Counseling for Reproductive Health & Healing ReproHeart

By Deborah Issokson, Psy.D.

Did you know that 10 to 20% of expectant and new mothers experience symptoms of depression and anxiety? This means that emotional symptoms are perhaps the most common "complications" of pregnancy. While many of these women are experiencing the normal range of emotions inherent in the childbearing experience, some of these women's symptoms are part of a larger picture that includes a personal or family history of depressive or anxiety disorders, trauma and abuse, eating disorders, death of a significant person, relationship difficulties, social isolation and reproductive challenges such as infertility and pregnancy or neonatal loss. In addition to psychosocial factors, there are also some women for whom the hormonal changes in pregnancy and the postpartum period will trigger the onset of a depressive or anxiety disorder.

We (healthcare providers, doulas, childbirth educators, therapists, lactation consultants, anyone having contact with childbearing women) are in a unique position as facilitators along the continuum of childbearing and family-making. As such, it is incumbent upon us to be aware of the risk factors for perinatal mental health problems and to intervene as early as possible in the name of prevention. I believe that timely identification of risk factors and intervention can result in lessening the intensity and duration of the symptoms women experience. Early intervention as a form of prevention can also eliminate the possibility that a woman's experience will reach a state of crisis.

"We are keeping an eye on her" acknowledges an awareness that there is a risk for potential problems. However, in and of itself, watchful observation is not an act of prevention. On behalf of all women, their family members and their babies, born and yet to be born, I ask you to err on the side of caution. If you become aware, either through a woman's disclosure or through your own observation and intuition, that a woman is at risk for perinatal mental health problems, please act as an agent of prevention. Talk with her, educate her, lovingly refer her to a therapist, a support group, a home visiting resource, or a psychopharmacologist for a medication evaluation if necessary.

I am always available to you, as a consultant, if you have questions or concerns about the women for whom you care or if you are in need of resources in order to make an appropriate referral.

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