“But you’re supposed to be happy.”
Too often, that is the message received by mothers during and after pregnancy, even as anxiety, depression or intrusive thoughts are overwhelming them. That message can be life-threatening for women who are suffering.
A new Mother-Infant Wellness Program, part of the Behavioral Health and Wellness Pavilion at Prisma Health-Upstate, aims to remove the stigma and come alongside mothers and families facing the critical time after birth.
Postpartum mental health complications are an epidemic
Psychiatrist Neha Hudepohl, Director of the Women’s Mental Health Program for the Department of Psychiatry for Prisma Health-Upstate, said it’s time to address the epidemic at hand.
“The most common complications of pregnancy are perinatal mood and anxiety disorders,” Hudepohl said. “Not a lot of people realize that, but depression, anxiety, OCD, all these things that we’re treating are really much more common than any other complication of pregnancy, affecting upwards of 20% or more women. That’s a huge number of people.”
Hudepohl said suicide and mental health conditions are the leading cause of death for postpartum women across the United States, including in South Carolina.
“It’s really an epidemic, and it’s a crisis,” she said. “I think we’ve made a lot of progress in terms of talking about these conditions, trying to identify them through universal screening programs and other support programs. But when women develop really severe, really significant symptoms of mood and anxiety disorders, whether it’s in pregnancy or after they give birth, it’s really important for them to have access to treatment. If we can catch it early, sometimes we can do this in the general outpatient setting, but a lot of these women get very sick very quickly. You have a brand new baby at home, it’s really hard to be psychiatrically unwell. It’s really hard to be depressed. It’s really hard to be anxious all the time. It doesn’t just affect you, it affects the whole family. It affects the child, it affects everybody.”
A hospital day program that keeps moms and babies together
The Prisma Health Mother-Infant Wellness Program, the first of its kind in South Carolina, is a partial hospitalization program for individuals during pregnancy and postpartum up to one year. It is group-based and short-term, five days a week for five or six hours per day.
“The philosophy behind our Mother-Infant Wellness Program is really to keep moms together with their babies for treatment and try to give them the most intensive kind of support of a wraparound cocoon, so that they have a safe place in which to talk about how they’re feeling and also to get better,” Hudepohl said. “This program is really modeled on some other programs across the country, particularly one up in Providence, Rhode Island that was the first of its kind in the country.”
The program includes intensive individual and group psychotherapy.
“Women that require medications are able to be followed very closely and hopefully get better much more rapidly,” Hudepohl said. “We do a lot of work with helping moms really connect and bond with their babies, because we know that when there’s depression or anxiety or other conditions, that can sometimes get in the way of that maternal-infant relationship. And we really want to work on helping take care of our moms, being healthy in the context of having their babies with them, because you can’t treat them away from their babies – it just doesn’t work in the setting. Our program really provides a safe and nurturing environment, where they can get really intensive treatment to get better quickly, so they can enjoy the rest of this time, because that’s what they deserve. They deserve to be able to enjoy this time.”
Not just “the baby blues”
Hudepohl said society tells mothers that the time of pregnancy and new motherhood should be the most joyful time in their lives.
“What does it say about you as a mother if you’re not joyful? I think that’s the stigma that we’re trying to combat,” she said. “Those are the narratives that we’re trying to overturn, because women don’t choose to be depressed and anxious when they’re pregnant or have delivered. It happens for many reasons. It happens for biologic reasons, psychological reasons, all kinds of different reasons. We need to be able to provide an environment where we can take care of these patients, and not just for them, but for their whole family. This affects the baby too, so it’s a place that we can intervene quickly and early to try to get the best outcomes.”
The program is for any point in pregnancy up to one year postpartum. Treatment is a team approach with the support of psychiatrists, therapists and nursing infant lounge attendants, with a wide variety of interventions, including art therapy, with the hope to add others, including yoga and music therapy. Hudepohl said there is no one-size-fits-all treatment, so care focuses on the whole person and includes the involvement of their home support and loved ones.
“It’s not just one type of therapy, it’s not just medications, it’s all of these things together. We know that when you put all these things together, that that’s more effective than when you just try to do one or two things alone,” Hudepohl said. “We want to really give these women the tools that they need, not just to get better while they’re there, but to keep getting better after they leave us, so that they can keep practicing these skills when they’re at home. And that’s the beauty of the day treatment model is that they’re with us during the day, and then they get to go home every night and practice what they’ve learned. It keeps them with their families at night and on the weekends. If we can avoid them having to be separated from their family, that’s ideal.”
Get help for yourself or someone you care about – don’t wait
Women can self-refer by calling the program’s intake line and scheduling an assessment with an admissions coordinator. The program accepts insurance, including Medicaid.
“We know that when women have preexisting mental health conditions, those can get exacerbated in pregnancy and in the postpartum period, but a lot of people also have new onset symptoms, either in pregnancy or particularly after delivery, and those can be really jarring for people who’ve never experienced anything like that before,” Hudepohl said. “I want people in the community to know how common these conditions are and how important it is to seek treatment, because when they go untreated, that’s really where risk comes from. We want people to call us if they need something, and even if this isn’t the right program for them, we’ll work really hard to try to find the right place for them.”
Learn more
Many women experience the “baby blues” after they give birth, but when these feelings last longer than two weeks, they may need to seek mental health care.
Symptoms may include:
- Feelings of anxiety, depression, guilt, isolation and/or inadequacy
- Crying more than usual or for no apparent reason
- Having trouble bonding or forming an emotional attachment with the baby
- Feeling moody, irritable or restless
- Sleeping too much or being unable to sleep
- Eating too much or too little
- Having strange or unusual beliefs/thoughts
- Thinking about harming herself or her baby.
(Source: Prisma Health)
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