Depression and the Perinatal Period

(this post was edited to move the references to the comments)

I just got some sobering statistics from my friend, doula client and now fellow doula Walker Karraa. She's working in Southern California as a labor and postpartum doula and is a member of the Los Angeles County Perinatal Mental Health Task Force. The Task Force is looking at developing a community-based birth professional training program based on the Health Connect One model, similar to the kind of work we're doing at Open Arms.

Read this press release from the ACOG (American College of Obstetricians and Gynecologists) to learn more about the importance of screening for perinatal depression and why this issue affects all of us in the community.

I'll have more on this topic some other time.

Meanwhile, here's what Walker shared with me:

Speaking of statistics, did you know that:

• Suicide is the leading cause of death for women during the first year after childbirth. 1
• Depression is also the second most common cause of hospitalization for women in the U.S., the first is childbirth. 2,3
• Reports show that it affects 10% to 25% of all women, and up to 48% of women living in poverty. 4,5,6,7
• There is a seven-fold increase in the risk of psychiatric hospitalization for women following childbirth. 8,9,10
• Postpartum depression is the theme of The President of ACOG's 2009-2010 presidential initiative. 11

For information regarding Suicide Prevention, please visit National Suicide Prevention Lifeline and remember 1-800-273-TALK for hotline.

For more information about postpartum depression and mood disorders, as well as local resources for your clients, please visit Postpartum Support International.

References are available in the comments.

Domestic Abuse in Pregnancy

A few people have asked me, "Will you be doing a post about domestic abuse on Super Bowl Sunday?"

That's because of the conventional wisdom that SuperBowl Sunday is one of the leading days for domestic abuse to occur. The idea goes that the losing team is out of control and the man takes it out on the family in retaliation - or the team wins and in one's excitement, he again takes it out on the family.

Well obviously I've missed SuperBowl Sunday, at least as far as this blog is concerned. After getting all the questions about posting on that day, I thought I'd verify that the domestic abuse injuries do indeed go up on the day of the Big Game and as it turns out, there isn't a big difference on that day. See Snopes discuss that here.

I guess the conclusion you can come to is that it's not better on any other day - domestic violence occurs every day.

So instead of talking about that, I'm going to tell you about this. The next time you hear that tidbit about domestic violence and the SuperBowl, share this one back.

Did you know that homicide is a - and quite possibly THE - leading cause of death in pregnant and postpartum women - and most often this is caused by an intimate partner?

We hear about some of these cases on the news. Laci Peterson and others, so many others, regularly hit the headlines and the world is shocked. However the homicides are the tip of the iceberg on domestic violence during pregnancy - most violence doesn't escalate to murder, but still has devastating consequences, among them premature labor, premature rupture of membranes, uterine rupture, hemorrhage and blunt trauma injuries to mother and baby as well as miscarriage and stillbirth. Assuming a woman and baby are not killed by the abuse, the abuse often continues - and escalates - and affects not only the rest of pregnancy, but labor, birth, postpartum and beyond for both mother and child. Read more about it here.

Whether it's "the" leading cause or "a" leading cause might be up for debate, but I think an important point to consider is that maternal homicides, and perinatal domestic abuse, tend to be under-reported - so the problem is certainly greater than we currently understand.

Text4Baby

Text4Baby - this rocks. Check it out.

http://www.text4baby.org

From their website:

Text4baby is a free mobile information service designed to promote maternal and child health. An educational program of the National Healthy Mothers, Healthy Babies Coalition (HMHB), text4baby provides pregnant women and new moms with information they need to take care of their health and give their babies the best possible start in life. Women who sign up for the service by texting BABY (or BEBE for Spanish) to 511411 will receive free SMS text messages each week, timed to their due date or baby’s date of birth.

This program was in all the news and is aimed at reducing infant mortality by using text messages to reach new moms with health information.

Read more news about this here.

Amnesty International and Maternal Health in the US

Often when I think about Amnesty International, I think of issues elsewhere in the world. But Amnesty International is calling for stories now about the United States and our appalling maternal health statistics.

Read the report.

When you consider the United States comes in 41st place in maternal health out of 171 countries, far higher than the European average, it really makes you think.

The Reuters summary of the report states that one US woman in 4,800 is dying from complications of pregnancy or childbirth. With that rate, the US is about equal to Belarus and slightly better than Serbia... but worse than some developing nations, such as Bosnia. Another alarming statistic: the death rate for black women was nearly four times that for white women.

It took me a while to find this, but here is the whole report from WHO, UNICEF, UNFPA, and The World Bank, for those of you who are interested.

If you want to learn more about this, you might like looking at this slide show - it has a lot of food for thought.

Describing Open Arms

I was at the board executive committee meeting today and we were discussing how we describe Open Arms. We do a lot in unique ways - sometimes it's hard to describe.

Many of the terms we use have specific meanings in the nonprofit community. We do home visits, we are community-based, and we provide doulas for the perinatal period (before, during and after birth). It's the combination of these things that provides the magic of what Open Arms is. But each of the terms is limited - and our mission spans all of them.

We do home visits - but most home visitation services don't attend births, so we are unique in that way. We attend births, but we do a lot of our work before and after the birth through our home visits and the scope is broader than what traditional, private-pay doula services provide. And, our community-based work ensures that the services we provide are culturally-relevant and anchor the family in the larger community that will continue support for years to come - something generally not done by either home visitation services or doula work.

And what comes out of this unique combination? We have a wide range of impacts - supported family, fewer interventions during birth, shorter hospital stays, increased breastfeeding, parent education, community support, increased support for early learning, lower postpartum depression, increased bonding....

We hope that the impact of support services at a pivotal time will last for many years. One of the things we discussed today is that our outcomes follow studies done nationally - we know that - for example, our breastfeeding rate is well over 90% and our c-section rate is more than half of the general Seattle population. But we need to apply statistical analysis to our data so that we will be able to say for sure what our outcomes are. We hope to get this kind of analysis underway this year. We also hope to follow our clients over the past 11 years (which can be hard with a mobile population) and find out what the long-term impact really is. We think we know, but we want to quantify it.

We'll keep you updated as this progresses.

Part of the family

We've been really busy around the office these days. Another year is in full swing!

Our Program Coordinator Yvette Dioubate went to a parenting meeting a few weeks ago and wrote this nice note to me:

An experience I had this weekend- I went to a parenting meeting Village of Hope to speak about WCELI Doula Services b/c I was told by the coordinator there were a few pregnant women from the area who might be interested. Well only one pregnant woman (and her mother) showed up. So, as we got to talking more, turns out she already has a doula from us (Rachel Liberto) and they could not stop singing praises about her. They say they "love, love, love" their doula Rachel and she is now part of their family. The client's mom was so thrilled that she was able to take her grandmother role and not have to be the sole support person, as well as she was thankful that at times when her daughter (the client) needed someone to talk to for pregnancy answers or wasn't comfortable with talking with family, she could call her doula. I left feeling very proud of our service, and our doula.

Thanks Rachel for all you do for our clients! And thanks for sharing the story, Yvette!

Open Arms doulas - got any more stories to share? Email me at peggy@openarmsps.org and I'll post them!

Luncheon - Wednesday, March 24, 2010

We're gearing up for our Annual Benefit Luncheon on Wednesday, March 24 at the Renaissance Seattle from 11:30 - 1:30 (program starts at noon). We really hope you'll be able to join us. You can get all the details and register on our webpage. Look for invitations soon. If you aren't on our mailing list and would like to be, email us at events@openarmsps.org and we'll be sure to get you an invitation.

Right now, we're looking for table captains and sponsors. If you're interested in either of these, email us at events@openarmsps.org as well.

We can send you a sponsorship form to look over and would be happy to discuss how this might work for you or your business.

If you are more interested in being a table captain, it's fun and easy and a great way to introduce others to the work that Open Arms does. The suggested donation per luncheon attendee is $100, and as a table captain, you do not have to buy the table - you just bring 9 other people along with yourself who are committed to supporting Open Arms, hopefully at the suggested donation or more, and we provide lunch and fabulous program. You and your guests contribute at the event as you are moved to do so, and we sincerely hope we'll show why supporting our work has lasting impact on women, families and communities!

Hope to see you there!