Special Edition: Helping Moms Before Crisis

0:00Mental health conditions are the remaining cause of pregnancy-related deaths. Today is Saturday, September 5th. It's a statistic many people don't know, and here's another one. One in five women will experience a mental health condition during pregnancy or in the year after having birth. And now, the trial of Lindsay Clancy has put maternal mental health in the national spotlight. If you haven't heard of this case yet, Lindsay Clancy is a Massachusetts mother and former labor and delivery nurse who killed her three young children in 2023. She also jumped out of a window, leaving her paralyzed. Prosecutors say she knew what she was doing, but her defense argues she's not guilty due to insanity, specifically with host-partum psychosis. The jury had been deliberating this week, but on Friday, the judge declared a mistrial because the jury was not able to agree on a verdict. Now prosecutors will have to decide whether to take the case to trial again. Either way, it's of course a devastating case. So today, we're not here to relitigate it, but we are using this moment to better understand maternal mental health from postpartum depression and anxiety to the much rare but more serious

1:03condition of postpartum psychosis and what families should know before symptoms reach a crisis point. Today, we're joined by Adrian Griffin, a nationally recognized expert and advocate in maternal mental health and the executive director of the nonpartisan nonprofit, maternal mental health leadership alliance. She also describes her own lived experience with postpartum depression. How to tell the difference between the regular baby blues and what it's time to get help and what to do before the baby even arrives to try to prevent the most severe cases? Welcome to the Newsworthy Special Edition Saturday, when we sit down with a different expert or celebrity every Saturday to talk about something in the news. Don't forget to tune in every Monday through Friday for our regular episodes, where we provide all the day's news in less than 15 minutes. I'm Erica Mandy, it's now time for today's Special Edition Saturday. Adrian Griffin, thank you so much for joining us here on the Newsworthy. Oh, thank you so much, Erica, for having me on the show. So I first want to touch base about the Lindsey Clancy trial. It's put a spotlight on maternal mental health and specifically postpartum psychosis.

2:07So what has been going through your mind as you've seen this case unfold? Well, it is such such a horrible tragedy with us family is going through. When we talk about maternal mental health, but it's really a range of mental health conditions that can impact women either during pregnancy or the first year following pregnancy. And it really, it starts with something very basic called the baby blutes. This impacts almost 80% of women in the first couple of weeks after the baby is born. As your body recovers from the physical and emotional changes that occurred in pregnancy, labor and delivery, very, very common moms. Well, it could be up and down. She may be laughing women at cotton and next, but it doesn't really interfere with her ability to deal with life and with her daily tasks. The next more serious illnesses would be anxiety and depression. And he's actually often start during pregnancy and then get worse in a postpartum here.

3:10And then the very far extreme is postpartum psychosis. This is the most serious of the mental health conditions. It impacts about one to two women per 1,000 bur. And it increases the risk of both suicidality and infanticide. And it's a medical emergency. Women experiencing postpartum psychosis need, most often to be hospitalized, decalty need intensive psychiatric care to make sure that they don't hurt themselves or their children. And what's very interesting about postpartum psychosis is that the symptoms can wax and wait. It's not like somebody has a break and they are psychotic forever. They could be psychotic for a couple of minutes. They could be covering their symptoms. So it's sometimes very difficult actually assess if somebody is in a psychotic moment. If you have that and then it goes away, you might question, oh, I was just dreaming where people

4:11might not get the help they need. Absolutely very well said. And what happens when somebody is experiencing psychosis is that they're at increased rates of having delusions or hallucinations. That means they're hearing or seeing things that may or may not be there. Oftentimes, particularly women in the postpartum period, if they go for a prolonged period without sleep, it can bring on an experience of mania or psychosis. And as you said, you're trying to remember, did I bring that? Is this real? So even the woman may not know if she's experiencing psychosis. Going back to this devastating case, how do you feel like people can talk about it in a way that takes accountability and public safety seriously, but also helps people better understand severe postpartum mental illness like psychosis? Excellent question. What we know is that women who are experiencing these conditions are at risk of putting themselves at their children. Nobody else. They are not a public health danger. They are not going to

5:17do anything. Besides, perhaps hurt themselves or their child. That is the focus. You can't the mom is so exhausted and overwhelmed and it's directly being related to pregnancy and childbirth and being a new parent. So what I want to emphasize here is that mental conditions during pregnancy and postpartum are real. We also know that mental health conditions are the leading cause of pregnancy-related deaths. So what does that mean? That means in the year postpartum after the year after the baby is born, mental conditions leading to suicide and overdose account for almost 30% of those deaths to women in that first year postpartum, which is just horrific to think about. It pains me every time I say that. While the leading cause, how widespread is any sort of postpartum mental health issue in America? These are the most common complication of pregnancy and childbirth. They impact at least one in five women, either during pregnancy or the first year filing pregnancy. So we know about a third

6:21of people who experience mental health conditions during this time frame will actually come into pregnancy with an underlying mental health condition. Things that indicate depression, they may not even be aware of it. About another third develop these symptoms during pregnancy and then that slinal third in the postpartum period. We also know if women don't get the care that they need, these conditions can continue for up to three years. And so those women then are coming back into pregnancy. They're the ones coming in with those underlying conditions. So we want to intervene and get one of the help that they need because we know untreated mental health conditions during pregnancy can have long term negative impact not just on the mom, the baby, but the entire family. And we also know I want to attend dads will experience postpartum depression as well. If you're willing, I'd love to hear a little bit more about your own experience with postpartum depression in 2001. What was that like? So I had never had a mental health condition before. This was my second baby. And with my first child, it was really very, very everything was easy. She

7:24was an easy pregnancy, easy labor, easy baby. I was getting enough sleep like up. We thought we were just the best parents are like, well, let's just have another baby, right? And it was a very, very different experience. I had a traumatic birth and my son was, you know, more typical baby, but he wouldn't take a bottle. And so I was up for every two or three hours feeding him for what seemed like months on and and I was just exhausted and overwhelmed. And I kept, I felt like I was drowning like I could forget my head above water. And I was fairly confident person, you know, I was I'm so tired. I remember talking to my sister at the time she had just had her fourth baby. And she's like, no, I'm gonna let them more time. I'm a little bit busier, but I'm doing okay. And I'm like, oh my gosh, I am, I cannot get it together. So I really knew that something was wrong. But it took a long time to get help. I remember I had a toddler and a newborn and I tried to get them to sleep for 15 minutes at the same time and then run down to the computer and get online and

8:24look at a look up for health care providers, mental health providers who might take my insurance and then make a phone call and well, we're not accepting new patients. And then that was like my one attempt that day to get help. And this went on for weeks, you know, for one. And it was really incredibly frustrating and very difficult. And I just remember in that dark time I was thinking, how can this be so hard? I knew nothing about the mental health system, behavioral health system. I didn't know the difference between a social worker and a psychiatrist. I had no idea. And I was trying to navigate this while I was already in the pit of depression and trying to care for a newborn on a toddler. And so it took me almost six months to get the help that I needed. And finally, I husband found a psychiatrist who specializes in this field and got me the help that I needed my education therapy and recovered. But I did decide during that dark time in life, I'm like, I have got to do something about this. I'm well-resourced. I had a husband. I had insurance.

9:25I internet. I speak English, all of those things. And I kept thinking that that's hard for me to navigate this complex system. What about somebody who doesn't know that something's wrong? Doesn't have the insurance. Like what happens to these women? And so I just decided during that time that I was going to do something about this. So here I am 25 years later. Yeah, still talking about it. Yes. And you're clearly making an impact. How much is it the external world? I'm not getting sleep. I'm not getting support. And how much is it potentially hormones and some of the more internal systems going on? Trade questions. So we've really think about these issues as bio-psychosocial issues. So there's certainly some underlying biological changes. Like you said, there's significant hormonal changes during pregnancy and in that immediate postpartum period, women's autoimmune systems change while they're pregnant. There's rewiring in her brain. There's changes in her, the gray matter in her brain. So there's a lot of biological things that are going on.

10:26So that's number one. The psycho is sort of like the inherent person. For example, people who may have times with transition. People who may have be having conflict with their partner. So there's sort of those psychological things that are going on. And then there's the social factors. Do I have support from work? Do are there people in my neighborhood I can spend time with? What other factors are impacting? Financial stress, family stress. I got to remember this one time a woman came into a support group and she had these twin and she's like, I used to be able to do anything. Now I can't even take care of these babies. I'm like, well, what's going on in your life? And it turned out like in the last six months, her partner lost his job. So they moved to pro-country to be their family. They bought a new house like Chouise before the baby for born and moved in. They had all of these external pressures. And so it's always a combination of these three things. Bio, psycho and social that becomes the tipping point. And let's go back to talking about

11:27what the top warning signs are that because most new parents are going to feel some exhaustion, some emotional ups and downs. And so how do you tell the difference between that and when it's time to get help? Most new parents feel tired, feel overwhelmed, but they know they can get through the day. Right. They can keep their wits about them and be like, yep, I'm tired, but I'm just going to slog through. Women who are experiencing more severe forms of anxiety and depression, I'm never thinking I cannot do this one minute more. And calling my husband at work, I'm like, you have got to come home. I cannot do this. I, you got home and I ran away from home. I'm like, I am out of here. I need to go somewhere where I can sleep for like three years. I'll be back when the like, do you remember saying, what are you going to hotel for the weekend? I'm like, you have no idea. Like the weekend is not nearly enough. And even like a mob of unlimited sleep. And so it's just this feeling like you are at least my extent was like, oh, yeah, I was thinking, how am I going to get through the next 18 years until my son sleeps through the night

12:30and then goes off to college? Like you can't see that this is temporary. You can't see that there's a way out. That's when we get really concerned. In particular, a woman says, a family would be get a rough out of the out me. My baby would be get better off without me. That's when we really get concerned. How does anxiety look different from depression? I mean, I remember feeling like, well, I don't, I have to make sure that he's in his crib for the nap. I can't do the nap on the go, looking back at that. I'm like, why was I so worried about that? But is that a normal new parenthood or is that a sign of anxiety? Yeah. So that's probably normal new parenthood. I was the same. I wasn't my baby's to sleep in their crib in part. So I could take a nap. Right? Right. But the anxiety when it becomes excessive, right? If you're checking your baby's monitor all the time, if you can't sleep when you're baby sleeping, like if everything else is taken care of, you got all that. If you, I remember lying there, my thoughts were racing. Oh my gosh, it's only two hours

13:30to use up again. Oh my gosh, it's now an hour and past. Right? If you can't relax and sleep when your baby's sleeping, that's a real high sign of anxiety. One way that mental health challenges manifest themselves, particularly in the postpartum period, but often during pregnancy as well is OCD obsessive compulsive disorder. But during this time frame, the full-oncy obsessions are around perhaps harm coming to the mother or to the baby often at the mother's hand. And women who are experiencing this often feel just horrified by their thoughts. Like so, for example, I remember stepping at the top of the stairs folding my son and I thought, what if I threw myself down the stairs? What if I dropped him down the stairs? What would happen? Who would find us? And I was like, holy cow, I would never do that. So I remember, I used to sit down as I was holding him and go down the stairs, sitting down so that I wouldn't fall down the stairs. So when women, when he starts disturbing, that's actually good. It means they recognize, well, that's like, no, I wouldn't do that. When we get more concerned as when women

14:33are saying, oh, I want to do those things. Those things are making sense to me, right? I want to let the baby stroller go into traffic. Right? So there is this differentiation between what is scary to the mother in terms of her thoughts and what she starts to align with and connect with. What role do you think fear or shame still play in today's world, even though we are talking about it more? Absolutely fear and shame and stigma still play a huge role. Women, new moms in particular are really concerned about being perceived as a bad mom. They are worried about the children being removed from their care if they acknowledge that they need help. They're worried about CPS coming to their home. One of my staff members talks about how, how when she acknowledged that she needed help that they said, we're going to close well, protective services. And she's like, I'm trying to get the hope that I need so I don't need CPS. So there are some real valid concerns. And I'll say particularly for women of color, women of color are more apt to have these

15:39things happen, have to help protective services called or have their their competence as mothers be questioned. So there is a real concern. And that doesn't make me think about while this Lindsey Clancy devastating case is bringing some awareness, it also could cause that fear of people who are responding of, well, I don't want that to happen. And so what's your advice to somebody who wants to get help, but maybe does have that fear of CPS being called on them? I think it's really important for women to acknowledge early that they need help before it gets to a crisis case. They need to say very clearly whether they're having thoughts of putting themselves or their child and find somebody who they trust who can help them, whether it's the nurse or the lactation consultant or a doula or a friend, but be honest about it so that women can get the care that they need before these crises occur. Still ahead, what our guest says still needs to change in the medical system so new moms can get help before they're in crisis. And it's a process that's

16:39already in place for other situations. Also how friends and family can check in in a way that actually helps and what families can do even before the baby arrives that can make a world of difference. But first, a break for our sponsors. Imagine buying your kid a toy only to find the batteries aren't included or buying furniture, but it's missing the tools to build it. Frustrating, right? Now imagine that exact same feeling, but you're paying way more. That is what buying business software usually feels like. Fragmented, disconnected, and incredibly expensive. Odo completely changes that. Odo is a complete, fully integrated business suite where all your apps actually talk to each other. We're talking automated lead routing for your sales teams, seamless AI integration, and an intuitive point and click website builder. It's everything your business needs to scale, saving you time, headaches, and money. Stop piecing your software together. Go to odu.com slash newsworthy. That's odo.com slash newsworthy to learn more. The newsworthy is also brought to you by 11 Labs. One of the most frustrating things is when you

17:41call a company with a simple question and the system makes it feel complicated before you ever reach a person. You press through the phone tree, wait on hold, repeat the same information, and then sometimes get sent right back to the beginning. And I always think the business wants customers to have a good experience, but the technology is getting in the way. That is the system 11 agents by 11 Labs is rethinking. 11 agents can listen, respond, carry on conversations, and of course hand off to a person when needed. That's the key to me. Better technology for routine issues to make that an enjoyable experience, while human teams can then focus on the situations that really need them. Already 11 agents handles more than 10 million conversations per week. I've used 11 Labs AI technology for things like removing background noise from a guest interview when needed, and they continue to be known for high quality AI tech. If you run a business or handle customer operations across support, sales, or marketing, you can start with a demo at 11labs.io slash newsworthy. See how 11 agents can fit into your workflows and help build experiences that your customers will actually love 11 labs dot IO slash newsworthy ELEVN LABS.io

18:48slash newsworthy. Now back to my conversation with Adrian Griffin. So I'm curious what have you seen improve and what still needs to get better? So we'd see a lot improve over the last 25 years. I mean, for example, the fact that we're talking about is as a vast improvement. We have medical organizations putting forth guidance to their members that they need to screen and treat new mothers for these conditions. We had many, many, many resources, many more available than there were 25 years ago. But obviously this is still not enough because we see the case like when the client, they somebody who was actively seeking mental health care, who was engaged in the system, who was seeing experts who knew where to go for help. We still see somebody falling through the cracks. We're obviously not doing enough. One thing that I'd really like to see is that, you know, we expect new loans to figure all of

19:50this out for themselves. Maybe make it back to their obstetrician for six weeks, then, or new guidance says that visits should start at like two weeks and ongoing care until 12 weeks. But don't really see that happening. But I think would be more helpful is if there were a care to their somebody who could adapt that new mom and see how she's doing. And perhaps get a mom connected with care before she needs it, before she falls into the pit of anxiety or depression, before she's drowning. Yeah, I think you've said that often does happen with some conditions, like if somebody's diagnosed with a serious cancer, there assigned someone to help them navigate the medical system and that you'd like to see that with new moms and new parents is that exactly. So I actually was diagnosed with cancer about 13 years ago and was given a care coordinator to help me set up reinitial appointments. Make sure I could all my testing done and really kind of holding my hand. We had the type of coordinators already in the obstetric setting. We know that all women are tested for gestational diabetes during pregnancy. And though only 10% of people are

20:55implanted, it's almost universal screening and women who go screen at risk or identified as heavy gestational diabetes. Up in times they're connected with a care coordinator who can help them navigate that full system. And so we had this proven care model and I think it just makes sense to expand that to include checking in on a mom's mental health. What about a friend or family member who's listening to this going, hmm, I think my friend or family member might have depression or anxiety or something more severe. How do they go about approaching it if that person has not approached them? Yeah, or should they? So absolutely. You know, in there's so many ways you can do it. Like, for example, if somebody's just listened to this podcast, they can say to that friend or loved one, hey, I just listened to this podcast and they were talking about post-podding depression. And some of the things they were talking out, I'm kind of seeing in you and so I wanted to check in and see how you're doing. It often is really helpful if the person checking and said, I went through this too. But you see if I can get you some help because that normalizes it, it makes

22:00that new mother feel like she's not the only one because I guarantee you every mother and for many, many years, I ran support groups. I talked to moms on the phone, the email, every single woman who grows through this feels like they are the only one who has ever felt this bad and that they are a horrible mother. And so to have somebody else say, hey, I went through this and I got help, let me get you some help too. Just let's the helium out of that balloon and it's like, oh, okay, thank you. So that's that's one way to do it. And just there's so much about you. I want to make sure that you are taking care of yourself so that you can be the best mother you can be for your baby. That's also a line that often really throws mothers to get the help that they need. Yeah, if we're not going to do it for ourselves, we'll do it for ourselves. 100%. What other resources of any should people know about to get help, especially if they need help quickly or it feels more urgent? We have some great resources. There is a national maternal mental health hotline. The number is 1833 TLC. Mama, this provides free confidential support 24 7 and English and

23:03Spanish. There's voice, text, chat option. And the second is an organization called post-cardom support international. And their website is postpartum.net. And what's your advice for somebody who maybe doesn't have an issue at this point, but they're pregnant. And what can they do to do their best to prevent issues? What kinds of systems can they put into place? Right. So, you know, we hear a lot about people having a birth plan, where they're really focused on what they want the birth to look like, whether they want it to be home or it has to work. Soft music or no medical intervention, whatever. People spend a lot of time focused on the birth. What we encourage people is to have a postpartum plan. What's going to be like when you come home with this baby? Think through things particularly if older children, like who's going to provide care for the children, who's going to bring us food. So to really think through some of these sort of practical things. So I'll tell you, like, for example, we had a third baby after I had postpartum depression with my second baby. And we

24:06put a lot of these things into place. So, for example, my mother came and stayed for two weeks and my mother-law came. And so they were able to help out with the other children. But the biggest thing on very, very sleep sensitive. And so we split the night shift. So we had a four-year-old, a two-year-old, and a newborn. And the four-year-old and two-year-old would go to bed at 8 o'clock. And literally, 8 o' 5, I'd be down in the basement with ear plugs in and you don't ask across my base. And going to sleep as soon as I had my husband would stay up with the baby for four or five hours. And then I was primarily breastfeeding. So I would wake up and then I would take over. And my husband would get hit four to five hours of uninterrupted sleep. And that's a key. You need four to five hours of uninterrupted sleep to function like a normal human being. And so if your baby is waking up every two hours to feed, trying to like at least give one of those feedings to somebody else is super, super helpful for a month's mental health. And you know, a lot of time people will ask me, well, I'm a thing of a parent or my partner's not available or whenever I said, okay, do you have a mother, sister, and aunt, a pebb and somebody who can come in and maybe just take that one night

25:10time feeding so you can get them sleep? Do you have a friend who's also a single parent? Maybe you was sleep over the weekend and in advance take turns, it doesn't have to be every night. But if you can get two or three nights of that uninterrupted sleep, it makes a huge, huge difference. So I talk a lot about the postpartum plan and I talk a lot about protected sleep. What's your final takeaway? If there's one thing you want people to remember about maternal mental health, what is it? Please remember that mental conditions are the most common complication of pregnancy and childbirth, affecting one in five new moms, one in 10 dads, and that we really all ought to be checking in on new families. How are you doing? But there's a family down the street that just had their third baby. And so I'm going to go down and say, hey, just checking in. How's it going? Not just first time parents either. Oh, correct. In fact, when I used to do this direct support to new moms in families, I remember very clearly my time. I got a call from a woman and this was her ninth baby. And she's like, I've never felt like this before. I don't know what's from a kind of talk to her about going on. It was a difficult baby. She wasn't getting enough sleep. Her husband was in the

26:11military, she was deployed. She had a lot of other factors going on. And so it can happen. First baby, third baby, ninth baby, every pregnancy, every labor delivery, every baby is different. Well, thank you so much to our guest, Adrian Griffin, as well as the maternal mental health leadership alliance. And again, whether it's you or someone you know who needs help, you can call our text the National Maternal Mental Health Hotline at 1-833-TLC-MAMA. That's 1-833-TLC-M-A-M-A. It's a 24-7 hotline or contact postpartum support international at postpartum.net. And we'll be sure to include these resources in today's episode notes over on our website, thatnewsworthy.com. Thank you so much for listening and for sharing this episode. If you think someone else might find it helpful. As always, we would love for you to join us during the week to stay updated on the day's news in less than 15 minutes a day. We will be off for the Labor Day holiday on Monday, but we're back on Tuesday with the latest news you need to know. Until then, have a great rest of your

27:14weekend.