You most likely know someone who has suffered from postpartum depression. Maybe it was you. But we’re not talking about it, and we’re not screening for it. This week I spoke with Mara Green, LICSW, a psychotherapist and owner of Strong Roots Counseling, about “perinatal emotional complications,” and some steps we can take to prepare for what happens after giving birth.

Congratulations on Strong Roots Counseling! What drew you to this particular field of health care?

Four Questions With Postpartum Therapist Mara Green
Mara Green

I’ve been practicing in the mental health field since 2001, with a focus on adolescents for the first eight years. After some time I noticed that people having babies were having some identity issues. I wanted to offer some support to moms. So I spent a year-and-a-half of self-study, going to classes and seminars. I still do work with teens; there’s something that brings adults and teens to therapy. As an undergraduate at Brandeis University, I studied anthropology and women’s studies and the role feminism plays in those fields, so I’ve been thinking about these concepts for a long time. There’s so much demonizing when it comes to mental health. The postpartum community needs to be de-stigmatized. This is about birthing healthier families. Perinatal emotional complications are the No. 1 issue postpartum. People need to think about this for the entire family; a healthy mom means healthy kids. It’s about supporting people in communities. With the changing worlds of a postpartum life, it’s best for mom and everyone she touches.

Being a new mother is so hard, probably the most difficult thing a woman will deal with. And that’s without postpartum depression. Is there anything a pregnant woman reading this can do as a preventative measure?

The first thing is to watch sleeping habits. I now understand why Amnesty International considers sleep deprivation torture. Getting sleep postpartum is really important. Women who have mild anxiety during their pregnancies should think about talk therapy, acupuncture, watching their sleep and getting exercise. It’s good to know risk factors and to talk to therapists to mitigate those risk factors. This should go for spouses too. Ten percent of dads will experience postpartum depression—“sad dad.” The estimated range is that 16-20 percent of new mothers will meet the criteria for depression, 10-17 percent for anxiety, and 3-5 percent for obsessive-compulsive disorder. That’s three times the rate of the general population. For 6 percent, it’s having post-traumatic stress disorder. You really don’t want to be naive around birth. People think of childbirth as this blissful thing, but the statistics don’t show that. But the good news is this is totally treatable.

Insurers are lukewarm on the idea of screening postpartum women for signs of depression. Nationally, the American College of Obstetricians and Gynecologists doesn’t support it. Do you think it’s necessary?

Absolutely! The only way to know about women’s lives at this point is all anecdotal. And generally physicians don’t know what to do. Most receive 10 hours of mental health training during their residency. It’s a really big challenge for social workers. Statistics show that only 17 percent of those with postpartum depression will get treatment. Think about the 83 percent untreated. Only when we start to screen will we learn about our lives and get them back. People talk about birth wishes, but let’s talk about a postpartum plan. Let’s look at this as a systems issue.

OK, let’s talk about something happy that comes from pregnancy!

Be hopeful there is a new normal. How do you share this new life with a new baby? This is all treatable.