National news was made last week when the University of North Carolina’s (UNC) Center for Women’s Mood Disorders in Chapel Hill opened our nation’s first, specialized, inpatient clinic for pregnant and postpartum women. The mental wellness and emotional needs of women during pregnancy, and after delivery have received increased attention in the United States over the last decade, but that attention hasn’t translated (yet) to a reliable, and comprehensive system of care for mothers. There are notable women’s mental health centers in the United States (one of which is the UIC Women’s Mental Health Program here in Chicago), but the focus is on outpatient treatment. Unfortunately, some women experience more severe problems with depression, anxiety, or psychosis (difficulties knowing what is real from what is not real) that require inpatient or overnight care. Currently, what this means is that a postpartum woman needing an inpatient level of care must seek help in a generalized psychiatric hospital where she will be separated from her infant for several days at best, and several weeks at worst. The woman’s safety will be managed well in this setting, but all of her other needs as a new mother cannot be managed well in this setting – bonding with her baby, breastfeeding, making a schedule, building her confidence in her new role, support with problem-solving around infant care and soothing, etc. Visitation policies in traditional psychiatric hospital settings are very limited with family and friends only being allowed on the unit for a few hours per day. Clearly this setting has serious limitations for postpartum women and their babies!
Then, there is the stigma. One of my missions in life is to normalize the emotional upheaval that both women and men experience when becoming parents, but the overall message that women (in particular) receive is that becoming a mother should “look” one way (joyous and content) and if women have other normal feelings at this time (overwhelmed, anxious, grief around loss of life before baby, wishing for a break from the baby, etc) they feel (and in some cases may be told by others) that something is wrong with them, and perhaps worst of all, that they are a “bad mother”. It takes great courage in our culture for mothers to acknowledge that they are not emotionally well, and to seek help from a mental health professional. Having a specialized hospital setting for pregnant and postpartum women goes a long way towards giving the message that not only do mothers need a unique approach to recovery than people with other kinds of mental health issues, but also that needing this level of help is OK and that women are not alone in their experiences.
It goes without saying that the United States needs more treatment centers like UNC’s clinic, and sadly, UNC’s original plan was to have 24 hour supervised infant care on the unit so mothers could be with their infants, as needed, day or night. However, insurance companies refused to pay for the infant’s care, so instead they have extended visitation hours for mothers and infants on the unit. This is an improvement, but also an example of the formidable financial barriers we face in this country when it comes to changing the standard of health care. However, I hope that the opening of this clinic will start a much needed trend towards changing both how we care for mothers, and our acceptance of a broader view of the emotional reality of becoming a mother.
For more information about UNC’s new inpatient clinic for perinatal women click here: