By David Murchland - Marshfield Now!
The emotional changes that come with pregnancy and a new baby are the focus of a new episode of Your Health Matters with Sanford Health - Marshfield Clinic. Host Laura Kibbel welcomes psychiatrist Dr. Alpa Shah and registered nurse Lindsey Dupee for a conversation about depression, anxiety and the support available to women before, during and after pregnancy.
Shah directs the Perinatal Mental Health Clinic at Marshfield Clinic, where Dupee serves as RN coordinator. Kibbel opens the discussion by acknowledging a concern many women share: They may be struggling, but are unsure whether what they are feeling is a normal part of pregnancy or new parenthood—and whether it is time to ask for help.
“The way to distinguish may not be easy for the individual,” Shah says. “The best thing to do is always reach out and ask, ‘Is this normal?’”
Understanding the baby blues
Shah explains that the first days after delivery can bring major shifts in mood. A mother may feel happy one moment and tearful the next while recovering from labor, getting little sleep and adjusting to hormonal changes. She describes these temporary feelings as the postpartum blues.
The guests discuss how depression can look different. Shah points to signs such as feeling detached from the baby, losing interest in caring for the baby or feeling hopeless. She cautions against expecting every mother to feel like the glowing, joyful parent often shown in photographs and advertisements. When a woman is uncertain about her symptoms, Shah encourages her to talk with a health care professional rather than try to make the distinction alone.
Shah’s interest in this work began during her obstetrics training in India. She recalls patients experiencing serious mental health symptoms after childbirth and not knowing at the time how best to help them. She later trained in psychiatry in Cleveland and completed a fellowship in women’s mental health in Chicago before coming to Marshfield.
Treatment is a conversation
Kibbel also raises a question that can be especially difficult during pregnancy: What if a woman needs medication but worries about its effect on her baby?
Shah says the discussion starts by recognizing depression and anxiety as medical conditions that can occur during pregnancy. A care team must consider the condition itself, how severe the symptoms are, and the possible effects of both treatment and leaving the condition untreated. Medication may be appropriate for some patients, she explains, while psychotherapy is another treatment option.
“It’s a thoughtful conversation,” Shah says. The answers depend on the person, her health history and where she is in her pregnancy or postpartum recovery.
That conversation can begin before a pregnancy. Shah says a woman who is planning to become pregnant and already has a mental health condition can discuss her treatment and medication questions in advance. The clinic also sees women during pregnancy and after delivery.
A first point of contact
Dupee describes her role as a connection between patients, providers and the rest of the health care team. She is often the first person a patient speaks with, and she takes time to learn what the patient is experiencing, where she needs help and what her goals are.
“It can be so vulnerable reaching out for help,” Dupee says. She wants that first conversation to feel as comfortable as possible.
The guests also address a fear that admitting to troubling feelings might mean being separated from a baby. Dupee says the team’s goal is to support the mother and baby while making sure everyone is safe. Shah says getting treatment can help families address symptoms before they grow more serious.
Women may be referred through an obstetric, primary care or pediatric appointment, and Dupee says they can also call the clinic directly. The direct line is 715-387-5744.
Kibbel closes with a reminder to anyone facing these concerns: “This is not a journey you need to go on alone.”
If someone is in immediate danger, call 911 or go to the nearest emergency department. For a mental health crisis, call or text 988.