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Battling extreme baby blues

El Camino leads fight against pregnancy-related mood disorders

El Camino Hospital recently became one of only two health care organizations in the country to offer inpatient treatment to expectant and recent mothers grappling with severe mood disorders related to pregnancy, said a behavior health official with the hospital.

The Perinatal/Postpartum Mood Treatment Program began accepting patients June 16, hospital officials said, noting that outside of a similar inpatient program at The University of North Carolina's hospital in Chapel Hill, El Camino is the only institution in the nation offering such a service.

The program expands upon El Camino's current program of Maternal Outreach Mood Services -- MOMS -- which offers outpatient support to mothers who endure elevated levels of stress, depression, mania and even thoughts of suicide in the lead up to giving birth or soon thereafter. Michael Fitzgerald, director of the behavioral health program, said El Camino was one of the first to offer the outpatient programs, as well.

According to Fitzgerald, hospital officials began MOMS and the new inpatient program because even though expectant and recent mothers develop serious pregnancy-related psychological issues, the population is woefully underserved by the medical community.

"It's a time where all of society expects them to be thrilled," Fitzgerald said of soon-to-be or recent mothers. Spouses, family and friends are often exuberant about the newborn, but for somewhere between 10 and 20 percent of mothers, that elation is "not what they're feeling." In fact, it can be the polar opposite, Fitzgerald said.

On the less extreme end of the spectrum, women with pregnancy-related mood disorders report extreme anxiety and episodes of panic or paranoia; on the other end, Fitzgerald recounts how one severely disturbed new mother telling him, "I had this urge to throw my baby against the wall."

It is understandable if a new mother feels she can't share such thoughts with family, or even with a therapists, he said, and so the feelings are bottled up, which can exacerbate the psychological distress.

Fitzgerald stressed that women who enroll in the Perinatal/Postpartum Mood Treatment Program will be able to share their thoughts -- either one-on-one or in group therapy -- with non-judgmental people who understand what they are going through.

"I think more than anything else that has been so beneficial," he said, talking to other women who are dealing with similar issues. "We are here and we will try our best to help out the moms."

The program is not only intended to help distraught mothers, said Dr. Nirmaljit Dhami, medical director of MOMS and the current vice chair of El Camino's psychiatry department. "Untreated depression, anxiety or psychosis can have a significant impact on the child," she said, as well as on the family and the spouse of an unbalanced woman.

Dhami said she and her team work with husbands and other family members of patients to help them understand how they can be more supportive to help the new mother through a hard time in her life.

According to Dhami, the new inpatient program is intended to treat the most extreme cases of perinatal or postpartum mood disorders -- for those who are having complete psychotic breaks with reality and may be a danger to themselves or those around them.

However, both she and Fitzgerald said they would rather be safe than sorry and they welcome calls and visits from those who are concerned, either about themselves or a loved one. Those with concerns or questions may call Fitzgerald at 866-789-6089.

"With this new inpatient program, we're also hoping to catch women at significant risk earlier in the process, and hopefully prevent a tragic outcome," Fitzgerald said. "There is no reason to suffer in silence."

Comments

Like this comment
Posted by Anonymous
a resident of North Whisman
on Aug 8, 2012 at 2:23 pm

My wife went from a seemingly normal individual to bipolar/manic over the course of about 1 week after having our baby. We ended up at the emergency room at El Camino and she was admitted to the mental health unit where she was introduced to Dr. Dhami and the rest of their group. I cannot say enough about how they treated and help my wife (and me). This was the most disturbing time in either of our lives. My wife made it through and was able to return to being herself after about 6 months or so. 3 years later, I've never really gone back to thank that group of people at El Camino. Perhaps i will now. :)


Like this comment
Posted by Jeanne Batacan
a resident of Blossom Valley
on Aug 9, 2012 at 12:49 pm

I am concerned about the issue of Post Traumatic Stress Disorder caused by our current (standard) medical model of care. There is a growing and alarming rise in iatrogenic PSTD related to childbirth and the typical care she receives (which according to research is sub-optimal).

There may be a conflict of interest involved when a hospital, that may be the source of a woman's disorder, tries to treat it.

It seems to me that the powers that be would discourage the therapists from addressing the issue due to potential liability issues.

I know from experience that this is true for the vast majority of hospital based childbirth education programs. Most instructors are
denied autonomy to teach mother-friendly, evidence-based courses because the hospital practice is not aligned.

If autonomy is not ASSURED in a treatment program, I believe the patient would be better off in a private non-affiliated center with therapists knowledgeable in treating childbirth related PSTD.


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