Meet our Mom

1. Explore the story of one Mom and how her experience demonstrates the role of community service providers in Mothers’ Mental Health. Meet our Mom MoM is a Mothers’ Mental Health Toolkit Project Learning Video with Dr. Joanne MacDonald Reproductive Mental Health Service IWK Health Centre Halifax, NS

2. MeetourMom MoM As a community service provider to mothers and young families you can create opportunities to promote and support mothers’ mental health. A mother’s positive mental health promotes the development of her child in physical growth and health, a solid self-esteem, confidence and skill in learning, emotional regulation and relationship success throughout life.

3. MeetourMom MoM • In the series, Meet our MomMoM, the Mothers’ Mental Health Toolkit Project team will introduce you to case descriptions drawn From the real experiences of our mental health clinicians and our Family Resource Centre partner staff. • These Moms have common presentations and problems that will challenge you to define your possible role and contributions to her well being. The Moms will also provide examples of how you might use some of the Toolkit resources in your work. • Have a copy of your Toolkit out for reference as we begin to Meet our Moms. • You could also print off this presentation and make notes as you go.

4. MeetourMom Tennika • Tennika is a 32 yo mother of 4 month old baby girl; previously employed as a bookkeeper. • Tennika and partner Jay conceived after many years of fertility treatments. • Pregnancy was complicated by threatened pre-term labour, bleeding and high blood pressure towards the end. • Baby Shania was born by C-section after a long difficult labour and fetal distress.

5. MeetourMom Tennika • Tennika’s mother came to help in first 6 weeks; she was very helpful although it was crowded in their small apartment. • She is avoiding taking Shania outside for fear of infection and Jay needs the car for work, so she doesn’t want to use bus with the baby. • She has been to the Family Doctor several times with concerns about Shania having an infection. She tells him she also feels short of breath and has chest pains that are new.

6. MeetourMom Tennika What are 3 possible mental health issues for Tennika? 1. 2. 3.

7. MeetourMom Tennika The Toolkit Project team identified: • Expectations of motherhood may have been high because of how long and how important it was to become pregnant. The pregnancy and delivery may have been disappointing and frightening. • Mom could have some Post-traumatic Stress reactions from the medical complication experiences and baby’s distress during labour - that increase her anxiety now. • Various presentations of anxiety are possible here – worry about infection that is excessive and has become obsessive; Generalized Anxiety Disorder and constant worry contributing to physical problems; or mild to moderate panic symptoms with a general sense of fear, shortness of breath, chest pain and the instinct to avoid the triggers for the fear.

8. MeetourMom Tennika What would you like to know more about this mom? 1. 2. 3.

9. MeetourMom Tennika The Project Team wondered about: • What were the experiences that created a sense of fear for Tennika? • Once the baby is safely delivered, sometimes the real experience of the mother is overlooked. The medical team sees the crisis as passed as mom and baby are now well; expression and resolution of the traumatic elements doesn’t occur and the busy life with a new baby begins. Tennikatruly felt Shania might die with every experience of bleeding, or threatened labour and then the sudden distress and C-section. She is still experiencing the memories of those moments.

10. MeetourMom Tennika 2. Has Tennika experienced an anxiety problem before becoming a mother? • Tennika was by temperament a quiet shy child, cared for by her loving grandmother. She had difficulty leaving the family to go to school, but did adjust in time. She was always a very good student, liked to be prepared well in advance, but could experience high anxiety just before exams. Once in community college she had a period of sleeplessness for a month when working on a major project.

11. MeetourMom Tennika 3. How does Tennika usually cope with stress? • Tennika has always focused on being prepared, planning and keeping lists, rehearsing what will happen in a new or stressful situation in her mind. Mothering hasn’t been quite what she expected or planned for. She feels somehow poorly prepared then for every day. She is a ‘worker’ in her mind and doesn’t have much experience with relaxation or recreation as strategies to reduce tension or stress.

12. MeetourMom Tennika What could be the role for you and your organization to support her mental health as a mother? 1. 2. 3.

13. MeetourMom Tennika Possible roles and contributions: • Encouragement and observation of the baby’s development may help Tennika see her baby as healthy and thriving, reduce fear and normalize the adjustments. • Fear of illness is limiting her social support and increasing isolation; your centre could be a destination she trusts. • You can provide information about how common worry is for mothers and the importance of screening when worry becomes an anxiety problem.

14. MeetourMom Tennika How might you use the Toolkit resources with Tennika? • A focus on the usual developmental stages and realistic appraisal of her baby will be an important support. • Pages 54 & 55 describe attachment development by infant life stage.

17. MeetourMom Tennika • You wonder if Tennika may have more than ordinary worry, possibly some form of an anxiety disorder. • Pages 122-127 are brief descriptions of common mental health problems for mothers. • Let’s look at the anxiety disorder possibilities

20. MeetourMom Tennika • How do you introduce the possibility of a mental health problem with Tennika? • You might approach her by re-stating something she has told you – for example: “ You mentioned you thought Shania might become ill if you went to the birthday party. “ These were her words which you can follow with a softly delivered question such as “How is all this worry about her affecting you?” • Conveys concern but doesn’t convey judgement about her emotion. You can then introduce the idea that women experience postpartum anxiety as well as postpartum depression. Page 121 is a general checklist you could offer, for her to do on her own, or with you

22. MeetourMom Tennika Key Points in Working with Worry • All mothers have concerns and need to be attentive. But constant worry is not typical or necessary for effective nurturing or mothering. • Respect the woman’s possible past experiences of fear or risk and how that could be shaping her anxious feelings and ideas now. She feels it strongly, which makes it real in her experience now. • Anxiety in the body and the mind can be very effectively managed or treated. Your mom doesn’t have to keep feeling this much distress.

23. MeetourMom Tennika Other Resources: http://perinatal.anxietybc.com - Part of a great web resource generally on recognizing and managing anxiety; this section was designed for mothers www.caringforkids.cps.ca – Official website of the Canadian Paediatric Society has a range of information about raising healthy infants and children, as a reliable resource for mom