Sarah Short Circuit

Heal, Nourish, Nurture

Tag: Birth (page 1 of 2)

Mental health is not a luxury

[W]e need to shift our focus from the baby to the mother.

What I didn’t realise was that I often made it harder for myself. I felt guilty asking for help when I wasn’t coping. I put myself last, all the time. And I never acknowledged that by having a baby, I had also become a mother.

Caring for yourself at a time of huge emotional and physical change is important. It can feel contrary to your instincts, because you love your baby so much, and their needs are so great.

We can all help new mums learn to put themselves first. Don’t let them disappear.

We still need to care for and cherish our babies. But let’s shift our focus occasionally to their mother.

Source: New mothers need to know their mental health is not a luxury

Read the book Hello Baby! Everything New Mums Need to Know About Life with Baby by Heather Irvine.

Know the signs and seek help early. PANDA National Helpline 1300 729 360 panda.org.au

 

 

Full recovery is possible

My story of postpartum psychosis has been published in The Guardian today alongside some great new research! I am so proud of the mother I have become and proud to be a PANDA Community Champion raising awareness of postpartum psychosis in our community.

“People can mistakenly describe what women like me go through as ‘baby blues’ or ‘depression’, but I was definitely not depressed,” West says.

West received treatment after a friend told her she was not behaving like her usual self and called the National Perinatal Anxiety and Depression Helpline [Panda]. They advised that West should be taken to hospital immediately for psychiatric care, and West is now a strong advocate for the helpline.

“I have to speak up because I don’t like the thought of other families going through what we did. This has to change and to do that we need better recognition of the condition.”

Source: Postpartum psychosis: research reveals full recovery possible within weeks | Life and style | The Guardian

 

Know the signs and seek help early. PANDA National Helpline 1300 729 360 panda.org.au

Shaky start

Becoming a mum was shaky start for me, not at all how I had imagined it to be. I had prepared myself in the months and weeks leading up to my due date. I read books, attended antenatal classes, participated in an Australian Breastfeeding Australia workshop, everything and anything to get ready to bring my baby into the world. However on my due date is when things started to unravel for me.

The night of my due date my waters broke and I thought to myself that everything is happening just as it should. The next day I went up to the hospital to get checked out and I was in the early stages of labour so sent home to progress the labour. This cycle continued for the next four days however my labour was not progressing. To be safe my doctor kept me in hospital, I was becoming tired and my baby was starting to show signs of distress. Within the space of 10 minutes I was prepped and being wheeled down the corridor to the operating theatre. My son was brought into this world in the nick of time with a cesarean section.

After the operation, I waited in the recovery ward for my son to be brought into me. And I waited, watching the time tick by, minute by minute waiting. Waiting for someone, anyone to come and tell me what was going on. I could hear commotion beside me with nurses rushing in and out, talking in hushed tones. Not quiet enough to be overhead by me as I understood the whispers of medical lingo to know that the patient beside me had passed away.

Paralysed, both physically from the analgesia and emotionally from being separated my baby, I laid there waiting. In a hospital that allows mothers to connect with their newborn during recovery after surgery, I did not get this precious time with my new baby. It was a long 45 minutes later my midwife came to take me back to the maternity ward where my son had been sharing his first skin to skin cuddles with his father.

On the ward I soaked up the snuggles and inhaled the scent of my baby boy with the biggest, exhausted smile on my face. I was elated to be with my family however no one spoke of what had happened on the recovery ward. Our parents came in to visit their new grandson and my dad noticed that I had the shakes. Little body tremors like my body had gone into shock. These shakes would come and go during the first few days after the birth. I felt quite lightheaded which I put down to having just gone through an operation. I remember sitting up nursing my son when this wave of nausea came crashing over me as I quickly asked my husband to take our baby before I vomited everywhere. The nurses came to our aid and helped me back to bed where they tilted the bed back to get some blood flow back to my head. And I slept, more sleep than I had had in the past 4 days, I rested till my baby needed his next feed.

Breast feeding with a cold cloth on my head

As new parents we muddled our way through the first few days, a blur of feed, sleep, change nappy, repeat. I strongly wanted to breastfeed my son, doing everything by the books and what I had been taught. My body didn’t get the same memo. Each time my son would latch on and start to feed I would get this feeling of starting to warm up to the point of being unbearable, my feet would start to swell and I would start to tremor. I would sit there and clutch my baby as I watched my feet swell up. It was like I was trapped in my body not able to say much as I either got the shakes or passed out. There was a number of times where we would either call my dad or our friends down the street to come and hold the baby whilst my husband supported me to land back on earth. I continued to experience these episodes of tremors and passing out till one episode I felt my chest was going to explode and the ambulance was called.

My feet swelling up

Hours later spent in the emergency department, with tests and a chest x-ray, it was a week to the day since giving birth to my baby. I was in a lot of stress during breast feeding and I had been calling the midwives regularly as I was emotionally upset that my baby was not breast feeding. I was very distressed about the health of my baby as I thought he had not been putting on weight. I had not had decent sleep in days and I had difficulty concentrating. The doctors described my episode as ‘went blank and then floppy followed by nodding of head, trembling of hands and feet’.

Diagnosis: Vasovagal Syncope

On my discharge papers an Acute Community Treatment Team (ACTT) referral was made re postpartum depression/blues with the ACTT social worker stating ‘Not an ACTT issue’.  Over the following days this all changed as I unravelled further…

What is vasovagal syncope? I will let you know in the next blog post!

Global Stress Summit

Postpartum and the Thyroid

Listening to Dr Kelly Brogan on the Thyroid Sessions back in 2014 was the first realisation that my thyroid may be a piece of my postpartum psychosis puzzle. Dr Kelly discussed the triangle of psychiatric symptoms, gluten intolerance and thyroid dysfunction and this was the first time I heard a medical doctor discuss postpartum psychosis directly. Women with first episode postpartum psychosis were 19% positive for thyroid antibodies and within 9 months 67% had a higher risk to develop autoimmune hypothyroidism (1). Dr Kelly discussed how postpartum thyroid symptoms can be easily attributed to being a new mum, such as lead limbs, feeling fatigued, super forgetful, mentally disorganised which at 9 months postpartum could be symptoms of Hashimoto’s disease or postpartum thyroiditis. Postpartum issues lead straight to psychiatry, no acknowledgement of the female hormones, not even a test for thyroid function. Dr Kelly says that psychiatric symptoms are usually endocrine related: thyroid or adrenal or blood sugar regulation with insulin or leptin or your sex hormones progesterone or oestrogen. Also, zinc, selenium, magnesium and iodine are key nutrients in thyroid function. To find out more about these psychiatric pretenders I recommend reading A Mind of Your Own.

Typically when you go to your General Practitioner, the thyroid test is limited to blood test TSH, which is a pituitary hormone measure, an indirect measure of thyroid function. To get the full picture of your thyroid free thyroid levels T3 and T4, reverse T3 and thyroid autoantibodies. My GP was reluctant to do further tests as my TSH came back ‘normal’ until I showed him a copy of the research paper (1). Remember there is not one size fits all, you may have symptoms even being in the ‘normal’ range.

The Thyroid Secret is on now and I am looking forward to tuning in to Episode 7: Motherhood Interrupted to discover more about the role of thyroid in the postpartum period (starts on Wednesday 8 March 10am Sydney time).

PS: My test results including my thyroid antibodies came back all good and my GP has noted on my file to check and monitor my thyroid function  if and when I fall pregnant.

References

1. Prevalence of autoimmune thyroid dysfunction in postpartum psychosis. The British Journal of Psychiatry Mar 2011, 198 (4) 264-268

Further Reading

 

Transmission of Trauma

Post Traumatic Stress Disorder (PTSD) is the long lasting effects of stress. In the flight/fight response to a threat, the sympathetic nervous system is activated, adrenaline is released to cope with the stress, then cortisol is released to stop the stress response and breaks down when the threat is removed. In PTSD the cortisol levels are lower, which are a reflection of a greater dysregulation of the HPA axis, including circadian rhythm alteration, glucocorticoid receptivity and alterations in cortisol metabolism.

In trauma survivors the stress responsive can be a transformative experience. The offspring of trauma survivors, such as the Holocaust, were also more likely to experience anxiety and depression and have lower levels of cortisol associated with child adversity.

Offspring make their own changes – is this transmission or accommodation? Developmentally programmed changes allow more flexible responding but may be a mismatch for the offspring.

Intergenerational Transmission of Trauma – Epigenetic mechanisms, the in Utero Environment and Early Attachment – Dr Rachel Yehuda, International Marce Society Conference 2016.

Further reading

Yehuda & Le Doux 2007. Response variation following trauma: a translational neuroscience approach to understanding PTSD.

Yehuda & Bierer 2008. Transgenerational transmission of cortisol and PTSD risk.

Shifting the perinatal paradigm

Conference breakfast with Dr Vijay Roach from the Gidget Foundation was sensational! It was so enlightening to listen to a doctor share their personal story of his family experience of perinatal mental illness from both a husbands and a doctors point of view. Dr Vijay reminded me of my own obestrician, who I still can recall visiting me in the mental health ward in his jeans and a tshirt, visiting me to see how I was going even though as doctor his duties were completed. This presentation by Dr Vijay was like an apology speech to me from the health professionals for what I have been through during my pregnancy, my traumatic birth expereince and my episode of postpartum psychosis. In tears, I gave Dr Vijay a huge hug of gratitude as a thank you on behalf of all consumers.


Different people have different perspectives including those in the birth industry. The birth industry is all about the things we ‘must’ do; natural birth, not drink alcohol, breast feed or demand feed and it goes on. Consumers are in the best position to understand what they experience. The Gidget Foundation is run by consumers and the Marce Society should be overrun by consumers (certainly not the case from what I saw at the 2016 conference). Illness works for health professionals, as an authority, understanding big words, knowing what is best for you even though they have never listened to your story, they disempower us with the words they speak.

Doctors will interpret the patient in the first 18 seconds of an appointment. Do women have a choice? Can women decline an exam? Refuse a test? Which woman wants to be the difficult patient? Doctors fail to recognise our feelings, beliefs, values, history, stories. What if the doctors don’t know all the information?

A male gynaecologist is no more disadvantaged, not limited by gender, as they too have the lens to make decisions, to listen actively in planning, pregnancy, trauma, birth to see the world through the woman’s lens. At no point in time did someone ask how we felt. We forget that women are people too, expect to do everything right, the pressure on pregnancy and mothers is huge.

We need to acknowledge what women give to us all. What doctors see as reality as correct is not right. Doctors communicate the fear yet missed the point. What happened to me? I need to understand why? We felt disempowered, no choice, had to do what the doctor said. Doctors hadn’t deliberately tried to harm but by participating in her trauma as health professionals we need to examine ourselves.

Think about the words we use, the posters of motherhood bliss in hospital wards. The gutless implications of the words we use. We do medicalise pregnancy and birth yet no one talks about the wonder of becoming parents and the human inside the womb. We forget the joy of existence. If we miss that, what else is existing? Consumers are people. If we are going to shift the paradigm we don’t need to disempower the consumer, we need their input. The true gift of the health professional is to empower those who seek their help. Its powerful to do no harm and to care; maybe we can make a difference. If we are going to change the paradigm we need to make the shift.

Gidget Breakfast Session – From Illness to Wellness; shifting the paradigm in perinatal mental health care, Dr Vijay Roach, International Marce Society Conference 2016.

Factors influencing decision making

1 in 5 risk of postpartum psychosis and half are considering pregnancy plans. Research is revealing the large variety of factors influencing decision making for women with bipolar disorder including social support, family history, stigma and fear.

Understanding the importance of stigma, contextual factors such as time pressures and social support from their partner and family, local service provision, fear including the fear of becoming ill and fear of social services, and the centrality of motherhood.

This study also enabled the inclusion of views of women who decided against having a child because of bipolar disorder (26%).

This highlights the problems of getting reliable information and advice to women with bipolar disorder and what women want from services as well as the need for more training for health professionals.

Read the full study here http://bjpo.rcpsych.org/content/2/5/294 (open access).

Factors influencing women with bipolar disorder when making decisions about pregnancy and childbirth: a qualitative study – Clare Dolman, International Marcè Society Conference 2016.

Glow

“In giving birth to our babies, we may find that we give birth to new possibilities within ourselves.” – Myla and Jon Kabat-Zinn

GLOW Perinatal Emotional Health & Wellbeing Clinic – a unique concept on the frontier of perinatal and infant mental health – Dr Araobi Udechuku, International Marcè Society Conference 2016

One third of women deliver in the private system and use some form of complementary medicine. The Glow Clinic in Melbourne, provides a holistic approach to perinatal mental health and has extended the perinatal period from the first 12 months to the first 5 years. This unique service includes not only perinatal psychiatrists and psychologists, paediatrics, midwives, lactation consultants but also early parenting consultants, nutrition, yoga, massage, meditation to support wellness in mind & body for the whole family.

I love Glow’s unique concept and model of care particularly with the lack and fragmentation of health services. I delivered my son in the local private hospital and I was admitted during my episode to the local public hospital with follow up through the public system as well. I have been advised to receive the care I would need if we were to have another baby that I am best to deliver in our public hospital; so what is the point of expensive public health insurance? Any complimentary or holistic services or treatment I were up to me to seek out as I recovered. Follow up appointments with a perinatal psychiatrist were self-initiated only because we were contemplating in having another baby and this was 2 years after my episode. If I see a general health professional or even the local child health clinic, it is up to my own discretion if I mention about my mental health history and how it impacts on my current care needs.

If a service existed like Glow in Sydney I would be still eligible to be receiving care with my son now 4 years old, my whole family would be taken care including my husband who would have the support he needs/needed, I wouldn’t feel conflicted between my wellness and nutrition approach and the advice of health professionals, perhaps I may not have fallen through the medical system cracks and be missed in follow up after my episode, and I would feel more comfortable if we were to have another baby that I would have effective management and support I need in a holistic, integrated, collaborative space.

MINDD 2016

The MINDD Foundation is committed to improving the lives of children and families by promoting a holistic approach to healthcare and living. After last years MINDD Forum changing the direction of my healing and recovery there was no way I was missing the MINDD Forum this year, especially with the key note speaker being Kelly Brogan.

Dr Nancy O’Hara was back again this year speaking about ‘It wasn’t me it was my germs’; love this concept! We are depleting our microbiome of the nutrients we need by the way we lead our lives. The majority of our immune system resides in our guts. Gut dysfunction is associated with germs including parasites and yeast. It was interesting to learn that a clostridia infection, a bacteria in our gut, has been found to associated with psychosis. The way to treat gut dysfunction is with nutrition as fresh, organic, unprocessed foods that are varied and rotated; probiotics to control inflammation and encourage gut movement; remove stressors;  and the best way to detox is a minimum of 1 stool per day.

There is no such things as junk food; it is either junk or food

– Nancy O’Hara

Great talk on effects of food on anxiety by Trudy Scott, eating real, whole, good quality foods is the foundation to maintaining optimal mental health. A lower risk of depression and anxiety was found with traditional diet of vegetables, fruit, fish, grass-fed meat, and whole grains when compared to western and modern diets in an Australian study by Jacka 2010.

Diet intervention

Trudy Scott

Food is Medicine but there is no “one size fits all” diet. Great talk on Using Bioindividual Nutrition to Personalize Therapeutic Diets. Julie Matthews spoke about how dietary intervention is at the foundation of healing. Individuals have specific dietary needs and diet needs to be bioindividually applied. Keep an open mind as you may need to use a particular diet in the short term or further restrict a diet or prioritize one diet over another or apply more than one dietary principle to improve function with the goal of the least restrictive, most varied diet possible.

no one size fits all

Julie Matthews

What an awesome way to spend a Friday with these inspiring wellness rock stars at the MINDD Forum Food is Medicine day. I loved the cooking demos learning from the best of the best Alexx Stuart, Jo and Isaac Whitton from Quirky Cooking, and Helen Padrin and Charlotte Carr. From digestive calm soup to lemon cheesecake panna cotta to best butter chicken ever to pantry essentials in an non-negotiable hour of power. Nourishing your family with quality, real food is simple, basic to basics home cooking. Change the way we do our shopping and change how we approach new ways of eating. Teach our kids real food, take time to spend with our kids, talk with our kids makes a difference when going through change.

Food is Medicine

Top: Alexx Middle: Isaac and Jo Bottom: Helen and Char

I had the honour of meeting Kelly Brogan MD. Kelly is such an inspiration to me and I am extremely grateful to Kelly for her focus on maternal mental health including postpartum psychosis and showing us that we do have ‪‎capacity to heal‬. Thank you MINDD Foundation for bringing Kelly to Sydney.

Kelly

Kelly Brogan and me!

Listening to Kelly Brogan speak about the root cause of depression and anxiety and the power of our food was awe inspiring. We need to stop looking at the symptoms and start asking WHY? The whys are sugar imbalance, gluten sensitivity, nutrient deficiencies, and thyroid autoimmunity. Depression is an inflammatory response, a symptom not a disease.

Medication is not better than doing nothing. We don’t know what medications are doing to our microbiome. We are passing the damaged microbiome onto the next generation. The principle mental health intervention needs to be dietary recommendations.

We have knowledge inside us how to interact with food in a healing way but it is hijacked early with processed foods. We have to get back to food as information for gene expression and our microbiome. We need to speak to our nervous system in a different way.

Your body’s ability to heal is greater than anyone has permitted you to believe.

“Through the alchemy of my darkest nights I heal and thrive. Today I rise!”

A beautiful and moving video shared by Kelly Brogan at the end of her talk which had most of the room in tears. We as women will transform this world!

Today I rise

Kira Sutherland spoke about the basic principles of healthy living for optimal wellness are natures 7 healers, of which most of us manage to achieve 2-3. However, if we achieve exercise this cascades into other areas and we are almost always then able to achieve all 7 healers. Exercise helps us to be better adapted to stresss, strengthens our immune system, improves our gut flora, helps our organs to detox, has been shown to be just as good as anti-depressant medications but with positive side effects. 

Exercise

Kira Sutherland

Other speakers included Erica Peirson on hypothyroidism in children on how brain development and every cell is dependent on the thyroid horone, pregnancy is a stress test on the thyroid and how the microbiome should be nurtured as much as the newborn itself; Elizabeth Mumper spoke about the Management of Prenatal and Postnatal Risk Factors of Autism and that so many things have changed so quickly for our kids and the basic recommendations for pregnancy include a well-balanced, organics, non-GMO diet, green your home, reduce stress, get enough sleep, regular exercise and avoid toxins; and Annalies Corse on Maternal Health and the nutritional considerations for conception, pregnancy, birth recovery  and the 4th trimester, and that it can take greater than 6 weeks for recovery after birth as this transition can be very stressful both emotionally and physiologicaly which can then further deplete us of nutrients and energy, with a labour + c-section birth the hardest delivery from an emotional point of view.

The postpartum period is a time when women tend to be amenable to health counselling; this provides a tremendous opportunity for promoting lifelong healthy habits.

– Annalies Corse

Help the brain heal the gut. A major aha moment for me listening to Dr Carlo Rinaudo talk about the role of the vagus nerve. If the brain is not working properly you have reduced brain-gut activation affecting gut and immune health. The vagus nerve is our largest cranial nerve connected to many different organs in our body.

Low vagal nerve activation results in

  • reduced gut motility
  • reduced release of digestive enzymes
  • reduced blood flow which reduces repair and nutrient transport
  • leaky gut leading to inflammation and autoimmunity

The typical response for low vagal tone is a sympathetic dominant state: adrenal stress, anxiety, poor sleep, hormone imbalances and poor posture. The vagus nerve stimulation has used in the treatment of inflammatory conditions, stress, anxiety and depression.

I had vasovagal syncope‬ (fainting) after the birth of my son in the weeks before developing postpartum psychosis. The pieces of my health puzzle are starting to come together.

Vagus Nerve

Dr Carlo Rinaudo

Right time, right place meeting Holly Bridges with a lovely long chat with Holly about the polyvagal theory and the 3 responses to stress: flight, fight and freeze. Our body goes into survival mode, into a state of safety, into a shut down response thanks to a weak control of the vagus nerve. With the help of neuroplasticity it is possible to reconnect the mind-body connection and re-engage the brain.

Holly has a fantastic, easy to read, easy to understand book explaining the polyvagal theory and how this impacts people with Autism. A huge piece of my health puzzle has been ‘reframed’. Thank you Holly!

Reframe Book

Holly Bridges

My books from the MINDD Forum 2016.  So grateful to get my copy A Mind of Your Own signed by Kelly Brogan MD. Finally got my hands on Bubba Yum Yum’s The Paleo Way and get it signed by Char and Helen.

books

Books from MINDD 2016

Save the date for the third weekend in May 2017 for next years MINDD Forum!

 

Functional Nutrition Course

 

Support

Recently I attended my son’s annual childhood clinic check up. In Australia, these are appointments with a health professional to check on the growth and development of your child and to work together to achieve the best health outcomes for your child.

While these annual check ups are focused on the child, they in my view are not in the best interest of the parent, particularly a mother with previous mental health issues. My experiences of these check up visits to date have been anxiety provoking, making you as the mother second guess the choices you have made and actions you have taken as the parent in the best interest of your child, with the health professional making you feel as if you have made the wrong decision. I had been assuming that as my son got older, my anxiety levels around these check ups would lessen; how wrong I was.

My anxiety with these check ups started just after my son was born and we were arranging the post birth home visit with the childhood clinic nurses, which is standard procedure. As I was starting to spiral into postpartum psychosis and we didn’t know it, I was misunderstanding the screening questions I was being asked prior to the home visit. This resulted in myself becoming delusional and confused around being asked if there was knives or guns present in the house (knives yes as husband is a chef; guns no) and thinking that my son was going to be taken away from me, which is a fear that causes women with postpartum psychosis to conceal their illness (McGrath et al 2013). In between the time making the appointment and the actual appointment I descended into psychosis and therefore was not actually present for the home visit as I was in hospital.

The subsequent appointments every 3 months for the first year I used to dread going, over-thinking what they were going to ask and over-analysing what was discussed at these appointments. I see these check ups as opportunities to ask questions about my child’s development and raise any concerns I may have as a parent to see if these are valid in the eyes of a health professional. All this results in is me questioning my ability as a parent, like the time I questioned about how structured in routines my son was at the time and I was presented with the option of doing a behaviour screening questionnaire.

At the recent check up I raised some concerns I had around my son and toilet training. We had started toilet training just after Christmas this year however my son was still struggling with a few aspects. Only in the week of the appointment did my son turn a huge corner and it all came together with toileting. However, I still raised my concerns with his progress to get the health professionals view on the situation, only to be told  that my son was ‘manipulating’ us as parents and that he is capable, but we as parents were not using effective reinforcement like reward charts, recommending a parenting program to us. The mother lioness came out in my and I spoke my thoughts to the nurse, informing her it was a cognitive development stage and timing issue, not a case of manipulation based on my background education in psychology and previous work experience in said parenting programs. Why do I feel like I have to go into battlefield with the health professionals using my education as armour against them, and if I am having this experience in defending my parenting skills with the level of education I have, how do other parents manage this?

Another concern I raised with the nurse at the recent check up was my son’s language development. As he has only just turned 3 I am not overly concerned with his speech, knowing from my uni studies that the syllables he is struggling with are the one that develop later. The response I was given to my concern was ‘Do you have private health insurance?’. A beg your pardon? The standard response is that they refer all children to a private speech pathologist as the public wait list is so long, and early intervention is key. Well, that is one sure way to induce a panic attack in a mother who simply raised a slight concern. The nurse hardly even listened to my son speak and proceeded to push the speech path response; so much for a health professional opinion.

My son attends family day care and is in the presence of other adults who have not raised any concerns with his development. I was quite rattled after this annual check up and it took a few days for my to bring my anxiety levels back down and under control. As a mother, I see the health professional as someone to guide parents on their development of their child, not to destroy the parents confidence.

The one thing that most gripes me about these annual child check ups with a health professional is that it is all child-focused. In a recent study by Megnin-Viggars et al (2015) several key themes were noted in the experience of care with perinatal mental health issues including this focus on children over mums, health professionals either being unable or unwilling to address mental health issues in women,  the need for support as well as the need for integrated care. In all the check ups I have done for my son, only one nurse has asked how I am going and if she can do a routine Edinburgh Postnatal Depression Scale (EPDS) on me. In this case, I actually had to prompt the nurse to read the file in front of her and say that should be a routine procedure for mothers with postpartum mood disorders. The nurse had a look of surprise when she took the time to read my file! One of the stages of recovery from postpartum psychosis is the tendency to conceal the illness, particularly from professionals (McGrath et al 2013). If the health professionals were more encouraging in women being open about their experiences, this would facilitate women to seek support and aid the recovery process (McGrath el al 2013).

For women who have experienced postpartum psychosis the support of health professionals, along with support from family and friends, is the second most important factor in recovery, with the women’s own determination being the most important (Engqvist & Nilsson 2014). To have hope and faith that you will get through, to have support that you will be ok is crucial for someone who has been experienced mental illness and forming a holistic perspective with professionals can be an effective approach for recovery (Engqvist & Nilsson 2014).  So for me not having the support I am looking for from a health professional is a hindrance to the recovery process. Why can’t the childhood clinic collaborate with other health professionals in the care of women with postpartum psychosis, or even with postpartum mood disorders in general? Psalia et al (2014) notes this disjoint of care from maternity services to child and family health services showing that processes and communication were lacking, such as transfer of information being reliant on discharge summaries alone, to ensure this collaboration occurs. A suggestion from Psalia et al (2014) for families ‘at risk’, which I consider mental health to be in this category, is to have regular meetings between midwives and the child and family services, particularly to ensure the understanding of each of their roles in the care provision.

I really wanted support from a health professional as I was lacking the parenting confidence, particularly as I was a first time mum, and this seems to be similar to other mums seeking support (Miller et al 2014). It appears though even with dedicated Postnatal support service (UPNCS) put in place across public health services, receiving almost double the amount of contact than normal services, there was no association between UPNCS and parental confidence or perception of the sufficiency and quality of care received (Miller et al 2014). It was noted in this study that the type of contact provided, either by midwives or Child Health nurses who have different skill sets and care focus, that further research is needed to investigate if this plays a role in the association between support received and quality of postnatal care (Miller et al 2014). From my experience, I feel that this certainly does play a role in the postnatal care and support provided, especially women with a history of postpartum mental illness.

A downside to these childhood check ups and not being focused on the mother is that symptoms of depression can persist into the early years of childhood. Horwitz et al (2009) found that depressive symptoms persist in mothers who have children of pre-school age and the pattern varies across assessments with 27.2% reporting intermittent symptoms. Socioeconomic factors, like trouble paying the bills, as well as psychological characteristics, like conflict in the family home and levels of parenting stress, play a role in the level of depressive symptoms reported (Horwitz et al 2009). This can have an impact on the child as mothers who report elevated depression symptoms report lower for their child’s health (Horwitz et al 2009). So what is best for the child may be what is best for the mother, and what is best for the mother is a health professional checking in, perhaps doing a quick EPDS, and seeing how the women is coping as a mother of a toddler.

How have you found your experiences with the childhood check ups? Do you feel that they are too child-focused?

References

Enqvist and Nilsson (2014) The Recovery Process of Postpartum Psychosis from Both the Woman’s and Next of Kin’s Perspective – An Interview Study in Sweden.

Horwitz et al (2009) Persistence of Maternal Depressive Symptoms throughout the Early Years of Childhood

Megnin-Viggars et al (2015) Experience of care for mental health problems in the antenatal or postnatal period for women in the UK: a systematic review and meta-synthesis of qualitative research

McGrath et al. (2013) The process of recovery in women who experienced psychosis following childbirth

Miller et al (2014) A call for better care: the impact of postnatal contact services on women’s parenting confidence and experiences of postpartum care in Queensland, Australia

Psalia et al (2014) Smoothing out the transition of care between maternity and child and family health services

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