Podcast Summary

Turning Points: Navigating Mental Health – S3E4
Episode Title: Understanding Maternal Mental Health: Pregnancy & Postpartum
Release Date: October 4, 2023
Host: Frances Leese (on behalf of Tufts Health Plan | Boston Globe Media)
Featured Guests:

• Jillian Amadeo (Licensed Social Worker & Patient Advocate)
• Dr. Shari Luskin (Reproductive Psychiatrist, Mount Sinai)
• Ebony Harvey (Holistic Health Coach, Doula, RN, Student Nurse Practitioner)

Overview

This episode of Turning Points dives deeply into the emotional complexities surrounding maternal mental health—especially as it relates to pregnancy, childbirth, and the postpartum period. Drawing on lived experience, clinical expertise, and advocacy perspectives, the episode explores the full spectrum of maternal mood disorders, from “baby blues” to postpartum depression, anxiety, OCD, and psychosis. The guests reflect on common challenges, barriers to support—including stigma and cultural factors—as well as emerging resources and community solutions.

Key Discussion Points & Insights

1. The Raw Reality of Motherhood (00:33–03:47)

• Jillian Amadeo’s Story: Jillian shares her struggle with intense postpartum anxiety and depression after the birth of her first child.
  • “The second my daughter was born, I had this wave of panic… something was not right with me.” (Jillian Amadeo, 00:54-01:24)
• Societal Myths vs. Reality: Media and commercials often romanticize newborn life, but “pregnancy is raw and real, and the infancy is raw and real.” Jillian emphasizes the lack of emotional support for mothers: “The baby is not the only life being born…the life of the mother is being born or reborn.” (Jillian Amadeo, 01:58-02:14)

2. Prevalence and Presentation of Maternal Mental Health Struggles (04:43–07:44)

• Postpartum Mood Disorders Are Common: 85% of people experience a mood disturbance after giving birth; 10–15% experience more intense symptoms.
  • “It’s not rare to feel moody during this time of life.” (Frances Leese, 04:43)
• Symptoms Can Be Misdiagnosed: Jillian describes being dismissed with "baby blues" despite persistent symptoms: “I remember calling my doctor...sobbing...and they said, well, it’s just the baby blues. You’ll get over it.” (Jillian Amadeo, 07:44)

3. Understanding the Spectrum: Baby Blues, Depression, Anxiety, OCD, Psychosis (07:44–11:26)

• Baby Blues: Temporary, mild mood changes in up to 80% of new mothers, resolving within 1–2 weeks.
  • “Every pregnancy, every child...is very different.” (Ebony Harvey, 08:22)
• Clinical Disorders:
  • Postpartum Depression: Lasts longer, can be severe, may include hopelessness and inability to care for self/child.
    • “10–15% of women have a clinically diagnosed postpartum depression.” (Dr. Luskin, 09:18)
  • Postpartum Psychosis: Rare but dangerous, involving psychotic symptoms and potential risk to self/child.
    • “That’s usually associated with the more severe…postpartum psychiatric illness.” (Dr. Luskin, 09:18)
  • Postpartum OCD: Intrusive, illogical thoughts about harm; often feared but different from psychosis.
    • “It may affect up to 40% of new parents…a classic one is they look at the microwave and say, oh my God, what if I put the baby in the microwave?...The patient knows something is wrong, but they're afraid if they tell you that, that you're going to call child protective services.” (Dr. Luskin, 10:00–11:26)

4. Getting Help: When, How, and What to Expect (11:26–15:05)

• Medication is Often Safe & Effective: Most psychiatric medications are safe during pregnancy—consult your providers.
  • “Don’t stop your medication. Have a consultation…make a decision together.” (Dr. Luskin, 11:31)
  • FDA has recently approved fast-acting medication for postpartum depression.
• Support Networks: OB-GYNs, midwives, therapists, doulas, and organizations like Postpartum Support International are crucial.
• Cultural Competency Matters: Resources must meet patients where they are, accounting for language, culture, and stigma.
  • “If the resource...can understand their cultural background...they would be more comfortable saying, hey, this is what I'm feeling.” (Ebony Harvey, 13:47)

5. Barriers in Seeking Support: Stigma, Fear, and Systemic Issues (15:05–18:42)

• Self-Censorship Due to Stigma and Fear: Many mothers hide symptoms out of shame or fear of losing custody.
  • “I was ashamed. What kind of mother feels that way?” (Jillian Amadeo, 15:58–16:01)
• Systemic Inequities: Black women and women of color face higher risks and additional hurdles in expressing concerns to providers.
  • “Most Black people…are afraid that someone would take their child away.” (Ebony Harvey, 16:39)
• Role of Doulas & Advocates: Doulas act as advocates, provide emotional support, and bridge communication between patients and providers.
  • “The skill that doulas bring…is the ability to listen, really listen, and facilitate communication…” (Dr. Luskin, 17:45)

6. Suicidal Ideation and the Power of Peer Support (19:24–22:22)

• Jillian’s Worsening Second Postpartum Experience: More severe depression, explicit suicidal ideation, and the critical role of family and friends in recognizing and responding to the crisis.
  • “I wrote a plan…to make sure my children were taken care of, my husband was taken care of…so that I could take my own life.” (Jillian Amadeo, 19:34)
• Validation and Compassion Helps: Friends and family offered no advice but “just offer[ed] validation and support…no judgment.”
  • “Saying these awful thoughts out loud and just being met with compassion was so healing.” (Jillian Amadeo, 21:08)
• Building Peer Communities: Jillian started a local coffee group that quickly grew into Moms for Mental Health, now with thousands of members.
  • “That grew to 600 people in a week, 1,000 people in a month, 3,000 in a year…and there is no judgment in that group.” (Jillian, 22:07)

7. The Value of Mutual Support & Advocacy (22:22–25:23)

• Moms Supporting Moms: Jillian emphasizes collective care: “What if together as a group of moms, we take care of each other?…Together, we’re a super mom. But it’s taking a big community to make that happen.” (Jillian, 23:00–23:55)
• Key Takeaway: Know the signs, build your support network, use your voice, and prepare for postpartum challenges—but with the knowledge that help and community exist.
  • “Just know who that support system is and just keep everyone in the loop.” (Jillian, 24:54)

8. Last Words of Advice (25:23–27:13)

• For Patients: "Your voice matters. This is your body and your baby. Please speak up." (Ebony Harvey, 25:27)
• For Providers: If unfamiliar with psychiatric meds in pregnancy, refer out. Always prioritize cultural competence and active listening.
  • “[Healthcare providers] bring their prejudices, their biases to the table. It’s okay to ask questions…your voice matters. Use it for the best outcome for you and your baby.” (Dr. Luskin, 26:30)

Notable Quotes & Memorable Moments

• “Childbirth is raw and real. Pregnancy is raw and real, and the infancy is raw and real…and there’s so much support that is offered to the baby. There’s not a lot of support that is offered to the mom.” – Jillian Amadeo (01:38–02:00)
• “What kind of mother feels like she shouldn’t be the mother of her child?...So I hid it for a really long time.” – Jillian Amadeo (16:01–16:18)
• “I just posted…‘I’m struggling with some mental health stuff…I just really could use some like-minded people’…the post got something like 60 comments in like an hour.” – Jillian Amadeo (21:41–21:53)
• “Together, we’re a super mom. But it’s taking a big community to make that happen.” – Jillian Amadeo (23:55)
• “Your voice matters. This is your body and this is your baby. So please speak up.” – Ebony Harvey (25:27)
• “If all else fails, examine the patient. If that doesn’t work, try talking to them. And if that doesn’t work, try listening to them.” – Dr. Shari Luskin (26:30)

Important Timestamps

| Segment | Timestamps (MM:SS) | |--------------------------------------------------|--------------------------------| | Trigger warning, introduction to Jillian | 00:00–01:24 | | Jillian’s raw postpartum experience | 01:38–04:43 | | Expert intros: Dr. Luskin & Ebony Harvey | 05:17–05:53 | | Symptoms: baby blues, depression, psychosis, OCD | 07:44–11:26 | | Treatment paths and the role of inclusion | 11:26–15:05 | | Barriers to honest discussion, stigma and race | 15:05–18:42 | | Jillian’s experience with suicidal ideation | 19:24–21:26 | | Peer support and group formation | 21:34–22:22 | | Advice for mothers and providers | 24:01–26:30 | | Final expert wrap-up | 26:30–27:13 |

Tone and Language

• Raw, honest, and emotionally resonant storytelling from Jillian
• Compassionate and practical guidance from clinicians and advocates
• Unfiltered discussion of vulnerability, fear, and the need for cultural competence in healthcare
• Empowering reminders that reaching out is a sign of strength, not weakness

Summary

This episode is an essential, compassionate resource for anyone navigating the complexities of maternal mental health. It counters stigma through storytelling, expert insight, and advocacy for community, urging mothers and providers alike to foster connection and speak openly. Above all, it highlights that no one is truly alone in these struggles—and that meaningful help is possible, accessible, and, most importantly, deserved.