Eleven percent of postpartum Virginians reported experiencing depression one year after giving birth, and another 11% reported anxiety, according to the Virginia Department of Health.
By Elizabeth Dosoretz
Those figures underscore a reality that often gets lost amid the expectations surrounding new motherhood: For a significant number of Virginia mothers, the postpartum period can bring serious mental health challenges at a time when they are often expected to be experiencing nothing but joy.
I understand the disconnect between that expectation and reality because I lived it. When I became a mother, I had a healthy baby, a wonderful husband, loving parents, and an incredible support system. I had dreamed of becoming a mom and had every reason to believe I would embrace the experience. Instead, I felt overwhelmed, unprepared, and increasingly unlike myself. I was incredibly hard on myself, and when breastfeeding was difficult, I interpreted it not as a challenge many new mothers face but as another way I was failing.
Looking back, I recognize that I was experiencing postpartum depression. At the time, I did not fully understand what was happening. My husband and parents recognized the changes before I did, and my OB-GYN noticed during a postpartum visit that I had lost weight and wasn’t eating well. Together, the people around me helped me recognize that I needed professional support and connected me with a psychiatrist who helped me tremendously.
As difficult as that period was, I also recognized how fortunate I was. My family could make phone calls, coordinate appointments, and advocate for me when I did not have the capacity to do those things myself. I had transportation, time to seek treatment and financial resources, and my family could pay out of pocket to make sure I received care. That experience has stayed with me throughout my career in mental health care because it raises an uncomfortable question: What happens to the mother who does not have those things?
Virginia’s data suggests that the question deserves our attention. The state’s postpartum health survey found that 14% of Medicaid-covered respondents reported postpartum depression compared with 10% of those with commercial insurance. Recognizing that you need help and being able to get that help are not the same thing. Although statistics cannot tell us everything about an individual mother’s experience, differences such as these reinforce something those of us working in behavioral health see every day.
A mother may be told to seek treatment, but that advice only goes so far if she faces a long wait for an appointment, cannot find a provider who accepts her insurance, or lacks transportation or childcare. She may have returned to work soon after giving birth or may not have a partner or family member who recognizes that something has changed. When someone is already emotionally exhausted, asking her to make multiple calls and navigate a fragmented health care system can become another barrier to treatment.
Virginia is taking meaningful steps to address the awareness of this problem. In May, the Virginia Department of Health and the Virginia Department of Behavioral Health and Developmental Services launched Beyond the Blues, a statewide campaign focused on increasing understanding of perinatal and postpartum depression, reducing stigma, and connecting families with support. The campaign is an important recognition that postpartum mental health deserves greater public attention, and awareness should be the beginning of the conversation—not the end.
Routine mental health screening during pregnancy and after delivery should lead to a clear path to treatment when concerns are identified. We need stronger collaboration among obstetric providers, pediatricians, primary care physicians, and behavioral health professionals, along with adequate insurance coverage, reasonable appointment wait times and options such as telehealth that can reduce transportation, scheduling, and childcare barriers. Care should be designed around patients.
Families and friends are part of that equation, too. Sometimes the people closest to a new mother notice that she is struggling before she recognizes it herself. That was true for me.
Postpartum depression ultimately changed the direction of my life and shaped my belief that mental health care should be compassionate, coordinated, and easy to reach. But no mother should need an exceptional support system or the ability to pay out of pocket to get appropriate care. Virginia has taken an important step by bringing postpartum mental health further into public conversation. Now we need to make sure that when a mother, her partner, or someone who loves her recognizes that she needs help, receiving that help is not the hardest part.
Elizabeth Dosoretz is the founder and CEO of Elite DNA Behavioral Health, which has offices in Virginia Beach and Chesapeake. For more information, go to elitedna.com.
