Maternal Mental Health Matters


Today is World Maternal Mental Health Awareness Day, and we’re helping to bring attention to an important health issue and available treatment options.

Worldwide, as many as one in five women experience some type of perinatal mood and anxiety disorder (PMAD). PMADs include postpartum depression, postpartum anxiety, postpartum obsessive compulsive disorder and others.

“There is still this myth that pregnancy is blissful and if you don’t enjoy pregnancy and having your baby, there’s something wrong with you,” says Patricia Widra, MD, assistant professor of psychiatry with the University of Maryland School of Medicine and a psychiatrist at University of Maryland Medical Center.

“But fifteen to twenty percent of women have this experience, and there are ways to treat it.”

Because of the stigma that often surrounds mental health disorders, many women hide or downplay their symptoms. Not getting support or treatment can have a devastating impact on the woman affected as well as on her partner and family. It’s important to treat a PMAD like any other health problem so that families can thrive.

“Most people don’t realize it, but post-partum depression (PPD) is the most common serious complication after delivery,” says Dr. Widra.

Women whose pregnancies end in miscarriage or stillbirth often experience not only grief but also postpartum depression. In addition, giving birth to a premature child, or having a child spend extended time in a neonatal intensive care unit (NICU) can also take a toll on a mother’s mental health.

Why is PMAD so prevalent? “We don’t know,” says Dr. Widra. “Part of it is depression in women in this age group is already more prevalent than in men anyway, even without pregnancy. Pregnancy is a major change-of-life event. Sometimes a woman doesn’t have enough social or financial support or doesn’t have a partner. Hormonal changes also have an effect – this is where a lot of current research is focusing. Somehow these shifts seem to trigger PMADs. We don’t know specifically why it happens in some people and not others.”

Symptoms of PMAD can appear any time during pregnancy and the first 12 months after childbirth. The good news is there are effective and well-researched treatment options available to help women recover.

“It’s important that a woman is medically screened for a mood or anxiety disorder at least once during her pregnancy – preferably in the second or third trimester,” says Dr. Widra. “Just as we screen women for diabetes and thyroid disorders during pregnancy, it is just as critical to screen for mood and anxiety disorders. Currently this is not the standard of care. There is a lot of push federally and in Maryland to make it the standard.”

What you can do: If you are a new mom, be aware of how you’re feeling, and seek help if you’re experiencing symptoms of PMAD. If you know someone who is a new mom, ask her how she is really feeling and encourage her to seek help if she needs it.

“Some women think that because they’re discouraged from taking most medications during pregnancy that there isn’t anything their doctor can do to help with an anxiety or mood disorder,” says Dr. Widra. This is not the case. “We now have research to show that there are non-medical treatments that are evidence-based to help women with mental health problems during pregnancy. It’s also considered relatively safe to use some antidepressants during pregnancy.” The bottom line, says Dr. Widra, is there are effective medical and non-medical treatment options available to women even during pregnancy.

Life changes around pregnancy make women more vulnerable to mental illness. Mental healthcare provides the necessary support to empower women to identify resources and personal capabilities. This can enhance their resilience to difficult life circumstances and support them to nurture their children optimally. Caring for mothers is a positive intervention for long-term social development.

Here are some mental health tips for women during their reproductive years:

  • If you are feeling blue, anxious or depressed, don’t wait. Talk to your doctor or a mental health professional about it as soon as possible.
  • If you’re taking medications for a mood or anxiety disorder and you become pregnant, don’t stop taking them without talking to a mental health professional.
  • Eating well, regular exercise, and a good night’s sleep are important during this period of your life as they are at any time in your life.
  • Do things that are good for brain health such as meditation and yoga.
  • If you have a history of depression, be proactive and aware of any signs and symptoms.

For more information or to make an appointment with a doctor who specializes in women’s emotional health and reproductive psychiatry, call 410-328-6091.

Nurse Manager Named Hometown Hero by the American Red Cross

By Malissa Carroll
UMMC Web Team

Connie Noll, the nurse manager for adult psychiatry services at UMMC, has been named a Hometown Hero by the American Red Cross, with whom she has been a volunteer since high school and throughout her career.

“Connie’s lifelong career with the American Red Cross demonstrates a commitment to caring for others that is truly heroic. It is a privilege and honor to work closely with someone whose dedication and compassion for others is seemingly limitless,” says Lisa Rowen, senior vice president for patient care services and chief nursing officer at UMMC. Rowen and Judy A. Slide, director of nursing for neurocare, behavioral health and radiology, nominated Noll for the award.

In 1994, Noll received training in disaster mental health (DMH). Since then, she has responded to help survivors at the most devastating disaster scenes in the country. As a Red Cross volunteer, Noll helped residents of Van Nuys, Calif., cope after a 6.8 earthquake struck the region.

When terrorism struck this country – in Oklahoma after the bombing of the Alfred P. Murrah Federal Building and on Sept. 11, 2001, in Pennsylvania and New York, Noll provided services at the scenes in the immediate crisis and in the months afterward.

She also visited New Orleans one month after Hurricane Katrina to aid local relief efforts. There, she served as manager for staff mental health and oversaw 2,000 paid and volunteer Red Cross staff. Last year, Noll provided support at the site of a plane crash in Buffalo, NY, where she accompanied families of the crew to the crash site.

In addition to her work with the national Red Cross, Noll remains active at the local level as well. She leads Red Cross Mental Health volunteers at the organization’s York, Pa., chapter and is a part of the Disaster Action Team that responds to local fires and other civil events in an effort to provide crisis intervention, psychological first aid and emergency referrals.

At UMMC, Noll has also been responsive. She was instrumental in establishing the Workforce Resilience Team to aid Medical Center employees after the economic recession began in 2008.