During the month of May we celebrate mothers but we also observe Maternal Mental Health Month and the work The Blue Dot Project is doing to close gaps in maternal mental health care through education, advocacy, and collaboration. In the age of COVID-19 and quarantine mothers are at greater risk for perinatal mood disorders. We are thankful one of Blue Dot Project’s ambassadors, Desirée L. Israel, LGSW Clinical Social Worker/Reproductive Mental Health Therapist, perinatal psychotherapist, birth doula and Reiki practitioner spent some time breaking down what’s happening mentally to mothers during this time.
Can you speak about the current landscape and how some of our hospital policies, albeit focused on safety, can result in significant birth trauma in light of Covid-19?
It is an anxious time to be giving birth during COVID-19, some hospitals have implemented no visitor policies or limiting to 1 person (not including or excluding birth support/doula). Families are having to choose between having their partner or doula to help them manage environment and being present for the birth. I have heard instances of birthing persons being induced to speed up their birthing process. Some families have had to switch providers completely and prepare for a home.
Stress related pregnancy complications can become magnified during this time. What are some tools pregnant people can use to help relax?
One thing I have been telling my clients is to move and get outside. Taking a walk in your neighborhood, low impact exercise, yoga, stretching and deep breathing are all activities I have suggested to my clients. Additionally, taking 30 minutes to participate in a mindful activity whether it be drawing, calligraphy, coloring, doing a puzzle or reading to help calm and ground the mind.
For folks who are afraid of birthing alone without the support of their partner and who’ve been told they can not have support of a doula, how do you advise them to prepare mentally and emotionally for the birth experience?
While the physical support of a doula may not be possible for some families, doulas are still available for virtual support. Have friends and families prepare affirmation cards to take with you to post in your room. Bring a laptop or tablet for video conferencing with loved ones who can also coach you while birthing. Practicing relaxation techniques such as deep breathing or tapping (emotional freedom technique) can help alleviate anxious thoughts.
What interventions are mental health providers putting in place to support patients in a time of social distancing?
Many providers, such as myself, have begun providing teletherapy and virtual support groups. It is a learning curve for many of us who may have not intended on having a teletherapy practice.
Telehealth is becoming the go-to method for folks to receive their care during Covid-19. How do people who need support find a provider right now?
There are many great options for directories. Here are a few of my go-tos: TherapyforBlackGirls, Psychology Today, Boris Henson Foundation and Therapy Den. If you’re unable to afford therapy or are uninsured I suggest Open Path Collective. Here in Maryland we have a resource for free counseling called the Pro Bono Counseling Project. Their mission is to ‘ensure that people with limited resources requesting mental health care are provided access to volunteer licensed mental health professionals and other necessary supportive services.’ Also, check with your insurance provider. You can find an in-network provider via your patient portal with most major insurance carriers.
How are providers working to make therapy more accessible to folks from marginalized communities that are hit hard by the crisis?
One of the positives that I have seen and have taken advantage of are states offering temporary licensure to licensed mental health professionals in other states. Current states offering temporary licensure are: New Jersey, Alaska, Massachusetts, South Dakota, New Hampshire, Oregon, Rhode Island, Utah, West Virginia, Wisconsin and Montana.
Can you speak about the correlation between chronic stress and PTSD and how pregnant women are at higher risk right now? What about black mothers?
According to Dr. Julie Wood at at Massachusetts General Hospital Women’s Mental Health Center, PTSD will occur in approximately 10% of women in their lifetime, with one-third of episodes lasting more than five years. Some physical changes during pregnancy or routine prenatal care could trigger symptoms in women with a history of sexual abuse. For black mothers, chronic stress and PTSD is often linked to racism. In these times of COVID, these instances, during pregnancy, may cause an increase of stress and PTSD as Black mothers often don’t feel heard by their providers when it comes to prenatal care, pain associated with pregnancy and postpartum concerns. It is recommended that psychotherapy and medication management (unless otherwise stated by a medical provider) be continued throughout the pregnancy.
What mental health resources and action tools can we put in place for new mothers and their loved ones as they enter into new motherhood?
Ask your care providers for local resources during telemedicine appointments, see if they’re connected to other providers. Now is the time for everyone in the healthcare field to work together. Check out Postpartum Support International for more local support. You can find support and connect with a coordinator in your state. They also have a directory of providers who specialize in perinatal mood and anxiety disorders.
Desirée L. Israel, LGSW Clinical Social Worker/Reproductive Mental Health Therapist, Certified Breastfeeding Specialist, Owner, MotherlandCo., LLC, Co-Founder, The Bloom Collective, Co-Founder, Perinatal Mental Health Alliance for People of Color
Desirée is a licensed social worker, perinatal psychotherapist, trained birth doula, Reiki practitioner, and owner of Postpartum Recovery helping women decipher the funk of motherhood through her practice in Baltimore, MD. Additionally, she serves as a diversity committee member for Postpartum Progress, a Maryland co-coordinator for Postpartum Support International and her practice is a Perinatal Safe Spot through the National Perinatal Task Force.