Welcome to my blog, which speaks to parents, professionals who work with children, and policy makers. Through stories from my behavioral pediatrics practice (with details changed to protect privacy) I will show how contemporary developmental science can be applied to support parents in their efforts to facilitate their children’s healthy emotional development. I will address factors that converge to obstruct such support. These include limited access to quality mental health care, influences of a powerful health insurance industry and intensive marketing efforts by the pharmaceutical industry.

Saturday, May 9, 2015

For Mothers and Babies: Big Weeks Ahead at Boston's State House

Recently the Massachusetts House of Representatives did a very good thing.  As described in a Globe editorial, they reinstated funding for a program that supports new mothers struggling with perinatal emotional complications.

At Southern Jamaica Plain Health Center (SJPHC), when a new mother reveals that she is overwhelmed and struggling in the care of her newborn, thanks to the special legislative commission on Postpartum Depression chaired by Representative Ellen Story, help is available on the spot. SJPHC is one of four sites chosen for this pilot program focused on perinatal emotional wellness and postpartum depression prevention. 

By placing perinatal support services within existing healthcare facilities, this program lowers barriers and increases access to care.  By bringing services to where women already are-- with a prenatal provider and/or a pediatrician—the program provides critical support to diverse and underserved populations, including many people who have no other access to healthcare.  

Clinicians meet with all new families at their first pediatric visit, often as early as 4 days postpartum. This is a period of uncertainty, and most new parents have many questions about sleep, feeding, caring for their baby, and managing the adjustment to parenthood.  

Divya Kumar, a doula and lactation consultation, describes how she can listen to new moms for extended periods. As she explains, “I can sit with a mom and say, ‘OK, I'm going to help you figure all of this out.  And if I don't have all of the answers, I'm going to connect you with someone who can help you get them.’ ”

It is not simply about screening for PPD and referring the mother for treatment. Divya and her team can hold the baby and mother together over time, seeing how the baby feeds, when the baby fusses, supporting a mother’s efforts to be present and calm in a way that soothes her baby. The program offers fertile ground for growing a healthy relationship.

Now another important program for mothers and babies, MCPAP for Moms, is on the chopping block.

In a new moms group, where mothers feel supported and listened to, extraordinary thing happen. As a consultant to groups at William James College Freedman Center, I have had the privilege of witnessing this powerful transformation again and again. On the first of eight weeks, when moms sense the safety of the group, they share experiences not only about the lack of sleep and ability to take a shower, but also fears, anxieties, self-doubt, sadness and even depression. By the last group meeting, these mothers, many of whom have developed powerful bonds with each other, interact with their babies, whose unique little personalities have emerged, with confidence and joy. 

In our culture today, where extended family may be far away, where spouses often return to work long hours almost immediately, mothers may be very much alone in the task of caring for a new baby. Mother-baby groups have a critical role to play in filling that void.

MCPAP for Moms, in collaboration with MotherWoman, an organization that offers a network of groups as well as training for group leaders, seeks to make these groups available to mothers all across the state.

This program, too, has its roots in the postpartum depression commission. While at first the focus of the commission was to implement statewide screening for postpartum depression, it quickly became clear that such a step was meaningless without first having resources in place to help mothers identified by the screening.

MCPAP for Moms works in collaboration with William James College INTERFACE Referral Service. When a new mother feels alone, scared and overwhelmed, a three-month- or even a three-week-wait is unacceptable. She needs help today. This program not only helps to locate a support group, but also will connect a mother with a mental health clinician who has experience treating mothers who are struggling with perinatal emotional complications. MCPAP for moms also offers toolkits, as well as immediate phone consultation, for a range of clinicians- including pediatricians, obstetricians, psychiatrists and family practitioners- who are in a position to identify and treat these vulnerable mothers and babies. 

Sadly, the $500,000 needed for MCPAP for Moms to be implemented throughout the state was not even included in the budget.

Budget amendments are due this week, and the floor debate will occur the week after. Let’s hope our legislators, and then Governor Baker, will do the right thing- reinstate the funding for MCPAP for Moms and approve the funding for the pilot programs.  When we as a community support new mothers, we promote healthy development of the next generation, and so the future of our country.  






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