Judy’s first pregnancy was planned, and she was looking forward to having a baby. Yet, halfway through the pregnancy, something changed. She began to feel down and bad about herself. She had less energy and struggled to concentrate. Thinking this was a normal part of pregnancy, she ignored it.
After she delivered her son, it all got worse. She felt as if she was in a black hole of sadness. She often gave her son to her mother, thinking he was better off without her. It wasn’t until a year and a half later, when she came out of the depression on her own, that she realized that she had not been herself.
Judy is a composite figure, based on the thousands of women for whom we have cared for or met during our clinical work and research. Her story demonstrates the profound impact that depression can have on mothers and their children.
Having a baby can be extraordinarily challenging. Women are extremely vulnerable to emotional changes during pregnancy and the year after delivery. In fact, depression is the most common complication of pregnancy. But women often have absolutely no idea they have depression, nor do anyone in their circle of influence, including their medical providers.
We believe there’s a missed opportunity to address depression in obstetric and pediatric settings: settings in which women are seen often during pregnancy and the year after birth. Women like Judy often drown in their illness, without anyone ever speaking to them about the possibility of depression. How and why does the health care system let this happen?
THE COSTS OF UNTREATED DEPRESSION
One in seven women experience depression during pregnancy and after birth. Depression negatively impacts mothers, children and families. It can affect birth outcomes, the way moms bond with their baby and children’s mental health later in life.
When untreated, depression can also lead to tragic outcomes, including suicide or infanticide. In fact, suicide is the leading cause of death among postpartum women with depression.
This illness is also costly. One case of untreated depression is estimated to cost over $22,000 annually per mother and baby pair.
Despite being a common illness with profound negative effects, most depression among pregnant and postpartum women goes unrecognized and untreated. Of the 4 million women who give birth in the U.S. every year, about 14 percent will experience depression. At least 80 percent will not generally get treatment.
There’s historically been no system in place to detect depression or help women get care. But professional societies and policymakers are starting to recommend screenings, while medical practices are beginning to integrate depression into obstetric and pediatric care.
This is a great first step. However, screening is not enough. After screening, the health system must ensure women get appropriately diagnosed and treated. Unfortunately, many providers aren’t trained or equipped with the proper resources to help women with depression, or may be reluctant to do so.
HELPING PROVIDERS HELP MOMS
In response to this need, our team is working on integrating depression into obstetric care in our state.
Our Massachusetts Child Psychiatry Access Program for Moms, launched in July 2014, helps frontline medical providers screen for and treat depression and other mental health concerns among pregnant and postpartum women.
MCPAP for Moms provides training and toolkits for providers, as well as telephone and face-to-face psychiatric consultation. For example, Judy’s obstetric provider could call MCPAP for Moms and talk to a psychiatrist to get guidance on how to treat, and with consultation, decide on a treatment plan that would include therapy. MCPAP for Moms also offers resources directly to women with ongoing mental health care.
Every provider in Massachusetts can access our services free of charge. MCPAP for Moms is funded through the MA Department of Mental Health. It also offers access to mental health care to pregnant and postpartum women in Massachusetts for less than $1 per month per woman. We are now evaluating how the program has affected outcomes for the more than 4,000 patients directly served since launch. Two other states, Washington and Wisconsin, are starting programs like MCPAP for Moms, and 17 others are seeking funding. Especially exciting, next year’s federal budget includes grant money for other states to establish such programs. We envision a health care system where all providers caring for pregnant and postpartum women are armed with the resources they need to support women with depression.
On any given day, a mother exhibits at least one superpower — whether it’s finding the missing Lego piece in the abyss of a playroom or staying up all night to keep tabs on a feverish toddler. One thing is certain: Motherhood is a responsibility like no other. We’ve found five exceptional mothers who not only are successfully raising their own kids, but also helping hundreds of other children and families in their own communities and beyond. Here are the women giving the definition of motherhood a much broader meaning. Kimberly Gomez founded STAY RVA to help Richmond public schools thrive.
KIMBERLY GOMEZ: THE MOM WHO EMPOWERS URBAN SCHOOLS
Richmond, Virginia, has a knack for offering amazing culture — respectable art museums, innovative cuisine, historic neighborhoods — in the most accessible way, making this riverside city incredibly kid-friendly. The problem? Once kids are ready for elementary school, many families either cough up the tuition for private school or relocate to the suburbs. This is especially true for white children, with only 27 percent enrolling in the city’s public schools. Kimberly Gomez, mom to three kids under age 6, didn’t want to fall in line with the status quo, and so last year she founded STAY RVA, a parent-led movement to support and enhance the public education system in an effort to encourage other families to stay in Richmond. “It just didn’t seem right to have a school around the corner and not have your kids go there,” Gomez says. “It’s part of our community.” Having spent more than a decade teaching in urban schools in Washington, D.C., and Houston, Gomez understood that tapping into the pulse of a neighborhood can create positive changes. “I started thinking about the resources that lie within people — those skill sets can be brought in, and there can be a bridge connecting the community with the school to help it thrive.” In its first year, some of STAY (Supporting Together Area Youth) RVA’s projects included redecorating school bathrooms and staff lounges, preparing a lunch spread for custodians and starting a cross-school club, called Be the Change, to empower kids with activities like yoga and art lessons. The changes taking place are not just within the schools; Gomez is noticing how parent volunteers are shifting their views about staying put in Richmond. Since STAY RVA’s launch party, 10 additional gatherings have taken place across different neighborhoods. Each was hosted by a local family to share ideas of what parents can do not just for their child, but for all students attending public schools in Richmond. “I really feel the spirit in the outpouring of local business support,” says Gomez. “Everyone has so many gifts and talents and resources, and this is a movement where all of those can be used for a greater purpose.” “Every time a donor gives us a dollar, they are hiring us to solve a problem,” says the Miracle Foundation’s Dianne Holbrook (center).
DIANNE HOLBROOK: THE MOM WHO WANTS TO HELP 8 MILLION KIDS
Dianne Holbrook’s job is to help put the Miracle Foundation, where she’s the executive vice president, out of business by 2040 — that is, to join forces with other international organizations and find permanent homes for the estimated 8 million children around the world who live in orphanages. Holbrook sponsored her first orphaned child in India 18 years ago, around the same time that her friend and former colleague, Caroline Boudreaux, started the Miracle Foundation on Mother’s Day in 2000. Two years later, Holbrook took her then 15-year-old son, Christopher, to meet the child. “It changed him completely,” she recalls. “He went to India as a boy and came back as a young man.” (Christopher has been sponsoring a child of his own ever since.) It was a move that would eventually put Holbrook on a dramatically different path, from a high-profile career in network television sales to nonprofit executive. Seeing that, even in the depths of extreme poverty, the children were beyond grateful for even the most basic displays of affection fueled Holbrook’s admiration for the foundation’s efforts. So when, last year, she received a call from Boudreaux to join the team, she jumped at the chance. Currently, the Miracle Foundation sponsors over 7,000 children globally; has sent close to 200 kids to college; and has reunited about 500 children with their families (about half the orphans Miracle Foundation works with have a living parent who had been unable to provide for them). Given that in the U.S., group homes and foster care have replaced traditional orphanages, the organization plans to roll out a social-networking app early next year targeted to foster families in Texas, with plans to expand to other states in the future. The app will help foster parents make sense of an incredibly complex system by providing resources, like hiring a vetted babysitter or scheduling meetings with social workers, at their fingertips. “It’s a privilege that I was invited to be a part of this organization,” adds Holbrook. “I get to be a mom all over again.” Serese Marotta joined Families Fighting Flu after losing her 5-year-old son, Joseph, to the virus in 2009.
SERESE MAROTTA: THE MOM WHO FIGHTS THE FLU
Influenza may not be new, but the brutality of this past flu season has shown that it is a vicious adversary. Families Fighting Flu, a national volunteer-based advocacy nonprofit dedicated to protecting children and communities, wants to show the public what the flu really is: a wolf in sheep’s clothing. “It’s not just a bad cold,” says Serese Marotta, chief operating officer for Families Fighting Flu in Arlington, Virginia, who lost her otherwise healthy 5-year-old son, Joseph, to the virus in 2009. “It can be a serious, highly contagious disease.” Marotta was an environmental scientist who made sure both Joseph and his then 7-year-old sister got their flu vaccines — except at the time, the nasal spray did not protect against the strain of H1N1 her son contracted. Joseph was one of nearly 350 children in the U.S. who succumbed to the pandemic during the 2009–’10 flu season; to date, there have been more than 1,600 influenza-associated pediatric deaths since the CDC started tracking that data in 2004. “I had no idea how many healthy children lose their lives to flu every year,” says Marotta. Six months later, she began speaking on behalf of Families Fighting Flu to local health departments, schools and coalitions. “This is a place for families just like mine,” she says of the organization. “We reach out with support because we have walked this path.” Marotta’s active involvement led her to her current role, in which she both serves as a pillar for families coping with a heartbreaking situation and raises awareness of flu as a public health concern. By sharing her own tragic story Marotta knows her work is instrumental. “I have changed people’s mind about the flu,” she says. “I’ve had people come up to me after [a talk] and say, ‘I know I should be vaccinating, but I never realized how important it is until today.’ Knowing that I am making a difference, and potentially saving other people from being seriously affected by the flu, makes my work worthwhile.” Sarah Yore-Van Oosterhout opened Lighthouse Immigrant Advocates to help undocumented immigrants who couldn’t afford legal counsel. SARAH YORE-VAN OOSTERHOUT: THE MOM WHO GIVES OTHERS A VOICE Imagine if an 8-year-old girl (falsely) accused your 12-year-old son of sexual assault, and then he was harassed by a local police officer and hauled off to jail. Now imagine how much worse it would be if you didn’t know what to do because you believe your immigration status prohibited you from advocating on behalf of your child. “Undocumented immigrants have come to associate law enforcement with deportation, and the fear of being separated from their family is often far worse [than not reporting a crime],” says attorney Sarah Yore-Van Oosterhout, founder of Lighthouse Immigrant Advocates in Holland, Michigan. Given that Michigan has about 150,000 undocumented residents, Lighthouse was a much-needed resource in the state. Yore-Van Oosterhout recognized that the people who would most benefit from legal counsel were the ones who could least afford it, and so in 2015 she opened Lighthouse to provide low-cost legal services, education and advocacy. To date, the nonprofit has worked with more than 650 families, helping them to understand their constitutional rights and preparing paperwork, like the guardianship of minors in the case of deportation. Lighthouse also hosts workshops at area schools, churches and businesses on immigration law and policy, and advocates on the local, state and federal levels. As a mother to two young daughters, Yore-Van Oosterhout knows first-hand the importance of having a strong support network. “My parents come once a week to take care of my girls,” she says. “I couldn’t do the work that I do without their support.” It’s an opportunity she wants everyone to have, but current immigration laws often keep families apart. “We’re forcing them to be separated for decades and to try to survive and thrive without the support of family. It’s cruel.” In a world that can be unwelcoming to immigrants, everyone who comes through Lighthouse’s doors are treated with the utmost dignity and respect, says Yore-Van Oosterhout. “It is so important for us that they are valued and welcomed. I hope my girls, who are at the office with me, are seeing that.” As CEO of New Moms, Laura Zumdahl helps provide housing and career counseling to young mothers. LAURA ZUMDAHL: THE MOM WHO BELIEVES IN SECOND CHANCES Motherhood is easy, said no one ever — least of all, young mothers disadvantaged by poverty, homelessness and poor social support. “It’s hard to parent, let alone think about how to go back to school if you don’t know where you’re going to spend the night,” says Laura Zumdahl, president and CEO of New Moms in Chicago. For the past 35 years, the nonprofit has provided stable housing, job training and parental mentoring to nearly 4,000 pregnant women and mothers under the age of 25. Since Zumdahl came on the scene five years ago, the organization has doubled in size, emphasizing the importance of community support in breaking the cycle of poverty. “We found that one of the keys to success, especially for a family in trauma, is to blend all of the supports in one place,” says Zumdahl. “That’s the secret sauce.” In addition to New Moms’ Transformation Center, which includes 40 apartments, Zumdahl has overseen the construction of a new building that will offer housing for an additional 18 mother-led households. She was also key in expanding the 16-week job-training program at the nonprofit’s social-enterprise candle company, Bright Endeavors. Zumdahl’s goal at work, and at home with her three teenage stepkids, is to show that the power of mother’s love is immense and that by carving out space for moms to build up their skills, they can overcome challenges and create stronger families. “There are a lot of people who go to bed and wonder, ‘Did what I do today matter?’” says Zumdahl. “I never think that. I know that it does matter. It’s not just about me — if New Moms wasn’t there, we’d lose generations, and that’s not OK.”
The day my mom was diagnosed with cancer at age 62, she turned to my dad in tears and said, “I’m not going to get to be the grandma.”
Many women today don’t want to be called that. They think it makes them sound “old.” When I hear this, a little part of me feels like yelling, “Do you know what a privilege it is to grow old?”
Aging — and one day, being able to live to 100 — should be celebrated. To me, “Grandma” is the name of an older person who’s reached the ultimate milestone. It’s something to be grateful for, not hide from. Forget your vanity! Be proud that you made it to a phase of life that many people never got to experience.
My husband lost his father at 13. I lost my mother at 30. Sometimes I worry that we won’t be around to see our young sons grow up. Becoming a grandmother and supporting my children when they become parents has become an ultimate goal.
Late in the summer of 2015, my mother (who’d never smoked) learned she had stage 4 lung cancer. Her oncologist was hopeful he could treat her. Yet hours after their visit, my mother couldn’t catch her breath, despite being on oxygen. My father rushed her to the hospital, where she was admitted to the ICU. My sister and I arrived less than an hour before my mother was put on a ventilator. She had no idea what was happening, and we didn’t either. We couldn’t imagine that her fight with cancer could be ending before it had even begun.
For the next two weeks, we were at my mother’s side, day and night. She remained on the ventilator, unconscious. Then one night, the doctor took us aside and told us there was no longer hope. Eighteen hours after my mother was taken off the ventilator, she passed away.
This was the most horrific month of my life. Just a few weeks earlier, my mother had been at a friend’s wedding, hosting her sister for a visit, celebrating my son’s first birthday…
Even now, it’s hard to believe that she’s gone.
When I was a child, my mother worked from home and was there every afternoon when I came home from school. If I close my eyes, I can picture her standing behind our kitchen counter, doling out an obscene amount of food, eager to hear everything about my day. (She had a lot of opinions.)
Even after I became an adult, my mother would do things for me before I’d even thought to do them myself. If I mentioned to her that I was sick, there’d be a knock at my door with soup from Second Avenue Deli.
Life without her has been an adjustment in so many ways. I miss her wit and wisdom. I miss our daily calls, texts and emails. And from a practical perspective, life has become more challenging.
There’s no substitute to a grandparent when you’re raising a small child. In my first year as a working mom, my husband and I rarely had a tiff, thanks to my mom swooping in when we were both stressed and sleep-deprived to watch our son, bring us a meal, tidy up our living room, send us on a date night or take some responsibility off our plate. (“I thought the baby could use some more pajamas. Here you go!”)
It’s hard to describe the value of a grandmother kvelling over your “perfect, beautiful, gorgeous, brilliant, elite, premium, beyond adorable” babies (to use her words). It’s the confidence boost every parent needs, and one that I hope to provide to my own kids — and even to their kids — if I reach 100.
If I were to live to that age, my fantasy is that I’d be in great health and living with my husband somewhere beautiful — perhaps a lovely little apartment in Chelsea or … Provence! — reading books, drinking wine, looking out at a beautiful view and seeing our children, grandchildren and great-grandchildren who just happened to have moved there.
I’d be grateful to hold them, share whatever wisdom I have and help them understand our family’s history and values. (Here’s to hoping I’ll also get to see our first female president elected!)
If I live to be 100, I will have lived almost 40 years longer than my mother did. Hearing my son say “Mama” is one of the most beautiful things in the world. I’m pretty sure being called “Grandma” is just as wonderful.
Julia Edelstein is a writer and editor specializing in health journalism. She is currently the senior health editor at Parents Magazine. She lives in New York City with her husband and their two young sons. This post is paid for by AARP.
Last week, a video about the “World’s Toughest Job” made a big splash on the Internet. For anyone who hasn’t seen it yet, a fake company called “Rethom” (read it backwards) posted a job listing for a “Director of Operations” position that had some pretty insane requirements:
– Must be able to work 135+ hours a week
– Willingness to forgo any breaks
– Work mostly standing up and/or bending down
– Demonstrate knowledge and experience in negotiating, counseling and culinary arts
– Have an understanding of finance
– Have an understanding of medicine
– Maintain a positive disposition at all times
The position is unpaid, you will be on call 24/7 — and the work will actually increase during the holidays. As Adweek writes, the ad for this position got 2.7 million impressions from paid ad placements, and 24 real-life people actually inquired about this job. On the day of their interview, they got dressed up, were told about the requirements from this job from you know where, and all their reactions were caught on video (which has gone viral in the few short days it’s been out and blogs have applauded it as a tearjerker and amazing). Of course, there’s a big emotional twist.
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Turns out (if you haven’t already guessed or watched the video, which was created by Boston ad company Mullen for the greeting card company Cardstore.com just in time for Mother’s Day next month) there are billions of people around the world who already have this grueling job. (Spoiler alert!) They’re mothers. MORE:Are Cars the Key to Single Mothers Achieving Self-Sufficiency?
Critics, however, have attacked the video for being schmaltzy or sidelining the dads who take on this role. Point taken, but perhaps the video struck a chord because it highlights the oft-ignored and thankless labor that women go through.
There are an estimated 85.4 million mothers in the United States, not to mention the millions of fathers and caregivers who also hold this position. Maybe instead of buying a greeting card or just forwarding the link of the video with the message, “I love you, mommy,” we should also do something that would really show how much they are appreciated?
Since mothers work 135+ hours a week, how about improving access and affordability of daycare centers or after school programs? ALSO:Here’s Why We Should Be Investing in Single Moms
Since there’s no vacation, what about increasing maternity leave? American moms take off about 10 weeks on average after giving birth compared to 52 weeks in the United Kingdom.
Since moms need to be medical, culinary and financial experts, what about making sure they actually have the means to keep their families healthy? We’re talking access to adequate health care and leaving welfare, food stamps and WIC programs untouched.
Since the job of motherhood goes unpaid, what about increasing the pay of their day job (or jobs) or closing the wage gap? It’s still 77 cents to every dollar a man earns. For all the talk about “Leaning In,” what about actively promoting more women to top jobs? Maybe then, women could really have it all.
Two other states, Washington and Wisconsin, are starting programs like MCPAP for Moms, and 17 others are seeking funding. Especially exciting, next year’s federal budget includes grant money for other states to establish such programs. We envision a health care system where all providers caring for pregnant and postpartum women are armed with the resources they need to support women with depression.
