As soon as a family announces a pregnancy it starts. There is advice, there are gifts, there are doctor appointments, questions, checklists, jokes about how you'll never sleep again and everyone you meet waxes poetic about the love you're going to feel. We also scare the crap out of moms. We do it regularly. We do it in the name of their (physical) health and the (physical) health of the baby. There are lists of foods to eat and avoid, what you can drink, how much, and when. There are blood tests and genetic tests and glucose tests. There are enough cups of pee to float the entire family across the globe.
No one seems to mind scaring pregnant people about possible physical health risks that are relatively rare. But if you suggest mental health screenings at every OB appointment you hear, "Well, we don't want to worry them". If you suggest that birth classes in hospitals and at birth centers feature information on parental mental health, risk factors, and symptoms you hear, "We don't want to scare them".
PREPARED DOES NOT EQUAL SCARED
20% pregnancies = a mental health issue during pregnancy or in the first year postpartum.
10% pregnancies = preeclampsia
8% pregnancies = gestational diabetes
4% pregnancies = high blood pressure
You know what's terrifying? Going through all of the tests, screenings, and medical hoops that come with pregnancy; giving birth and then having your entire world come crashing down around you with no idea what is going on or how to get help.
My OB saved my life and my son's life when she diagnosed me with preeclampsia and performed and emergency c-section on me. I will always be grateful to her for that. I will always wish that instead of just asking me, "How are you feeling?" she had used a screening tool and asked me about my mental health. I will always wish that she had pointed out the risk factors for PMADs that were all over my medical chart. I have always wondered how different my postpartum experience would have been if I had been on anti-depressants before my baby was born.
What expectant parents need are birth professionals who are dedicated to their physical and mental health. They need a support system around them that understands that these things are linked. They need to know what their risk factors are, they need mental health screening at EVERY SINGLE APPOINTMENT.
Why screen every time? So that the expectant parents understand the importance of their mental health. Screening every time breaks down the stigma associated with perinatal mood disorders and helps parents realize that these issues are important, they are common and there is help available. Screen expectant parents at every single appointment because I promise you that you are missing it.
There are some really great screening tools and resources available online.
SCREENING TOOLS/PROVIDER TRAINING
MCPAP For Moms Toolkit For Adult Providers
Perinatal Toolkit For Women's Health Professionals
FOR PATIENTS
There is a wonderful package of tools on the Postpartum Progress website. These were written specifically for new and expectant parents by parents and would make a great addition to the information you provide expectant parents. You can download them here.
If you are a parent, were you screened during pregnancy? How often?
If you're a provider, what do you need to begin screening every expectant parent?