Let’s just admit it, motherhood is hard. Being pregnant and having a baby is portrayed as one of the most joyous times for a family, and it can be… at times. Though we are getting better, the culture in the U.S. generally fails to recognize that this is one of the most vulnerable and challenging times in a woman’s life.
There are body changes, hormone changes and lifestyle changes that moms may know are coming but can’t truly prepare for until they happen. It is not uncommon for women to have feelings of irritability, guilt, sadness, loneliness and fear. In fact, perinatal mood and anxiety disorders (PMADs) are extremely common and a leading cause of complications from pregnancy and childbirth in the U.S. and globally.
One in seven women in the U.S. experience PMADs with higher rates found among more vulnerable women, such as those that are young, have experienced depression before, live in low-income households, are unmarried and have experienced a stressful life event in the past year. In Harris County alone, it is estimated that 15,000 women experience PMADs every year.
The negative impacts of PMADs on the mother and her infant, as well as her family and society, can be felt for a lifetime. Maternal depression can impact a mother’s ability to bond with her baby and infants of depressed mothers are at a greater risk for delayed psychologic, cognitive, neurologic and motor development, which can be lasting without intervention.
The good news is PMADS are treatable through social support, therapy and medication. The bad news is our current healthcare system does not have enough qualified mental health providers to meet the need. Even if there were, access to care, cultural norms and stigma would still be obstacles for many women.
In 2019, a team from Baylor College of Medicine and Texas Children’s Hospital conducted a randomized control trial to compare the effectiveness of a brief home visitation program using licensed social workers to that of an in-clinic appointment with a reproductive psychiatrist for women with symptoms of mild to moderate depression.
The results demonstrated that women who were randomly assigned to the home vitiation group had decreases in their depressive symptoms similar to the decrease seen in the in-clinic psychiatry group. Not only that, but women in the home visit group had significant improvements in maternal self-efficacy and had better appointment attendance rates than women assigned to in-clinic psychiatry visits. There was an overwhelming positive response from women seen in the home visit group.
“Thank you for helping me in a time of need where I felt lost and not able to talk to anyone because I felt embarrassed.”
“Great that this is a home visit because one feels more relaxed, calm and comfortable and convenient. I like that I don’t have to get ready [with] my baby to go to an appointment and I can simply wait for my appointment in the comfort of my home while cooking.”
Feedback from women in the study led us to add more modules to the model to address other issues common during this time in a woman’s life, such as guilt, the need for boundaries and feeling disconnected.
We recently received state funding to provide this program, now called upLIFT, free to women in Harris and surrounding counties. If you would like more information about this program or wish to refer a women you know (or yourself) please contact us at email@example.com or 832-826-0440.
By Yen Nong, M.P.H., research associate, Division of Public Health Pediatrics, Baylor College of Medicine/Texas Children’s Hospital; Bethanie “Beth” Van Horne, Dr.P.H, M.P.H, director of research, Division of Public Health Pediatrics, Texas Children’s Hospital, and assistant professor of pediatrics, Baylor College of Medicine; Lorena Diaz, LMSW, Sr. Medical Social Worker, Division of Public Health Pediatrics, Baylor College of Medicine / Texas Children’s Hospital