken nuggets, and instant noodle soups.
Researchers recommend “fixing the food first” (in other words, what we eat) before trying gut modifying-therapies (probiotics, prebiotics) to improve how we feel. They suggest eating whole foods and avoiding processed and ultra-processed foods that we know cause inflammation and disease.
But what does my gut have to do with my mood?
When we consider the connection between the brain and the gut, it’s important to know that 90% of serotonin receptors are located in the gut. In the relatively new field of nutritional psychiatry we help patients understand how gut health and diet can positively or negatively affect their mood. When someone is prescribed an antidepressant such as a selective serotonin reuptake inhibitor (SSRI), the most common side effects are gut-related, and many people temporarily experience nausea, diarrhea, or gastrointestinal problems. There is anatomical and physiologic two-way communication between the gut and brain via the vagus nerve. The gut-brain axis offers us a greater understanding of the connection between diet and disease, including depression and anxiety.
When the balance between the good and bad bacteria is disrupted, diseases may occur. Examples of such diseases include: inflammatory bowel disease (IBD), asthma, obesity, metabolic syndrome, diabetes, and cognitive and mood problems. For example, IBD is caused by dysfunction in the interactions between microbes (bacteria), the gut lining, and the immune system.
Diet and depressionA recent study suggests that eating a healthy, balanced diet such as the Mediterranean diet and avoiding inflammation-producing foods may be protective against depression. Another study outlines an Antidepressant Food Scale, which lists 12 antidepressant nutrients related to the prevention and treatment of depression. Some of the foods containing these nutrients are oysters, mussels, salmon, watercress, spinach, romaine lettuce, cauliflower, and strawberries.
A better diet can help, but it’s only one part of treatment. It’s important to note that just like you cannot exercise out of a bad diet, you also cannot eat your way out of feeling depressed or anxious.
We should be careful about using food as the only treatment for mood, and when we talk about mood problems we are referring to mild and moderate forms of depression and anxiety. In other words, food is not going to impact serious forms of depression and thoughts of suicide, and it is important to seek treatment in an emergency room or contact your doctor if you are experiencing thoughts about harming yourself.
Suggestions for a healthier gut and improved mood
By: Bethany Braun-Silva
"Expecting parents have multiple checklists of everything they need to get ready for their baby’s arrival. Cribs, bottles, car seats, and strollers are just a few of the essentials you need to consider before welcoming a new baby. But even before any of that, there’s the hospital bag checklist. A robe, a nightgown, slippers, and a few blankets are sure to make the list, but oftentimes, a postpartum recovery kit gets overlooked.
A postpartum recovery kit has what moms need to help with bleeding, soreness, and overall discomfort. You can create your own kit by buying things like disposable underwear, ice packs, and perineal spray separately, but there are also ready-made kits for moms that include all these things and more.
Many moms agree that postpartum recovery kits are a great choice. The Frida Mom Hospital Packing Kit for Labor, Delivery, Postpartum, for example, has over 1,000 five-star reviews on Amazon and a near-perfect 4.8-star rating. “I would 100% say that every postpartum experience needs this kit,” writes one customer. “I think it’s well worth the price for the comfort you’re getting.”
The Miloo Mom Hospital Labor and Delivery Gift Packing Kit for Delivery, Postpartum is also a great choice available on Amazon. One reviewer writes, “I was very impressed with my kit, and I used all of it when I was in the hospital.”
Convenience is so important when you have a new baby, especially when it comes to your healing. The first six weeks after giving birth are a critical time in the healing process, and having the right tools handy can make all the difference in your physical (and mental) health. If you’re pregnant or know someone who is, check out the postpartum recovery kits below."
By: Cedars-Sinai Staff| October 21, 2019
"The biggest misconception women have about exercising while pregnant is that they can't do it at all, says Dr. Keren Lerner, OB-GYN at Cedars-Sinai. "It's not uncommon for women to wonder if working out during pregnancy will put the baby at risk," says Dr. Lerner. "I get asked that a lot."
Not only is it safe for pregnant women to exercise, but engaging in physical activity while pregnant can be beneficial for the health of a woman and her baby.
It can reduce the risk of preeclampsia, gestational diabetes, and hypertensive disorders during pregnancy. It can also minimize discomfort.
The American Pregnancy Association recommends at least 30 minutes of physical activity every day for women who have a normal, healthy pregnancy.
The best types of workouts for pregnant women
It's important to know that not all pregnancy workouts are created equal.
Dr. Lerner says workouts like Barre and Pilates are great because they focus on core strength, which can make the delivery and recovery process easier.
"Prenatal yoga classes can be great for mind, body, soul, and core," Dr. Lerner says, as long as women are careful not to overextend their backs with deep bends or twists.
She also recommends swimming, especially in the third trimester.
"When there's more weight being carried, a lot of women end up with back pain," Dr. Lerner says.
"Because gravity is less of an issue in the water, women tend to be more comfortable in the pool."
No matter what workout they choose, pregnant women should drink plenty of water and take a rest if they start to feel dizzy or lightheaded while exercising.
Workouts to avoid when pregnant
All pregnant women should avoid contact sports, as well as activities like skiing, snowboarding, rock climbing, horseback riding, and scuba diving.
If the pregnancy is high risk, women should talk to their doctor about their workout options.
Women should also seek medical advice if they get injured while exercising.
While 30 minutes of daily activity during pregnancy is recommended, women who enjoy working out aren't limited to this, Dr. Lerner says.
"Certainly those who are used to working out or have active jobs or lifestyles can endure more," Dr. Lerner says.
"They just need to be sure they're listening to their bodies."
Perinatal Mental Health: How to Tell if You're Struggling With Mental Health During Pregnancy and Postpartum
"How can you tell if you're struggling with mental health during pregnancy and postpartum?"
By: Women's College Hospital
"Lifestyle changes to improve and prevent symptoms of depression and anxiety."
I knew he’d run the other way if I jumped too quickly into a medical referral or diagnosis, so we started with the most human approaches — connecting about what was really going on for him, and exploring readily available lifestyle changes that aligned with his interest, motivation, and values. Within weeks, his spark started to come back, and within months he felt he had a new lease on life. He wasn’t suddenly happy all the time. But he felt a new sense of his capacity to take charge of his mental health.
Will everyone have an outcome like Roy from lifestyle changes? Definitely not — anxiety and depression are complex conditions with tremendous individual variation, varied underlying causes, and varied levels of severity. But can everyone benefit from learning the foundation for how to care for their mind either separately or as an adjunct to professional treatment? I believe so.
The following seven health behaviors are key ones linked to prevention or symptom improvement of anxiety and depression.
While everything on this list is simple, it’s far from easy. Change is hard. And if you currently have depression or anxiety, it can be especially challenging. That’s why one of the key behaviors is being kind to yourself.
If moved to do so, choose one area to work on at a time, perhaps an area you feel especially motivated or confident to address, or an area that feels aligned with your most important values. Then take it one step at a time. The funny thing about change is we often don’t know it’s happening, we just keep rowing in the right direction, and usually after a few, or a few thousand, twists and turns, we look back in awe at how far we’ve come.
While 10-18% of adults in the U.S. experience chronic sleep issues, this number jumps to 65-90% of those with depression, and over 50% of those with generalized anxiety disorder. Of those with depression, 65% had sleep issues first. Addressing sleep issues can alleviate symptoms of mental health conditions, and given sleep problems are a risk factor for mental health conditions, can also help protect your mental health.
There are many resources to help improve your sleep, such as this free app.
A disposition that tends towards self-critical, or perfectionistic, can be a risk factor for anxiety and depression. This can include feeling like you must be perfect to be accepted, an inability to accept flaws within yourself, intense self-scrutiny, or an unrealistic sense of others’ expectations and your capacity to meet them.
Despite the fear of many who have this characteristic, the antidote to perfectionism isn’t letting it all go, or saying goodbye to standards – it’s self-compassion. According to researcher Kristen Neff, self-compassion has three components: self-kindness vs. self-judgment, common humanity vs. isolation, mindfulness vs. overidentification. How we treat ourselves through the ups and downs of life can have a tremendous impact on health and mental health.
3. Social Connection
From the time we are born, we need social connection in order to thrive.
A recent study lead by researchers at Harvard sought to understand what could most protect us from depression that is within our control. After analyzing over 100 potential factors, they found that social connection was by far the most important protective factor.
It’s been a lonely year for many. And many are anxious at the prospect of going back to normal. But connection doesn’t mean a big party or bustling office. It can be confiding in one trusted person about how you’re really doing, listening to how someone else is really doing, giving a meaningful thank you, or having a (safe) visit with any family member or friend. If this feels out of reach, try making a short list of people who at any point have given you a sense of belonging. Other studies have shown that just calling positive relationships to mind can have a positive impact on our capacity to tolerate stress."
By: Catherine Pearson | 10/28/2020
"It's not just right after giving birth. A new study shows that for a significant number of moms, symptoms persist for years."
"When Jane gave birth to her baby 10 years ago, she very quickly began experiencing significant postpartum depression. It felt as though her brain had been abruptly “rewired,” and her symptoms grew worse over time.
“It felt like there was this thing in me that took root and grew,” said Jane, 47, who asked to use only her first name for this story. “Especially feeling suicidal. Those thoughts had a life of their own.”
As the months passed after giving birth, Jane found herself making clearer and clearer plans for how she’d take her own life. She recalls at one point, when her son was 3, nearly pointing out an overpass from which she could easily jump while strolling with her toddler and husband — then immediately recoiling. Not from the thought itself, but from the fact that she had almost casually given her “secret” away.
When her son turned 4, Jane finally recognized her own need to get help and got a prescription for Prozac. Practically overnight, her thoughts of suicide disappeared. And despite the fact that it was years after she had given birth, the roots of her depression felt obvious.
“For me, it could not be more clear that what I had was postpartum depression,” said Jane, who often worried she’d sound “crazy” if she opened up about what she was experiencing — particularly because she adored her son. “It felt almost like my brain was rewired during pregnancy.”
New research published in the journal Pediatrics this week supports what parents like Jane, as well as mental health professionals who specialize in the issue, have long known: that “postpartum” depression is not just something that strikes in the weeks and months immediately following childbirth. It can last for years and grow worse with time.
In the study, which tracked 5,000 mothers in New York over time, one-quarter of the women experienced elevated depression symptoms at some point in the three years after giving birth.
Of course, up to 80% of new moms experience some version of the so-called “baby blues” in the first few weeks after delivery. They may feel sad, anxious and cry a lot. Their moods may shift rapidly as their hormones fluctuate and they learn to care for a vulnerable new infant on extremely little sleep.
Postpartum depression may be more severe (though not always) and lasts longer, often appearing weeks after giving birth but sometimes not for a full year — or, as this new research suggests, even longer. It builds on a recent scientific review that found up to 50% of moms with postpartum depression struggle beyond the first year.
Expanding our collective understanding of how long postpartum depression can persist is important largely because of screening.
The American College of Obstetricians and Gynecologists — which sets the guidelines OB-GYNs and other women’s health providers often use — recommends at least one screening for postpartum depression using an official tool or questionnaire. The American Academy of Pediatrics recommends pediatricians screen for mental health issues in patients at various points in the first six months after they’ve given birth.
But that timeline may not do enough to catch those who are struggling, particularly because many patients with postpartum depression are reluctant to speak about what they’re experiencing out of a sense that their symptoms somehow mean they are bad parents.
That is why the authors of the new study clearly state that screening within the first year after giving birth is insufficient and that pediatricians should consider assessing patients for at least the first two years after they have a baby.
“We know that if a PMAD [perinatal mood and anxiety disorder] is untreated, it can continue. The symptoms can become worse, and many women can ride them right into a subsequent pregnancy,” echoed Paige Bellenbaum, chief external relations officer for The Motherhood Center, a mental health clinic based in New York City.
Even so, Bellenbaum believes far too few pediatricians, OB-GYNs and midwives meet even the current bare minimum recommendations for screening patients for depression and anxiety — to say nothing of assessing how they’re doing years down the road."
by Alexandra Samuel-Sturgess| February 5, 2021
"The best way to feel empowered during your pregnancy and birthing experience is through education on the process and exercising your right to choose. This starts with making your first prenatal appointment. Making that appointment is imperative, but can feel scary if you do not know what to expect.
Here are eight steps to help you feel empowered during pregnancy and as you enter into parenthood.
Contact your Insurance Provider
If you do not have insurance at the time of pregnancy, you have options. Please reach out to your local social service agency for assistance with State Assisted Medicaid in order for you to have access to prenatal care.
If you already have health insurance, it is time to do some research. Contact your insurance provider to understand your benefits during pregnancy, which may cover the cost of a birthing center or doula support. Also, speak with your insurance company to discuss preferences for your doctor such as sex of the doctor, ethnic preference, language preference, location preference, etc. You have a right to request what you would like; do not be afraid to ask!
Prepare to Meet Your Provider
Now that your insurance has provided you with options and you have your first appointment scheduled, it’s time for a visit. When getting ready for your first appointment prepare some questions for your provider to help you determine if it’s going to be a good fit. The best way to do this is by having them prewritten on good old fashioned paper or on your phone.
You might be wondering what to ask. Here are a few questions to start:
You made it to your first visit, and the receptionist gives you a clipboard to complete information and documents to sign. Be sure to read the informed consent and pay close attention to your rights as a patient. Learn what to do if you ever need to file a grievance, feel pressured by the doctor, midwife, or staff to participate in testing, or if someone refuses to explain procedures. You have a right to file a complaint with your insurance company and with your state’s medical board if the violation you experienced is egregious.
Ask for Clear Explanations of all Procedures
Now that you have read your informed consent and have your prepared questions for your provider, they will call you back to your appointment. Once you go behind that closed door, ask your provider to explain what will be done during this appointment. It is important for medical professionals to explain what procedures will be done during the visit.
If at any time you feel uncomfortable, please speak up! If you plan to bring a support person such as a partner, friend, or family member to this first visit, it might be helpful to think of a code word beforehand, so your support person can speak up for you if you become overwhelmed.
Don’t forget to ask the questions that you prepared. Feel free to take notes as they answer your questions. Notice how they respond to questions. Do you feel heard or is the provider rushing you? After the visit, take time to reflect on whether or not you felt comfortable with the provider during your appointment. This is a huge deal because if you are not comfortable, it is going to be hard to ask questions or feel as though you are receiving quality care. If you did not feel comfortable, it is okay to search for a different provider. You will be in the care of this individual for 9 months, so it is important to have the right team of people supporting you. You want to feel empowered during your pregnancy.
Bottom line: Tune in to how you feel. As a birthing person, you have choices and rights no matter what birthing environment you choose. If you don’t feel comfortable at any point during your pregnancy, it’s not too late to find a new environment or provider.
Take Advantage of Opportunities for Education
What creates an empowered pregnancy? Education, education, education! Education allows you to make the best decisions for yourself and your family. Search online for different birth techniques and methodologies, and then find a class at your hospital, with a local organization, or even online!
Take time early in pregnancy to think about how you want your labor and delivery to go. Do research on classes that are in alignment with what you desire during the birthing process. There is something out there for whatever you want your birth to look like. Attending various classes can help you learn about different decisions you will have to make once the baby is born. Classes can help you think through decisions like knowing when you want to cut the cord, what newborn procedures you want your baby to have, when to do baby’s first bath, and infant feeding. Education allows space to have conversations and ask for help where needed so you can have an empowered pregnancy.
Find a Community of Support for an Empowered Pregnancy
Nothing says empowerment like community. Join a group in your local community or online for additional support. Find a group of expecting pregnant people so you can add to your support team. Every new parent needs support, so do not be afraid; get involved. There is so much power in feeling understood by someone who has been through what you’re experiencing.
Prioritize your Physical Health
Proper nutrition before, during, and after pregnancy can improve birth outcomes and has significant implications for maternal health. Focusing on whole foods especially fruits and vegetables, eating enough protein and limiting processed food can play a role in reducing the risk of pregnancy-related complications, such as preeclampsia. Preeclampsia is a condition that disproportionately impacts Black pregnant people and can be a result of the long-term psychological toll of racism as well as current systemic barriers to proper treatment that delay the diagnosis or treatment of the condition. If this all sounds like a daunting task, you are encouraged to seek guidance from your doctor, midwife, doula, or support team.
Doulas can support your nutrition by offering suggestions for healthy meals and providing accountability and support. They can also make sure you’re being monitored for early warning signs of pregnancy-related complications.
Last but not least, physical exercise is another important aspect of prioritizing your physical health. Yes, it is safe to exercise while pregnant! Walking regularly, stretching, and yoga have been found to have significant benefits during pregnancy for both you and your baby. Being idle and sedentary during pregnancy presents its own risks, so do not be afraid to get your body moving. There are modified workouts that are readily available to pregnant persons. It is important for pregnant persons to speak with their provider about exercises that are safe for them.
If you need help finding easy, delicious recipes that focus on healthy fats, protein, and fruits/vegetables, check out our 5-ingredients or less recipe generator. Click to learn more about the benefits of doing a Whole30 while pregnant!
Prioritize your Mental Health
Focusing on your physical health during pregnancy is important; however, do not neglect your mental health. Venturing into parenthood is wonderful and stressful at the same time. If you are feeling overly anxious or depressed, ask for help.
Mental health professionals can equip you with tools for how to manage your stress, learn how to better communicate with your partner, heal emotional wounds, and help you replace toxic thoughts with more positive ones. Look for a trained perinatal mental health professional."
By Christine Michel Carter| August 16, 2019
"Moms of color have an increased risk of experiencing PPD and related disorders than women in other ethnic groups, but fear is keeping them from getting the treatment they need. Here’s why, and how Black families can get the right mental health support."
"During her first year as a mom, Karen Flores, then 31 years old, was afraid she was not emotionally stable enough to take care of her daughter. On the particularly hard days, Flores would take a walk with her daughter on the beach. “Out of nowhere, this bizarre thought came to my mind ‘push the stroller over the rocks and see what happens,’” she wrote on the site Maternal Mental Health Now. “I was paralyzed by the thought but forced myself to keep on walking while wondering where it had come from—'Oh, My God, am I crazy?' I wondered.”
Flores, now 50, was not crazy. She was suffering from postpartum depression, a condition that affects up to one in seven women, according to the American Psychological Association. Flores didn’t immediately seek out help. “I was extremely anxious and ashamed thinking that I was losing my mind and that my baby would be taken from me,” she says. “I tried praying and did a lot of cardio.” Before her daughter’s second birthday, she began working with a therapist to manage the symptoms of her depression.
Black women like Flores are less likely to get help for postpartum mental health issues compared to both white women and Latinas, according to a study published in the journal Psychiatric Services. Part of this hesitation is caused by fear—these women fear they will be considered unfit and have their children taken away from them by Child Protective Services. These fears are not unwarranted since one in nine Black children will spend time in foster care by the time they're 18, according to data from the Adoption and Foster Care Analysis and Reporting System. This is the second-highest risk racial/ethnic group to end up in the foster care system behind Native American children.
“There’s a lack of trust of medical practitioners within the Black mom community nationwide,” explains Shivonne Odom, LCPC, LPC, founder of Akoma Counseling Concepts, LLC, in Silver Spring, Maryland, who specializes in maternal mental health counseling for mothers with perinatal disorders. “Many medical practitioners are not trained to refer or treat perinatal mood disorders so when they hear patients report typical symptoms of postpartum depression, practitioners mistake the severity of the symptoms for abuse.” Odom, who is Black herself, adds that many practitioners do not recognize a difference in how perinatal mood disorders present among ethnic groups. “This leads to improper treatment or poor rapport between practitioner and client,” she says.
Postpartum depression, anxiety, and other perinatal mood and anxiety disorders can affect any mother and can manifest up to one year after delivery. However, there are cultural nuances during pregnancy, labor, and delivery that can increase the risks of experiencing PPD for Black mothers. Statistics show that Black women are three to four times more likely to die during or after delivery than white women. From 2011 to 2015, there were 42.8 deaths per 100,000 live births for Black non-Hispanic women—a higher ratio than any other ethnic group. “These statistics along with birth trauma and untreated mental health issues prior to and during pregnancy may lead to postpartum depression,” Odom says.
Suffering in silence
Odom says she often sees the same themes preventing Black mothers from seeking mental health therapy. First, there’s the fear of losing control, independence, respect from others, or mental sanity. “Sometimes holding in this fear leads to a manifestation of irrational thoughts—'I’m not a good mom,’ ‘I feel empty,’ ‘I’m not emotionally connecting to my baby,’” she says. “The belief that something is wrong, which must mean I’m doing something wrong and I’m a bad mom is an extension of these irrational thoughts.”
Then she often hears that these women would prefer to seek help from their friends, family, and church rather than a mental health professional. “There’s definitely a cultural stigma discouraging mental health counseling in the Black community,” Odom explains. “Some believe that if you go to therapy you have to be admitted to a psychiatric hospital or will be required to take addictive prescription medications. Some people’s religious beliefs also shape their views on mental health and can impact their help-seeking behaviors.” There’s also concern passed down from generation to generation that mental health practitioners are suspicious of Black mothers."
By Murphy Moroney | October 24, 2020
"The coronavirus pandemic has brought on a slew of challenges for expecting women and new parents. With so much uncertainty, women must take care of their mental health. Because COVID-19 has disproportionally affected people of color, mothers in these communities need more support than ever, as people of color have less access to mental health services compared to white people. Moreover, when they do receive care, it is likely to be of poorer quality.
In honor of National Pregnancy and Infant Loss Awareness Month, we spoke with Shonita Roach, executive director and spokesperson for the 2020 Multicultural Maternal Mental Health Conference, to learn why discussing issues that directly affect maternal mental health will positively impact women of color.
"This awareness month is very dear to my heart, as I also lost my son to an accidental death nearly 18 years ago, and I suffered postpartum depression and even contemplated suicide," Shonita told POPSUGAR. "Through extensive therapy, parenting classes, and spiritual healing, I have been able to thrive, create a loving family with my three boys, and serve as an advocate for women and mothers."
How a Lack of Diversity in the Medical Field Is Affecting Black Maternity Health
It's widely known that Black women experience higher chances of maternal health complications than white women in the US, and unfortunately, the lack of diversity in healthcare professions isn't making it any easier for women of color to get the help they need.
"When you talk about mental health or seeing a therapist or even taking medication for the condition, there is a lot of judgment and misnomers," Shonita told POPSUGAR. "So when you take into account the implicit (and explicit) bias against Black women and healthcare, it makes it especially challenging. The lack of multiculturalism in mental healthcare, from a discrepancy in diverse professionals to the lack of community-based services, creates a major barrier that is difficult to overcome."
Additionally, having more nonwhite doulas and medical professionals can have a positive, lasting impact on maternal health across the board. "Studies show that having doulas of diverse backgrounds contributes to reducing maternal and infant mortality rates," she explained. "What I love about doulas is that they are community-based and do a lot more intimate, one-on-one work with women. They fill the gap where the traditional healthcare system lacks."
How COVID-19 Has Negatively Impacted Black Maternal Health
COVID-19 has disproportionately affected communities of color, and in turn, has extended to Black maternal healthcare. While Shonita is encouraging families to do whatever they can to limit their exposure to the virus, she knows that can be difficult to do when you're pregnant or have just welcomed a child.
"It's important that communities everywhere practice the safety precautions to reduce the spread of this deadly virus," she explained. "However, those same precautions, such as reducing the use of public transportation unless absolutely necessary, isolating yourself, and staying home puts further strain and stress on expecting and postpartum women."
"Not only that, the acceleration of the need for accessible technology and internet services proves to be paramount during the pandemic," she continued, noting how access to telehealth is a privilege and can be a challenge for marginalized communities. "The pandemic is also very isolating when it comes to prenatal visits: women are having to attend these alone without their partner or support system. Also, your friends and family are no longer allowed to visit the hospitals during and after delivery. The entire situation is so unfortunate and does not create a conducive environment for a healthy state of mind as you transition into motherhood, whether you're a first-time mom or a mother to multiple children."
Black Women's Struggle With Accessing Reproductive Healthcare
We would be remiss if we didn't mention some of the historical and cultural reasons that Black women have struggled to get adequate access to reproductive healthcare in the US.
"Medical experimentation on the bodies of women of color and the oversexualization and degradation of Black breasts — which contributes to negative stigmas on Black breastfeeding — are just two examples of why it negatively impacts the sexual and reproductive health of Black women," she said. "This creates barriers of mistrust, misinformation about our bodies. All of this plays into the current disparities and stigmas surrounding reproductive health in marginalized communities."
January 28, 2021
During pregnancy and postpartum, it is important to eat well so that you and your baby have the proper nutrients to sustain adequate energy levels and to feel good overall. When it come to eating fruits and vegetables, it is always a good idea to check the most recent list of the dirty dozen and the clean fifteen put out by the Environmental Working Group.
The Environmental Working Group works to provide a list of foods that contain the most pesticides-the dirty dozen-as well as a list of foods that contain the least amount of pesticides-the clean fifteen. It is best to try to purchase organic produce for the items on the dirty dozen list.
Here is the list for 2020's Dirty Dozen and Clean Fifteen:
The Dirty Dozen:
The Clean Fifteen:
Follow me on Pinteret for healthy recipes to try that incorporate these nutritous fruits and vegetables. Happy Eating!
A New Study Finds That Postpartum Depression Can Last Years—So Let's Take a Look at What It Actually Is
By Jaime Stathis| November 10, 2020
"Postpartum depression, a strikingly common experience among new mothers, spent decades being a taboo, barely-acknowledged topic.
It wasn’t until celebrities like Brooke Shields, who candidly wrote about her experience with postpartum depression in 2005, encouraged destigmatization and invited women to discuss grief during a time in their lives where they expected to feel nothing but joy.
As PPD continues to be discussed among celebrities and on social media, and as women begin to bring the issue to their doctors and mental health professionals in hopes of getting treatment, this begs the question: What is postpartum depression, exactly? Let’s take a closer look.
What is postpartum depression?
According to The Cleveland Clinic, postpartum depression is a mental shift new mothers experience after delivery, also called the “baby blues.” The symptoms exist on a spectrum and everything from mild blues to postpartum psychosis that falls under the umbrella of postpartum depression. The symptoms can be as mild as sadness, irritability, and trouble sleeping, or as dramatic as paranoia, hallucinations, and obsessive thoughts.
How common is postpartum depression?
The Cleveland Clinic states that an estimated 50-75% of women experience an emotional shift after the birth of their child, with up to 15% experiencing more severe, prolonged symptoms which is called postpartum depression. Among those women, approximately 2% suffer from postpartum psychosis, which comes on quickly and is a medical emergency.
When also taking into account women who had stillbirths or miscarriages, the number of women affected in the United States is around 900,000.
The underlying causes of postpartum depression explain why it’s so prevalent. Hormones drop after pregnancy, and the shifting levels of estrogen and progesterone can trigger mood changes similar to premenstrual syndrome but amplified. Fatigue, stress, and a history of depression are all contributing factors."
"The tween and teenage years are already filled with heightened emotions and social pressures – adding a pandemic to the mix only makes things more complex. How can we best support older kids who have been impacted by COVID-19?
Our guest experts will discuss how to help your teens and tweens through this difficult time, how to monitor and care for their mental health, and more."
This webinar is a free event being held on Thursday January 28th from 9PM-10PM (Eastern Time).
"Winter's here - how will we continue to keep our youth active and healthy during the pandemic? Many sports have had to take a time-out due to COVID-19. Indoor activities have been cancelled, and, pandemic or not, weather doesn't always permit us to enjoy being physically active outdoors. The cancellation or delay of sports seasons have also had long-term impacts on the futures and identities of youth and young adults.
So, as parents and caregivers, how do we keep our children active, healthy, and strong, while helping them (and us) mourn the loss of the activities that help them thrive? Join us and our guest experts as we discuss the ways to tackle these issues and help our children cope physically and mentally so that everyone "wins."
This webinar is a free event being held on Thursday January 14th from 9PM-10PM (Eastern Time).
By: Cory Turner, Anya Kamenetz, & Meghan Keane| December 10, 2020
"For the kids in our lives, the last nine months have been many things. Scary — because an invisible, unknown illness was suddenly spreading across the globe. Maybe even fun, when the possibility of school closing felt like a snow day. But for many, that novelty has given way to frustration and sadness — even depression and anxiety. Just like adults, kids are wondering: Will I get sick? Will someone I love die?
It's a lot for kids and parents to handle. So we talked to the experts and came away with five tips for how you can help your kids through this.
Make sure your kids wear their masks
"Kids generally don't get very sick from this virus," says Dr. Ashish Jha, dean of the Brown University School of Public Health. But, he says, they can still play a part in making sure others don't get sick by wearing their masks and social distancing.
It might take a little imagination. If you have younger kids, you can explain the spread of the coronavirus by comparing their mouths to a bottle of bug spray. Weird, yes — but it's one way for young ones to visualize the tiny droplets they spread, even when they aren't sick. If they wear a mask, it helps keep those droplets in.
If you've got older kids or teenagers, take this a step further: Encourage them to spread the word. Practice what they might say if they're with friends at the park and someone takes their mask off. Maybe your 13-year-old has been waiting months to see Grandma and could say, "I need to keep my Grandma safe, so do you mind putting your mask on?"
Rehearse it with your kids so the conversation goes smoothly.
Practice positive thinking and mindfulness
In a recent report, researchers interviewed 46 teenagers in California and found that the teens reported a huge sense of loss — similar to the stages of grief. Most of the teens were sleeping badly because of lack of activity and lots of screen time.
Kids of all ages — as well as their parents — can probably relate.
In addition to the obvious prescription — trade in some of that screen time for physical exercise — try some brain exercises too, like replacing negative thoughts with positive ones. You might try saying a few things you're grateful for each night before dinner or before bed. There's evidence behind that: Gratitude boosts your immune system, lowers blood pressure and motivates us to practice healthy habits. It may feel awkward or cheesy, but practicing mindfulness and positivity very consciously can help kids and parents too.
It's also important to watch for signs of something more serious too.
"Depression in teenagers sometimes looks like a prickly porcupine. Everybody rubs them the wrong way," adolescent psychologist Lisa Damour says. Don't take it personally; just keep offering them a listening ear."
Ted-Ed Animations| October 1, 2020| Lesson by TED-Ed, directed by Roxane Campoy and Charlotte Cambon.
"Discover how pregnancy changes every organ in the body— from the heart, to the brain and kidneys— and what we still don’t know about it. -- Muscles and joints shift and jostle. The heart’s pounding rhythm speeds up. Blood roars through arteries and veins. Over the course of a pregnancy, every organ in the body changes. Initiated by a range of hormones, these changes begin as soon as a pregnancy begins. Explore what we know— and don’t know— about pregnancy's effects on the body and brain."
"We’ve been through so much together since this summer, and we still have a long way to go as pandemic parents and caregivers. (Remember, psychiatrist and child trauma expert Dr. Bruce Perry said it’s a thru-hike, not a sprint or even a marathon).
With our co-founders, Dr. Lindsay Malloy and Dr. Amanda Zelechoski, leading the way, let’s take a brisk walk down memory lane (because nobody has time for a stroll right now) to share some of our most impactful moments so far since our first Pandemic Parenting Exchange."
This webinar is free and will be held on Thursday, December 17th, 2020 from 9:00-10:00 PM (Eastern Time) via Zoom.
How racism can impact your pre- and postnatal care — and advice for speaking to your Ob-Gyn about it.
By Erica Chidi and Erica P. Cahill, M.D. | October 22, 2020
"The data is heartbreakingly clear: Black women in America have more than a three times higher risk of death related to pregnancy and childbirth than their white peers. This is regardless of factors like higher education and financial means, and for women over 30, the risk is as much as five times higher.
While the recent national dialogue created in response to the data has been a critical leap forward, it has also brought up a lot of fear and questions from Black women about how we can prevent these outcomes.
Last year, we sought out resources to help Black women navigate their prenatal and postpartum care in light of this knowledge, but came up empty when looking for a resource that explicitly called out encountering racism during this time and how to tackle it.
As a result, we partnered to create an education guide that would offer pregnant Black women agency when planning their care (which, in most cases, would be with white care providers). We felt it required an allied, intersectional perspective that acknowledged the importance of care providers and health educators working together on behalf of patients.
We aimed to have a discussion with medical racism and antiracism at the center, especially since increasing evidence points to the effects of structural racism as the reason for this mortality inequity. Medical racism is present whenever health care professionals or institutions alter the diagnostic or therapeutic care provided because of a patient’s race, particularly if the decision puts the patient at an increased risk of poor outcomes.
We wanted to inform Black women of the unique risks they could encounter during their pregnancy, birth and the postpartum period, as well as what they could do to prepare for them. This guide is meant to help Black women feel safer, and to provide a modern framework for medical providers to actively address their own racism."
"We’ve all been there. Exhausted. Busy. Hungry. Bored. You name it—we turn the [insert electronic here] on. (Warning: The mom/parent guilt around this can be strong.)
But what are the actual, science-based facts on screen time…and too much of it? As the weather turns colder, we explain the fact-based pluses and minuses of screen time to increase our knowledge on this hot topic. Jonathan S. Comer, Ph.D. will join as our guest panelist, and Natalie Hong, M.S. will guide the discussion as moderator."
The webinar will be held on December 7, 2020 from 9:00-10:00 PM (Eastern Time) via Zoom.
"Every family is unique in its own ways, and parents are navigating the pandemic the best way they know how. We want to shine a light on our co-parenting parents and single parents who are experiencing their own set of distinctive challenges during the pandemic and provide resources to ease the burdens they may be experiencing."
The webinar will be held on November 24, 2020 from 9:00-10:00 PM (Eastern Time) via Zoom.
App Review| May 10, 2020
What is Peanut App
"Peanut App Review: Peanut App is a popular social networking app for women that connects like-minded women and enables them to share their experiences. This app creates a network where women going through similar experiences meet as well as support each other. The app is a reminder for the women during the phases of fertility, pregnancy, as well as motherhood that they are not alone.
Peanut app serves as a gift for women during their overwhelming moments. Moreover, the app allows women to share their struggles and concerns with other women who can understand their situation well and avail genuine advice. This app makes it easier for women to meet, chat, as well as learn from each other.
Features of Peanut App
Peanut offers women with a number of exciting features which makes it even more special for them. Here are some of the best features that the app offers.
October 15, 2020| NPR Staff
"When I was growing up, I marveled at how my single mother was able to come home after a long day of work, make dinner, iron our school uniforms and help me and my sister with our homework.
I can't imagine how she would have managed during this pandemic.
What would she have done if she was laid off from her job at the airport? Would she be able to figure out — or afford — virtual school? How would she keep us safe from the virus?
Around the world, mothers have been struggling with these very challenges during the pandemic. We spoke to three mothers who shared how they've been faring: a mom of two in Jordan, expecting her third child and missing the in-person support from family; a dairy farmer with four teenage children — and 165 cows — to look after; and a single mom helping her son, who is on the autism spectrum, find joy in spite of coronavirus restrictions.
Read their stories, check out our special report on 19 women facing the coronavirus crisis — then find out how to nominate a woman to be profiled at the bottom of the story. -- Malaka Gharib"
"Calm And Juggling On A Dairy Farm
The cows rode around the milking carousel, a circular platform lined with 30 individual holding pens that slowly turn clockwise. In each pen, a black and white Holstein or brown and white Montbéliarde waited to be milked.
In the pit below the carousel, 40-year-old Nienke Pastoor stood at udder-height, attaching the milk-extracting pump to each cow as it passed her.
Pastoor, her husband Jaap and Henk, an employee, need just 90 minutes to milk all 165 of the farm's dairy cows.
Pastoor and her husband co-manage a 336-acre dairy farm. One of her many responsibilities is to help run the daily milking operation. She's also the mother of four teenage children; she cooks and cleans; and she manages the farm's books. She regularly gives tours to schoolchildren from the nearby city of Groningen, taking them around the farm and letting them milk the cows by hand.
For a while Pastoor cherished the sudden quiet and freedom that COVID-19 brought to the "Other World": the name given to the remote farming district in the far north of the Netherlands where the Pastoor family have been dairy farmers for 75 years. "We established a strange new family rhythm during the lockdown," she said on a blustery blue-skied afternoon.
The only set routines were the morning and afternoon milking of the cows, and the e-lessons of her children: Thomas, 17, Daniel, 15, and twins Emma and Paulien, 13, who like many students in the Netherlands switched to remote learning in March.
"There was less pressure," she said. "No music lessons or sports games to drive the children to. And because the weather was so nice, life definitely felt a little more relaxed." The only visitors to the farm during the lockdown, which lasted from March 15 till June 2, were the truck drivers who came by three times a week to pick up 3,079 gallons of milk, and the vet who visited every two weeks.
But the pandemic also added new tasks to Pastoor's farm routine. She suddenly had to help the children with their schoolwork. "I made sure they were sitting at their laptops when they were supposed to be. I told them, 'We all have responsibilities in life. I have to do things. And so do you. You make sure the thing you are doing is done on time.' "
The children didn't mind the sudden shift to learning at home. They were able to sleep longer in the mornings as they didn't have to bike to school. The only frustration was the frequent technical glitches — no sound, the teacher's screen not working.
Pastoor was so busy she couldn't do the books for a month. Work kept piling up on the long wooden kitchen table where she normally sits.
"In the end, I had to tell [Jaap and the children] to get out of the kitchen so I could have some time for myself."
"It was difficult being a mother and a farm manager," she said, reflecting on lockdown life. "Everyone expected me to successfully juggle everything."
But dealing with all these responsibilities didn't concern Pastoor. What truly worried her was how she would cope if her husband were to get COVID-19 and succumb to the virus — and she'd be left to manage the farm on her own. "The pandemic really brought that home."
By: Sarah Chorney| September 28, 2020
"Following the birth of her third child, Jorgia Hamel Nevers experienced Postpartum Depression (PPD) for the first time. The 30-year-old from Robeline, Louisiana, identified her symptoms and spoke with her husband, Travis, and a counselor. They informed her doctor during a 6-week postnatal follow-up appointment. He prescribed Zulresso, the first FDA-approved drug designed to treat postpartum depression. It is an IV treatment which can reportedly help patients feel relief from symptoms within 48 hours. Soon, Nevers felt a loving, healthy attachment to her baby River and her 2-year-old and 5-year-old sons again. She decided to share her story because she says she wants women who are experiencing PPD to know that they can speak up, seek treatment and get better. This is her story, as told to PEOPLE.
River was born August 27, 2019. I started having some PPD symptoms a week after her birth. Since she’s my third child, I knew what PPD was from warnings in pregnancy classes I’d previously taken and also from my social work courses. (I’m currently a full-time social work student at Northwestern State University in Natchitoches, Louisiana.) My PPD symptoms showed up as irritated and depressed moods; I wouldn’t get out of bed, had severe anxiety attacks, would cry for no reason and wasn’t feeling a true connection with River or my two sons. On top of that, I felt guilt for what I was experiencing and how it was affecting my family as a whole. I just had a lack of will to do anything at all — except for being alone.
While I experienced the depressive moods and crying in the beginning, it then progressed to the other symptoms. The lack of will was difficult because inside, part of me was still saying, “Get up, take care of your family, do your schoolwork.” But my body just would not move. I felt paralyzed. And as it progressed, I started not to care. I’d think, “River is crying, oh well, Travis will get her. She doesn’t need me anyway,” or “Sammy has something at school for parents to attend, but I don’t want to get up, oh well.”
This is completely the opposite of who I was before PPD. The lack of maternal connection played into the lack of will. At first, I didn’t feel like River was my child. Then I didn’t care anymore about trying to build that bond with her, or to maintain the bond I had with my sons. The anxiety attacks were physically debilitating, in particular. My entire body would tense up, I would cry, I couldn’t breathe, and I was just terrified each time they came. (I had these symptoms until my treatment of Zulresso was completed.)
I had never experienced “baby blues” or PPD with my other two children. After about a month of having symptoms, I told my husband that I felt like something was wrong. I didn’t fully say PPD, just that I wasn’t feeling like myself. Then, a classmate and friend of mine sent a message to check on me. I told her what I was experiencing, and she advised me to see a counselor and tell my doctor. I didn’t want to admit to myself that something was wrong, but I was taking a course about mental health and read about depression symptoms in the Diagnostic Statistical Manual. I sat in my chair and checked off “yes” to almost all of the symptoms listed. That woke me up.
At that point, I decided to tell my professors what was going on, to make a therapy appointment, and to inform my doctor at my routine 6-week checkup. I am lucky that Dr. Olatinwo was involved in the trials for Zulresso. He saw its potential for me.
My physical experience of the treatment involved staying in a hospital room for three days with an IV that administered Zulresso and other fluids. It is a 60-hour infusion, so I had food brought to me and I was checked on every two hours. I watched a lot of Disney+ and just focused on getting better. My husband would also bring me snacks, and he brought River (while the boys were in school and daycare) to the hospital for a visit. I also FaceTimed with them in the evening to say goodnight. After being on the treatment for 30-35 hours, I started feeling better — more like myself. I had the urge to get up and take a shower. I wanted to take care of myself."