Health and Wellness - Maternal Health

 What is a crisis?

If you are experiencing a crisis, it is important to tell your health care provider if you are currently pregnant or have been pregnant in the last year. 

A mental health crisis occurs when acute or chronic stressors become too much to handle. You may feel overwhelmed and unable to function in your daily life. You may feel at risk of hurting yourself or others. 

When you’re in the midst of a crisis, it can be hard to know where to turn. Your Life Iowa is here to walk beside you until your life is back on track. We can connect you to services and trained professionals to help in a mental health crisis. 

Here are more support options that may be available in your community: 

• Crisis Stabilization Community-Based Services are short-term services. They provide services where the individual lives, works or socializes. They help de-escalate and stabilize an individual following a mental health crisis. 
• Crisis Stabilization Residential Services are short-term living arrangements. They help to de-escalate and stabilize an individual after a mental health crisis. 
• Mobile Response is an on-site, face-to-face mental health service. It is for individuals experiencing a crisis. Mobile response staff are able to intervene wherever the crisis is occurring. 
• 23 Hour Observation and Holding is a secure and protected environment. Individuals can stay up to 23 hours. It is a staffed my medical professionals and supervised treatment environment. 
• Warm Line is a telephone line staffed by individuals with lived experience. They provide nonjudgmental, nondirective support to an individual experiencing a crisis.

Support and help is available through Your Life Iowa. Live Chat, by calling (855) 581-8111 or by texting (855) 895-8398. 

Learn more about available crisis services    See mental health providers in your area

 Talking to Your Doctor or Midwife

Some women are uncomfortable talking with their doctor about depression. It's important to share your concerns. Your mental health is important to you and to your baby's health. Take the below questions with you to ask your doctor. Bring a notebook to take notes or to write down any other questions you might have.

Remember, your healthcare provider is there to support you to help you. 

Understanding Perinatal Depression

Can you explain what postpartum depression is and how it differs from the "baby blues?"

• What are the signs and symptoms of postpartum depression?
• Based on the symptoms I've described; do I have depression?
• What kind of depression do I have?

Doctor’s Experience 

• What is your experience in treating women with depression? 

Risk and Prevalence 

• Am I at a higher risk for developing postpartum depression? 
• How common is postpartum depression among new mothers?

Screening and Diagnosis

• How is postpartum depression diagnosed? 
• Will you screen me for postpartum depression during clinic visits? 

Medication 

• Do I need to take medication for my depression? 
• What medications are safe for new moms; what if I am pregnant or breastfeeding? 
• How effective is the medication? 
• What are the common side effects and when will they go away? 
• Will people be able to tell that I am taking medication? 
• How long does it take for the medication to start working and how do I know that it’s working?
• Should I avoid certain foods, alcohol or other medications?
• What should I do if the medication doesn’t work? 

Counseling and Therapy 

• Would counseling or therapy be beneficial for me? 
• Can you recommend someone in my community who can counsel or provide therapy? 

Impact on the Baby and Family 

• How can postpartum depression affect my baby and my relationship with my baby? 
• What can my partner do to support me if I experience postpartum depression? 
• Preventive Measures and Self-care 
• Are there steps I can take to reduce my risk of developing postpartum depression?
• Can changing your lifestyle help to prevent or deal with postpartum depression? 
• What should I eat? 
• How much should I move? 
• Are there other changes I should make? 
• Can changing what I eat and how much I move help me prevent or deal with postpartum depression? 

Support Groups and Resources 

• Are there support groups or resources for women with postpartum depression? 
• Can you tell me where to find reliable information and support online? 
• Duration and Recovery How long does postpartum depression usually last?
• What is the recovery process like? 
• Does having postpartum depression increase my risk of future depression? 

Impact on Future Pregnancies 

• If I have experienced postpartum depression once, will I have it again? 

Emergency Situations 

• What should I do if I experience thoughts of harming myself or my baby? 
• Who should I contact if I need immediate help or support? 

Insurance and Costs 

• Will insurance cover the cost of treatment for postpartum depression? 
• Are there affordable treatment options available if I don’t have insurance coverage? 

Follow-up Appointments 

• When should I schedule my next visit to check-in with you?
• How will I know when to stop taking medication? 
• What should I do if my symptoms get worse between appointments?

 Maternal Mental Health & My Baby

Maternal mental health, including depression, can affect your baby. Early bonding is important for your baby's development. Becoming close to your baby is a big part of that bonding. When you have depression during pregnancy or after birth, it can be hard to become close to your baby. You may not be able to respond to what your baby needs. If there are older children in the house, they may be missing your support as well. 

Early treatment is important for you, your baby and the rest of your family. The sooner you start, the faster you will start to feel better. 

How Depression Affects Children and Families 

Growing up in a family where one or both parent experiences depression may be challenging. In some cases, depression interferes with the emotional bonding between parent and child. This can lead to various developmental and behavioral issues. 

Impact on the Baby: 

• Emotional Development: Babies can sense their parent’s emotions. They may become more fussy or difficult to soothe in response to a parent’s sadness or anxiety. 
• Attachment Issues: Depression can interfere with a parent’s ability to bond with their baby. This can lead to attachment issues and developmental delays. 
• Behavioral Problems: Children of parents with untreated depression may exhibit behavioral problems. They also have developmental delays as they grow older. 

Impact on Older Siblings: 

• Emotional Stress: Older siblings can pick up on their parent’s mood and may feel worried, anxious or sad. 
• Feeling of Neglect: Older children may feel neglected. Parents may struggle to meet their children's emotional and physical needs. 
• Guilt and Blame: Older children might blame themselves for their parent’s sadness. They may feel guilty, thinking they did something wrong. 

Talking with Children About Depression 

Communicating with children about mental health, including depression, is important. Talking about mental health helps prevent feelings of guilt, blame and anxiety. Here are some tips for talking with your child: 

• Pick a quiet time without interruptions or distractions.
• Use words that your child can understand and be ready to answer their questions. 
• Let them know that mental health problems are treatable and that you are seeking help. 
• Let them know that your depression is not their fault and they are not responsible for fixing it. 
• Encourage open dialogue about feelings and concerns. 

Importance of Transparency and Openness 

Hiding depression from children is not helpful. Children can sense when something is wrong. Talking it out is good - it leads to reducing family tension, strained relationships and behavioral issues in children.  Seeking professional help is crucial for the well-being of the entire family.

 Self-Care Checklist

Below are some ways to help care for your mental health after having a baby. Remember to talk to your doctor about any concerns you're having. Balancing self-care with professional guidance can help you in your recovery process. 

• Seek Professional Help
  • Schedule regular appointments with a healthcare or mental health professional. 
  • Follow the recommended plan, including medication, if prescribed.
• Connect with Loved Ones
  • Reach out to family and friends for support.
  • Communicate your feelings with your partner and/or loved ones.
• Establish a Routine
  • Create a daily schedule to include time for self-care, rest and bonding with your baby.
  • Focus on tasks and set realistic goals.
• Sleep
  • Aim for six hours of sleep per night. Take turns with your partner or a loved one caring for the baby at night, if possible.
  • Take naps when the baby naps during the day.
• Eat a Balanced Diet
  • Eat a variety of fruits, vegetables, lean proteins and whole grains. 
  • Drink more water and limit the intake of caffeine, alcohol and sugar.
• Engage in Physical Activity
  • Aim for at least 30 minutes of moderate-intensity exercise most days.
  • Choose activities you enjoy, such as walking or yoga.
• Practice Relaxation Techniques
  • Learn and practice mindfulness, meditation or deep-breath exercises.
  • Consider trying progressive muscle relaxation or guided imagery.
• Set Aside Time for Yourself
  • Engage in activities you enjoy and that help you relax, such as reading, drawing or gardening.
  • Take short breaks throughout the day to rest, take a bath or shower.
• Education Yourself about PPD
  • Read reputable sources to understand PPD better.
  • Learn about the signs, symptoms and treatment options available. 
• Limit Stress
  • Identify and reduce sources of stress in your life. 
  • Delegate tasks and ask for help when needed. 
• Create a Supportive Environment
  • Surround yourself with positive and supportive people.
  • Set boundaries and communicate your limits with others. 
• Focus on Bonding with Your Baby
  • Spend quality time with your baby each day. 
  • Engage in skin-to-skin contact and responsive feeding.
• Be Patient with Yourself
  • Recognize that recovery may take time.
  • Be kind to yourself and avoid self-blame.
• Keep a Journal
  • Write down your thoughts, feelings and experiences.
  • Use journaling as a tool to reflect and gain insight.

More ideas for Self-Care

 Screening is important

Screening for perinatal depression is a routine part of your health care. Screening can occur during and after pregnancy. Health care providers like your doctor, your baby's doctor or a nurse can assist. 

Take a Self-Screening (English and Spanish)      See mental health providers in your area

Confiding in people you trust can help to improve your treatment outcome. If you aren't sure who to talk to; call, text or chat with Your Life Iowa for a referral in your area. 

 How PPD Support Groups can help

PPD support groups are a valuable resource for emotional support and shared experiences. Please remember that support groups do not replace professional help. 

• Shared Experience and Understanding: Members often have similar experiences. They can offer understanding and empathy that friends and family might not provide.
• Emotional Support: Support groups offer a safe and private place to talk. It’s important to talk about your emotions, past and future, present and future events. They can help your feel less alone and isolated. 
• Practical Advice and Information: Participants can share strategies that have helped them. The group can provide information and resources to manage PPD.
• Enhanced Coping Skills: Learning how others cope with similar situations can help you.
• Increased Motivation: Seeing others recover from depression and do well can be motivating and give you hope. 
• Reduced Stigma: Being in a group with people who have depression can make you feel like your experiences are normal. That you are not the only one struggling.  

Things to know about PPD Support Groups

• Support Group Dynamics: Many different people attend support groups. Personalities and member behaviors can impact the helpfulness of the group. It may take time to find the right one for you.
• Accessibility: Sometimes, finding a local support group can be challenging. There are also online groups available if an in-person group is unavailable to you.
• Groups are not for Everyone: For some, the group setting may not be helpful.  Remember that one-on-one therapy or other forms of support are also available. 

Where can I find a PPD support group? 

Here is a list of resources where you can find support groups for Postpartum Depression (PPD):

• Postpartum Support International (PSI) 
  • PSI offers support, resources and local PPD support group information. They also help for other maternal health issues. They have groups meetings and chapters across the United States.
    • Here’s the link for PSI online support groups 
• Groups on social media
  • Search for PPD support groups on Facebook. 
  • Many local and international communities offer support and advice.
• National Alliance on Mental Illness (NAMI)
  • NAMI offers maternal mental health support and education programs. These programs are for individuals and families.

 Treatment is available

Various treatment options can be helpful for PPD. Each option has its unique approach, advantages, and disadvantages. Our YLI counselors can help you find the right one for you.

Medication Therapy 

Decisions about medications should consider the clinical history of individual. Women with a history of severe symptoms during pregnancy are more likely to become ill. Risk to the fetus is also important to consider. Risk of self-harm and suicidal thoughts are other factors. Discussions of the potential risks and benefits of treatment or foregoing treatment are necessary. 

MotherToBaby Website

MotherToBaby is a helpful one-stop interactive website for mothers on medications. This can be during pregnancy or breastfeeding. The resource provides helpful information on the safety and risk of: 

• Medications
• Vaccines
• Chemicals
• Herbal products
• Substance Use
• Maternal health conditions
• And more! 

This no-cost service is for pregnant and/or breastfeeding individuals. It is also open to family members, health professionals and the general public. Help in English and Spanish is available via chat, text, phone (toll-free 866.626.6847) and email.  

MotherToBaby has over 300 up-to-date evidence-based and helpful fact sheets.  New fact sheets include information on monkeypox, COVID-19 vaccines and Plan B One-Step®. 

Learn More About MotherToBaby 

Psychotherapy 

PPD symptoms often respond well to therapy. Therapy is often provided in a one-on-one situation. Here is a brief description of the types of psychotherapy that may be helpful:

Interpersonal Psychotherapy (IPT)

Interpersonal Psychotherapy is an effective for treating PPD. IPT is a time-limited form of therapy (12 to16 weeks) and the main goal is symptom relief. IPT focuses on learning how to communicate about:  

• Grief Life stage & Social transitions 
• Intimacy struggles 
• Relationships 

IPT is manual-based and follows a specific course of treatment. 

Cognitive Behavioral Therapy (CBT) 

CBT is best known for its efficacy in treating anxiety, including OCD. CBT helps us understand our thinking processes and how affects our feelings. Therapy focuses on helping mothers learn to have control thoughts and how to change them. 

This therapy helps a mother develop coping strategies to manage stress or distress. Relaxation, mindfulness and other exercises help stop irrational and unhelpful thoughts. 

Dialectical Behavioral Therapy (DBT) 

Like CBT, DBT uses exercises and practice to improve mental wellness.  Skills taught include mindfulness, distress tolerance, emotional regulation and interpersonal effectiveness. DBT is often supported by both individual and group therapy.

Solution-Focused Therapy 

Solution-Focused therapy focuses on working towards positive change. This type of therapy focuses on the strengths and skills of the mom. Setting goals that are solution based is the key to therapy. Several sessions are the standard course of treatment to see results.  

Group Therapy

Group therapy uses the role of community in support.  Community interactions are often very helpful in validating personal experiences. Validation from others in the group is helpful in learning of not being alone in their struggles. Education is a big component, teaching about maternal mental health. Personal stories on stress management and coping skills benefit the entire group. 

Couples Therapy 

Couples therapy provides a safe space for partners. Behavior patterns in the relationships help form the basis for learning. Learning new communication and listening strategies help couples adapt. Therapy works around maintaining the health of the couple’s relationship, including: 

• Education on maternal health and mental health 
• Symptom reduction 
• Life change management 
• Infant attachment support 

Neuromodulation 

Neuromodulation uses electromagnets to stimulate the brain. This treatment leads to improved mood and other symptoms. There are several types: 

• Deep brain stimulation (DBS) 
• Electroconvulsive therapy (ECT) 
• Transcranial magnetic stimulation (TMS) 
• Transcranial direct current stimulation (tDCS)

These options can be helpful when other treatments are not effective. Neuromodulation does not involve taking medication. 

Hospitalization 

Sometimes, in rare situations, maternal mental health may put the health of the baby or mother at risk. The following are situations where hospitalization help keeps everyone safe. 

• Suicidal Ideation or Attempt | When the mother has thoughts of harming herself or has made attempts to do so. 
• Harmful Thoughts Towards the Baby | When the mother has thoughts of harming the baby or is unable to care for the baby due to her mental state. 
• Psychotic Symptoms | When the mother is experiencing hallucinations, delusions or severe confusion. 

Learn More About Crisis Services     Find Mental Health Provider Near You 

 Encouragement. One Text at a time. 

You can never have too much support. That’s why Your Life Iowa created our supportive text messaging program. Sign up to receive encouraging messages, no matter what you may be facing. 

SIGN UP FOR TEXT MESSAGES 

 The Language We Use Matters 

How we talk and think about mental health impacts those with mental health concerns. The stigma around mental health often prevents people from seeking or accessing care. The good news is that there are safe, effective tools for combating stigma. You can help reduce stigma in your home and community. 

• One of the main ways people perpetuate stigma is through language. 
  • Terms like “crazy” and “psychotic” create the idea that those with a mental illness are dangerous or bad. Slang or derogatory terms also perpetuate negative connotations. Instead, use person-first language and proper medical terms (i.e., a person who has depression). 
  • Do not use a mental illness as a “catch all” to describe a negative behavior. For example, do not use “She’s so bipolar” to describe someone’s actions. 
• Have open, honest conversations about stigma and mental health. Make sure to listen and support them. Offer to help connect them with more support. Your Life Iowa can help you start a conversation about mental health with a loved one. 
• Learn more about mental health concerns and how they are treatable medical conditions. People with a mental health concern or mental illness deserve compassion and respect. 

Learn more about mental health and stigma