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Approaching Mother's Day:
Reflections on Maternal Mental Health
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Mother’s Day can bring a complicated web of expectations and feelings. Many will celebrate their own mothers or the mother figures in their lives, while others who are mothers, may be celebrated by their own children (adopted, foster, surrogate, or biological). Sociocultural norms promote gift-giving and an emphasis on celebration which can interfere with an authentic process of remembrance and reflection and a recognition that Motherhood and thus, Mother’s Day can trigger complicated and perhaps painful memories and experiences.
Some mothers may have had complex relationships with their own mothers, they might be grieving the loss of their mother, while others may be dealing with the loss of their ability to become a biological mother, and some mothers may be grieving the loss of an infant or child, or separation from their child due to difficult situations (incarceration, involvement with child welfare, custody issues). Then other mothers may be working through negative or difficult thoughts and feelings related to motherhood.
May is Mental Health Month with a special focus on Maternal Mental Health. Maternal Mental Health and Mother’s Day have some shared significance.
Before delving into further reflections, we would like to acknowledge that fathers and birth partners are equal partners in pregnancy, birth and parenting, and their involvement and relationships are just as important in the lives of their children, as mothers.
What to know about perinatal mental health:
New and expecting mothers face not only changes to their lifestyles, but also changes to their bodies, physically and biochemically. Each woman’s experience will be different. For some, adapting to the changes of pregnancy and having a baby may come easily – they will adopt new routines and their bodies will return to pre-pregnancy shape and chemistry with little difficulty. For others, there may be physical and mental health struggles that arise.
Maternal mental health disorders typically occur in what is called the perinatal period. This includes the prenatal period, or time that a woman is pregnant, and the postpartum period, which is the first year after the baby has been born. Depression is the most common maternal mental health disorder, followed by anxiety disorders (Generalized Anxiety Disorder and Panic Disorder), Obsessive-Compulsive Disorder, birth-related Post Traumatic Stress Disorder, Bipolar Mood Disorder, and Postpartum Psychosis. (A report from the California Task Force on the Status of Maternal Mental Health Care. https://www.2020mom.org/ca-task-force-recommendations). Collectively, these are known as Perinatal Mood and Anxiety Disorders or PMADs. Postpartum Support International (PSI) has descriptions and symptoms of each of these PMADs https://www.postpartum.net/learn-more/
Prevention: How to address perinatal mental health:
Parents of every culture, age, income level and race can develop Perinatal Mood and Anxiety Disorders. Symptoms can appear any time during pregnancy and the first 12 months after childbirth. There are effective and well-researched treatment options to help you recover.
A critical mechanism for preventing PMADs, promoting awareness of PMADs and ensuring access to treatment and care for PMADs is to normalize and destigmatize emotional and psychological changes. The universal message of Postpartum Support International is You are Not Alone, You are Not to Blame, With Help, You will be Well. Mothers need to feel accepted and supported; to internalize a sense of belonging and safety during this major role transition.
States and communities must build and maintain perinatal mental health infrastructure to serve as a catalyst for improving maternal mental health outcomes and to form a safety net so that mothers are not suffering in silence and shame. Social isolation is one of many risk factors for experiencing depressive and anxiety symptoms so free and accessible groups such as Breastfeeding Support Groups, Perinatal Mental Health Support Groups, Family Resource Center Playgroups, Perinatal Loss Groups, Infant Massage Groups, Mother-Baby Social Groups and 4th Trimester Groups are essential! Sadly, these groups are difficult to find, are offered infrequently and rely heavily on a robust volunteer base. New parents need opportunities to share their experiences, practice parenting in a social environment and to observe other infants and caregivers and learn from them.
Addressing perinatal mental health begins before birth. Hospital-based and Doula-led childbirth preparation and postpartum planning classes expectant parents information about pregnancy changes, self-care, newborn states of consciousness and early parenting. However, if these classes continue to be offered in the “marketplace”, only well-resourced parents will have access. Grant funded classes such as the CT OEC funded UConn Health Parenting “Prenatal Parenting” course is a good example of a free program where birthing people can begin to consider their needs, build parental confidence, reduce prenatal stress and access resources. However, this model should be replicated throughout the state. Expectant parents are hungry to learn about fetal, newborn and infant development and their instincts are validated when this information is shared through a reflective and relational lens. This is a nurturing learning environment where the “Ghosts in the Nursery” can be considered as part of the parents’ healing and development. Throughout the prenatal period and into the first years of life, a child’s brain and body develop rapidly, relying on secure attachment and vulnerable to environmental influences.
When we consider perinatal mental health, Dr. Arietta Slade reminds us to “Keep the Baby in Mind”. Indeed, we must hold the needs of the entire family system in mind and advocate for many more opportunities for expectant and new families to have access to information, support, treatment and care and for infants and their families to have access to social and developmental activities to promote and protect parental and infant and early childhood mental health.
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Interventions that ensure that new families have access to necessary medical care, food, housing, and social supports are fundamental to child health and nurturing parenting. Healthy Start, Healthy Beginnings, Home Visiting and WIC programs are successful in addressing short-term difficulties, long-term physical, developmental and mental health risks and provide vital connections to other services such as Psychotherapy and Group Programs. While formats and content vary, these programs work with pregnant women and new mothers into early childhood to provide education about child development and positive parent-child interactions, serve as social support, and increase access to social and health services.
Psychotherapy is a clinical intervention that address PMAD symptomatology, self-esteem, relationship problems, trauma and more. Psychotherapists working with perinatal families should have special training in all aspects of perinatal mental health such as diagnostic assessment of PMADs, perinatal loss, birth trauma, PMADs, perinatal scary thoughts and attachment and be able to be a resource for complementary interventions such as Breastfeeding Support, Doula Services, Parent Education/Developmental Guidance, Home Visiting and Group Services. PSI offers a number of trainings for therapists and allied health professionals (see below for links). CT Breastfeeding USA, La Leche League and Breastfeeding Resources of Stratford are the primary CT based resources supporting lactation.
Medication Therapy compliments Psychotherapy when PMAD symptoms are moderate to severe. PSI offers free Reproductive Psychiatry Consultation. Mother to Baby CT provides free consultation and resources to families and providers with questions about exposures during pregnancy and breastfeeding including psychiatric medication.
https://health.uconn.edu/medical-genetics/mothertobaby-ct-2/mothertobaby-ct/
https://www.postpartum.net/resources/medication-resources/
National Programs Addressing Maternal Mental Health
Postpartum Support International is the lead organizational in the US addressing PMADs through awareness, education, workforce development, resource linkage through volunteer support coordinators, specialized coordinators and perinatal mental health support groups. All services to families are at no cost. An array of free online support groups are listed at https://www.postpartum.net/get-help/psi-online-support-meetings/
PSI information and resources in Spanish can be found at https://www.postpartum.net/en-espanol/
This spring, PSI will be launching the country’s first Maternal Mental Health Hotline funded by HRSA. PSI has always had and will continue to operate a Helpline which offers support and resources and linkage to local PSI volunteers in every state. Here in Connecticut, there are 12 volunteer support coordinators. Connecticut was the first state in the nation to form a chapter of Postpartum Support International in 2016; establishing a board of directors, several active committees and a bridge to the PSI parent organization www.psictchapter.com
Listing of Programs in Connecticut Addressing Maternal Mental Health:
Legislation:
Senate Bill 5500 passed this week in Connecticut advancing Doula Services by establishing a Doula Services Taskforce. PSI CT is collecting information on Doula Practices in the state and is currently housing this information on an online bulletin board https://padlet.com/jvendetti/Connecticutdoulas
Maternal Mental Health Resources for the CT-AIMH Workforce:
Free Perinatal Mental Health Online Support Groups
https://www.postpartum.net/get-help/psi-online-support-meetings/
Free Maternal Mental Health Webinar
https://www.postpartum.net/professionals/mmh-online-webinar/
Additional Training on Perinatal Mood and Anxiety Disorders
https://www.postpartum.net/professionals/certificate-trainings/
Honoring Maternal Mental Health Month
https://www.thebluedotproject.org/mmhweek2022
https://wmmhday.postpartum.net/
Annually, the PSI Climb Out of the Darkness events in the US and around the world bring families, providers and advocates together in solidarity of recognizing perinatal mental health complications. Find a Climb closest to you and invite personal and professional connections as a way of recognizing Maternal Mental Health Month! June 25, 2022!
https://padlet.com/jvendetti/COTD2022
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We are pleased to announce that CT-AIMH is now on the LinkedIn platform. Please, join us so that we can stay connected, and invite your colleagues to join the CT-AIMH family. Learn more about our organization, as we offer information about Infant and Early Childhood Mental Health, training opportunities, Endorsement, and Reflective Supervision, to more infant and early childhood professionals. Help us spread our powerful mission to better the lives of infants, children and their families in CT. | Celebrate Babies Campaign | CT-AIMH celebrates all of you who contributed your thoughtful reflections during the week of October 18, 2021. CT-AIMH invites you to enjoy last year's Celebrate Babies "Reflections from Connecticut" video! | |
Tanika Eaves, PhD, LCSW, IMH-E®
Assistant Professor
Undergraduate Social Work Program
Marion Peckham Egan School for Nursing and Health Studies
Fairfield University with a colleague at Albertus Magnus College are collaborating to recruit professionals working with pregnant and early parenting women to discuss their lived experience providing care to BIPOC women and families and how racial inequities in maternal-infant health outcomes impact their experiences.
They would like to invite professionals to participate in their survey.
We greatly appreciate it!
| Tanika Eaves, PhD, LCSW, IMH-E® | |
Help CT-AIMH in celebrating a mother, a CT-AIMH Board member, a maternal mental health educator, advocate, and social worker of the year: Jennifer Vendetti!
Jen, thank you for your amazing contributions to the field and for helping with this article and the many resources about maternal mental health!
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CT-AIMH OFFERS
AUDIENCE-SPECIFIC
IMH TRAINING SERIES
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CT-AIMH continues to offer our popular 8-topic IMH training series to DCF professionals, OEC home visitor supervisors and community partners.
CT-AIMH is also continuing our 11-part IMH training series for childcare professionals. The first series will be held in Spanish beginning May 5, 2022. The second series will be held in the fall, in English.
Check out our website for more events and trainings!
www.ct-aimh.org
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Current and Upcoming Events | | | |
2022 CT-AIMH
Spring Conference
We are looking forward to this years Spring Conference featuring Karol Wilson, and Dr. Deborah Weatherston. The topic will be: Honoring diversity Identity, and Race through Infant Mental Health and Reflective Supervision.
Current events such as the pandemic, racial violence, and exposed systemic racism and disparities, test us personally and professionally. Examining Infant Mental Health (IMH) and Reflective Supervision (RS) through a lens that honors diversity, identity, and race is crucial to best practice.
CT-AIMH 2022 Virtual Spring Conference
Thursday, May 12, 2022
9:00am-3:00pm
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Karol Wilson
LMSW, IMH-E®
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Deborah J. Weatherston,
PhD, IMH-E®
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Karol Wilson, LMSW, IMH-E®, was one of the Program Supervisors for the Partnering with Parents Program at Starfish Family Services until she retired in June 2021.Karol has been a part of the infant mental health field for more than 25 years as a home visitor, mentor, program supervisor, trainer, and individual and group reflective supervisor/consultant. Karol has co-author of 3 published articles and recently authored a chapter in a recently published book: Therapeutic Cultural Routines to Build Family Relationships (Talk, Touch, and Listen While Combing Hair), edited by Deborah Weatherston and Marva Lewis. Karol now works parttime as a Reflective Consultant and continues to provide trainings and individual reflective supervision. She takes pride in being one of the first Michigan Association for Infant Mental Health (MI-AIMH) Diversity Fellows and is the first African American to achieve endorsement by MI-AIMH as an Infant Mental Health Mentor (Clinical).
Dr. Weatherston co-founded and directed the Graduate Certificate Program in Infant Mental Health (IMH) at Wayne State University and served as the Executive Director of the Michigan Association for Infant Mental Health and the Alliance for the Advancement of Infant Mental Health, Inc. She has published books and articles about Infant Mental Health principles, practices, training, and reflective supervision. She served as an elected Board Member of the World Association for Infant Mental Health (WAIMH), received the WAIMH Sonya Bemporad Award for policy, edited WAIMH Perspectives in Infant Mental Health, and is a consulting editor for the Infant Mental Health Journal.
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CT-AIMH is pleased to announce the success of our first 4-part March Mindfulness Class! CT-AIMH will offer another free 6-part class on Mindfulness in the fall for those professionals working with families and young children who have experienced trauma. Mindfulness can be a tool to help professionals who are experiencing high levels of stress and secondary trauma.
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IECMH-E® Requirement Change | |
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In the fall of 2020, the Alliance assembled a task force to examine the reflective supervision/consultation requirements for Infant/Early Childhood Family Specialists (I/ECFS). The task force was composed of 9 members, who represented associations for infant mental health (AIMHs) in Florida, Michigan, New Mexico, New York, South Carolina, Tennessee, Washington. The task force was co-facilitated by Faith Eidson, Ashley McCormick, and Andrea Penick, all of whom are Alliance staff and members of the Michigan AIMH. As they set out to reach their goal of gathering information and understanding how the current requirements for the I/ECFS categories of Endorsement impact the workforce, particularly looking at how they impact AIMHs’ ability to offer a diverse, equitable, and inclusive Endorsement system, they also stumbled upon other Endorsement requirements that posed barriers and inequities for users.
The task force recommended that the following requirements be changed. Their recommendations were unanimously accepted and will go into effect as follows:
- Require all endorsees to attend a minimum of 1 hour of diversity, equity and inclusion in IMH training as part of annual renewal training hours; the 1 hour will be part of the minimum 15 hours required
- Endorsees will be required to obtain these hours in 2023 and submit them as part of their 2023 renewal (i.e., due by 12/31/23)
- Require all Infant/Early Childhood Mental Health Mentor-Clinical (I/ECMHM-C) applicants to attend a minimum of 30 hours of in-service training specific to IMH PLUS a minimum of 15 hours specific to the provision of RSC PLUS 3 hours specific to diversity, equity and inclusion in IMH, totaling a minimum of 48 hours of training
- Required for I/ECMHM-C applicants beginning January 1, 2024
- Require all Infant/Early Childhood Mental Health Mentor - Policy (I/ECMHM-P) and Infant/Early Childhood Mental Health Mentor - Research/Faculty (I/ECMHM-R/F) applicants to attend a minimum of 30 hours of inservice training specific to IECMH PLUS 3 hours specific to diversity, equity and inclusion in IMH, totaling a minimum of 33 hours of training
- Required for I/ECMHM-P and I/ECMHM-R/F applicants beginning January 1, 2024
- I/ECMHM applicants are required to document a minimum of 3-years of leadership experience specific to IMH. Leadership activities may be demonstrated through paid AND unpaid work experience. *Previously I/ECMHM applicants were required to have both paid AND unpaid leadership experiences. The new requirement demonstrates that paid and unpaid leadership experience is valued equally (i.e., we want to eliminate the emphasis on volunteer experience, as being able to volunteer outside of paid work is a privilege and not available to everyone)
- Required May 1, 2022
- No degree required for I/ECFS applicants; applicants can upload their unofficial transcripts and select competencies from any coursework or degree earned within the education section of their application
- Effective May 1, 2022
- The requirement that applicants must request “official transcripts” in order to document degree and competencies has been removed. All Endorsement applicants can submit unofficial transcripts to document their educational experiences. *We have removed this requirement because agencies, organizations, and/or licensing boards already require official transcripts for professionals to obtain the work experiences that they list within their applications (i.e., we do not want the duplication of requesting transcripts to be a barrier)
- Effective May 1, 2022
- The requirement that applicants must request transcripts from every institution where a degree was earned has been removed. All Endorsement applicants can upload only the transcripts that document relevant degrees/coursework to the competencies. For the categories of Endorsement where a degree is required, the applicants will list the degree earned as they did before; it will be up to them whether they want to upload transcripts or not
Endorsement requirements have always been and will continue to be ever-evolving as the IECMH field grows and evolves. We are excited about the new changes and the direction we are heading! You will receive information from your local AIMH about these changes in the near future, along with noticeable changes in EASY and across Endorsement resources and documents.
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CT-AIMH is part of the Alliance for the Advancement of Infant Mental Health (Alliance)community along with 32 other US state associations for infant mental health (AIMHs) and the Ireland and Western Australia AIMHs. Being a member of the Alliance means that we all utilize the workforce development tools, Competency Guidelines (MI-AIMH Copyright © 2017) and Endorsement for Culturally Sensitive, Relationship-Focused Practice Promoting Infant and Early Childhood Mental Health (Endorsement). |
The Alliance Team is Growing!
Spring has sprung and the Alliance staff are feeling sunny and bright! We have added two amazing members to our team since the start of the year. Join us in welcoming Amber Keeler & Lacretia Powell! Both Amber & Lacretia are serving as Endorsement Central Service Coordinators and come to us with significant clinical expertise with little ones and their families. Our team is dynamic and each one of us is excited to connect with you, our community!
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Back row, from L to R: Ashley McCormick, Amber Keeler, Anicia Battles, Nichole Paradis, Hannah Schottenfels, Kelly Dieffenbaugher, & Faith Eidson
Front row, from L to R: Andrea Penick, Lacretia Powell, Veronica Rosa Sandoval, & Kelly Sipotz
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Addressing Suspension & Expulsion in Early Childhood Settings
Download our latest resource, Preschool Expulsion & Suspension Report, to support your advocacy work around suspension and expulsion in early childhood education settings. Download here.
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THANK YOU!
The tremendous work of the task force aligns closely with the Alliance strategic plan: Goal #1: Advance Workforce Development Efforts that Reflect our Commitment to Diversity, Equity, Inclusion, and Racial Justice and to Sustain the Sector; Strategy 2: Change Workforce Development Standards to be Anti-Racist.
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In a nutshell
NEW Endorsement Renewal Requirements for 2022
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As a reminder: Annual Endorsement® Renewal Endorsement® renewals are due by January 31 of each year. There are NO annual fees for Endorsement® renewal. In order to renew your CT-AIMH Endorsement®, the following criteria has been added:
- For IECMH-E IFS, IECMH-E MH Specialist, or IECMH-Mentors: If you are providing RS/C to others, then 3 hours of the minimum 15 annual renewal training hours need to be Training on RS/C
- All categories of Endorsement will be required to attend a minimum of 1 hour of DEI training as part of the minimum 15 annual renewal training hours.
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HONORING "JUNETEENTH" JUNE 19th
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JUNETEENTH IS NOW A FEDERAL HOLIDAY
On June 19, 1865, the enslaved African American people of Galveston, Texas, learned they were free from bondage. Although President Abraham Lincoln issued the Emancipation Proclamation in 1863, it took two more years before some of the last enslaved people were freed in this country. Last June, President Biden signed the bill making Juneteenth the first new federal holiday since Martin Luther King Jr. Day over three decades ago. Representative Sheila Jackson Lee (Yale College ’72), Senator Ed Markey, Senator John Cornyn, and several senators who graduated from Yale introduced the bill for Juneteenth that Congress passed with bipartisan support.
Juneteenth is a day of reflection and rejoicing, as well as a moment to acknowledge the long civil rights movement. The holiday gives us the chance to celebrate the end of slavery; to remember the experiences, labor, and lives of enslaved people; and to recognize the contributions of members of the Black community to this country.
We join you in commemorating Juneteenth next month and in honoring those who have worked with courage to seek freedom, justice, peace, and dignity for all.
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Infants and Toddlers Needs in the Time of War and Evacuation from their Homeland
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A letter of support and gratitude
Suggestions for volunteers and staff working in
Resettlement/Refugee Organizations
Dear Colleagues,
THANK YOU to the staff and volunteers for the work you are doing to support and comfort families seeking refuge.
What to Know About Babies:
War brings trauma to babies as well as to their families.
Babies’ brains register both what is happening to them and what is happening around them in their environments.
Babies’ early experiences set the foundation for later learning and relationships.
Babies need secure, warm, and consistent relationships from a primary caring adult to buffer any distress that is happening to them.
Trauma experiences such as war and its effects, go unresolved with the absence of warm and loving relationships.
Unresolved trauma can lead to disorders of great consequence.
Mothers and caregivers need to know they are doing the best they can.
Babies cry to communicate, to say that they are experiencing discomfort and that they need food and/or that they need comforting care.
Play is an effective way to promote responsive relationships, resilience to hardships and to reduce sources of stress.
What to Do:
Assure that caregivers (mothers, fathers, family members) have a place to care for their babies, a place to always be with their infants and toddlers.
Affirm mothers and caregivers when they give attention to their babies. Let mothers and caregivers know they are keeping their babies safe.
Affirm mothers and caregivers holding, feeding, and talking to their babies. “Your baby is looking at you with such love.” “Your baby knows you are doing your best.”
Offer needed items to mothers in the context of the mother/baby relationship: “We found a place for you to stay (or food to eat or clothes to wear) that will be comfortable and safe for you and for your baby.”
Suggest (not tell) ways of calming crying babies. “Have you tried swaddling (or “sh-sh-sh-ing”, or singing, or swinging, or side-rocking) to calm your baby?”
Offer a comforting response every time babies cry. Comforting will not spoil the baby. That is how babies learn to feel safe and secure, how they learn to count on adults to care for them, especially in a confusing world.
Be warm and responsive with mothers and their needs, exactly the way you want mothers to be with their babies.
Offer a place for mothers and babies to play together, a time to enjoy each other, that both builds brains and reduces stress.
For background supporting these suggestions: https://developingchild.harvard.edu/resources/
https://www.allianceaimh.org/
For more information and to learn about opportunities for more learning please contact:
Heidi Maderia, MS, IMH-E®
CT-AIMH Executive Director
Heidi.maderia@yale.edu
(860) 617-1965
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CT-AIMH | www.ct-aimh.org | | | | |
