Postpartum help is coming

UNC center expands services for women suffering depression after childbirth

WRALEIGH ithin hours of giving birth, Kerri Hall's mood quickly turned from the elation of a new mom to the worry of a woman troubled by severe anxiety.

Hall was still in her room at Rex Hospital when the first pangs of nervousness and insomnia struck. Soon, she'd harbor obsessive thoughts she might hurt her newborn daughter. Within three months, Hall attempted suicide.

Hall suffered from one of the worst forms of postpartum depression, the condition that at least 10 percent to 15 percent of new moms experience, although experts say these estimates are likely too low.

These mothers suffer from a range of symptoms, though overwhelming anxiety and worry are hallmarks of the condition. Others include sadness, insomnia, fear of hurting their baby or themselves and the feeling of being completely overwhelmed.

Hall is getting better now. But her three-month journey searching for adequate treatment in the Triangle is, in part, why the UNC Center for Women's Mood Disorders is expanding its services to women with postpartum depression.

On Wednesday, the mood disorders center will open a weekly outpatient clinic at Rex for women with postpartum depression. Rex is part of the UNC Health Care System.

And, on Nov. 3, a six-bed inpatient unit for women with the illness will open at UNC Hospitals in Chapel Hill. The rooms will come equipped with gliders for rocking babies and breast pumps for nursing mothers. There will be space for extended visits with their children, therapy for the patient and her family, and help from lactation consultants and doctors.

Hall played a role in this. She ignored the stigma felt by some women with postpartum depression, writing letters to hospital officials that detailed her difficulties at Rex and UNC.

"I don't have the shame as much as other people do because I don't want anyone else to go through this," she said.

UNC's inpatient program will be modeled after similar programs in Britain. A couple of hospitals in the United States offer day programs for women with the illness. But UNC's unit, where women will stay overnight, likely is the only one of its kind in the United States.

Research has found that babies as young as six months respond to stress differently if their mother is depressed. That makes helping women and their families recover a public health imperative, said David R. Rubinow, chairman of UNC's Department of Psychiatry.

"In my mind, there can be no greater public health priority than properly treating mothers of newborn children," said Rubinow, who has studied women's mood disorders for the past 30 years. "Given the ubiquitous nature of this problem, it's really just an opportunity to give people what they deserve, which is expert care of a debilitating and extraordinarily injurious illness."

Fear of stigma

Records of women with postpartum depression go back centuries, but, even now, it's difficult for women to find adequate treatment. Women often suffer in silence. The stigma of mental illness keeps them from seeking help, said Samantha Meltzer-Brody, director of the Perinatal Psychiatry Program at the women's mood disorders center.

Also, the diagnosis and treatment of postpartum depression falls outside the traditional focus of doctors who treat newborns and their mothers, she said. That's changing. In 2004, Meltzer-Brody started a weekly outpatient clinic at UNC that now serves women daily. And in 2005, doctors at UNC began universal screening of women for postpartum depression.

Obstetricians and pediatricians have been more open to checking women for symptoms of the illness, but in Wake County there had been no place that offered specialized care to mothers diagnosed with postpartum depression.

"It's hard when women come to the group and there's not one good place [in Wake County] that just focuses on women with a perinatal mood disorder," said Anne Wimer, who suffered from postpartum depression after the birth of her two children and is a founder of Moms Supporting Moms, a decade-old support group at Rex.

Wimer is also executive director of Postpartum Education and Support, which works to educate the community about the illness.

In the Triangle, some women have found help at a handful of support groups such as Moms Supporting Moms and from private therapists. Women such as Hall, who had to be hospitalized, are typically mingled with general psychiatric patients. Hall spent time on an eating disorders wing and with drug and alcohol addicts at points during her hospital stays.

"You can save people an enormous amount of grief and suffering by getting it right the first time," Meltzer-Brody said. Women with mild symptoms can quickly recover, she said.

'The saving grace'

Hall is glad she helped spur change. She's since found help from Meltzer-Brody and is getting better with therapies and medication. "She's been incredibly effective," Meltzer-Brody said. "She has made a big difference in a really amazing way."

"My daughter is absolutely wonderful and has been her whole life," Hall said. "That's been the saving grace of all of this."