She walked into my office and sat down on the sofa, looking at me. I said, “Welcome, how are you?” She started to cry and said that she had almost cancelled our session. It was a first session, we had only spoken briefly on the phone. Her baby was at home with her mother and she hadn’t wanted to leave. She shared that she had been given a screening assessment in the hospital and had been told that she was at high risk for postpartum depression. Her impression of mothers with postpartum depression was that they were bad mothers who could hurt their babies. But she was so very worried about her baby and was doing everything to protect him. She asked me how the hospital could possibly know that she was going to be a bad mother? Exhausted and distraught, she continued to cry. We spoke for a while and I assured her that she wasn’t a bad mother, but a new Mom who was struggling. And that she was most certainly not alone.
Last week, I interviewed my friend and colleague, April Gabriel-Ferretti, MS, MFT. April is a Marriage and Family Therapist, a Certified Doula and the Lehigh Valley Coordinator for Postpartum Support International.
You’re a Marriage and Family therapist as well as a birth doula, can you explain a little what that means?
As a marriage and family therapist I treat a variety of serious concerns including: depression, marital problems, anxiety, individual psychological problems, and child-parent relationships. MFT’s can be master’s or doctoral level and are recognized as a “core” component of the mental health community, along with psychiatry, psychology, clinical social work and psychiatric nursing.
Birth doulas play an integral role in the preparation of birth via education and work with mothers and their birth partners to provide physical and emotional support. The doula is present to help their clients better self-advocate and aid the client in having an empowering and memorable labor and birth experience.
You’re also the Lehigh Valley Coordinator for PSI. What is that organization?
I am honored to be the Lehigh Valley coordinator for Postpartum Support International. My goal is to provide current information, resources, education, and to advocate for further research and legislation to support perinatal mental health. PSI members, leaders, and friends work tirelessly across all levels to meet goals of the shared PSI mission to support those living with mental illness through various activities, including:
www.postpartum.net – PSI’s website receives more than 100,000 visitors a year who seek PSI for support, education and local resource information.
800.944.4PPD (4773) – PSI’s toll-free Help Line, in English and Spanish, serves more than 600 callers a month, and rapidly refers callers to appropriate local resources including emergency services.
PSI Newsletter – Available to PSI members around the world, this bulletin gives up-to-date information on worldwide news, conferences, resources, research and events.
Area PSI Support Coordinators in all 50 U.S. states , Canada, and Mexico, and more than 40 other countries around the world. These support volunteers provide telephone and email support, information, and access to informed local resources.
Online Support Groups in English and Spanish every week, led by trained PSI facilitators.
Standardized Training and Educationfor hospitals, public health systems, clinical providers, support group leaders, social support volunteers, and others.
PSI Educational DVDs for families and providers.
Free Phone “Chat with the Experts”First Mondays for Dads and every Wednesday for Moms, facilitated by PSI Professionals.
Resources for Women, Families, Students, and Professionals.
Links to multi-language resources
Membership Directory where you can update your own profile, and conduct a search for other PSI members by name, profession, location, or interest. JOIN PSI HERE
How did you first become interested in postpartum depression?
As a mother of three I have personally struggled with both postpartum depression and anxiety. I know first hand how overwhelming, shameful and lonely motherhood can feel particularly when you are struggling! It was through my own experiences and having worked with countless mothers and families as a doula, that specializing in maternal mental health felt like a no brainer!
How prevalent is it?
Postpartum depression impacts nearly 1 in seven women and 50% of the time starts as early as pregnancy! Some studies suggest that it’s as much as 1 in 5.
There seem to be a lot of misunderstandings about postpartum depression, for example, those Mom’s shouldn’t have had children and they’re bad mothers. Or Mom’s with postpartum depression need to be separated from their babies for the safety of the infant. Do you run into that perception and how do you address it?
Us frontliners are working hard to better educate professionals who come into contact with our mothers during the early weeks and months after the baby arrives. Our hope is that by educating we can debunk some of the more common misperceptions of PPD such as mom lacking the desire to be with baby, mom being suicidal or at risk of harming her baby. This is not to say that these circumstances don’t arise. However, it’s very rare that mom poses a threat to herself or her baby! The best way to address these concerns is to keep educating and having dialogue about these very important topics!
If a Mom has postpartum depression, will she automatically have it again with subsequent deliveries?
No. Having postpartum issues like PPD, PPA etc does not guarantee that mom will automatically have anxiety or depression with subsequent births. That being said, having these issues does put mom at a higher risk for facing similar complications with future pregnancies and births. But there’s good news! In many instances, mom knows what to look for. She is better prepared, better educated and her family and friends know what to expect and look for!
Can men have postpartum depression?
Absolutely! It’s estimated that close to 1 in 10 fathers will have PPD. This estimate is conservative, since research has shown that men are less likely to report their mental health concerns.
What are some examples of what postpartum depression looks like? How can families and friends be supportive?
Typically we start to become concerned when we are seeing symptoms beyond 2 weeks postpartum. This is usually an indication that something more serious is at play. Some of the most common symptoms involve feelings of hopelessness, irritability, significant sleep or eating disturbances, feelings of disconnect with baby, worthlessness and guilt.
Friends and family can help in a variety of ways. It can be really beneficial for mom to have others who are encouraging her to carve out some time for herself. Whether it’s simply time to shower uninterrupted, a childfree outing to the grocery store or a chance to catch up on sleep, mom needs to know that taking time for herself is not only ok but needed in order for her to put her best foot forward!
Families can also help by educating themselves about perinatal mood and anxiety disorders and by gathering resources. Some excellent resources can be found at www.postpartum.net
I’ve had some experience in my private practice where I’ve seen Moms with postpartum depression experiencing obsessive compulsive disorder and anxiety as well. Have you seen this? To what extent?
Postpartum anxiety is just as common as postpartum depression. In my own experience, I would venture to say that I’ve seen more cases with women struggling with postpartum anxiety than simply postpartum depression.
What resources are available to women and men experiencing postpartum depression?
In addition to visiting Postpartum Support International’s website, there are local resources available as well! Over the past several years I have spent time culminating resources to help support, treat and educate women and their families. Below is a link to my resource guide and a link to the Facebook group I run. The Facebook group called Lehigh Valley Postpartum Support, is made up of primarily local moms who are either currently in the trenches or who have been in the trenches and have finally made it to the other side. In the group there’s a lot of supportive women who were sharing their stories and their experiences, which can be healing and validating. I also make a point of educating people about what they can expect or look for in regards to their own mental health and experiences in motherhood.
Thank you so much, April! I’m grateful you’re doing this work!
It was great to talk with you, Peg!
April’s contact information is below. If you, or someone you know may be experiencing any of these feelings, offer help and support.
April M. Gabriel-Ferretti, MS, MFT, Owner
Gabriel-Ferretti Psychotherapy and Consulting, LLC
Lehigh Valley Coordinator for Postpartum Support International