Dr. Dresner explains why psycho-education is important for new mothers.
I think that psycho-education is the most important part of any intervention that we can make for pregnant women and for new mothers. If the patient’s obstetrician is savvy and holistically-oriented, she will get a packet when she comes for her first prenatal visit that talks about not just what to expect when you’re expecting, and sort of what kind of formula to use, and what the best books are to buy, but what normal psychological or emotional changes occur during pregnancy. What to anticipate, how to sort of manage those stressors and transitions, and what typically happens postpartum.
So if all through a woman’s pregnancy she is anticipating, "Yes, I might get stretch marks and I'm going to use my Vitamin E cream on those. Yes, I might start to feel emotional or fearful about delivery and that I should talk to my doctor about the sort of details and help to get a better sense of what exactly is going to happen.
Yes, it’s normal to feel overwhelmed after the baby is born. My hormones are going to be rapidly changing in the first postpartum days and week, and I am going to be feeling a roller coaster of emotions, anxious, ecstatic, freaked out. That’s normal; it will go away in a few days."
That kind of preparation is the most important thing that we can do for new mothers so that they know, "If I have those symptoms, they’ll go away in a few days; I should wait, and it’ll get better. If those symptoms aren’t going away, or if I begin to feel overwhelmingly depressed, suicidal, or if I start to feel like I am really no good at this, this was a bad idea. Someone else should take care of this baby because I am not cut out for this," and those kinds of feelings persist over the course of a couple of weeks, that’s somebody who should seek mental health treatment.
People who have a history of depression, women who have a history of depression, when they become pregnant, they should consult with a mental health provider, not just their obstetrician/gynecologist about what the best course of action is.
So even if they had been stable on medication, pregnancy is a sort of point of, an opportunity to intervene and to re-evaluate so that even if you’ve been stable on your medication for years and your primary care physician, your obstetrician, prescribed that medication for you, when you become pregnant, that’s the time to have comprehensive kind of re-evaluation.
Look at the big picture: what cocktail of medications are you on, what might be more appropriate and safer treatments for you during pregnancy, do you really need to be on these medications during pregnancy at all, and an opportunity for collaboration with the obstetrician and eventually the pediatrician about care during pregnancy and postpartum.
About Dr. Nehama Dresner, M.D.:
Dr. Nehama Dresner, M.D., is a licensed, Board-certified psychiatrist (in general psychiatry and psychosomatic medicine) with specialized training and nearly 20 years experience in Women's Mental Health and Medical Psychiatry. She is Associate Professor of Clinical Psychiatry and Obstetrics/Gynecology at Northwestern University Feinberg School of Medicine and is actively involved in medical education. A fellow in the Academy of Psychosomatic Medicine and the America Psychiatric Association, she speaks locally and nationally on issues related to psychological aspects of women's health and medical psychiatry. Dr. Dresner's clinical specialty is psychosomatic obstetrics, and gynecology, women's emotional development, and psychiatric treatment of the medically ill.