BlogHer readers, while we're getting ready for this exciting upcoming event, we'd like to ask for your help!  What questions would you like to ask Valerie with regard to her postpartum experience?  Please post your questions in the comment section as soon as possible so that we have them for the interview.  Thanks!

From what I remember, I couldn't really do much of anything.  What I really wanted to do when I was depressed was stay in bed and do nothing.  It took a monumental effort to get up and do my best to take care of myself and my newborn in between bouts of sobbing.  I think someone giving me a list of things to do would have made me feel like I was being crushed under a Buick. 

I realize, of course, that people are only trying to help by providing suggestions of things that will help us get through the day positively.  But I'm not sure they know that it usually takes a rational person to execute a list.  When you're not rational or logical, it becomes very difficult to do rational and logical things.  So if you give us a list and we don't do much or any of it, don't give up on us.  We'll get there.  It takes time.  And remember that people don't recover from postpartum depression just because they follow a list, but because they get proper medical care and love and support from the people around them.

I like the perspective of this blogger at Impacted Nurse who says: "My advice is to never take much notice of anyone who purports to be able to improve your life in ten bullet-point steps… unless you know them very well and they are proof writ large of the effectiveness of their list."  For a good laugh about list-making, check this out from The Onion.    

"At 11 weeks postpartum these employed mothers continued to experience several childbirth-related symptoms, indicating a need for ongoing rest and recovery. Postpartum evaluations should include screening for anxiety and depression and evaluation of fatigue and other physical symptoms, including those related to job stress."

The study recommended that women showing continued symptoms should receive counsel on strategies to decrease job stress and increase social support at work and home, and that physicians should talk with them about the possible need for intermittent leave under the Family and Medical Leave Act to help them manage symptoms.

One of the most fascinating comments was this, from Pat McGovern, PhD, MPH at the School of Public Health at the University of Minnesota in Minneapolis, and her colleagues who wrote the study:

All new mothers know this is true but I don't think I've ever seen it stated so plainly.  Our healthcare professionals are essentially focused on making sure our uteruses (or is it "uteri"?) are in working order ... but the rest of us?  Not so much. 

Dr. Laurie Barclay writes on Medscape.com:

"Because of the increased prevalence in the workplace of mothers with infants, greater understanding of factors that could improve postpartum health and facilitate return to work is greatly needed. Recovery from childbirth and successful return to work may be affected by personal factors such as preexisting health status, parity, breast-feeding, and social support from family and friends; as well as work-related factors including the timing of return to work, job stress, and support in the workplace."

Honestly, I think the results of this study apply equally to women who don't go back to work.  All new mothers suffer a compounding list of stresses that make it difficult to cope with daily responsibilities, and there is no specific group of healthcare professionals who has taken on the task of monitoring our whole health.   

Which group of clinicians will make sure women are properly evaluated and counseled?  The study specifically cites the need for screening new moms for anxiety and depression, but who will do it?  At the moment, no group of doctors taken on the job of providing that safety net.  I sometimes wonder whether they're all hoping someone else will step up to the plate so they can be relieved of the duty.  Sure, there are pockets of doctors and nurses in different places throughout the country who have recognized the importance of paying more attention to the health of new moms over a more extended period of time, but as a general rule many ignore it, and I wonder if some of the larger physicians' groups aren't actually against it.

The OB/GYNs are concerned with taking responsibility for the process of pregnancy and childbirth.  The pediatricians are primarily focused on the health of the baby.  Your primary care physician may not see you for months unless you come down with the flu, so they may never know if you're having problems.  They all say they don't have time, they don't have the proper training, they aren't reimbursed for it, they worry about the legal ramifications, etc.  And they're right on all those points.  Yet mental health screenings and treatment remain completely necessary if we care about having healthy mothers in this country. 

New moms are just not very likely to wander by the office of a mental health professional and drop in to say hello.  These people are specialists, for whom you generally need a referral.  We need a comprehensive nationwide process to get mothers mental healthcare if they need it, where the doctors responsible for screening and referral have buy-in and there is a clear line of sight.  Somebody is going to HAVE to take responsibility for this, so we need to work together to begin developing workable solutions.  Hopefully the MOTHERS Act will help to address this when it is passed, and it becomes federal law that all women are screened for postpartum depression and anxiety.  Notice I sad when, not if.

That is why I was so happy to hear from Samara, who reads my blog Postpartum Progress and felt it important to send me the following email:

I wanted to let you know of something that occurred when I recently had my son. I delivered at Spectrum Health Butterworth in Grand Rapids, MI.  When I arrived at the postpartum room I had a bunch of brochures including one on postpartum depression, there was a TV channel with a program on postpartum depression and a questionnaire that I needed to fill out. The next day a nurse came to discuss postpartum depression with me, go over my risk factors and let me know that they would also be sharing these results with my physician. Six and eight weeks after I gave birth, a nurse called to see how I was doing. If they didn't get a hold of me the first time they left a message and called a second time.  While some hospitals do not screen for postpartum depression I thought it was nice that Spectrum went above and beyond the norm for screening."

Well I'll be!  Perhaps it's not so hard for you healthcare professionals after all.  I looked into it, and Spectrum offers screening for every single new mom, hosts a support group, provides a toll-free number for service referrals for all women regardless of their insurance situation, and maintains their own Spectrum Health Postpartum Emotional Support Program phone line to answer questions, expedite appointments or referrals to counselors and connect women with peer support. 

This is the way it should be in every hospital in America.  Way to go Spectrum!