In postpartum traditions around the world, having trusted helpers (different than visitors) is essential. Helpers provide physical and emotional support early on to aid the family’s adjustment. Unfortunately, in our current systems, early support remains spotty.
In 2016 legislation was passed that required health care providers to screen for Postpartum Depression. The purpose was to assess a client’s risk. However, once noted to be at risk, what services are there for the family? Jennifer Winter had an excellent article in the New Yorker that thoroughly describes the dilemma of care for families.
The reasons for lack of support are familiar and concerning.
• The view that postpartum is a few weeks and they will get ‘back to normal.’
• There aren’t enough providers, especially those trained in postpartum mental health.
• Finding help that is nearby, or getting to an office, can be a problem. Online sites may be helpful.
• Assurance that there is insurance coverage for treatment.
Postpartum is a biologically sensitive time when the brain makes key changes for parenting. Many things can cause an imbalance and it becomes debilitating to a parent. The ‘old traditions’ understood this. We need to be aware of new families. Even you, as a community member, friend, non-professional, can re-cultivate parts of these ‘traditional” models of care.
In my experience, home visits provide an important continuity of care. To be clear, the family has to welcome you to visit (avoid ‘just dropping by’). In addition, you should know other resources beyond yourself. I have included two at the end of this blog. A consistent, calm person and some routine can be reassuring and ease the transition. I’ve often assisted with simple nap times.
When I met Pam, her pseudonym, she was near full term. She knew she’d need reliable support. During her childhood, her own mother had spent much of every day staring out the window, not engaging with anyone. The daughter, Pam, came to understand this as depression. Thus, she made a postpartum plan for herself that included home visits, a few days a week for six weeks.
Once at home with her new baby, she recognized specific fears. “I feel like I’m falling into a dark hole”, she said. “That’s not normal, is it?” She shared this with her provider and told me. For her, what mattered was that the baby was okay and she knew someone was nearby.
The routine was for her to breastfeed then nap. I sat next to the bed and she held my hand while she rested, reassured that someone was there. This routine and some Ambien gave her the necessary respite to recover and adjust. At six weeks, she was much more confident and clear. This perplexed Pam’s mother, the grandmother, who told me “In my day, we never had this kind of help”. Sadly, other grandmothers have confided the difficulty of their own postpartum time. That feeling can linger for decades.
Pam knew to ask. She had a provider who heard her, a supportive partner and health insurance. Still, it was a fragile time. A little personal attention went a long way. When a family needs more, they need an advocate. The stress and blame is on the new parents when the situation deteriorates. Serious depression requires professionals… and we work to find those professionals. We can provide regular non-judgmental support, though “we” needs to include medical, legal and work policies that respect and support families.
Meanwhile, keeping our eyes and ears tuned to a new family, connecting with them for a small thing is essential to caring. That is a valuable new-not-so-new tradition.
Keep this handy for phone support.
1-833-TLC-MAMA (1-833-852-6262) Call or text. English or Spanish. The National Maternal Mental Health Hotline.
1-800-944-4PPD (1-800-944-4773) Call or Text. English or Spanish. Postpartum Support International.