By Joy Burkhard, MBA
This weekend, something that has never happened in maternal mental health happened:
A mother's story went viral on Facebook.
A mom in Sacramento California, went to her Ob/Gyn on Friday for help with postpartum depression, including symptoms of anger and scary thoughts. The next morning, Saturday, January 20, she posted this:
I had a really hard time deciding whether I should post something about what happened last night, since putting it on Facebook wouldn’t help the situation. But I don’t know, I feel like this has to be said out into the world so you can all see how little support mothers get from our healthcare system.
I had an OB appointment yesterday, my first since giving birth 4 months ago (because they kept cancelling my appointments), which is inhumane in my eyes. I went to the appointment alone with Kira. It was at 2:10, and I was not called back to a room until 3:15. A nurse practitioner comes in (one I don’t particularly care for) and I tell her everything my husband told them when he scheduled me the appointment a week ago. That I have postpartum depression that is manifesting in fits of anger, and I want to discuss my medication options. I tell them I have a very strong support system at home, so although I would never hurt myself or my baby, I’m having violent thoughts and I need medication and therapy to get through this. She rushed through my pelvic exam, barely spoke about medication, said she needed to talk to the doctor about my PPD, and left the room.
They called the f[******] cops on me....
I was treated like a criminal and then discharged with nothing but a stack of xeroxed printouts with phone numbers on them.
Read more here.
2020 Mom was formed at the urging of the California legislature seven years ago and we have painstakingly been talking with patients, Ob/Gyns and others to get to the bottom of "why" women keep falling through the cracks. We know the health care system and we have high expectations of Ob/Gyns, but recognize that they can't do this alone.
Consider these facts:
Many Medical Doctors -MDs (including Ob/Gyns and primary care doctors -PCPs) report receiving little training during graduate medical school in mental health, let alone the nuances of maternal mental health disorders.
There are critical shortages (and not just in rural areas) of psychiatrists (MDs that our healthcare system has relied on to diagnose and treat mental health disorders), and super-shortages of psychiatrists who are trained or interested in keeping up with the ever changing research regarding treatment of pregnant and lactating women (known as "reproductive psychiatrists").
More and more childbearing age women have pre-existing anxiety and depression.
Our healthcare system is at a critical crossroads. We can and should expect Ob/Gyns to know the basics of identifying and treating depression and the range of anxiety disorders (including OCD with scary thoughts), and to know how and where to refer women who screen positive for bipolar disorder (which cannot be treated with an anti-depressant alone, as anti-depressants can trigger mania and possible psychosis).
Ob/Gyns must meet core competencies to address Maternal Mental Health.
We can, and should also expect, that Ob/Gyns have support in keeping up with the latest treatments through a provider-to-provider consult service, and help from health insurers identifying referral pathways to talk therapists, and to psychiatrists when needed.
This is what California is poised to address*. And when we can do this in California, we can do it anywhere.
Thank you, Jessica, for telling your story and inspiring a nation to act (#ACTION4Jessica). And thank you in advance, health care system (Ob practices, hospitals, insurers, trade associations and more) for prioritizing maternal mental health once and for all. We are here to support you.
Join us or follow us live on Facebook, next Monday, January 29 as Jessica leads an ACTION 4 Moms Rally (#ACTION4Moms) in Sacramento on the steps of the state capitol.
*Read more about California's maternal mental health strategic plan here: 2020mom.org/ca-task-force.