Originally posted May 20, 2013.
Spring was a great time for Women’s Reproductive Health events in New Jersey. I was fortunate enough to attend and also was invited to present at La Leche League of the Garden State’s Annual Conference in Jamestown, New Jersey. I also went to an event hosted by St. Clare’s Hospital and the Partnership for Maternal and Child Health of Northern New Jersey.
I had so much fun meeting and seeing some virtual colleagues/friends, such as Ruth Callahan and Colleen White at LLL and Ivy Shih Leung and Irina Polanco-Ventura at St. Clare’s, and of course meeting new ones! Apparently, St. Clare’s has a kick-ass postpartum depression group. I was so glad to get pointers on getting my group in Wayne, NJ going to be as kick-ass as that one!
At the St. Clare’s dinner-lecture, the speakers were Dr. Patricia Dreyfuss, an ob-gyn whose medical practice is located in Mountain Lakes, New Jersey; Ivy Shih Leung, well-known PPD blogger, author of One Mom’s Journey to Motherhood and resident of New Jersey; and Dr. Michelle Preminger, a reproductive psychiatrist, with certifications in both obstetrics and psychiatry, whose medical practice is located in Waldwick, New Jersey.
Patricia Dreyfuss, MD
Dr. Dreyfuss has been in practice over 30 years. She talked about discerning the overlap existing along the spectrum of: normal overwhelming feelings of motherhood, the baby blues, postpartum depression and then the spectrum of perinatal mood disorders through postpartum psychosis.
Dr. Dreyfuss compassionately said that women should get help early on in that spectrum. She stressed that help with meal preparation and housework is an important commitment to well-being and that many other cultures provide such care. She also urged women to get at least 3 – 4 hours of sleep in a row. Dr. Dreyfuss urged women to manage their expectations of themselves; to avoid perfectionism.
She listed several interventions for well-being: self-care, time with your partner, help with the housework, peer support groups, professional counseling and lastly, medication. Dr. Dreyfuss said that sometimes you can’t get into a well and sometimes you just can’t climb out a well without a hand up: medication might be what is needed to provide that hand up.
Dr. Dreyfuss also commented on the current breastfeeding culture: the opposing concepts of intensive motherhood and the reality of the demanding modern life. She noted that in her practice, the emphasis on breastfeeding is causing a lot of anxiety in her patients. She said breast pumps should be tossed into the ocean. She says the current situation with the lack of family leave and the reality of working women is driving women to be feeding the pump rather than feeding their baby; and it is causing a lot of women unnecessary stress, guilt, unhappiness and physical discomfort.
I loved Dr. Dreyfuss’ personal take on the modern culture of breastfeeding. I wish I was a cartoonist and could draw those pumps being thrown into the ocean.
Ivy Shih Leung, Postpartum Depression Author
“Ordinary postpartum depression”
Ivy Shih Leung talked about her personal experiences with infertility, a medically complex birth and her postpartum depression. She said there are so many celebrity autobiographies about postpartum depression, she wanted to demystify the condition by writing about “ordinary postpartum depression.”
Here is an excerpt from her book:
“I was in a cycle of fear & despair… I’d start having a panic attack where coldness would start from my shoulders and creep down both arms to my fingers. I’d have a tough time breathing, and my stomach would turn to knots. Very quickly the cold would take over my entire body and I would start shaking…..”
Does that sound ordinary to you?
Ivy talked about how her doctors were very uneducated about perinatal mood disorders and were extremely uncaring and dismissive of her psychiatric symptoms. Ivy is a tireless advocate for education and information about perinatal mood disorders. She has done much to shine a light on the dark shadows in which we cloak postpartum depression. She is an inspirational speaker who has taken her suffering, helped herself through writing our her experiences and also helped others by sharing her experiences. Ivy hopes that other women
do not have to suffer the way she did.
I won an autographed copy of Ivy’s book! Take a look!
Michelle Preminger, MD
Dr. Preminger has been in practice over 20 years. She has practiced as both an obstetrician and as a psychiatrist. Her passion is reproductive psychiatry. Her presentation was scholarly and down to earth at the same time. She started out by saying that New Jersey is the only state that routinely screens for postpartum depression.
Dr. Preminger showed us a chart from a research article that showed the gender differences in depression rates between men and women. She says that women are twice as likely to suffer from depression than men. Women are more likely to suffer from depression during and after pregnancy than other times of their lives.
Dr. Preminger talked about the importance of getting medical care for mental health problems during and after pregnancy. She says that in, 2013, there is now more research data available on the use of psychiatric medications during pregnancy than any other type of medications. A few tidbits from her lecture:
Work your sleep schedule; ask for help in getting six hours of sleep so you can get into that deep REM sleep
Taking medications for your anxiety and depression is a decision
Not taking medications for your anxiety and depression is a decision
Managing anxiety during pregnancy is important, as sometimes anxiety beforehand can indicate depression may occur after delivery
Motherhood is a time of big life adjustment, including changes in the mother’s identity and a huge hormonal shift
All psychotropic medications to date are secreted in breast milk
Prozac has a long half life, so stays in the breast milk longer
Pregnancy is not protective on new psychiatric disorders, as was previously incorrectly believed
If you are taking medications for bipolar disorder, you should be monitored by a psychiatrist, as some are known to be teratogens
Bright light therapy is effective for some people in treating depression, for those with bipolar disorder it can cause mania
Dr. Preminger had a wealth of information to share. The one thing she stressed was that there is a lot of information to digest. She says taking medication during pregnancy and when breastfeeding is a very personal decision. When she talks about this with a pregnant mom and partner, she gives them all the data and lets them come to their own decision. So one size doesn’t fit all.
I consider myself lucky to be able to get so much targeted education in my local area of northern New Jersey.
Tune in for an interview with Irina Polanca-Ventura, manager of the Postpartum Depression Program of the New Jersey Maternal Child Partnership, who will discuss the mental health treatment resources available for women who are under-insured or uninsured.
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