Any mother can tell you there are a lot of joys and hardships that go along with having a new baby. One aspect of motherhood that is not talked about as much is Perinatal health as whole. Today we have Jessica Allred, an LCSW and PMH-C here to talk to use about this very important subject to what it is, how to help others who are struggling and what we can do as a community to get the conversation about Perinatal started.
Jessica holds a Bachelors Degree in Psychology and a Masters Degree in Social Work from the University of Utah. With over 12 years of experience in private practice, Jessica’s dedication to expanding her services led her to become the Co-Owner and clinical director of Treat Counseling, where she now trains other clinicians.
Specializing in Perinatal Mental Health, Jessica is certified in this field with a PMH-C and is deeply committed to empowering women, helping them find their voices, and fostering self-love. She has written a curriculum for, and begun a free support group for pregnant and postpartum moms and runs the group weekly both virtual and in person.
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Jen: Welcome to the Parents Place podcast with Hilary and Jen.
Hilary : Welcome to the Parents Place podcast. Today we have a special guest with us. This is Jessica Allred. And we are so excited she is here to share a little bit about what she does and how we as individuals can access these resources that are truly necessary. And so I'm so grateful that she is able to be here today to share, share her knowledge and share what she does. So, Jessica, I'm going to turn it over to you and I'm just going to let you tell a little bit about who you are and what you do.
Jessica: Fantastic. Thank you so much for having me. I'm excited to be here. So, I am a Licensed Clinical Social Worker. I'm a therapist. I have been doing therapy since 2010, so a good long while. I'm also a PMHC, which is a perinatal mental health certification and. So, I'm the owner of a group therapy practice in Utah. Here we specialize in perinatal mental health with, you know, all the therapists that are working here and I also see clients and run a support group here at tree counseling and I always like to add as well that I am a mom who has experienced postpartum depression and anxiety. And so that's what's kind of led me down this road and also giving me kind of the passion that I have to work with perinatal families. So yeah.
Hilary: Awesome. Well, I just want to jump right in with this conversation and I will be very transparent. I have 4 little ones myself. I don't know if I would refer to them as little anymore because they're all school age children. But I know very little about what exactly perinatal health is when it comes to the therapeutic level, and I'm making the assumption that there are many of our listeners that are in the same boat. So tell us a little bit about what that is.
Jessica: Absolutely. Yeah. So, perinatal mental health really is describing any mental health complication that can happen during pregnancy and up to one year postpartum. And the language has changed a lot. It used to just be, oh, postpartum depression, and it's now transitioned over to perinatal because lots of these things. And present in pregnancy or like I said, like a year up until a year after birth. And then it's parental mental health disorders instead of just postpartum depression, because actually a lot of different mental health complications can present during pregnancy and postpartum, it's actually so mental health concerns are the most common complication of childbirth and pregnancy, and the statistics are about one in five moms will experience a perinatal mental health disorder. So, if you know five moms, you know one that's going through something. And they can range from postpartum depression to actually postpartum anxiety or pregnancy. You know, perinatal depression or anxiety. Bipolar can present for the first time, psychosis can present for the first time in this period. There's like 7 times increased risk of OCD in the pregnant and postpartum period. About like I think it's about 4% of moms officially get a post traumatic stress disorder diagnosis from delivery, but up to 55% of moms will describe their birth as traumatic. So traumatic birth is something that we're seeing and that a lot of moms are experiencing. And so there's the whole spectrum and range of complications that can happen in this period of time. And so, yeah, that's kind of what we're talking about when we're saying perinatal mental health disorders.
Hilary: Hmmm, that one in five I that is great. I mean and. But you're right. We think about. I mean I think about the individuals, my friends, close family members and neighbors. And you're right, I can pinpoint a handful of people already that have experienced that. So I'm so glad that this this talk topic is coming to light and that we are. They're better at recognizing it and better at accessing the help that we need during that time. So that's perfect now. You say that this starts it's prenatal all the way to the first year, and so is this something that you would encourage all individuals to be involved in if we've had mental health, mental health history in the past? What, who would you suggest should access these resources?
Jessica: Yeah, absolutely. That's a great question. So having a previous mental health diagnosis is one of the biggest risk factors for pregnancy or postpartum. But like I said, about half of moms have never experienced mental health disorder before this period of time. And so there is what we like to call the like, conspiracy of silence. There's a lot of stigma and shame that surrounds these disorders because most people generally think of pregnancy and postpartum as like a glowing time or beautiful time, or so you know, fun. And you have this cute little baby and. And so many people, even that have been through infertility. That's actually a risk for perinatal mental health disorders. So even people that have worked very hard and paid a lot of money to become pregnant and have a child are at higher risk for these complications. And so yeah, it's really important, I think, for every mom to be aware that these are things that can happen and that if they do happen, you're not alone. For instance, I mean, and I can share a little bit of my experience. So, I did experience infertility for a couple of years, was very excited to become pregnant with my first child. And I had already been a therapist for a long time. A number of years treating anxiety and depression. And when I had my first child, what I experienced was just a lot of hyper vigilance around the mothering of the baby, right? Like so. My sweet little baby. He's 8 now. Anytime he would cry, I would just run to him, right. And my heart rate would go through the roof. So and I was just like always kind of in the fight or flight state. I wouldn't really let other people watch him. I was experiencing what we call in our sphere, maternal gatekeeping. So, like, not really letting anyone else participate in watching him. I went to lactation professionals who told me to like. You need to, you know, be feeding him every two hours around the clock. And I did until he was like 9 months old. And so just all of. This is happening and I had no idea until years later that what I was actually experiencing was carrying me like anxiety. But from the outside you can't tell because it just looks like I'm being a really great mom, and we have these ideas, we they call it in our sphere intensive mothering. Our current culture really emphasized intensive mothering. And so it just looked like I was doing intensive mothering or, like, very good mothering. When actually like, this is the mental health disorder and I have no idea. And so even perinatal anxiety feels even less diagnosed or understood than depression. Because of the ways that we just expect mom to act sometimes, and it wasn't until I had my second baby and I was of course completely exhausted from the first one that I experienced perinatal depression and then was getting all of the trainings and she's 6 now, I adore her. And. But then I started getting training and having some understanding about this and one thing that it's really important for moms to know is that postpartum depression doesn't present like regular depression. You know, often it really looks on the outside like everything's going great. You're getting up, you're doing all the things you're supposed to do for your kids. You're even going over and beyond a lot of time. But you just are not feeling connected to yourself or your kids. You're not feeling like yourself, and there's a lot of irritability and rage that actually presents itself. So it almost looks like depression of a teenager or something where you can't really tell that the person's depressed. They're just really irritable and ragey. And so it gets missed a lot. So I think just for moms in particular, I would want them to know like, if you don't feel like yourself. You know, or if you're really irritable or having a lot of rage, or if you can't sleep when your baby's sleeping, or if you're really hyper vigilant about your baby. Like, those are all indicators that you should be reaching out and getting some help.
Hilary: Ohh sorry. Yeah, good. Go ahead, Jen.
Jen: You're good. You were talking about the intensive mothering. And it made me think of my nieces husband. Can men or dads experience this as well? Some sort of this? Because he gets into that very don't touch my baby or gatekeeping is what you were talking about. Don't touch my baby. Nothing like that. And he is always right there. And so can dads experience something similar.
Jessica: Absolutely. Yeah, the statistics are about 10% of dads that'll experience either depression or anxiety in the perinatal period and actually postpartum support International Utah is having an expert come and doing a conference in the fall about postpartum dad specifically. But yes, absolutely. It's interesting because part of the reason that the perinatal period is such a time of vulnerability for mental health for moms is because of hormone shifts like giant hormone shifts, and we can talk more about those. But dads actually have hormone shifts as well. They have a decrease in testosterone with the birth of a baby and it's, you know, seen as, you know, maybe an adaptive response, right? Like we're having less aggressive, you know, kind of energy and more nurturing energy and but certainly a lot of factors can impact the, you know, dads that have that are having babies. And another large risk factor for dads of having perinatal depression or anxiety is if their partner, you know, one person or their wife has, you know, perinatal depression or anxiety too. So you will often run into situations where Dad is not OK either. And of course, that's even more stigmatized and less well understood than a mom going through this. And so it is a big push right now with postpartum support international to be educating about perinatal mental health disorders in dad.
Jen: Interesting. Thank you.
Jessica: Yeah. And they've also actually the research is very new, but perinatal mental health disorders and adoptive, you know, couples or same sex couples or, you know, stargate, like, they're really they're really across the board impacting all of these groups of people.
Jen: It's so interesting that it's taking us so long to figure this out, when we've been having children for thousands of years.
Jessica: And you know, there's a lot of people that say, you know, there's bias in the research, right. And there absolutely is. Most of the research, the medical research is done by men. And there is this huge stigma around perinatal mental health disorders. And so it's really ignored. OBGYN don't get regular training in it. They get like one day even right now. And so there is a huge bias in the resource but also you know families in the United States. Are really struggling. Parents in the United States are really struggling, and historically, you know, taking care of children in other cultures has been a responsibility of the tribe. It's a multi generational responsibility, but with the individualistic culture that the United States has also the United States is the only developed country that doesn't have paid maternity or paternity leave policy in the world. So, with the individualistic culture and the lack of support that happens, we definitely have, you know, a significant problem in in the United States right now with this. And research shows it's a very clear risk factor that when moms lack social support. On both practical and emotional support, the risk of perinatal mental health complications is way higher. So there are some countries that do a better job than the United States also at supporting new moms.
Hilary: So what? What can we do to improve upon that? To, you know, eliminate this stigma? Are there things that you see the other countries are doing that we can advocate on behalf of?
Jessica: Yeah, I don't know that I know of things other countries are doing to eliminate the stigma, but certainly other eastern countries in particular, like just have a culture of after you have a baby, you need to stay in your bed for six weeks. We're feeding you certain types of food you're having all the multi generational family members come over to your house to help you, right? Like so just a lot of different roles there with other countries. I mean, I know that Europe obviously is way ahead of us and that. They have, like a year of paid maternity and paternity leave and they have paid childcare. That's high quality from zero to five. So I mean, there are a lot of other countries that have systems either built in or just natural family systems that are better at supporting new moms. Some of the ways that we're trying to fill in those gaps is with doulas and Doulas are great. You know, postpartum Doula that you know, obviously in the United States, you kind of have to hire your village. And that's why I talked to a lot of moms about, like, let's see if we can get you a doula. Let's see if we can get you a house cleaner. Let's see if we can get you some. Childcare support, you know, let's see if we can, you know, get you a group in your neighborhood where you're trading off, you know, babysitting, that kind of thing. So I try to intervene in in those ways. Certainly, I think with the stigma, we just need more education. We just need more people talking about it. And we need more Mons that are not afraid to share their experience, right. And we have we have an issue particularly here in Utah, of motherhood being put on a pedestal and, you know, put in this place of like real, like, you know, wonderful. This is this is the greatest thing you can do. And it actually I think it's meant to support women, but it's actually dangerous, you know, for moms. Because they're having such a human experience. And when their experience doesn't match this cultural ideal or cultural standards, they are completely silent. They will not share, right. Like you don't wanna go to a moms group and say, like, I hate my baby. I wish I didn't have this baby or I'm having panic attacks every day. Or actually I feel like hurting myself or, you know, no one's gonna say that when someone asked how are you? Congratulations. You wanna stay great? I'm doing great. Right? And so there's, you know, a lot of work to be done in terms of educating and just giving moms the space to actually be honest about their experiences with motherhood and whether that be a perinatal mental health disorder or not. Right. There is this other term that I love called matressen, which basically means just the natural transition to motherhood and they compare it to adolescents actually because you have huge hormone changes, you have roll shifts every one of your relationships is getting exploded. Your identity is getting exploded. Everything that you knew before is kind of gone, and there's some grief and loss involved in that and so even just talking about mattressen and talking about some of those things that that happen, you know, in in every situation, you know, where someone has given. I think it's. Helpful in terms of decreasing stigma and just allowing more communication about real experiences.
Jen: I just think being a stepmother. That's what I don't have any biological children. But I have a stepchild. That was she was marrying when we got together. And I really that first year of marriage I was like. This is overwhelming. I don't have my space anymore. I don't have you know. Things that I just do by myself and so that. And she was just so lack of boundaries when it came to physical space, so she would just come and plop and lay on me and my husband's thinking. Ohh, you're having a great thing and I'm like, give me my space, please. So it it's so interesting. When you said adoptive children and foster. And all of that that it, it does play it play a part in all of those parts of mothering.
Jessica: Absolutely. And in our support group. So, I've written a manual for the support group that I that I offer a weekly. And one of the chapters is on mattressen. And as we are talking in the support group, we actually list what are some things you've lost since becoming a mom and then what are some things you've gained, you know? So we're opening space to grieve that together, right. I lost my sleep. I've lost my free time. I've lost my physical space, right and over. Stimulation is also such a part of motherhood. Does not discuss like just the physical touch. We call it being touched out, but just that physical stimulation happening all the time, whether that be touch or noise, and how overwhelming that can feel as well. Yeah. So definitely I think those are common experiences.
Hilary: That idea of that transition, I think that that is such a powerful concept because like you said, we may not expect perinatal mental health disorders or whatnot. But I think every like I'm like that transition needs to be talked about in the hospital before we leave. Like we need that education needs to happen in the school like because that will happen to everyone. Because like you said, I love that you compared it to that adolescence transition. But I'm thinking that transition happens like Jen mentioned to husbands, but I think. You probably also have an extent of that transition happened to siblings as well too, because their role is going to look different than it was before. So, I love that idea of helping parents recognize. That things are going to look a little bit different. They may be very different in the short term, but they're still going to be different in the long term. And I love how you mentioned having that comparison list of here's the things that we may feel that we have lost. But here's some things that we have gained as well too. But I think realistically speaking sometimes we just like you said, try to sugarcoat it. You have a new baby. You should be so excited. Not everybody has its experience, right? So, I love that you can say there's definitely good from this, but it's really hard too.
Jessica: Absolutely. Yeah. I mean and once again, I think that when women feel that their experiences or any parent you know feels that their experiences are not matching the idealized norm, they feel shame. They feel like something is wrong with them individually. And if we all talk to each other, we would understand that. No, you're absolutely in the norm with this, mattressen with this grief and one of the really singular things about motherhood as well, is that you can feel two opposite emotions at the exact same time. And there, you know, haven't been a lot of things in our life, maybe previously that create this complex of an emotional landscape, right? Like you can have this really intense emotion of, like, I love this child with literally all of my heart. And I would jump in front of a bus for this child. But I also really want to run away to Mexico and disappear. Those can both exist at the same time. And people don't understand that they're like ohh, they're judging that, you know, like oh, if I run away, if I wanna run away to Mexico. Like does that mean I don't love this child? No. Those both exist at the same time. And those are things that we do need to be talking about and just creating space to be honest about with each other.
Jen: I remember an Oprah episode a long time ago where there was someone talking about postpartum depression and. It was interesting to hear Oprah say so. It's OK not to like your child. And I've always remembered that. And. Just in what I do for work and things like that. You know, we always love our children, but there are days where we do not like them and that's OK to say. And you could hear the audience going like it was like this sigh of relief of, OK, I've been given permission not to like my child today.
Jessica: Well, and once again, like we're just still human, right? Like when we transition to parents like we're still humans. And I feel like we often have superhuman expectations of ourselves, you know, and we still are gonna have bad days, right? We're still gonna have fights with our partner. We're still gonna have. Like, yeah, really tired days where you don't feel like doing this right and that's not personal. It doesn't mean anything. And I mean, even if you take into account, like intrusive thoughts like intrusive thoughts are such a common part of postpartum in general. Intrusive of thoughts about like losing the baby or the baby getting hurt, or even hurting myself or the baby. And some moms even experienced postpartum OCD where they're having a lot of intrusive thoughts about. Am I going to hurt my baby? I'm going to hurt my baby. I might hurt my baby and a lot of hyper vigilance around that. And they're terrified to tell anyone. And so that it's very, you know, rare for them to actually get an accurate diagnosis of treatment because the majority of the time they're having intrusive harm thoughts toward themselves or baby. And they're not at any risk of actually carrying out any harm for their baby. They're not in any danger of doing that. But they're, you know, staying up all night watching the monitor because they're afraid their babies gonna, you know, have a SIDS episode and, you know, pass away or, you know, they're just, they're really doing all these compsulsions. And that are getting it in the way. And so yeah, that's another thing that you know we can talk about. It's just the spectrum of intrusive thoughts that can happen in this period of time as well.
Hilary: So, can you speak? I'm curious because can you speak a little bit more to the diagnosis? Because I'm assuming there's a lot of parents that are fearful of seeking out a diagnosis and maybe even taking medications because we're so aware of what's going into our body at that stage of life, so. Medications with breastfeeding and you know post Natal care are those things OK?
Jessica: Yeah, absolutely. They're PSI. When you go through the training, they talk a lot about this. Because particularly if someone has, like, a preexisting bipolar disorder, their relapse rate, if they go off of their medications during pregnancy is 70%. So, the relapse rates are incredibly high for women that are being taken off of their SSRI's or their depression or anxiety medications during pregnancy. And you know, so really it has to do with talking to your provider and doing a cost benefit analysis because these the SSRI's, especially the new ones, are safe for pregnancy and breastfeeding and lots of doctors are afraid to touch it. And so it's very important to get a perinatal specific medication provider. Who actually has the research, sees the latest statistics because there's actually a lot more risk to your baby of you being really severely depressed or, you know, going through a bipolar episode during pregnancy or postpartum and taking those medications. So, I will talk with moms about these decisions often. But you know, a lot of times we're leaning toward staying on the medication because your just your relapse rates are so high. If you go off, if you're taken off for you to experience one of those again. And there are biological reasons for that. So, during pregnancy, your estrogen in particular goes up to like 20 times its normal rate in the bloodstream and progesterone as well. And estrogen and progesterone actually modulates serotonin and dopamine function, and that's all just a very high-level way of saying that. You know your, your medication is dealing with serotonin. Usually your depression or anxiety medication. And when you deliver a baby, you're going through a period where your whole serotonin system is being messed with, like significantly messed with. And so, it's a period of particular vulnerability for you to become anxious and depressed. Or relapse into another, you know, anxious or depressed or bipolar state. And so that's one of the things I feel like postpartum support international. It's very passionate about advocating for is, you know, probably you need to go talk to someone that's specialized. It's, and. If your doctor's really just getting you off of your meds without considering cost and benefits like that's problematic in this period.
Hilary: OK. You mentioned those hormones and you mentioned kind of this wave. What point does it tend to stabilize or does it yeah?
Jessica: The I mean most of the literature says around six months, you know, and they talk about baby Blues, which is like under two weeks that period of under two weeks where you're going through the significant like changes in all those hormones and they actually kind of separate the baby blues from postpartum depression or anxiety. They talk about in postpartum. You kind of need to wait until that two weeks until the dust is settled to probably determine exactly a diagnosis, but yeah, it can take up to six months for those to kind of re regulating and especially if you're breastfeeding, right prolactin. Is going to continue suppressing those hormones of estrogen and progesterone. And so breastfeeding brings in kind of even a more complex dynamic with all of that. And so yeah, it can take some serious time for those to kind of readjust back to where they were before, but it's like. There is nothing that ever compares to this hormone shift in a woman's life or in a man's life. And actually they have identified, you know, that women who have what they call hormonally sensitive brains, so women who have had, like depression or anxiety or like irritability during PMS, you know, during that drop in the menstrual cycle or women that have had really bad emotional reactions to birth control. That might be indicative that they have what they call a hormonally sensitive brain, which means your brain is more sensitive to these hormone shifts, right? And your mood is more sensitive to these hormone shifts, so that's another risk factor for having a perinatal mental health disorder as well as some people's brains are they just are more sensitive to that big drop in the hormones or to changes in hormones in general. And so that's an assessment question that I'll talk with moms about when they come in, you know, did you feel like you had PMS? Like, do you feel like you struggled during that period of time? And then I'll know that that could be a contributing factor to what's going on right now.
Hilary: So, talk to us a little bit about. You mentioned that assessment process. So you know, let's say that I am, I am a mom and I'm listening to this conversation, right? Right now I'm thinking. That's exactly what I need. That's exactly what I need. I'm pregnant, but I'm struggling and I've struggled in the past. So tell us about this process of connecting with you and what that looks like, how often, what does that help you know? Like, what do you, what do you offer when it comes to that help in those resource?
Jessica: Yeah. So, finding a perinatal specific provider is incredibly important, particularly with therapy because therapy in the perinatal space looks different than general therapy, right? We're not going to try and go talk about everything in your childhood and we're not going to try to do all of your trauma work right now. You know, we're trying to do. Some assessment and problem solving and we're getting some support for you, right. And so I think really it's important because you're, if you're in the parental period and you're pregnant or let's say you're a new mom who's brain is swimming in hormones and you're sleeping two hours at night, you're gonna remember, like, two sentences of what your therapist says to you. If you're lucky, right. And so it's important to have a clinician that understands the limitation of the perinatal, you know, just emotional bandwidth, right, or physical bandwidth and postpartum support international has a directory of perinatal trained therapists and doctors and midwives and doulas, and that's on their website. I've linked to that in the show notes and the PSI Utah. It's called the maternal mental health or maternal Utah maternal Mental Health Collaborative, I think, is what it's called. Also has the Utah Specific directory for perinatal trained professionals and I linked that in the show notes as well, and so being able to really access, you know those resources and for medical, for medication providers as well. So, there are directories PSI keeps track of everyone who's taken their training and puts that on there directory there's also a lot of support groups like we've discussed. Social support is a huge piece of the pie for perinatal mental health disorders. It's a risk factor and a protective factor. So, if you can access social support, it's actually a protective factor for your mental health. And so I've LinkedIn the show notes as well. Postpartum Support International has free support groups for everything you could possibly think of military moms you know, PTSD, OCD, depression, anxiety, infant loss, you know, miscarriage, infertility. Like, you know, moms of color, moms of color experience actually significantly higher rates of mental health disorders. And they die three times more in childbirth and white women. Yeah, it's something also that PSI is really working on right now. Because you know the racism that, you know, kind of intertwines itself with all these issues causes black women, women of color, to be listened to a lot less by their medical providers and their pain to be taken less seriously. And so they're dying three times more than white moms and. And so yeah, there's a lot of work to connect with black midwives. And kind of getting more access there but there support groups for PSI for like moms of color, you know moms of all these kind of different minority groups and those are also great resources that are just online. You can just sign up and start that support group as well. So that's a really great place to start. PSI also has. What are they called? I am one now. I'm not gonna be able to think of a name. The name of it, but they have basically like, they have a free help line. And if you call there's a. It's a support coordinator. And so they have support coordinators in most counties in most states. That will give you a call and let you know all the resources that are in your area and they'll help set you up with the therapist because they can also be very overwhelming, not only finding a perinatal trained therapist, but one that takes my insurance, but it has openings or etcetera. So calling that helpline through PSI is also great because those coordinators can really kind of streamline that process of getting you set up with some help.
Hilary Oh, I'm so glad that there are so many resources available nationwide. And it's not just specific to our area, but it sounds like we have connected the dots quite well to make sure that we are covered.
Jessica: Yeah, there are a lot of efforts, you know, going toward that, which is nice.
Hilary: Yeah. Now, do you have, I mean, I'm making the assumption that like you said. Once those hormones have become somewhat more stabilized, since once we're sleeping a little bit better and you know, I'm assuming that most individuals, after six months a year you know are like I think I'm OK, but do you tend to work with some individuals longer than that?
Jessica: For sure. Yeah. I mean mental health. Perinatal mental health concerns are super treatable, right. And we do as soon as you sit down in my office, we're gonna be problem solving sleep. We're gonna. I'm. I recommend that everyone gets on a high quality EPA and DHA supplement because that's in all the research and is like a really low. Risk thing that you can do to decrease inflammation. And help with some of these like hormone transitions. It has to be high quality fish oil, but it's in all the textbooks and research, so I'm going to be suggest that. I'm going to be trying to problem solve with you how to get four to five hours of uninterrupted sleep because your mental health is going to completely suffer until you can get that. And so we're talking a lot. Like can we do shift work with your partner? And if you're breastfeeding, can you do one relief bottle at night? You know, you go to bed. At 9, you know, and he watches the baby until one or you go to bed at 8 and he watches the baby until midnight and that gives you your 4 hours, right? And then you can take from midnight until whenever else, right. And so I'm problem solving with moms. How can you bring in partner? How can you bring in support network? How can we get you a four to five hour stretch of sleep? I'm telling moms you need to be eating protein every two hours because blood sugar is so intensely connected with all of these inflammation hormones. And so I'm telling them. You need to go to Costco or whatever, yeah. Get all the high protein snacks you can find and you need to put them everywhere that you're feeding your baby. That includes the night stand, Your rocking chair, your you know the dashboard of your car, like every single place you are and every time you feed baby, you need to be eating protein. So we'll go through some problem solving like that. That usually we're having to work through family a little bit of family of origin because the perinatal period is a time where you kind of need your mom and it's really interesting that way because you can kind of get through your most of your adult life without really feeling like you need your mom. But when you have a new baby, one of the needs of new moms is to be mothered, actually and. So sometimes we're working through grief and loss about I, you know, I've lost my mom or my mom can't be there for me or she's not an emotional support. Daniel Stern, who wrote the book The birth of a mother, calls it the affirming matrix. Which basically means that every new mom needs a group of mothers that has gone before her to hold space for her to emotionally support her, but also to be like the 2:00 AM phone call of like what? This is the color of snot. Like what do I do, you know, like well, how do I like do I go to the doctor or not, you know. So, we're talking through some of that and we're I'm really helping moms shore up their support network. So, we're doing all these things in therapy. Those are kind of the first go to’s that I'm helping moms problem solve. We're doing boundaries. We're doing assertive communication. We talk about human giver syndrome and how it really doesn't serve you as a mom to all of your needs, to the side and for your child. I'm. I work with them a lot on the affirmation. That's good for you. It's good for your child. So we work through a lot of that. We work through perfectionism. And I tell them to get off social media and stop reading parenting books. So we really try to buffer them from all of the high expectations and outside influences that are just creating problem. And once we've done that, a lot of moms feel a lot better, right? Of course, there are situations where maybe mom is in an abusive relationship or, you know, Mom has a really significant mental health complication or just other things going on, right, or PTSD or things like that. That that are going to take longer to treat, right? And so those are issues that are more long term that that we're going to be, we're going to be talking for a longer period of time, once we can get them in, like you said, kind of work through this problem solving. Get sleep a little bit better established. Then she's going to be feeling a lot better.
Jen: I'm sitting here. My niece just had a baby on Sunday. And so I'm just thinking like, what can her husband, what can her mom look for her if she is going down this road of having, you know, postpartum or other issues? What are some signs to look for?
Jessica: Yeah, absolutely. So, the biggest sign is she just doesn't seem like herself, right. And if she seems just kind of off, I mean, you know, your wife or child. And so you kind of know their personality. And so, if she doesn't seem like herself, certainly looking for irritability and rage, that's a big indicator. We're looking for that maternal gatekeeping. Like, if nobody else is allowed to wash this baby or if I'm having hypervigilance about the baby, we're watching that if moms not able to sleep, that's a big one like, because all moms are so exhausted that, you know, if they're having insomnia. Then that's a pretty telltale sign that mom's going through a perinatal mental health disorder. And also, I think just if mom, if you can tell that mom's being super perfectionistic and trying to make everything look really, really good. Like, actually, if you have a mom that looks really, really good, I worry about her. Right. So if she's going out a week or two after she. Has a baby. She's all made-up. Her clothes are perfect. The baby looks perfect. Everything's all whatever I worry. I'm worried about her. So those are kind of some of the things that I will look for.
Hilary: I like the fact you're giving me permission to come out in my pajamas with my hair not done. Perfect.
Jessica: Well, if you're doing that, then I think you're mentally healthy, right? Because perfectionism is one of the risk factors for perinatal mental health disorders, like having really perfectionistic tendencies, right. And I know how hard it took for that mom to get her makeup on and get her cute clothes and get her baby in cute clothes and then getting out of the house and she looks like that. I'm really worried about the amount of pressure she's putting on herself. Like I'm like, are you OK? You know, I don't know if you are.
Hilary: You, you know, as you mentioned everything that you guys do as part of this process, I love that it is such a holistic approach because I think a lot of parents, a lot of moms, are fearful that they're just going to hand me some medication and say here this will fix it, be on your way. But I love how you're bringing in, you know, protein. You've got diet in there. You've got the social supports you mentioned, even like working on communication skills. And so I love how there are so many different, you know, pieces that you are tying together to make this plan. I just think you. It's such a smart, you know, it's laying such a smart foundation for these moms in order to have success. And I'll share. I'll share my experience and I've shared this on our podcast before this story. Before that, it made me laugh when you mentioned the parenting books because I can remember this memory is ingrained in my brain. But I can remember sitting on my little ones like floor sitting on the nursery floor. And I had three parenting books in front of me, all of which had conflicting messages. And, you know, Jen and I haven't talked about this before. You also add the stress of being a family life educator and going to school for this, you know, and so feeling like you have an understanding of child development and what kids are and aren't supposed to do it. And so I remember I can't remember if I was looking up information. It was something very simple like. A Binky. You know should I offer my child a Binky? Yes or no? Three different books. Three. One of them was saying yes, one of them. Was saying no. That's horrible. The other one was saying, well, it depends. And I'm just sitting on the floor sobbing because I have no idea what I am supposed to do. And then I'm feeling this additional mom guilt because I'm thinking Hilary, you went to school for this, you should know better. How come you don't have the answer? and so I think. Motherhood is to me it's funny, and this is gonna sound awful, but I feel like it is like a perfect storm here because you have this beautiful, wonderful child that we love. But then you throw in lack of sleep and then you throw in these hormonal imbalances and then you throw in the social stigma of being perfect and having all the answers. And I just think we are just stirring the pot here. We're just created this perfect storm. And so I love that we have. We are getting better as a society about understanding what this is and being able to talk about it.
Jessica: Absolutely. I mean, I had a similar experience with sleep, right, like there's books about you have to sleep, train your child. If your child is sleep deprived, all the bad things will happen. And then there's books about you have to Co sleep with your child or they're gonna feel abandonment. And I'm a therapist and like, obviously very concerned about attachment. And so I'm freaking out. Right. And so every mom that I talked to you. I'm like, you know what? Look at the child. Look inside yourself. You do not need all this information like I feel like it's a scam. So many people make money off of telling you what you're supposed to do as a mom, right? And I even. I have it now. Right. Like we've got. I have elementary school age kids it doesn't stop. Right? We have the home school moms. We have the organic food moms. We have the. You know all of these research about all these things and if you get in the habit of doing that, you're in a world of hurt for sure, just and especially now with social media where you have people that are not even experts and aren't even researchers. They're just going out and giving all this parenting advice and then obviously on your Instagram algorithm, they know when you're having a baby and they're just gonna fill your feed up with that with them. And it's horrible. So yeah, I'm really telling mom, like, you are needing to be in charge of your resources. Mental, emotional, physical and you cannot be draining resources on this crap. You know? You just you don't have it right? And so much coaching too, with couples, right. And this maternal gatekeeping piece. You know, we all know Gottmann's research that 69% of couples experienced the significant drop in marital satisfaction with the birth of the first baby. But when he looked at the other couples, they experienced an increase in marital satisfaction. And the biggest change was that, you know, Dad is more involved in caregiving like the other parent is more involved in caregiving with the child and so educating moms about that and especially these maternal gatekeeping moms. You have to leave your baby with your partner, you know? And if it's a dad like dads have to do a lot more trial and error with baby than you do to soothe baby. So baby might be crying more with dad and you have to fight every tendency that you have to go in that room and take baby away, you know, and fix that for dad and baby. And often I'm coaching moms like you have to leave the house. You have to give Dad time to figure this out because if you don't. Not only are you impacting Dad's relationship with baby, research shows that dads look to moms to determine if they're doing a good enough job at parenting or not, and if moms give them an indicator that they're sucking at parenting, they're gonna shut down the majority of the time. So not only are you impacting that relationship with maybe you're impacting your relationship with your partner in an. This way, and as much as it feels like you're helping to go rescue Dad every time he's struggling with the baby, you're actually really harming a lot of things. And so that's a ton of coaching that we do as well. And yeah, it is a holistic picture. There is a biological and psychological and a social component of every mental health diagnosis. And it's especially important to keep that in mind within this period of time.
Hilary: Mm-hmm. I feel like we could continue this conversation for many, many more hours, but.
Jessica: I can talk about it forever.
Hilary: Ohh my goodness and I love this. I think you have provided such wonderful information to our audience that I know they are gonna benefit from as we are as we as our time is coming to a close. I just want to ask if there's any, maybe final thoughts or advice you would offer?
Jessica: Yeah, I love the motto of postpartum support international. You know that says you are not alone. You are not to blame. And with help you will be. Well, so I really love that message. Right in motherhood, we're all really in the same soup, right? And so I think don't be ashamed. And I think maybe not having the expectation that this is going to be a beautiful smooth experience. And is super helpful and yeah. Just letting people know. That the support is out there, it's not a failing of yours like. You know, so many things have exploded in your brain and in your hormones and in your life that if you're struggling, just reach out and get the help, you know, don't suffer by yourself. Don't suffer in silence. You know, it can get so much better if you reach out and get that support and help. So I think that's my main message.
Hilary: Awesome. Thank you.
Jen: Thank you so much for joining us today. I mean. I had the thought probably a year ago of to become the doula and then the thought just when. Talking about this, it's like oh. We really should go and do that. So thank you so much for your information. I mean, you've given us so much great information to help moms while they're pregnant and after. So thank you so much we appreciate. It we want to thank our listeners. They're coming. And we want to remind you to be kind and patient with yourselves and we will see you next time.
Thank you for listening to the Parents Place Podcast, if you would. Like to reach us you can at parents@thefamilyplaceutah.org or you can reach Jen on Facebook. Jen Daly - The Family Place. Please check out our show notes for any additional information. Our website is thefamilyplaceutah.org. If you're interested in any of our upcoming virtual classes, we'd love to see you there.
Subject Resources: - Free online support groups: https://www.postpartum.net/get-help/psi-online-support-meetings/ -Provider directory for perinatal trained providers: https://psidirectory.com/ - Local provider directory: https://maternalmentalhealth.utah.gov/ - Free hybrid support group: https://treatcounseling.com/perinatal-support-group/ - Therapy practice with trained providers: https://treatcounseling.com/ - Helpful Podcast with Utah Resources: https://thesadmomsclub.buzzsprout.com/
Contact us:
-Email us questions or topic ideas: parents@thefamilyplaceutah.org
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