Perinatal Therapy should be the norm...

It is no secret that I recently had a baby. In my own care, I realized some troubling things about the way we talk about perinatal/postpartum mental health.

I gave birth at a birth center, and as part of that birth center, I did all of my prenatal appointments with a group of parents also due within a month of us. It was WONDERFUL to have this support. Each week had a different discussion regarding preparing for labor, parenthood, and the aftermath of child birth.

One week, we discussed postpartum mental health. As a mental health professional, I was curious to discuss. They explained the warning signs, the differences between full-blown postpartum depression and baby blues, and when to get outside help. This was information I had heard before, and I was fairly confident things would be fine and normal for me after I had my baby.

Fast forward 8 weeks, and I have my baby. I am a hormonal TRAIN WRECK. I am crying out of joy, despair, anxiety, fear, insecurity. All the feelings. I was incredibly sensitive.

And yet, my husband and I were advised that because I seemed to be coping well, sleeping as often as I could, and enjoying most things about being a new mom, there was no cause for concern. I was not flagged for being at-risk in my mental health. I was encouraged to take regular walks and get outside of the house when possible (and safe).

Here's the thing: I did not meet criteria for a diagnosis. I was doing pretty well considering. But everything about my life had changed. My body looked different (still does), I was not sleeping much, my family treated me differently, my husband treated me differently, I was not working. I had a massive identity crisis. Did I need a prescription for trazedone? No. Did I need to process that I am a completely different person all of the sudden? HECK YES.

So, I went to the free support group offered by the birth center. It was facilitated by a nurse typically. I LOVE the nurses at the birth center. But when a bunch of moms get together for a support group, what do we do? We offer advice. Advice is the enemy of perinatal mental health. As I am writing this, I am realizing I need to write an entire post about why advice, although extremely well-intentioned, exacerbates our issues.

Your OB/pediatrician/midwife is looking for obvious signs that you may be a danger to yourself or others. They have been trained to look for DIAGNOSABLE mental health issues. They give out a depression survey. As a therapist, I am here to tell you that you may not qualify for a diagnosis, but you could still benefit from processing this massive life transition in a supportive, affirming environment.

Now say it louder for those in the back: Perinatal mental health services should be the norm. Just like some parents need to have their perineum checked twice after giving birth then never again, and some parents need to go to a pelvic floor specialist for months after having a baby, some parents will benefit from talking to a therapist 3-4 times, and some parents will benefit from that support through the first year of life. But my experience is that we all need a mental health check up!