Online Therapy For Pregnant & New Moms

In the past decade and what I now call typical times, many of the pregnant and new moms I have worked with utilized remote counseling (also called online therapy or teletherapy), as it allowed them access expert help from a maternal mental health specialist without worrying about driving a long distance or weather conditions.

When you have a newborn, the unpredictability of the baby’s schedule, nursing and  your physical recovery or tiredness may mean that getting out of the house to an office appointment can be difficult and teletherapy means that you can get that extra support at the time you are most likely to need it.

Because we are in the middle of a global pandemic, these are not typical times! No woman who became pregnant in the last few months, or gave birth recently, expected to be facing social distancing or the fear and uncertainty Covid-19 has brought and now remote sessions are a necessity not an option.

Becoming a parent is one of the most life-changing transitions you will experience and research over the past two decades has shown that typically 1 in 5 (20%) new moms will experience pregnancy and/or postpartum anxiety or depression and approximately 5-9% of women will experience postpartum post-traumatic stress disorder (PTSD) following childbirth.

We don’t know the statistics yet, but I think the uncertainty, isolation and stress that has accompanied Covid-19, will mean a much greater percentage of women will experiencing anxiety, depression or trauma symptoms. What I do know though, is that when moms are supported, they have a much easier time navigating the challenges of pregnancy and early motherhood.

 

Currently many pregnant and new moms are struggling with these questions:

1. How am I going to cope with the added stress and uncertainty of being a new mom during a pandemic?

2. Is social distancing going to affect my support and leave me isolated?

3. I am typically an anxious person, but how am I going to cope now my anxiety is through the roof?

4. How am I going to cope if my labor experience isn’t how I expected it to be?

Whether you need a few sessions to help the transition, or perhaps longer treatment due to a prior history of anxiety or depression, or a traumatic delivery, it certainly can help to work with a professional who understands how treatment of maternal mental health issues are different from treating general anxiety and depression.

You are not alone in going through this and I know how to empower you by providing short-term, solution focused therapy to develop your coping strategies and process the difficult, conflicting emotions you may be experiencing.

Therapy provides a means of helping you gain a different perspective and insight about what you are experiencing and Cognitive Therapy (CBT) gives you the tools to manage overwhelming emotions.

The important thing at the moment is that you are carving out some time to look after your own mental health. During times of stress, you are more able to deal with your own stress or issues with your family or spouse, if you take time for your own self-care.

 

But Is Remote Therapy An Effective Treatment For New Moms?

Although I have been working with pregnant and postpartum women for 25 years, I only started thinking about offering remote therapy about 10 years ago. I found that because there weren’t enough therapists who had specialist training and experience treating maternal mental health issues, I was getting contacted by women from all over the state, many who traveled over an hour or more each way to see me.  That is when I began looking for research studies that showed postpartum depression can be equally effectively using online therapy.

One of the first studies I found was a British study that showed the women who received the remote counseling for postpartum depression reported better results for depression and anxiety scores immediately after they had received the treatment as well as six months after treatment. The study lead researcher, Dr. Heather O’Mahen, said that the results (published in the journal Psychological Medicine), indicated that internet-based treatment had a positive effect in reducing postpartum depression as a whole and because it provided support in their homes it was convenient allowing them to complete a course of therapy. She added: “Our hope is that this will allow more women to access and benefit from support, with all the knock-on positives that come from that: happier families, improved quality of life for moms”.

More recently, the American Psychological Association (APA) published an article stating that research demonstrates that psychotherapy delivered via the phone is as effective as the care delivered in person. A review of 13 studies found significant reductions in symptoms of anxiety and depression when therapy was provided via telephone (Coughtrey and Pistrang, 2018) and the World Journal of Psychiatry concluded that there is a large evidence base that supports teletherapy being as effective as in office therapy.

In addition to the research on postpartum depression and teletherapy, I have found that pregnant moms experience the same rates of depression and anxiety as postpartum moms and remote therapy is also effective during pregnancy as it can be very helpful to develop coping strategies to deal with anxiety before the baby arrives. Both pregnancy and postpartum anxiety and depression are very common and treatable. I do want to stress that whether support is provided remotely or in my office when social distancing is over, you don’t have to go through this alone.

 

Is Remote Therapy Confidential & Private?

Yes! At the moment I am conducting remote sessions from my home office which is in a separate area from the rest of my family so no one can overhear or interrupt our sessions. When we are no longer sheltering in place, I also conduct remote sessions from my Northbrook office.

I use a HIPAA compliant video conferencing platform that can work on wifi or cellular data, which means it enables my clients to find a way to talk to me in whatever way they can, whether it is a place in their house where they won’t be disturbed (I don’t mind if the only place you can get a bit of privacy at the moment is in your bathroom or closet!) or they sit in their car in their garage or parking lot or go out for a walk. We will find a way that works best for you!
 

Is Remote Therapy Covered By Insurance?

Although there are some variations depending what policy you have, most healthcare insurance plans provide coverage for teletherapy in the same way they cover in-office therapy.  I am out of network with all insurance companies and you can read more about my fees and how out of network insurance works, including questions to ask your insurance company before you start therapy on this page Dr. Allen’s Fees and Out of Network Insurance.

 

Dr. Allen offers online or telephone sessions to make it more convenient for pregnant and new moms to get specialist help.

Click here to read more about accessing help via online or telephone support.

 

Other articles by Dr. Allen you may be interested in:

When Your Baby’s Cry Causes You Anxiety

 

 

 

The Facts About Pregnancy and Postpartum Anxiety

 

 

 

When Your Childbirth Experience Wasn’t What You Hoped For

 

 

 

Is It Postpartum Depression or Something Else?

 

 

 

 

Click to read more articles on  Dr. Allen’s Pregnancy & Postpartum Blog

 

If you want to read more about maternal mental health download the FREE Guide To Pregnancy & Postpartum Stress, Anxiety & Depression. It is full of information about symptoms, different types of maternal mood disorders and advice about what to do to start feeling like yourself again.

Dr. Sarah Allen has 25 years experience as a psychologist empowering women as they transition through pregnancy and being a new mom, whether it is your first or not. She is also the Director of the Postpartum Depression Alliance of IL, a non-profit offering info and support to pregnant and postpartum moms and their families.

She offers telephone or online counseling as they are the most convenient way for pregnant and new moms to access support and help. Unfortunately, Dr. Allen’s professional license only allows her to work with IL residents.

If you have questions after reading this article or the Guide To Pregnancy & Postpartum Stress, Anxiety & Depression or have any questions about how counseling can be useful to your particular circumstances please contact me at 847 791-7722 or on the form below.

 

 

During this difficult time I will be offering remote therapy via phone or video conferencing while the Stay At Home order is in place in Illinois.

Read more about how remote counseling works Dr. Allen Telephone & Video Sessions

 

Types of Pregnancy & Postpartum Mood Disorders

In this article, which is a chapter from my free downloadable booklet called A Guide To Pregnancy & Postpartum Stress, Anxiety & Depression, I describe the different symptoms and types of mood disorders that can happen either during pregnancy or after having a baby. The most commonly known is Postpartum Depression but there are other conditions you may be experiencing and it is important to get the correct diagnosis for treatment to be most effective.

I am a psychologist who has worked with new moms for over twenty years and we used to think that maternal depression only happens postpartum (after the baby is born) and we concentrated on treating Postpartum Depression (PPD).

But more recent research in the past decade has showed us that many women experience these symptoms during pregnancy too. Contrary to popular belief, pregnancy does not protect women from getting depressed. Approximately 15% of women experience significant emotional problems during pregnancy too.

Once studies stated looking in more depth we also realized that it is not just depression symptoms either, pregnant and postpartum women can also experience anxiety, obsessional compulsive disorder (OCD) which often focuses on some type of harm coming to the baby and post-traumatic stress (PTSD) if they have a difficult birth experience.

We now have a name that covers all the symptoms that women may experience during pregnancy and postpartum – Perinatal Mood Disorders (or PPMDs) and we know between 10 – 20 % of women can experience them.

Remember though that is only the percentage of women who are reporting it. Many women feel unnecessary guilt and shame and do not want to tell anybody how they feel, so it is probably a much higher percentage!

During Pregnancy

Women are just as likely to experience significant anxiety and/or depression in during pregnancy as they are after having a baby (approx. 15%). Read the specific sections about depression and anxiety below to find out more information on symptoms.

 

Postpartum or Baby ‘Blues’

The “blues” affects 60-80% of all new mothers and often includes frequent and prolonged crying, anxiety, irritability, poor sleep, quick mood changes and a sense of vulnerability. It usually occurs within the first three days following birth, continues for a couple of weeks and goes away on its own. Read more about the baby blues; what it is, why it happens and what helps.

Pregnancy & Postpartum Depression

Pregnancy Depression (also called antenatal or prenatal depression) and Postpartum Depression (PPD) affects between 15-20% of all new mothers.

Symptoms are characterized by lack of despondency, tearfulness and intense feelings of inadequacy, guilt, anxiety and fatigue. There may also be physical symptoms such as headaches and rapid heart rate and moms may feel disconnected from the baby.
Symptoms differ for everyone but might include any of the following:

• Crying and sadness
• Loss of interest, joy or pleasure in things you used to enjoy
• Feelings of anger or irritability
• Lack of interest in the baby
• Appetite and sleep disturbance
• Feelings of guilt, shame or hopelessness
• Possible thoughts of harming the baby or yourself

These feelings can appear any time during the first few months to one year after the birth.

For more information about Pregnancy Depression read The Truth About Pregnancy During Depression and for tips for coping read 10 Tips For New Moms About Pregnancy & Postpartum Mood Disorders

Pregnancy & Postpartum Anxiety

Approximately 6% of pregnant and 10% of new moms experience anxiety. Let’s start with pregnancy. Pregnant women get a lot of advice about what they should do or not do from family, friends and social media. It can make everyone a little paranoid about what not to eat, do etc… The process of trying to get pregnant, fear of miscarriage, especially if there is a previous loss and what is going to happen to your life once this baby arrives can all cause anxiety or exacerbate pre-existing anxiety.

When the baby arrives every new parent worries that they don’t really know what they are doing and somehow, inadvertently, they may do something, or not do something, that causes harm to their baby. These little humans are totally vulnerable and now you are responsible for it! This can be scary sometimes but these worries are totally normal and everyone gets them occasionally.

But postpartum anxiety is more intense and persistent than typical new parent concerns. If you have any of the symptoms below for most of the day, you probably have postpartum anxiety.

• Racing thoughts
• Worrying
• Lack of concentration
• Restlessness
• Sleep disturbance
• Irritability
• Physical tension
• No appetite

Panic attacks are like anxiety multiplied by 10. They have a sudden onset and are accompanied by intense fear of something bad happening.

Physical symptoms include shortness of breath, chest pain, dizziness, heart palpitations (people often think they are going to have a heart attack), sweating and gastrointestinal upset.

Emotionally you may feel that you are going to somehow lose control, go crazy and may start to avoid situations where you have experienced panic attacks for fear of one happening again.

Panic attacks seem to go in waves, but it is important to know that they will pass and will not hurt you and there are techniques to calm your mind and body down.

(For a more detailed post about pregnancy & postpartum anxiety read The Facts About Pregnancy & Postpartum Anxiety)

Postpartum Post-Traumatic Stress Disorder (PTSD) Following Childbirth

When childbirth or the time frame just before or after labor is seen as traumatic, women can develop PTSD like symptoms. Affecting up to 6% of mothers, the traumas can include women feeling that either their life or the life of their baby is at risk during the labor or shortly thereafter.

Symptoms of postpartum PTSD might include intrusive re-experiencing of a past traumatic event (which in this case may have been the childbirth itself), flashbacks or nightmares, avoidance of stimuli associated with the event, persistent increased arousal (irritability, difficulty sleeping, hyper-vigilance, exaggerated startle response), anxiety and panic attacks, and feeling a sense detachment.

Women who have experienced a previous trauma, such as rape or sexual abuse, are also at a higher risk for experiencing postpartum PTSD.  ​I have done research on PSTD and childbirth and worked with many women who have experienced it. It is important to recognize that this is different than Postpartum Depression so treatment can be tailored effectively.

(For a detailed post about Postpartum PTSD read When Your Childbirth Experience Wasn’t What You Hoped For)

Postpartum OCD

Postpartum Obsessive-Compulsive Disorder (OCD) is one of the scariest and under-diagnosed of the perinatal mood disorders.  It is estimated that as many as 3-5% of new mothers will experience symptoms such as obsessions (also called intrusive thoughts) which are persistent thoughts or images often relating to harm coming to the baby and compulsions to do certain things again and again to reduce her fears (called compulsions).

The thoughts, images or visions can be really horrific and seem very real. Women tend to not tell anyone they have these thoughts for fear of what others may think of them. When we keep thoughts in our head though, they grow more severe and even more frequent.

The moms with OCD know that their thoughts are bizarre and are very unlikely to ever act on them but are still fearful of being alone with the baby.

Postpartum Psychosis

Postpartum Psychosis or PPP (found in 0.1% of new mothers) is a serious, but relatively rare disorder, with reactions such as extreme confusion, refusal to eat, delusions or strange beliefs, auditory hallucinations (seeing or hearing things that aren’t there), feeling very irritated & hyper, decreased need for or inability to sleep, paranoia and suspiciousness and rapid mood swings. Most of these reactions occur within 3-14 days following the birth.

You can see that PPP is very different and much more severe than having the anxiety-provoking horrible thoughts that women with postpartum OCD have. In a psychotic state, a woman’s delusions and beliefs make total sense to her (but would be irrational to others) and feel very meaningful. Risk factors for PPP are a family history or previous personal history of psychosis or bipolar. Treatment needs to be immediate and requires hospitalization.

If you would like to read more of my Pregnancy & Postpartum related articles please click  Dr. Allen’s Pregnancy & Postpartum Blog

 

If you want to read more about maternal mental health download the FREE Guide To Pregnancy & Postpartum Stress, Anxiety & Depression. It is full of information about symptoms, different types of maternal mood disorders and advice about what to do to start feeling like yourself again.

 

Dr. Sarah Allen has 20+ years experience as a psychologist helping women transition to being the mom they want to be. She is also the Director of the Postpartum Depression Alliance of IL, a non-profit offering info and support to pregnant and postpartum moms and their families.

In her Northbrook office, in the North Suburbs of Chicago, or via telephone or online counseling she offers the most convenient way for you to access support and help.

If you have questions after reading this article or the Guide To Pregnancy & Postpartum Stress, Anxiety & Depression or have any questions about how counseling can be useful to your particular circumstances please contact me at 847 791-7722 or on the form below.

 

If you would like to read my blog posts of a variety of topics such as Anxiety, Depression, Parenting, Emotional Eating and Couples & Family Counseling click  Dr. Allen’s Blog and then go to the relevant section that interests you.

 

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