Perinatal health encompasses several women's mental health problems related to pregnancy and the postnatal period. During this time, clients may be at increased risk for depression, anxiety, and related mental health needs. Perinatal care providers often see clients for other needs such as infertility, miscarriages, and the loss and grief of infants and children.
Why is it important for clinicians to know?
Clinicians can conduct preventive and screen-based health exams to access specific service needs. Early intervention can help minimize the impact of these problems on both mother and child. Maternal health services can also support life changes as part of routine perinatal progression.
Many women receive benefits such as education and planning in connection with finding a trauma-informed provider, developing a birth plan that strengthens and fits their lifestyle, and planning support needs during and after pregnancy. Providers can also assist in finding and advocating appropriate support services (e.g., physical therapy for pelvic floor well-being) during and after pregnancy.
Early intervention and precautionary measures also have an impact on the development of the child and can serve as a protective factor. The studies of adverse childhood experiences and related studies provide the basis for providing healthy, safe and caring environments for children. This includes the time in the womb, as epigenetics and maternal health affect a developing child in many ways. In this regard, maternal preventive care acts as a protective factor for children.
How can I determine if my customer needs special services?
Proactive and ongoing mental health services offer a number of benefits to customers. As part of their services, providers can monitor and assess the need for specialized perinatal care.
The first step is to find out about the risk factors and the aspects of working with this population. Risk factors for perinatal problems include a history of mood disorders or related mental illnesses such as depression, anxiety, post-traumatic stress disorder, or obsessive-compulsive disorder. Physical symptoms, such as hormonal imbalances or previous complications from a previous pregnancy, labor, delivery, or loss of pregnancy can also increase these risks. Social factors such as lack of support from family or friends or stress factors such as poverty can also increase the risk of needing perinatal support.
Warning signs can be mothers who suffer from feelings of guilt, hopelessness or anger, insomnia and related physical symptoms. It can also manifest itself in mothers thinking about harming themselves or the baby and losing interest in activities that they used to enjoy.
For more information on what to look for in perinatal clients, see the screener at the end of this article. This screener can be used to assess the need for specific referral services and can also help you, the provider, gather information and monitor ongoing changes during the client's perinatal period. This will help you effectively plan treatment and associated support services if necessary.
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How do I know if a perinatal counselor is trained?
PMHC is the official certificate for perinatal psychological counseling. If you have access to a certified professional in your area, you can recommend them for perinatal services as part of individual or support services that can be used in conjunction with the current therapy the client is receiving.
Some locations only have limited certified specialists in their area. Other geographic areas do not have certified professionals for this population. Doctors can recommend competent service providers after consulting providers about their training, experience, and qualifications related to providing these services. Some providers are not certified but still have training in this area or are supervised / advised in order to be certified for this specialty.
How can clinicians be trained and supported in order to provide perinatal services?
Clinicians can take part in special training courses and also receive advice and supervision in order to develop skills in this area. Many training providers now offer training on women's issues and offer sessions on postpartum depression or anxiety. These can help raise your awareness of women's problems.
For clinicians who want to provide services only to this population, certification is another great way to develop your skills in this focus of counseling. For perinatal mental health certification, visit https://www.postpartum.net/professionals/certification/.
Integrative screener for perinatal health and well-being
The purpose of this screener is to provide a brief reference guide to help identify specific service needs. Adjustments and changes in typical routines and daily life are part of pregnancy and postnatal periods. To best meet your needs during this time, a certified perinatal mental health provider can assess and evaluate your specific mental health needs and goals.
This screener can be used in conjunction with PHQ-9 and Edinburgh Postnatal Depression Scale. This questionnaire includes more general baseline indicators of postnatal depression, postnatal anxiety, and symptoms of traumatic childbirth syndrome. This screener can be self-administered or managed by a provider, spouse, or friend. Please remember that regardless of your screener results, proactive and maintenance advice can be part of an inclusive health plan to help you meet your wellness goals.
Please rate the following statements on the basis of a scale from 1 to 4: 1 totally disagree, 2 disagree with something, 3 agree somewhat and 4 strongly agree.
A) Symptoms of postnatal depression
__ I regularly do activities that I enjoy.
__ My relationships are as strong as they were before the pregnancy / birth.
__ I feel just as happy as before the pregnancy / birth.
__ I can recognize my strengths and appreciate myself just as much as before the pregnancy / birth.
__ Total number of points
B) Postnatal anxiety symptoms
__ I can accept my mistakes and not go into them.
__ I let go of things and don't spend time worrying about things that I can't control.
__ I feel just as calm and centered as before the pregnancy / birth.
__ I have the skills to deal with concerns when they arise.
__ Total number of points
C) Traumatic birth symptoms
__ I had a positive birth experience.
__ I felt listened to and heard during my birth experience.
__ My wishes were respected during work and delivery.
__ My providers and supporters met my needs during work and delivery.
__ Total number of points
D) Symptoms of a recovery complication
__ I have recovered physically from work and childbirth.
__ I have recovered mentally and emotionally from work and childbirth.
__ I have the support I need to fully recover.
__ I have the resources to fully recover.
__ Total number of points
E) Only for pregnant women
__ I value my body as much as I did before my pregnancy.
__ I have a healthy perspective.
__ I have the emotional support I need to be healthy during pregnancy.
__ I have the resources I need to be healthy during pregnancy.
__ Total number of points
Evaluation criteria for all specified areas:
Score 3 and 4: Continue your current wellness plan. Continue to monitor symptoms with the screener as needed. Remember to see a specialist if you think it is necessary, regardless of your score.
Any score of 1 or 2: Find a perinatal specialist.
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Rebekah Lemmons strives to improve outcomes for children, emerging adults, and families. For the past decade, her practice and research has been primarily in the non-profit sector, with an emphasis on conducting program evaluations, teaching, running services, counseling and monitoring clinicians. Contact them at [email protected].
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