Health
5:10 am
Thu August 11, 2011

Groundbreaking Clinic To Treat New Mothers

After childbirth, most new moms will experience some form of what doctors call the “baby blues.” That’s the low feeling after childbirth that comes from a dramatic drop in hormones. But for some women, those feelings persist and turn into post partum depression. In the most severe cases, these women need to be hospitalized.

Traditionally, mothers with severe post partum depression have been treated alongside patients with schizophrenia, dementia and other mental illnesses—until now. Next week, the University of North Carolina Hospital in Chapel Hill opens the first free-standing perinatal psychiatry unit in the country.

Maria Bruno knew something was really wrong when she put her newborn son, Nicolas, down for a nap and then was too afraid to pick him up. She’d had depression before with her first three children. But this was different. She stopped eating and drinking. Her in-laws became worried and took her children in with them, thinking Maria just needed a break. Being alone, Maria says, just made it worse. In her desperation, she called her midwife and said.

Maria Bruno: "I don’t know what’s wrong, but I can’t take care of the baby and I’m miserable all of the time. And she said, ‘Well what’s wrong? Are you having thoughts of hurting yourself? And I just laughed and said, ‘All the time. I just need to get out."

Believing her life was in danger, Maria’s midwife called the police. The police came and took Maria to the hospital at UNC Chapel Hill. There, she was diagnosed with severe post partum depression. The hospital had no inpatient program specifically for postpartum women. So Maria was checked into the same ward that houses schizophrenics, drug addicts, and dementia patients. The staff put Maria on 24-hour high suicide alert. They trailed her everywhere she went.

Bruno: "When I pumped I had to have someone outside the door because they didn’t want me to strangle myself with the pump parts or something ridiculous."

Ridiculous because Maria says she never intended to act on her suicidal thoughts. She just felt overwhelmed—unable to be the capable mother she wanted to be. But because the staff was not trained to deal with post partum depression, they simply treated her like every other patient. Maria felt trapped.

Bruno: "I started to ask the nurses. What is it gonna take for you to let me out?"

To get released there were rules. Maria had to stop crying. She had to take Zoloft. She had to go to group therapy—even though the session was for alcoholics and drug addicts. Maria did exactly what the staff told her to do because she was afraid they would force her to stay. After 5 days she was finally released.

Bruno: "And I can’t talk about it without crying most of the time."

Chris Raines: "It was horrifying for me to know that she went through that experience."

That’s Chris Raines. She’s a nurse practioner and therapist at UNC’s Perinatal Mood and Anxiety Disorders Program. Raines met Maria after she transferred into outpatient therapy. Raines sees thousands of women suffering from post partum depression each year. She says a lot of them will come into her office scared by what they’re feeling and thinking.

Raines: "They will say emphatically, I never thought about hurting my baby but I would have these thoughts that I would see my babies with knives in it. And so I’ve had moms that won’t go by the kitchen because they’re afraid to pick up the knife because they’ve had this thought and they don’t know what it means."

Raines assures the women that these thoughts are just that: thoughts. But a lot of health care providers, who aren’t trained in treating post partum depression, don’t understand this. Raines says Maria’s story is the one that really motivated her to push for an inpatient clinic— a clinic at the hospital where the staff understands the needs of women with postpartum depression.

Dr. Samantha Meltzer-Brody is the director of the Perinatal Psychiatry Program and UNC Center for Women's Mood Disorders. She’s giving a tour of the clinic as it’s being built.

Meltzer-Brody: "OK, so what will be here. We will have a 5-bed unit."

Meltzer-Brody says everything the on ward will be geared to meet the needs of women with postpartum depression. There will breast pumps and gliders; individual therapy and family therapy. Babies will have extended visiting hours so that mom and child can create a routine, even while mom is hospitalized. It’s the kind of treatment, she says, that these women should expect.

Meltzer-Brody:" In the same way that women expect to go to a labor and delivery setting and deliver their baby not in the middle of the heart clinic or not in the middle of a different ward but in a specialty ward that takes care of women during pregnancy and post partum and we think the mental health services for the people that need it also needs to be appropriate."

And Meltzer-Brody says the clinic will serve as a model for what should be happening across the country. Calls are already coming in from Michigan, Arizona and other states across the southeast, from women and doctors inquiring about the new clinic’s services.