Advice to support pregnant and postpartum moms

ADVICE FOR HUSBANDS, PARTNERS AND FAMILY MEMBERS TO SUPPORT PREGNANT AND POSTPARTUM MOMS

Pregnant women, new moms and even new dads can sometimes struggle emotionally. A supportive community has an important role in helping a family transition to life with a new baby. Women who have significant mood changes often struggle to ask for help from their medical provider and their support network. A spouse, partner, family and friends are all important parts of a support network. A new mom may feel ashamed and embarrassed if she isn’t feeling great about the baby, herself or the transition to motherhood. If she has spoken to her doctor about how she is feeling, she may have been given some information about her risk for a perinatal mood disorder and, hopefully, given information about treatment. A perinatal mood disorder is, typically, a significant episode of depression or anxiety during pregnancy or the postpartum period. Spouses/ partners, family members and friends may be the first to suspect that their loved one needs help.

Support networks play an important role in helping a new mom who is struggling.

Family members and spouses/ partners have an important role in encouraging and supporting new moms experiencing depression or anxiety. It can be difficult for someone who is struggling to communicate what they need. Partners and spouses may not get a lot of guidance from the medical or behavioral health community on what they should say or do when their partner is struggling. Many new moms who are struggling doubt themselves, have unrealistic expectations of themselves and have self- critical thoughts. It can feel very hard to support someone who is going thru a dark time emotionally. Thankfully, there are things that you can say and do that will be helpful. The following summarizes some do’s and don’ts from Karen Kleinman, author of Postpartum Husband:

What you can Say:
• Tell her you know she feels terrible.
• Tell her she will get better.
• Tell her she is doing all the right things to get better (therapy, medication, etc.).
• Tell her it’s okay to make mistakes; she doesn’t have to do everything perfectly.
• Tell her you know how hard she’s working at this right now.
• Tell her to let you know what she needs you to do to help.
• Tell her you know she’s doing the best she can.
• Tell her you love her.
• Tell her your baby will be fine.

What you should NOT Say:
• Do not tell her she should “get over” this.
• Do not tell her you are tired of her feeling this way.
• Do not tell her this should be the happiest time of her life.
• Do not tell her you liked her better the way she was before.
• Do not tell her she’ll snap out of this.
• Do not tell her she would feel better if only: she were working, she were not working, she got out of the house more, stayed home more, etc.
• Do not tell her she should lose weight, color her hair, buy new clothes, etc.
• Do not tell her all new mothers feel this way.
• Do not tell her this is just a phase.
• Do not tell her if she wanted a baby, this is what she has to go through.
• Do not tell her you know she’s strong enough to get through this on her own and she doesn’t need help.

Practical things you can do:
1. Help around the house
2. Set limits with friends and family
3. Answer the phone. Take a message.
4. Throw in a load of laundry. Order take-out for dinner.
5. Accompany her to doctor’s appointments
6. Educate yourself about PPD, read the books your wife gives you
7. Write down the concerns and questions you have and taking them to her doctor or therapist.
8. Make a list, together, of the things that may provide an outlet for her so you can both refer to it when she needs a break.
9. The single most important thing for you to do to help is to just be with her. Sit with her. No TV, no kids, no dog, no bills, no newspaper. Just you and her. Let her know you’re there. This isn’t easy to do, especially with someone who seems so sad or so distant. Five minutes a day is a good place to start.
Postpartum Depression and Anxiety are very treatable!

Consistent support makes a difference!

Recovery takes longer when a woman does not get help to treat the mood disorder and when she does not get effective help from her support network. Spouses/ partners, friends and family members have an important role in providing support and in encouraging their loved one that she will get through this difficult time.

Good communication improves relationships

What is good communication?

Good communication with your partner is one the most important signs of a healthy relationship. Being able to tell your partner what you feel and need is essential as a first step to being able to work through inevitable issues that arise in relationships. I have worked with hundreds of clients who struggle to communicate with their partners and spouses. There can be a lot of frustration and intense feeling around this issue. Many times, I have heard the response that the partner “should already know what I need” or an incredulous “how can they not know?!” Open and direct communication can feel scary. In fact, there are destructive patterns in relationships where communicating what one is feeling or needing can be met with outright hostility and aggression, if not violence. This blog on communication is intended to help address some basic barriers and strategies that arise in relationships. However, if you find that you fall into the category of being frightened that expressing your needs will be met with violence or hostility, I strongly recommend seeking professional advice. As obvious as it may sound, your partner cannot read your mind, even when the relationship has lasted for year. Here are some strategies that can help you communicate better.

Why should my feelings matter?

Before you tackle important issues with your partner, it can be useful to evaluate what feelings are getting stirred up for you. It can be worthwhile to do a self- check. Pause to ask yourself, “What am I feeling right now? This can be a good starting point. Some feelings can overwhelm us and we may want to push them away. Generally speaking, being able to identify what you are feeling can help you understand what is getting triggered in situations with your partner. When there is a history of trauma, you may need to work with a therapist on understanding difficult emotions. Feelings are neither “right or wrong”. We want to work on observing them without judging them. An everyday example might be feeling upset after a long day and finding that laundry is sitting unfolded and your partner is sitting next to the basket but on their computer playing games. You might have a mix of feeling like anger, frustration or resentment that your partner is not doing more to help out. The point of observing your feelings is to recognize that something important is going on internally that needs to be tended to.

What are spiraling thoughts?

The next step is to ask, “What am I thinking or believing in this situation?” This can be helpful because sometimes your thoughts or beliefs may not be completely related to what is actually going on in the present moment. In the laundry example, thoughts can spiral or escalate. Here is one example: “He is choosing the computer over doing the laundry. I told him that I need him to help out more with chores. He doesn’t care about me or what I need”. Our thoughts can sometimes make incredible leaps from concrete needs (the laundry needs to be folded and put away) to much more intimate needs (love and affirmation). The goal of this exercise is to try to help you to clarify what you are feeling, identify what you need and what is important to communicate. I usually recommend that if it is important to you, it is worth talking about with your partner, even if it seems minor.

What do I really want from my partner?

I usually ask my clients to clarify what they think is most important to ask of their partner. It may be something concrete like needing more help with specific household chores or help with managing childcare responsibilities. Other times, it may be something more directly tied to wanting to feel appreciated, loved and affirmed. I then ask what they have directly communicated. There is usually a disparity between what has been directly communicated versus what the client thinks should be understood without direct communication. This may sound obvious but your partner cannot read your mind so ere on the side of communicating concretely and directly. You are more likely to get your needs met if you let your partner know what is going on inside you. Approach communication with the idea that what you are communicating may or may not be what your partner is hearing or understanding.

Here are a few tips:

1. Schedule time to talk. Don’t try to have an important conversation in the middle of other activities. While it may feel very important in the moment, you may have a more successful conversation if you schedule time later in the day and give your partner the heads up that this is important to you.

2. Be direct and be specific. I will often hear “I am overwhelmed. I want my partner to help more” which is not as helpful to your partner as saying “I am tired and need your help with the dishes and sweeping every night before we go to bed.”

3. Try to be open to hearing your partner’s perspective. Relationships are often about negotiation and rarely work out well when one partner insists that they are always right and their partner is always wrong.

4. If emotions are flaring, take a time out to regroup and calm down.

5. Never have important conversations if you or your partner are under the influence of drugs or alcohol.

Communicating with your partner may not come out perfectly. That is ok. Think of this as a skill that gets easier the more you practice it. Do your best to try to identify the problem and what you need. You are much more likely to get your needs met if you talk about it.