For Erica Larkin, a Bloomington mother of two, loving her babies came naturally. But when her baby was born, she couldn’t stop intrusive thoughts from harming her mental health.
Thoughts that led her to believe — for no logical reason — she might hurt her baby.
“I would walk by stairs with my daughter and I was worried I would trip and fall and throw her over the banister somehow, or that like, spontaneously, I would feel like I should drop her down the stairs,” she said.
Stairs became a fixation in her house.
“I looked at her and I loved her, and I didn't want to hurt her, but this thought just was in my head all the time,” she said.
Larkin never hurt her daughter or her second child. She was simply suffering from postpartum depression, or PPD, like so many moms do.
A national problem
About 13% of women nationally suffer from postpartum depression, according to the Centers for Disease Control and Prevention. In Illinois, the number of women is slightly less, with fewer than 11% of women developing PPD.
Many of these women aren’t getting help, according to a recent assessment by the Policy Center for Maternal Mental Health. It says the U.S. is “failing mothers” due to lack of adequate behavioral health resources.
The Policy Center ranked every state on its ability to connect mothers with mental health care. The average score was a D, with 35 states obtaining between a D and F. California got the highest score, a B-.
Illinois was among the five states to get a C, and five other states earned a C-.
States were graded on three categories: providers and programs, screening and screening reimbursement, and insurance coverage and treatment pay. Illinois did well in the insurance category and largely failed the others.
Illinois requires improvement in areas including provider ratios, inpatient programs, and screening options.
The problem in Bloomington-Normal
In Bloomington-Normal, providers and community members said the area is doing well in providing for moms, but more work must be done.
Nicki Petersen is a mom and co-founder of Surviving to Thriving, a peer support group for moms with perinatal disorders. She also volunteers at the Policy Center through Mom Congress, though she was not part of the group that created the report cards.
She said a C is still a lousy grade.
“While the C seems like, ‘Oh, man, Illinois, ranked among, you know, one of the top states,’ there are still so many gaps to fill,” she said.
Resources for moms in Bloomington-Normal have grown since she started Surviving to Thriving five years ago, Petersen said, including added support groups at hospitals. But she said there were several identified ways that the state can improve, such as increasing providers.
She said there’s also still a “stigma” around maternal mental health.
“Everyone thinks having a baby should be the happiest time of your life and you should be enjoying it, and then when moms aren't enjoying it, they think there's something wrong with them,” she said.
Larkin, who joined Surviving to Thriving, said she didn’t initially identify her thoughts about the stairs, or her random bouts of rage that had her screaming at her baby one night, as postpartum symptoms.
The symptoms she knew were her mom’s: not feeling attached to her child. Larkin’s doctor told her she was probably suffering from “baby blues,” which is a mild form of PPD that typically lasts a couple weeks and includes feelings of “worry, unhappiness and fatigue,” according to the CDC.
Unlike some, Larkin had gone into her pregnancy knowing PPD might be an issue. She was on PPD medication during her pregnancy and monitored throughout.
“I didn't feel sad, so I almost went — almost a full year without realizing I had postpartum even though I thought I knew what it looked like,” she said.
When screenings asked how she was sleeping, she would say normal because she thought her lack of sleep — which was actually insomnia — would be considered normal for a new mom. She didn’t say she wasn’t eating well because she thought her sleeping patterns were the cause.
As a result, her doctor didn’t see any red flags.
“Although I was answering the questions nicely on the sheet, and it was scoring well, I wasn't doing well,” Larkin said. “But I didn't say ‘I feel off,’ or ‘I don't feel right,’ and so no one stopped to talk to me.”
She just didn’t know the signs.
“I wish more people knew [about] that like rage, insomnia, horrible anxiety, intrusive thoughts, even if they're something mild,” Larkin said, adding that there can also be postpartum psychosis at the severe end of the spectrum.
Local care options
At the Carle BroMenn Medical Center in Normal, Mother Baby Unit Supervisor Keli Sidebottom said the goal is to make moms like Erica more comfortable sharing their concerns.
“We have to have a culture here at the hospital where we are providing respectful care,” she said. “So that means our patients feel safe, and they feel comfortable to express concerns or to bring up mental health issues, or for that matter to honestly answer those screening questions.”
The Mother Baby Unit partners with Dr. Rachel Immen, who specializes in behavioral health. She provides care to Carle moms throughout pregnancies and educates other doctors and practitioners in Carle about how and where to refer moms with behavioral health needs.
Mother Baby Unit Manager Stephanie Wollenberg said she thinks Carle has a wealth of providers to take care of moms. She added that Carle highlights mental health for all patient care, but that moms play a particularly important role.
“They're the ones that, you know, they have to get those kids up and go to school in the morning, and they have to get them to their doctor's appointment, and we need to make sure that they're healthy,” she said, adding that they are the “foundations of these families” and deserve care for perinatal mood disorders, general anxiety, and even just the adjustment to motherhood.
Carle is doing the best it can with current resources, Wollenberg said, but both Carle and the community are looking to do more. She said resources are there, “we just have to dig them up and find them.”
OSF Healthcare’s Laura Cartwright, who works in Ottawa, said each OSF outpost is increasing its options for moms.
“The communities are aware of the impact of maternal health before and after birth and I have seen that they have started to provide counseling for mothers either before or during pregnancy or after birth,” said Cartwright, a behavioral health provider and licensed clinical social worker.
Like Carle, they will refer Bloomington-Normal mothers to local behavioral health providers. OSF also has peer support groups at many of its locations. Bloomington’s is called “Moms of Beautiful Babies” and there is a Facebook Group for people to join.
A resource for mothers in need of immediate help is the Brightpoint Bloomington Crisis Nursery, which can help with behavioral health concerns, as well as mothers who are in need of housing.
National change
Last week, the FDA approved the first-ever pill to treat PPD. Sage Therapeutics is offering the pill, but the price and availability are unclear. There may also be barriers to access for people who are uninsured.
The other option on the market right now is also from Sage Therapeutics. It’s an intravenous treatment that costs about $34,000.
Larkin said she took Zoloft — a generic depression treatment — when she was pregnant. She said she hopes the new pill will be able to cost less and act fast.
“That could be the difference,” she said. “If you're in psychosis, or something more serious, that can pull you out of it quickly.”
For now, people will have to wait until Sage Therapeutics releases more information.
