Postpartum Mood Challenges and Disorders with Keisha Reaves
Keisha Reaves is a PMHC and it's Perinatal Mental Health Certification and it is governed by Postpartum Support International.
Society expectations in postpartum versus the reality of postpartum?
I think it's a vast difference. Society definitely romanticizes it. It makes it seem like you'll have a baby, you'll breastfeed, and then you'll lose all of your weight. That it's a natural bonding experience. And it's a very magical thing that happens. And you move on with your life and you have this beautiful family that you asked for and is a blessing. That's how society portrays it to be, but the reality of it all is oftentimes doesn't go as expected.
For a while, it's a lot of trial and error of a bunch of different things on top of sleep deprivation. There's not a lot of discussion about that or how that also affects your mental health. We live in a very binary culture where either things are good or bad. But it can be both- you can feel so blessed, but you can also be very frustrated and feel very stressed. We don't spend enough time talking about this huge traumatic shift that happens and how it affects you mentally, physically, spiritually, and your entire world.
Most people think of Postpartum Depression as simple as that word, but it actually is a whole spectrum is perinatal mood and anxiety disorders, and more common than not most women suffer the anxiety part of postpartum. Anxiety can be triggered by all of those outside factors, such as not having support, not having a partner, not having family, living in a place that's far, etc. They have the idea of the parent or the mother that they want to be, but all of these things may not allow them to be the image in their head.
So I think one of my biggest missions when we talk about postpartum is to normalize all the things that society has kind of taught us. We expect that these mood challenges can appear any time in that first year after you're having a baby or, when you wean from breastfeeding. It is typical to have experienced postpartum depression or anxiety after miscarriage, because that is a hormonal shift. So if you have experienced loss such as, a stillborn, for example, your body's still in the process as if the baby is physically still here. So you may continue to lactate and your hormones are still going through like the normal process. So you can still have it, but when we talk about those external factors, you're emotionally dealing with a loss. So that's a contributing factor to kind of make you more susceptible more at risk of experiencing a perinatal mood and anxiety disorder because of everything that's going on inside of you hormonally and then also in your day-to-day life.
Each birth is different. Every birth is different, but I think just being educated and learning as you go to just be able to just have trial and errors and keep in mind that a lot of the times it sounds like a death sentence for women. Sometimes that's why they don't want to say this is what they're experiencing. However, it's so common. One out of seven women experience it- and it's treatable. It's something that you can be seek help for and be fine and get back to the person that you were before.
It's very difficult to like prepare yourself for the unknown. I definitely encourage all pregnant women that I work with or pregnant parents to just kind of like expect whatever. Have a birthing plan and have someone that can advocate for you for what you desire, but also go in knowing that a lot of the times things don't go as planned. Like you may think you're going to have a natural birth and then opt to change your mind. No one expects or plans for their child to be in the NICU or to have a traumatic birthing experience. Ultimately I think it's good to seek out therapy or just be able to go to a support group. To have a space to be able to process that so they do not just internalize it and deal with it alone.
That's so much for your brain to try to process. I always encourage people to have a plan to set up a counseling session with someone afterwards, just for a check-in you may even feel fine. If not a counseling session, a support group- just to be able to check in, hear from other moms, process your story, and just to make sure that you're doing okay. A lot of the time the doctor at your six week check-up is just like adding up postpartum test scores, but not really asking, "okay, so how are you really doing? Or how was it really?" You may not even talk about it with your partner because you're kind of just trying to get by as new parents. So I think that that's a good way to be able to navigate that.
Oftentimes people are looking for like a red flag symptom. Sometimes it can just be as simple as you just don't feel like yourself. It's been two weeks and something just doesn't feel right. If you feel like the crying spells are continuing past those two weeks, if you feel like your anxiety has become heightened, that you are always worried about your child's safety, your safety- that's always something that's on the forefront of your mind. If you feel like your mood has kind of dropped and the bonding with your baby isn't occurring, if you're having any type of thoughts of wanting to harm yourself, if you feel like you are starting to fixate on a particular behavior, any type of obsessive compulsiveness in how you interact with your baby or day to day- all of those can be kind of red flags. You can ask for somebody to talk to and get some support, to be able to get through that. And a lot of circumstances can happen out of our control, but you're not alone in how you feel and you can get to a better place.
Postpartum Mood Disorders and Your Partner
Statistics show that if the birthing parent is experiencing any of the perinatal mood and anxiety disorder, that the partner is also experiencing some form of anxiety or depression. Everybody's affected by all of this and your partner is trying to support you. They're also trying to adjust. This is something that's new for them as well. It's good that both parents get counseling or couples counseling as well. There's also new parent groups that people can be able to go to get more resources and to be able to navigate this transition. And it should be said, you don't have to be a birthing parent to go to a new parents group. There are a variety of new parent groups to fit the needs of all new parents. If we are worried about our partners, we are looking for the same exact signs and symptoms: not feeling the joy, weepy/crying, being quick to anger/rage, disconnected, and just kind of not feeling ourselves. Also, know that the anger here is the surface reaction to something that could be deeper. The response could be rooted in depression or anxiety - or just having a difficult time adjusting. Feeling overwhelmed, lack of sleep- so you're irritable. Anger is just the natural reaction outwardly that you're expressing.
Racial Disparities in Postpartum
The media or society often tries to portray racial disparities postpartum as if it's a socioeconomic issue or an educational issue alone. However, a lot of it is just based off of race. Sometimes it can be if you live in a rural area and you can't choose your OB-GYN. So you're just given someone and this person isn't listening to you. There have been studies showing that some doctors that are white may look at their black patients as thinking that they have some sort of super strength to sustain pain longer than others. So then that's how they'll treat their patients versus being able to say, "Oh, something's not right." Or actually just really listening to the patients.
Making sure that your partner, or somebody else in the room with you, will speak up for you. That they can identify the things that are going on and be educated in this process. It's unfortunate that it has to be this way- the idea that we are thinking, "Let's make sure that we go in here and we come out alive and everybody comes home." This is unbelievably unfortunate because other races don't have to go through that. But it's the cards that were unfortunately dealt. And if anything, we can just be adamant about changing that.
For white women, I think it's more so just being educated. Understanding what your biases are, being able to talk to your peers, being able to work legislatively, identify this as an issue and work through it. If anyone notices anything that's done within an office or within a practitioner, call it out for what it is. I also think about how America handles maternity leave and the postpartum experience for mothers. There are so many corporations where you have to do short-term disability versus there just being like an actual leave where you get paid a hundred percent of what you were making and you just have that time to adjust. Or for there to be a paternity leave so that your partner or whomever can be able to be home with you and be able to take some time off. All other countries have it right where they can give them a substantial amount of time to be off from work. This is a huge change on you mentally and physically- it is a huge adjustment. It is not something that should be based off of what class you're in for people that can get education or support, but it should be all women who are pregnant/postpartum equally able to get the help that they need.
Long-term Sustainable Support from our Partners
As long as this baby is here, then the support is indefinite basically. I think that the first thing that can be said from a partner is just like, 'what do you need from me?' On the other hand, it's maybe not always looking for some guidance, but just doing. I've heard from several mothers that they can get frustrated if their partners are asking, 'what do you want me to do?'- when there's chores around the house, there's food that could be cooked, there's laundry that could be done, bottles that could be washed, etc. Not having to have to have that constant guidance and being able to take the lead and initiative. We encourage moms to sleep when the baby sleeps, but moms oftentimes don't want to because they are thinking, 'Oh, the baby is having a three hour stretch- now I can go do laundry and I can go take care of all these other things'. They have a partner that could take that off of their hands. So they don't feel the guilt to have to do that. Then they can really like sleep and heal and be replenished. They can show up and be the parent that they want to be.
I also feel like oftentimes mothers feel this feeling of losing themselves and becoming a mom and feeling like they're missing the person that they used to be. You have this person that has come into your life that is completely dependent upon you and really needs you. You can just kind of feel like an object that is just providing, providing, providing, and not really pouring into yourself. Their partner can encourage them to not lose that connection to the life that they were versus just being like, 'well, she said she's fine'. The partner can encourage them. Even if mom doesn't say that she wants it - still advocate for her. Make her feel like she deserves it.
Finding Support Postpartum
It's always good that you get someone that you feel you can trust. Someone that makes you feel heard. And that allows you to be really vulnerable and you can open up and get the help that you need. Most therapists offer a free 15 minute consultation before you have to book an appointment. So that gives you the time to ask those questions, get kind of like a feel of how they are over the phone. Then you can decide to book from there. I've had several clients that have called who have a list of therapists that they're going through kind of interviewing just to figure out who they think may be good for them.
Also, don't think that it is a luxury that only people who make a certain amount of money can have. A lot of towns have community service boards. A lot of providers offer sliding scale fees where they can do it as low as the person would be able to afford. Some organizations may have an intern that will see someone at a lower fee and that interns is being trained in that specific area. There's different avenues to be able to meet your needs financially.
You can check out Psychology Today- they have a directory where you can filter it based off of how you are going to pay for therapy. You can also filter by to tele-a-health sessions, gender, race, etc. You can call your insurance provider and ask them if they can be able to provide you with the list. Plus, there's also something that's called the employee assistance program, where the company that you work for typically pays for a certain amount of sessions for you to be able to seek counseling. You can contact your HR department to find out what's the name of your EAP provider. Your employer will never know that you're in counseling. They are two totally separate companies- your employer has already paid for a certain amount of sessions for all of their employees to be able to have counseling at no cost to them.
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