"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." 

By: Sarah Greenberg, MFT

• "Lifestyle changes can help people manage anxiety and depression, and take charge of their mental wellbeing.
• Some behaviors that are linked to improving or preventing anxiety and depression include addressing sleep issues, connecting with others, eating a nutritious diet and exercising.
• Change can be hard, especially for those with anxiety or depression, so it's important to be kind to yourself. 
• The best way to care for your mental health is the approach that works best for you. In some cases, professional help may also be needed."

"When Roy came to see me for longstanding symptoms of depression and anxiety (they often co-occur), he was hesitant at best. He wanted to feel better, but “getting treatment” didn’t fit with his narrative for what he was “supposed to be doing as a grown man” in his culture. He had a decent, consistent job, but felt his life lacked meaning and joy. He was so hard on himself and avoided others for fear of judgement.

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. 

1. Sleep 

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.

2. Self-Compassion

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."

"​In just 5 minutes you can reset your day in a positive way."

"Women who had Covid while expecting experienced guilt, shame and unhealthy levels of stress."

"Kate Glaser had chalked up her exhaustion to being 39 weeks pregnant and having twin toddlers in the house. She also wondered whether her flulike symptoms were a sign that she was about to go into labor. But when she woke up one morning with a 100.4-degree fever, she called her doctor and got a rapid Covid-19 test.

Two nurses came to deliver her results to her in the waiting room. They were dressed in full gowns, masks, face shields and gloves.

“I knew by the eerie silence and the way they were dressed that I was Covid positive,” she said. “It was an emotional moment; I felt really disappointed and shocked and, as a mom, I felt a lot of guilt. What did I do wrong?”

Glaser, who lives in the Buffalo, N.Y., area, returned home and isolated from her husband and the twins in her bedroom, where she spent hours mentally replaying all her activities leading up to the positive test result. She also made a public post on her Facebook page about her positive status, and what she was feeling — guilt, embarrassment and panic. The post went viral, and Glaser started hearing from women around the world who were pregnant and worried about Covid-19. The majority of the of the 2,300 comments she received were supportive; a few were harshly critical.

“I was going down a rabbit hole of guilt and stress,” Glaser said, adding that for her, as much as the physical symptoms were bad, the mental stress of Covid was much worse.

Prolonged stress can have real consequences on pregnant people even outside of a pandemic and has been tied to low birthweight, changes in neurological development and other health impacts in children. And the pressure associated with a positive Covid-19 test increases these mental health risks.

The anxiety is not without reason. As of November 30, there have been more than 42,000 cases of coronavirus reported in pregnant women in the U.S., resulting in 57 maternal deaths. U.S. health officials have said pregnancy increases the risk of severe disease for mother and child, and being coronavirus-positive in late pregnancy may increase the rate of preterm birth.

Prenatal care and birth plans are also disrupted by a positive test result. “Women are expressing so much fear about being infected, but also about going to the hospital, delivering and being separated from their child,” said Laura Jelliffe-Pawlowski, an epidemiologist who is the primary investigator of HOPE COVID-19, a new study that focuses on the well-being of women who are pregnant during the pandemic.

The study launched in July and will follow more than 200 women around the world, from pregnancy to 18 months postpartum, to understand how Covid-19 and the pandemic response impacts pregnancy and infant health outcomes.

Dr. Jelliffe-Pawlowski and her team have analyzed the data from the first group of women, and they are finding “absolutely incredible” levels of stress and anxiety. “Sixty percent of women are experiencing nervousness and anxiety at levels that impede their everyday functioning,” she said, citing preliminary data. “There are a number of women, particularly lower-income women, expressing how hard it is to choose to stay in a job that puts them at risk versus quitting the job and not having enough food for their baby.”

Nearly 70 percent of the participants reported feeling worried about decreasing family income and more than 22 percent worried about food insecurity (though none had experienced it at the time of the survey). Dr. Jelliffe-Pawlowski worried that women were not necessarily getting the psychological care they needed: “If you can’t feed your family, seeking out mental health care is not your top priority.”

She also said more than 84 percent of women reported moderate to severe anxiety about giving birth during a pandemic. “Many women do not want to get tested because they will be stigmatized or separated from their baby or not allowed to have people in the room to support them,” she said. She added that similar visiting rules often hold true for babies in the NICU after being born preterm during the pandemic: Only one parent can be present in a 24-hour period. “It’s heart-wrenching to see families go through those choices.”

Dr. Jelliffe-Pawlowski is particularly interested in how stress impacts births and long-term outcomes for children as psychological stress is highly associated with preterm birth. After the attacks of September 11, 2001, the risk of preterm births almost doubled for people living near or working at the site of the fallen towers. She’s also concerned about long-term effects of stress and anxiety on maternal bonding during the pandemic.

Margaret Howard, a psychologist at Women & Infants Hospital in Providence and postpartum depression researcher at Brown University thinks it is absurd for pregnant women who test positive for an infectious virus to bear any guilt or stress associated with their diagnosis: “Are moms in a special category where they are expected to not get Covid? What about a sinus infection? Hay fever? Cancer? Why is Covid a moral failing for mothers?”

When Erica Evert, a pregnant mom in northern Virginia, received her postive Covid-19 test result, it didn’t make sense. She was near the end of her pregnancy, and hadn’t left the house in four and a half months, except for ob-gyn appointments to check on the baby.

“My first thought was, is this a false positive? I feel fine. And my second reaction was to start bawling,” said Evert. She was scheduled to have a cesarean section with her second baby and the test was merely a formality — until it was a life-changing event.
​
The hospital gave her a choice: She could deliver the next day and be treated as a Covid-19 patient — separated from her baby with no skin-to-skin contact, per the hospital’s policies. Or she could wait 10 days from the date she received the positive test result and deliver with her regular plan. She had four hours to make a choice she wasn’t expecting. “I kept thinking: am I going to make a decision that results in my child dying?” said Evert."

"Registered Dietitian Tracy Lockwood Beckerman gives tips on the most nutritious foods to eat to support your baby in each trimester of your pregnancy."

By: Catherine Pearson | 10/28/2020

"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."

"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:

• Is there a nurse line that I can call if I have questions?
• If I experience bleeding or cramping, do I call you or the nurse?
• What do you consider an emergency?
• Will I need to change my habits regarding sex, exercise, nutrition?
• When will my next prenatal visit be scheduled?
• What type of testing do you recommend and when are they to be done? (In case you want to research the tests to decide if you want them or not.)

Know Your Rights

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."

Opinion| Megan Markle: The Duchess of Sussex

"Perhaps the path to healing begins with three simple words: Are you OK?"

"It was a July morning that began as ordinarily as any other day: Make breakfast. Feed the dogs. Take vitamins. Find that missing sock. Pick up the rogue crayon that rolled under the table. Throw my hair in a ponytail before getting my son from his crib.

After changing his diaper, I felt a sharp cramp. I dropped to the floor with him in my arms, humming a lullaby to keep us both calm, the cheerful tune a stark contrast to my sense that something was not right.
I knew, as I clutched my firstborn child, that I was losing my second.

Hours later, I lay in a hospital bed, holding my husband’s hand. I felt the clamminess of his palm and kissed his knuckles, wet from both our tears. Staring at the cold white walls, my eyes glazed over. I tried to imagine how we’d heal.
I recalled a moment last year when Harry and I were finishing up a long tour in South Africa. I was exhausted. I was breastfeeding our infant son, and I was trying to keep a brave face in the very public eye.

​“Are you OK?” a journalist asked me. I answered him honestly, not knowing that what I said would resonate with so many — new moms and older ones, and anyone who had, in their own way, been silently suffering. My off-the-cuff reply seemed to give people permission to speak their truth. But it wasn’t responding honestly that helped me most, it was the question itself.

“Thank you for asking,” I said. “Not many people have asked if I’m OK.”

Sitting in a hospital bed, watching my husband’s heart break as he tried to hold the shattered pieces of mine, I realized that the only way to begin to heal is to first ask, “Are you OK?”

Are we? This year has brought so many of us to our breaking points. Loss and pain have plagued every one of us in 2020, in moments both fraught and debilitating. We’ve heard all the stories: A woman starts her day, as normal as any other, but then receives a call that she’s lost her elderly mother to Covid-19. A man wakes feeling fine, maybe a little sluggish, but nothing out of the ordinary. He tests positive for the coronavirus and within weeks, he — like hundreds of thousands of others — has died.

A young woman named Breonna Taylor goes to sleep, just as she’s done every night before, but she doesn’t live to see the morning because a police raid turns horribly wrong. George Floyd leaves a convenience store, not realizing he will take his last breath under the weight of someone’s knee, and in his final moments, calls out for his mom. Peaceful protests become violent. Health rapidly shifts to sickness. In places where there was once community, there is now division.

On top of all of this, it seems we no longer agree on what is true. We aren’t just fighting over our opinions of facts; we are polarized over whether the fact is, in fact, a fact. We are at odds over whether science is real. We are at odds over whether an election has been won or lost. We are at odds over the value of compromise.

That polarization, coupled with the social isolation required to fight this pandemic, has left us feeling more alone than ever.

When I was in my late teens, I sat in the back of a taxi zipping through the busyness and bustle of Manhattan. I looked out the window and saw a woman on her phone in a flood of tears. She was standing on the sidewalk, living out a private moment very publicly. At the time, the city was new to me, and I asked the driver if we should stop to see if the woman needed help.

He explained that New Yorkers live out their personal lives in public spaces. “We love in the city, we cry in the street, our emotions and stories there for anybody to see,” I remember him telling me. “Don’t worry, somebody on that corner will ask her if she’s OK.”
​
Now, all these years later, in isolation and lockdown, grieving the loss of a child, the loss of my country’s shared belief in what’s true, I think of that woman in New York. What if no one stopped? What if no one saw her suffering? What if no one helped?

I wish I could go back and ask my cabdriver to pull over. This, I realize, is the danger of siloed living — where moments sad, scary or sacrosanct are all lived out alone. There is no one stopping to ask, “Are you OK?”
​
Losing a child means carrying an almost unbearable grief, experienced by many but talked about by few. In the pain of our loss, my husband and I discovered that in a room of 100 women, 10 to 20 of them will have suffered from miscarriage. Yet despite the staggering commonality of this pain, the conversation remains taboo, riddled with (unwarranted) shame, and perpetuating a cycle of solitary mourning."

"​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: Shanicia Boswell | August 26, 2020

"​Raising awareness about the history of Black breastfeeding and the factors that contribute to low rates of Black mothers breastfeeding is an important way to close the gap."

"I sat on the sofa crying silently between my mother and my fiancé. Tears spilled over my cheeks as we watched a movie and I held my newborn daughter. I was three days postpartum and my breasts were painfully engorged with milk. How was this happening? I had survived a med-free labor and delivery. This was supposed to be the easy part. Looking back nearly eight years ago at my breastfeeding journey, I always remember this day. I was a first-generation breastfeeder.

​That day and many other days, I sat between people I loved the most and felt completely alone and isolated. My partner could not help me with breastfeeding because he was a man who had no experience around breastfeeding. My mother could not help me because she had not breastfed me or my brother. My friends could not help me because I was the only one in my friendship circle who had a baby. Like many Black millennial women, I was embarking on this journey alone.

​Without the proper resources, my breastfeeding journey only lasted six months. I felt defeated. In fact, the statistics show that Black women are less likely to start breastfeeding than any other race of mother and even less likely to continue breastfeeding for six months. Only 69 percent of Black women initiate breastfeeding compared to 85 percent of white women. The question that is often asked after hearing statistics is why? There are many reasons. There are unfortunate events deeply connected to our race as a people: a history of wet nursing, oversexualization, lack of economic and familial support, are a few. For me, the question became how do we raise the numbers?

This is where Black Breastfeeding Week comes in. Black Breastfeeding Week is August 25 to 31, 2020, and is a campaign that has been part of National Breastfeeding Month for the past eight years. This year, through virtual events, Black mothers, lactation experts, and public health professionals have space to discuss their breastfeeding journeys, raise awareness, and explore public policies that address the disparities in statistics around Black maternal and infant care. Black Breastfeeding Week has become even more controversial this year because we are in a time where extreme emphasis has been placed upon race and it creates a space where white mothers feel isolated. White mothers are asking why Black women are choosing to segregate themselves, even down to the topic of breastfeeding. 

As the creator of Black Moms Blog, a collaborative blogging platform for mothers of color, I am no stranger to the "why aren't we included" questions from white mothers. The truth is, weeks like this should not have to exist. Platforms like mine should not be a necessity—but they are. The needs of Black mothers as well as the specific barriers we face are left out of the overall breastfeeding conversation. The historical and cultural context as to why is important.

​The History of Black Breastfeeding

Cultural reference should always be considered when discussing breastfeeding. During slavery, Black women were used as wet nurses. A wet nurse is someone who breastfeeds another woman's child. The true definition of a wet nurse states "employed," but replace that word with "forced," and the reality becomes clear. It is generational that Black women have developed a disdain for breastfeeding due to our historical relationship with wet nursing. Because of wet nursing, many Black women were unable to breastfeed their own children. Can you imagine the psychological effect that must have had on a moment that every mother should enjoy?"

"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: 

• strawberry
• spinach
• kale
• nectarines
• apples
• grapes
• peaches
• cherries
• pears
• tomatoes
• celery
• hot peppers

The Clean Fifteen: 

• avocado
• sweet corn
• pineapple
• onions
• papaya
• sweet peas frozen
• egg plant
• asparagus
• cauliflower
• cantaloupe
• broccoli
• mushrooms
• cabbage
• honeydew melon
• kiwi

Follow me on Pinteret for healthy recipes to try that incorporate these nutritous fruits and vegetables. Happy Eating! 

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."

By Rafael Nam| November 12, 2020

"Like many married and working couples first confronting the pandemic, Bianca Flokstra and Victor Udoewa tried to go on with their lives as normal.

Flokstra continued to work full time while taking care of their kids, ages 4 and 2. She also handled most of the housework, with her husband helping from time to time. It didn't work.

"Those first couple of months were really hard," Flokstra says. "There was ... a lot of fighting. A lot of tears."

The pandemic has upended many aspects of domestic life, and that has brought new attention to one of the most enduring disparities between men and women — the wide difference in handling housework and child care.

It's what Marianne Cooper, a sociologist at the Stanford VMware Women's Leadership Innovation Lab, calls one of society's most "stubborn" divides.

"The traditional gender division of labor is very durable," Cooper says. "Even the most egalitarian-thinking couples, after having children, find themselves in a much more traditional division of labor than they ever would have intended."

Cooper, who has studied the issue extensively, says that divide, which is rooted in history and perpetuated by persistent societal norms, has endured even as women have joined the workforce in larger numbers over the decades, making record gains.

Yet even as more families become dual-income households, women still do 30% more of the housework and 40% more of the child care, Cooper says.

The disparity in work done at home is now having a serious economic impact as entire families are forced home with schools closed and no child care options available.

More than 2.2 million women have left the workforce this year, far more than the 1.4 million men who have left as a result of the pandemic, according to the monthly U.S. Bureau of Labor Statistics data.

Proportionally, more women were employed in sectors that were hit hard by the pandemic, including hospitality and retail.

​But Cooper, as well as many economists, says the burden placed on working moms during the pandemic is another key variable forcing many women out of the workforce.

Some couples have adapted.

Flokstra, for example, says she had little choice. She desperately needed sleep after exhausting days at a new job in international aid while also taking care of all of her other responsibilities.

She started sending the kids to her husband, unprompted. Then, she started drafting to-do lists — activities she and her husband would split day to day.

​But getting there wasn't easy. It wasn't that Udoewa wasn't willing to help; he was.

Flokstra says she had become so used to doing household chores that she found it hard to delegate — and trust — her own husband to do the job.
​
That hesitancy is surprisingly common among women, according to Cooper.

​It's a complicated mix of "mother's guilt" as well as societal expectations on couples, where men are still seen as the breadwinners."

By Pallavi Gogoi| October 28, 2020

"Women are seeing the fabric of their lives unravel during the pandemic. Nowhere is that more visible than on the job.

​In September, an eye-popping 865,000 women left the U.S. workforce — four times more than men.

The coronavirus pandemic is wreaking havoc on households, and women are bearing the brunt of it. Not only have they lost the most jobs from the beginning of the pandemic, but they are exhausted from the demands of child care and housework — and many are now seeing no path ahead but to quit working.
​
Women have made great strides over the years: More women than men are enrolled in college, in medical schools and law schools.

The number of women in the workforce even overtook men for a brief period of three months through February this year.
But the uncomfortable truth is that in their homes, women are still fitting into stereotypical roles of doing the bulk of cooking, cleaning and parenting. It's another form of systemic inequality within a 21st century home that the pandemic is laying bare."

​Already, their parents are getting sick and dying. Their kids are falling behind. So along with doing everything else, working becomes impossible.

"The problem is that right now a lot of women don't really have choices, right?" says Martha Gimbel, a labor economist at the nonprofit initiative Schmidt Futures. "They can't send their kids to school. Someone has to supervise the learning. Someone has to deal with the cooking. Someone has to deal with the cleaning, and it's falling onto them. And so they can't make choices that they want to make because they're being restricted in all these ways."

Women are back in 1988
The pandemic's female exodus has decidedly turned back the clock by at least a generation, with the share of women in the workforce down to levels not seen since 1988.

​A growing, prosperous economy depends on a large and committed workforce, with women playing a vital role. If women decide to stay on the sidelines, the very dynamism of the U.S. economy is at risk as many households lose half of their earnings and productive capacity. This trend could even turn back the clock on gender equity, with harmful consequences to society and the economy.

Economists are worried.

"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. 

​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.

• Meet: This app encourages women to meet with new people who are going through the same phase of life as theirs. Peanut enables you to connect with many other like-minded women who are nearby. Moreover, the simple and modern design of the app makes meeting even easier. Simply, you need to sign-in and swipe. This will enable you to arrange meetups with other moms.

• Chat: Peanut enables women to message each other and get engaged in chatting. Moreover, you can even create groups and initial engaging conversation among a number of people. Without having to go anywhere, this app gives the moms an opportunity to chat, share, and reduce their stress.

• Join: In addition, to meet and chat, Peanut offers the women a chance to join different groups. This app enables you to join various groups on the basis of your specific interests. Moreover, you can also join groups depending on the particular neighborhood you are living in.

• Share: Peanut gives the women a great platform to share all their anxieties, struggles, and concerns during pregnancy or motherhood. The app allows them to give as well as receive advice on various topics. Moreover, Peanut also allows the creation of polls to know the views of the majority."

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."

"​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."