Mental Health During Pregnancy and Postpartum: 5 Ways Pelvic Rehab Therapists Can Help

Katie McGee, PT, DPT, (they/them) is a pelvic health physical therapist based in Seattle. Katie received their Doctor of Physical Therapy from the University of Washington in 2014 and their board certification as a Women’s Health Clinic Specialist (WCS) in 2018. Their practice, B3 Physical Therapy, centers on transgender care and perinatal rehabilitation. Join H&W and Katie to learn about perinatal mental health in Perinatal Mental Health: The Role of Pelvic Rehab Therapist - Remote Course scheduled for February 5, 2022. 

Due to the COVID-19 pandemic, rates of perinatal mental health conditions—such as anxiety and posttraumatic stress disorder—have risen sharply1. Around 70% of pregnant people are now reporting psychological distress1. With many families under increased stress and financial worry, the odds of developing postpartum depression have jumped from one in seven to one in five(1)!

Fortunately, pelvic rehabilitation therapists can make a difference in the mental health of their perinatal clients. In fact, many pelvic rehab therapists are reducing the risk of perinatal mental health issues without even knowing it! Simply supporting clients in keeping up with physical activity and reducing bodily pain are proven strategies for lowering the risk of perinatal mental health issues (2,3). Pelvic rehab providers can go even further in supporting their perinatal clients’ mental health with some simple actions:

1. Ask – Many birthing people feel shame around negative feelings and thoughts related to pregnancy and postpartum. Asking perinatal clients about their emotional challenges can help break through that shame. A good ice breaker for talking about perinatal mental health is letting your clients know that a mood disorder is the number one complication of pregnancy. Be sure to listen attentively and avoid interruption whenever someone discloses their mental health challenges.

2.Screen – Screening for mental health conditions can guide pelvic rehab therapists to know when it’s time to refer clients to specialized care, such as medication and/or therapy. Pelvic rehab therapists are qualified to use several screening tools in the perinatal period, including the Edinburgh Postnatal Depression Scale, the Patient Health Questionnaire-9, and the Generalized Anxiety Disorder-7. Best of all, these tests are free to use and easy to administer.

3. Gather resources – When a client discloses that they have thoughts of self-harm or are experiencing violence in their home, you want to be prepared with the next steps to help. Collecting resources ahead of time can go a long way in turning what would have been a fumbling offer to help into a confident action plan. Looking to grow your resource list? Check out these three links:

• Perinatal Mental Health Resources: https://www.postpartum.net/
• Intimate Partner Violence Resources: https://www.rainn.org/
• Substance Use Resources: https://www.samhsa.gov/

4. Connect – Racism leads to People of the Global Majority birthing in the United States to experience increased rates of preterm birth and low infant birth weights (4). Both these outcomes have been tied to worse postpartum mental health (5). Research shows that when People of the Global Majority are connected to culturally congruent birth doulas, rates of preterm birth and low infant birth weights fall (6). Other research similarly supports the concept that when people are paired with culturally congruent providers, health outcomes improve (7). Whenever possible, think about how you can offer your clients resources/referrals that match their identity and background to support their mental wellbeing.

5. Learn – Join Katie McGee, PT, DPT (they/them) for the Herman & Wallace course, Perinatal Mental Health: The Role of Pelvic Rehab Therapist - Remote Course scheduled for February 5, 2022. By participating in this remote learning class, you will:

• Develop a basic understanding of perinatal mood and anxiety disorders
• Bolster your listening skills for working with perinatal clients
• Gain additional tips for screening for perinatal mental health issues
• Learn how to help clients create perinatal wellness plans
• Expand your toolbox of coping skills to teach clients

Don’t miss this opportunity to truly change the lives of your perinatal clients!

References

1. Yan H, Ding Y, Guo W. Mental Health of Pregnant and Postpartum Women During the Coronavirus Disease 2019 Pandemic: A Systematic Review and Meta-Analysis. Front Psychol. 2020;11:617001.
2. Mathur VA, Nyman T, Nanavaty N, George N, Brooker RJ. Trajectories of pain during pregnancy predict symptoms of postpartum depression. Pain Rep. 2021;6(2):e933.
3. Marconcin P, Peralta M, Gouveia ÉR, et al. Effects of Exercise during Pregnancy on Postpartum Depression: A Systematic Review of Meta-Analyses. Biology (Basel). 2021;10(12):1331.
4. Andrasfay T, Goldman N. Intergenerational Change in Birthweight: Effects of Foreign-born Status and Race/Ethnicity. Epidemiology. 2020;31(5):649-58.
5. Anderson C, Cacola P. Implications of Preterm Birth for Maternal Mental Health and Infant Development. MCN Am J Matern Child Nurs. 2017;42(2):108-14.
6. Thomas MP, Ammann G, Brazier E, Noyes P, Maybank A. Doula Services Within a Healthy Start Program: Increasing Access for an Underserved Population. Matern Child Health J. 2017;21(Suppl 1):59-64.
7. Towning EJ, Purohit A. Black babies cared for by black doctors less likely to die in the US: revolutionize medical education to tackle the problem in the UK. BMJ. 2020;370:m3783.