Becoming a mother fulfills a woman’s identity. Or, does it? Traditional American family values look to mothers to provide nurturing, guidance, and growth to the family unit, whether they are stay-at-home mothers or working mothers. Juggling personal and family relationships while keeping the house tidy, making sure children have clean clothes, and attending pediatric medical appointments, oftentimes contribute to mothers questioning their personal success in such an influential role. Although there is not one contributing factor that leads to postpartum depression, the issue of maternal mental health is often ignored because societal culture strongly embraces self-resliance or at least having the appearance of being able to successfully manage it all.

Maternal mental health illnesses, more specifically known as perinatal mood and anxiety disorders (PMADs), affect approximately 20% of women during or after pregnancy. The most notable illness, postpartum depression, has garnered intermittent attention from the media and high-profile celebrities which somewhat keeps the issue in the minds of people. According to the Centers for Disease Control, approximately 3.7 million women delivered babies in the United States in 2017. The American College of Obstetrics and Gynecology (ACOG) and American Academy of Pediatrics (AAP) only recently released screening guidelines to assess for maternal depression during medical appointments. Still, with over 720,000 mothers in the United States suffering from depression, anxiety, obsessive compulsive disorder, bipolar disorder, or psychosis during the perinatal time period, inconsistent screening practices by healthcare providers contribute to women suffering in silence as they struggle to live up to society ideals and consequently, the high expectations mothers place on themselves.

In my role as a perinatal psychotherapist, I have heard hundreds of women describe the confusion, disappointment, and concern related to becoming mothers. One woman in particular, Monica (named changed for confidentiality), viewed the physical changes to her body during pregnancy as a major influencer of her husband’s likelihood toward infidelity. She also admitted to having no emotional connection to her unborn child and even made statements about leaving her baby in the family’s basement, so that she could complete all of her household chores. Toward the end of her pregnancy, Monica became excessively focused on the pain she was going to experience during delivery and the potential for her own imminent demise due to her inability to suffer through labor. Although this is only one story out of many, it is the prevalence of similar stories and the deterioration of a woman’s self-worth that are the reasons more attention must be given to PMADs.

Now is the time to embrace the intersection between popular culture and healthcare. Currently, there are two intensive inpatient psychiatric programs and 23 intensive outpatient psychiatric programs specifically tailored to treating mental health illnesses in pregnant and new mothers in the United States. Missing are intentional efforts to arm perinatal healthcare providers with specialized training to develop their diagnostic and assessment skills, in addition to fostering collaborations with mental health community providers. As intensive psychiatric programs continue to become established in towns and cities throughout the country, it will be necessary for concurrent efforts to be developed to integrate healthcare providers to be part of the process.

In the Commonwealth of Virginia alone, approximately 1 million women delivered babies in 2017. Therefore, roughly 200,000 mothers in Virginia experienced a PMAD in 2017. It is unacceptable to allow women to emotionally struggle as they attempt to fulfill the unrealistic expectations in society. Not only do mothers suffer, but their partners, children, and families. Join me in developing the Commonwealth’s only intensive outpatient program for perinatal women, which will include hyper-focused attention on establishing screening and referral protocols for healthcare providers, thereby strengthening the doctor patient relationship and easing access to mental health treatment for perinatal women. The long-term benefits will be felt through women’s improved self-esteem, better family dynamics, and healthy child development.

Rosalie Zuniga, LICSW, LCSW, PMH-C is the Founder of Postpartum Wellness, a one-stop-shop for mothers in Northern Virginia. Services include counseling, lactation support, sleep experts, doulas, classes, groups, massage, and health coaches to support women through their transition into motherhood. She can be contacted at info@postpartumwell.com