As a Boston psychotherapist specializing in perinatal mental health, I often see a universal struggle of parenthood: Women giving birth and families raising kids without adequate support. The Boston area draws some of the brightest minds to its many high-quality schools and training programs, and couples often leave their extended families and existing social networks to attend them. Then they find themselves here during their childbearing years without the established community so essential to easing into parenthood.
Although environment is not the only factor that puts someone at risk for developing a perinatal mood or anxiety disorder, it does play a significant role. The families I see feel isolated, insufficiently supported, and lacking resources. Many experience tremendous pressure from their jobs or educational programs, and so they are transitioning to parenthood as a stressed family unit.
When I see women, men, and families dealing with perinatal mood and anxiety disorders (the most common complication of pregnancy), I am always struck by how much they are asked to bear on their own. In particular, how much is expected of new moms and how little understanding there is that this is monumental.
Needing help is not a barometer of parenting effectiveness. And yet I see bright, capable women felled by exhaustion and isolation, berating themselves for (in their words) "failing" at motherhood.
With all the proven methods for relieving perinatal emotional distress – including psychotherapy, medication, and lifestyle changes – I would like to suggest another key intervention: changing our focus from supporting moms to building healthier families.
Think about it. Rather than seeing the struggles a new mom faces as hers alone to bear or to be supported through, what if we thought about ways to make the transition to parenthood a collective responsibility involving employers, spouses, community groups, and friends? What if everyone in a new family's social circle contributed to the well-being of that new child and his or her family? How can we do this?
What the community needs to do
Be responsible for meeting basic family needs. All new families must have a basic set of needs met: nutrition, understanding, rest and relaxation, spirituality, and exercise. (This theory is based on the research by psychiatrist Deborah Sichel and nurse practitioner Jeanne Watson Driscoll.) Meeting these needs is an easy way for community institutions such as schools, churches, PTAs, and community centers to play a role in building a healthy family.
Websites like Meal Train or Lotsahelpinghands can ensure a steady stream of food and support comes to a new family's home. Free community classes for parents on breastfeeding, and baby care, as well as exercise classes that welcome babies, can be places where families can build their confidence as parents and find a new community.
Programs with volunteers who visit pregnant women and new families weekly in their home to answer questions and provide company in those early, overwhelming days are also great resources. The one at Boston's Center for Early Relationship Support is a good example.
Work toward universal paid parental leave. Research has shown that paid parental leave improves quality of life and outcomes for babies and families by reducing the depressive symptoms new moms experience. It also lowers their long-term risk of stress and mental health disorders, increases vaccination rates, lowers infant mortality, and improves mother-child bonding. If you want to get involved with advocating for comprehensive leave policies and shifting attitudes on childrearing and caretaking, check out National Partnership for Women & Families or MomsRising.
What expectant or new parents can do
Create a community before giving birth. Identify a group of friends, a religious community, a therapist, or other supports that can be available to you in the postpartum period, and talk to them before you give birth. Tell them how they can play an essential role in helping your family adjust, and ask them for specific help after the baby comes.
If you are having a hard time coming up with people to include in your support system, talk to your partner, a good friend, the contact person for your Employee Assistance Program, your birth professionals, your religious leader, or a therapist. Even if you've already given birth, it's never too late: Check out the positive postpartum plan we created at Strong Roots Counseling.
Find peer support. This can be online or in-person, like a support group for new parents. In Boston, families can find support with us at Strong Roots Counseling or at the Center for Early Relationship Support. The Seleni Institute offers support and resource groups for new moms and dads in New York City. Families in other places can find local resources through Postpartum Progress and Postpartum Support International. Also check whether your local hospital, birth center, or community center hosts such a group.
Care for yourself first. You cannot adequately take care of your child if you do not take care of yourself. If you find that hard to accept, you have my professional recommendation to put self-care at the top of your priority list. You need to feel like yourself in order to parent as best you can.
I never tell parents that they will feel "normal," but I do remind them that we are working toward a new normal with more players in the mix. Getting out for a 10-15 minute walk daily, scheduling a night out with friends, taking a bath, or having a brunch date can all help.
Change how we think about "help." If we can all adjust our beliefs about who is responsible for raising happy, healthy families, then the meal you receive from a member of your church, the hour your friend spends watching your child, and the times when your husband gets up with the baby during the night all become collective responsibilities we have a right to, rather than favors we feel guilty about asking for or accepting.
We cannot completely prevent perinatal mood and anxiety disorders, but we can reduce some risk factors by acting as a community to provide food, rest and relaxation, breaks, wisdom, and companionship to new families.
And we can help them move through difficult times much more quickly. Research confirms that there are far-reaching positive outcomes for everyone when moms and families feel taken care of. If we make healthy families a collective responsibility, rather than leaving new parents to navigate these transitions on their own, we can have a tremendous impact on the health of our society.