Transcription:
Paola Peralta (00:08):
Welcome to Perk Up, a podcast about workplace culture and benefits brought to you by the team at Employee Benefit News. I'm Paola Peralta, your host for season three. We've already tackled what it's like to get pregnant, go through those experiences and then give birth. So for the remainder of the season, we're going to be more or less discussing what comes after you grow your family, tackling the personal and professional challenges that are often closely intertwined. Today's episode is focused on a pretty difficult topic, postpartum depression and anxiety. I'm joined again by senior reporter Deanna Cuadra, who spoke with a behavioral healthcare manager and a psychotherapist at WINFertility about how to navigate the mental health complications that can often follow childbirth or even adoption and surrogacy. Hey, Deanna, glad to have you back.
Deanna Cuadra (00:51):
It's good to be back. It's an important topic that I don't think I've heard many parents talk about.
Paola Peralta (00:55):
I mean, yeah, we're jumping right into the postpartum experience today, which seems like a pretty under-discussed issue when it comes to maternal or really paternal healthcare in general. But that doesn't necessarily mean that it's not common.
Deanna Cuadra (01:08):
So there's definitely this expectation that having a newborn baby is this really blissful experience, and that can be true, but there's also pretty high risk of maternal health challenges in those early months. In fact, up to 85% of birthing parents will experience a temporary, relatively mild form of depression called baby blues, while nearly 15% will have the more intense diagnosis of postpartum depression according to CDC, postpartum depression is a factor in 20% of all maternal deaths. And this isn't just a problem for birthing parents. Dads non-birth partners, as well as parents who adopted or say use surrogacy may feel depression anxiety with the arrival of their new family member. But many people feel guilty or uncomfortable talking about it,
Paola Peralta (01:49):
Which is genuinely such a shame. But for anyone who might be struggling with this today or is expecting soon, you spoke with a mental health professional who really lays out all of the signs and symptoms and most importantly, what they can do.
Deanna Cuadra (02:02):
Yes, I spoke with Alyssa Baron, a behavioral healthcare manager and psychotherapist at Family Health Benefits Company WINFertility. She has advice for families as well as employers who are looking for ways to better support their working parents.
Paola Peralta (02:14):
Well, let's see what Alyssa has to say.
Deanna Cuadra (02:16):
Welcome to the show, Alyssa. Could you first talk a little bit about the mental health challenges birthing parents often struggle with after having a baby?
Alyssa Baron (02:23):
Yeah, so I mean, there's a wide range of mental health challenges that birthing parents might struggle with. They can range from mild to severe. So when we're thinking about the more mild end, we're probably talking about something like the baby blues, which about 60 to 80% of new mothers experience, and it lasts anywhere from two to 14 days after birth. And it's thought to be brought on by hormonal fluctuation, sleep deprivation, all things that happen to everyone after they've had a baby. If symptoms persist after two weeks, then it's not baby blues.
Deanna Cuadra (03:00):
And for parents out there, what does postpartum depression anxiety look like in someone's day to day? What are the signs?
Alyssa Baron (03:05):
So I think for postpartum depression, there can be this feeling like an overall feeling of this doesn't feel like me. It can feel like drowning, right? I'm just overall really low mood, sadness, tearfulness, loss of interest or pleasure in things that you used to enjoy, feelings of agitation or rage, feelings of hopelessness. Again, that sense of regret of I made a huge mistake by having this baby difficulty with sleep, decreased appetite. So it can range from more mild symptoms to quite severe symptoms of I don't want to be here anymore. In terms of anxiety, I should say that oftentimes these things coincide, right? So we might have postpartum depression and postpartum anxiety or that there's a lot of overlap between the system, the symptoms, but for postpartum anxiety, your mind probably more feels like a hamster wheel that can't stop. So the anxious thoughts can maybe start out kind of mild and quickly escalate to feeling catastrophic. So if my baby doesn't nurse every two hours for 30 minutes, she won't get enough nutrition and then she'll fail to thrive, and then she'll have permanent lifelong struggles. And then there are subsets of anxiety like OCD, which I think isn't talked about too much, but just a lot of unwanted or intrusive or scary thoughts and then feeling like I need to change my behavior in order to accommodate some of those thoughts.
Deanna Cuadra (04:36):
At what point do you think it's necessary to seek out more serious medical care?
Alyssa Baron (04:40):
The most severe would be perinatal or postpartum psychosis, which is a true mental health emergency. A visit to the emergency room, it's rare about one to two people out of a thousand onset is usually within two weeks of birth, but not always. And it can just kind of feel like you're living in an alternate reality. Things are not what they seem developing strange beliefs that feel real, but are not real seen or hearing things that aren't there and just feeling really disconnected from reality. And that's obviously quite severe. So people kind of typically talk about postpartum depression, but we really refer to the umbrella term as PMADs, which stands for Perinatal Mood and Anxiety Disorders to encompass all of the various mental health challenges that someone might experience.
Deanna Cuadra (05:34):
Why are postpartum mental health conditions stigmatized? Where does that shame come from?
Alyssa Baron (05:38):
So I think first, the shame and guilt over being perceived as a bad mom or an unfit parent can run very deep. Women are often told that they'll fall in love with their babies as soon as they're born, and they'll have this maternal instinct that will just kick in and they'll know exactly what to do and they will just be in bliss. And it's just often not the case. That's not quite how it happens when someone has their baby, who we can assume is very much wanted. They're so thankful for it, but they're experiencing a wide range of emotions, and it can almost feel impossible to admit or tell someone that you're experiencing perhaps feelings of regret or sadness or hopelessness or what have I done to my life? So if you've been telling yourself that this is going to be the best time in your life and it feels like the worst time in your life, it can be very damaging to
Deanna Cuadra (06:30):
Early intervention is really key here. So what can parents do if they find themselves experiencing symptoms of depression and anxiety
Alyssa Baron (06:36):
Therapy with someone who specializes in reproductive health or dealing with postpartum parents, I think is really important. And talking about some of their thoughts, beliefs, but also what kind of support systems they have. So I always think of who's taking care of the caregiver, who's actually helping to provide support for them. Sleep is very important to anyone who's experiencing a PMAD, which does not go hand in hand with having a newborn. There are a lot of medications that are safe to take when you're pregnant or nursing, and that is something that can be hugely helpful. Again, not needed for everyone, but to at least have that consultation and find if it's something that would help you or that person potentially in the short term. None of these things are lifelong, so we're not going to be in therapy forever. We're not going to be going to support groups forever, and we may or may not be on medication forever, but it might be a piece of the puzzle that can be helpful for people and getting good information about what's safe is really important.
Paola Peralta (07:50):
And we'll be back after this short break. So Deanna, it seems like what Dr. Baron describes definitely goes beyond your typical depression, and I can't imagine that it's easy to seek help, especially when there's a newborn baby that you have to worry about. Now
Deanna Cuadra (08:07):
While accessing mental health care in the US can be virtually impossible maybe or not, but the bottom line, parents need a support network and they need to feel safe enough to share what they're feeling. Postpartum depression, anxiety aren't things that anyone should have to go through alone, and
Paola Peralta (08:22):
They do say it takes a village, and I feel like employers should very much be part of that village too. So what role can employers play in easing kind of this postpartum experience, whether it's mental health benefits or a great health plan, what other things should benefits or policies should there be?
Deanna Cuadra (08:39):
It isn't actually anything too groundbreaking, but can still be overlooked by employers starting with paid paternal leave and flexibility. Here's what Dr. Baron shared with me. It's no secret that working parents do need more support and social safety nets on a national, but in lieu of that, what, at least on an employer level, what benefits can genuinely make a difference for birthing parents, especially those struggling mental health conditions like postpartum depression?
Alyssa Baron (09:05):
So obviously leave is probably the most obvious answer, but not only leave for mom, we're all sort of on board that people need maternity leave, but thinking of it as family leave I think is really important. I kind of hate the differentiation between maternity leave and paternity leave because to me, all leave is really for the health of the family. So if just mom has maternity leave and dad either doesn't have paternity leave or is not encouraged to take it, then that's not helping the family structure because again, someone needs to take care of the caregiver. I also think giving some people some flexibility over their schedules when they return to work is really helpful, and again, is so dependent on the kind of job you have or employer. But in general, if there's sort of a transition period that we think of, so I think we often think of like, okay, you're on maternity leave maybe three months.
(10:03):
So then you come back and it's like zero to a hundred. You haven't been here and now you're back a hundred percent. And if we think about it as more of a continuum as a transition, that maybe zero to three months or whatever it is that you're on leave, and then for the next three months there's a transition. Maybe you start out working from home a couple of days, or maybe we give you some flexible hours so you can make your childcare arrangements work. Or if you're still in therapy, you're still going to support groups that there's some time for you to take out to have a continuous level of care.
Deanna Cuadra (10:39):
What other benefits should be in place to help ease that transition back to work and also reduce some of the overwhelm of those early months?
Alyssa Baron (10:46):
I think caregiving benefits can be really helpful, feeling like if the baby's sick, I have someone who I can call on, or just that I have a group of people who can help take care of my baby if I'm not able to be there. And even having access to additional benefits such as a postpartum doula can be really helpful. I also think oddly enough that the emphasis needs to be on how we're treating new dads also and encouraging them to take part in the family during those early years of parenthood in addition to mom. I think encouraging just people overall to sort of share the burden of some of what it is to have a child and not place all of that on women and then tell women that they don't care about their career because they take on that burden. It's just an impossible position that people are in.
Deanna Cuadra (11:37):
And why is it so crucial for companies to care about their birthing parents?
Alyssa Baron (11:41):
First and foremost, retain talent. So this person has been working in the company or working for several years before they had a baby, right? That they have a lot of knowledge and talent and retaining that. Retaining good employees is at least for the employer, a huge incentive.
Deanna Cuadra (11:59):
For parents who might feel alone in their experience. What words of advice can you share with them about not just mental health, but overall support?
Alyssa Baron (12:06):
So we often come up with birth plans, but I often think about, well, what's our postpartum plan? Oftentimes the postpartum plan is like, well, I'm just going to take care of the baby, but really feeling like what's the postpartum plan for me if I'm taking care of the baby or if we're taking care of the baby, who's helping to take care of us, and how are we taking care of each other? And what is the division of labor in our house and what supports do we need to make that happen? Because it's an impossible thing to do alone. And there's a lot of shifts that happen when a baby is born, right, physically, emotionally, but priority and identity shifts and a lot of that can feel very jarring, and that's normal. But feeling like I have a plan and we have support I think is hugely important.
Paola Peralta (12:58):
Those were all incredibly great resources that Alyssa shared, and I really hope that in the future, this becomes a topic that does not so taboo and does not have to be so highly speculated, and it becomes a normal part of the family building process and of the support system that they grow at work.
Deanna Cuadra (13:14):
It's an important conversation. I do hope more parents feel comfortable having and more employers feel comfortable having as well. I think benefits and policies could really, really improve from talking more about postpartum depression, anxiety,
Paola Peralta (13:27):
Absolutely. Families deserve all of the support that they can get. Well, that wraps up our fifth episode of Perk Up. I'm Paola Peralta, and thanks again to Deanna Cuadra at EBN, as well as Alyssa Baron from WINFertility. Stay tuned for another episode in just two weeks. This episode was produced by Employee Benefit News. Rate us and review us wherever you get your podcasts and check out more content from the EBN team at www.benefitnews.com.