A Conversation About Maternal Mental Health

Dylan Chudoff, Second Semester Medical Student 

Baby blues is a very common depressive disorder where we’ve seen sadness, even feelings of anxiety, and tiredness associated around the time that a mother gives birth to her child. It’s generally the weeks following.  

When it comes to postpartum depression, it can onset very similar in terms of symptoms, but the depressive symptoms are more severe. It can start a few weeks before delivery or a few weeks or months after. But the progressive amount of time in which the mother experiences it could be up to multiple years.  

Hilary Serbin, Second Semester Medical Student 

As Dylan mentioned, postpartum depression is a more intense sadness. It also comes with feelings of having difficulty bonding with your child. Not wanting to hold your child. This also comes with anxiety about being able to take care of your child. It can go so far as having trouble taking care of yourself and also taking care of your child. When untreated, it can go as far as hurting mom or baby. 

Dr. Natalie Humphrey, Assistant Dean of Community Engagement 

The time of pregnancy and after delivery for a new mother can be a bit of a mystery. Sometimes moms struggle with the way they’re feeling physically and mentally—“Is this normal? Is this part of motherhood? Or is this something different?” With the changes in your sleep and all the excitement around the new baby, it can be really hard for them to determine. 

So, it’s wonderful when there’s someone with the mother, who knows the mother well, who can say this is a little bit different, this is not like her, or this is making it hard for her to deal with baby. When mom is having those thoughts and feelings, they can often feel bad about that. “I've got a brand-new baby. There’s no reason for me to be so sad or upset.” 

That guilt about feeling bad actually loops around and makes mom feel even more worried and anxious and begin to question her capacity to take care of her baby.  

Hilary Serbin, Second Semester Medical Student 

We want to first make it clear that any woman can experience postpartum depression.  

Baby blues happens in about 50% of women. Postpartum depression now is up to one in six moms will experience postpartum depression. So, both are very common. 

Ultimately, it comes down to support for the mom and baby and stress that mom is experiencing. Examples of stress could be medical complications during the pregnancy or the baby being a medically complex child or challenging for mom.  

Relationship distress or domestic violence can also increase the risk of postpartum depression. Another big risk factor is if mom has a previous history of mental health illnesses, including depression.  

Dylan Chudoff, Second Semester Medical Student 

Depressive symptoms can often lead a patient into isolating themselves. Then we also have the stigma of mental health particularly in the Caribbean but still very much around the entire world.

Dr. Natalie Humphrey, Assistant Dean of Community Engagement 

Sometimes the simplest approach is the best solution. There have been several studies that looked at women with postpartum depression to find out what really works, to help them stay safe, get engaged in care, and to help them to feel like themselves again. Those programs actually focus on check-ins. 

It’s very impactful to follow up with mothers. This could be home-based nursing services to support mom or baby. This could be a social worker or a mental health provider making home visits. Or this could be a peer-based program where someone in the support group has routine check-ins with mom.  

There is treatment for postpartum depression, which is a combination of counseling and medication for some mothers. In fact, there has recently been a new medication approved that does not harm breastfeeding babies. 

Dr. Natalie Humphrey, Assistant Dean of Community Engagement 

As part of our endocrine and reproductive health module during the first year and a half of medical school at AUC, students learn about mental health challenges experienced by women during pregnancy.  

We’re very excited about a new program which is part of an existing community engagement certificate program. That’s an elective program where students work collaboratively with a community organization to develop programs in St. Maarten that support the health of people living here. This year, the students from the certificate program are in partnership with the Obstetrics and Gynecology Department at Saint Martin Medical Center as well as Rotary International to develop a program that promotes awareness regarding postpartum depression here in St. Maarten.  

The best part of the program is that they will be joining women and their partners in the waiting areas during prenatal visits to really focus on educating partners about what to expect from their partner in terms of mood during pregnancy and post pregnancy.

Hilary Serbin, Second Semester Medical Student 

When we were doing our literature review, we learned how big of a difference it makes to have check-ins and that peer-based interventions are super effective. So, we thought it would be a great idea to have a group of volunteers or someone who would be interested in offering to call or talk to moms once a week. We pitched this idea to a church group, and they are interested in spearheading it. 

We want the things that we do now to progress on, even after we leave the island and go on to practice medicine. We want to make sure that we actually leave an impact that truly benefits Saint Maarten’s community as a whole.