Carol Lawson’s dining room table won’t be ready for any kind of formal dinner anytime soon. It’s strewn with research papers, journal articles, and books — anything she can get her eyes on to learn more about talking to new moms about a serious subject: postpartum depression.
A nurse for the last 19 years in the mother-baby unit at UCHealth Memorial Hospital, Lawson teaches nurse colleagues how to have therapeutic conversations with new mothers who may be at risk for postpartum depression, when feelings of sadness or despair last longer than two to three weeks.
It can be hard to talk about mental health, no matter what your relationship is to a person who may have mental illness. There’s a kind way to do it – in a caring and nonjudgmental way — that is at the essence of Lawson’s teachings.
“That human interaction with patients, and letting them know ‘I’m listening to you’ is essential for patients,’’ Lawson said. “While it’s chaotic for the nurses on the floor, it’s important that the patient feels that and we’re taking the time to listen.’’
While Andrea Yates, the Texas mother who drowned her five children in a bathtub in 2001, put a spotlight on postpartum depression, it’s still a topic that needs to be illuminated. Nearly one in seven new mothers suffers from postpartum depression.
“It is real and we can show that it is real,’’ Lawson said. “We want our moms to know that they’re not alone, and it is OK to ask for help.’’
At the core of Lawson’s teaching are the three C’s — communication, compassion and collaborative care. Every new mother at Memorial Hospital fills out a questionnaire that is actually an Edinburgh scale, a tool published in the British Journal of Psychiatry in 1987 to detect those at risk for postpartum depression.
A Women’s Services medical social worker visits with postpartum women prone to risk to provide additional education, support and community resource referrals. Nurses are trained to develop and foster therapeutic nurse-patient relationships. Physicians and nurse practitioners develop an individualized care plan – all part of collaborative care.
A few weeks ago, Lawson sat and talked to a new mother the night before she was supposed to go home from the hospital. The mom, who had underlying mental health and substance abuse issues, poured her heart out to Lawson after she asked a simple question.
“Who is going to pick you up?’’ Lawson asked.
The young mother responded: “I don’t have anybody. I’m not safe tonight, and I’m afraid I’m not going to make it to the morning.’’
Lawson intervened and made arrangements to help ensure a safe plan of care for the mother.
Lawson teaches that through therapeutic communication, a patient can be reassured, be placed at ease and feel as though she has been taken seriously. It helps patients understand their illness more fully and empowers them to voice fears and concerns. It may also encourage patients to be more motivated to follow a prescribed regimen and/or seek help from health care providers or community support.
New mothers are at risk for postpartum depression for as long as a year after giving birth. It is recommended that all postpartum women follow up with their primary care physician for a four to six week postpartum checkup, including evaluation of mental well-being. Peak Vista Women’s Clinic checks in with postpartum mothers at two weeks and six weeks. Memorial postpartum nurses also teach new mothers to re-visit the Edinburgh postpartum depression screening tool at two weeks and six weeks, and to reach out for help if the Edinburgh score is increasing or if they are experiencing symptoms of postpartum depression.
A woman may have PPD if:
- Feelings of sadness or despair last longer than two to three weeks.
- She experiences a depression that starts three weeks or more after delivery.
- She experiences physical symptoms, such as headache or rapid heart rate, bowel problems or problems with breastfeeding.
- Feelings of depression include feelings of being alone, vulnerable, sad, hopeless and worthless.
- She has a lack of interest in her new infant, herself or things that were once important.
- There is a feeling of being overwhelmed by the parenting role.
- She is afraid of harming herself or the baby.
- She is overly concerned for the safety of the baby.
- She feels sluggish, always tired and exhausted.
Lawson said that post-partum depression can be brought on by life stressors, family stressors and a lack of support.
“I’m concerned about these moms after they go into the community,’’ Lawson said. “Having a baby is a life change, a responsibility change. We want to teach families what to look for and to teach mothers that their mental and spiritual wellbeing is very important to their overall health.’’
Lawson said that by nurses providing therapeutic communication – and letting new mothers know that they can, at any time, reach out for help, could make for a healthier outcome for mother and baby.