A Journey Back From Postpartum Depression
In a small, tidy office on Chapala Street, a young Latina mother
still recovering from postpartum depression (PPD) recalled the
voices that once told her to walk into the ocean with her children
and never come back. “Just go, go … at the beach,” said Danielle
Vasquez. “Just go in with the kids.” Like most mothers with PPD,
Vasquez (not her real name) didn’t realize she had a common and
treatable disorder. She thought she was either on her way to being
crazy or already fully there. She slept a lot and stayed in her
room, too afraid to leave the house or to drive. Even the sound of
her two school-aged children playing was difficult to tolerate. “I
was feeling like I was worth this much,” said Vasquez, holding her
thumb and forefinger a half inch apart.
Vasquez and her children could have been the subjects of a
tragic news story. Instead, intervention from a child abuse
prevention program operated by CALM (Child Abuse Listening and
Mediation) helped this pretty, dark-eyed woman pull her life and
her family’s life back from the precipice. CALM is the acclaimed
Santa Barbara nonprofit devoted to preventing, assessing, and
treating child abuse here since 1970. It began when a resident
named Claire Miles became so troubled by a fatal case of child
abuse that she installed a dedicated phone line in her home for
stressed-out parents to call for support.
The program that helped Vasquez is called Great Beginnings and
its best feature is its efficacy. It actually works. Studying their
records, the Santa Barbara County Department of Child Welfare
Services (CWS) found that despite the additional risk factors for
abuse and neglect in Great Beginnings’ clients, the department
hasn’t opened a single case involving one of these families since
2001. Also noteworthy is the fact that there is a lower incidence
of reports to CWS from this group of families than from the regular
population. At its core, Great Beginnings is a home visitation
program, augmented throughout the years by other services, like
access to therapists, an in-house psychiatrist, a nurse
practitioner, a child development specialist, and the only known
PPD support group for monolingual Spanish-speaking moms in
California.
As CALM discovered, the PPD support group in particular is
meeting an urgent need; between 10 and 13 percent of new
mothers — irrespective of economic strata or race — experience
postpartum depression. Only a fraction of them discuss their
symptoms with a health professional. In Santa Barbara, there is the
popular Postpartum Education for Parents (PEP), which includes
mother-to-mother support groups and 24-hour counseling via its PEP
Warmline. But it caters mainly to middle-class, English-speaking,
Caucasian moms.
Vasquez was fortunate in that when her son was born, a Cottage
Hospital social worker picked up on her depression and referred her
name to Great Beginnings. There, her name was passed along to
social worker/home-visitor Genevieve Soto-Berry. Soto-Berry oozes
love and support as naturally as she takes in breath. After being
assigned to Vasquez’s case, Soto-Berry immediately began calling
her on the phone. The new mother was screening her calls and
deleting 99 percent of her messages. Still, something about
Soto-Berry’s messages — perhaps the sincerity in her voice — made
Vasquez want to leave them on the tape. Then one night, feeling
particularly bad, Vasquez decided to call Soto-Berry on her
cell.
“Poor thing — she just talked about everything, her fears. I
mean, she thought she was going crazy and didn’t know why,”
Soto-Berry said. “I said, ‘Let me come over. I need to meet you.’”
Over the phone, Soto-Berry made a verbal contract with Vasquez that
she wouldn’t harm herself or her kids until they met the following
morning. Once together, Soto-Berry explained that Vasquez was not,
in fact, going crazy, but she did have severe PPD and needed
treatment before it got worse. At that first meeting, Vasquez
agreed to sign a written contract that she wouldn’t hurt herself as
long as she and Soto-Berry were working together. During the next
18 months, they remained in close contact, speaking at least
everyday and seeing each other at weekly visits. Soto-Berry’s
priority was getting Vasquez help for the voices. She brought her
to see CALM’s resident psychiatrist and then connected her with a
therapist.
It was four months before Vasquez began to feel better and a
year before the PPD support group for monolingual Spanish speaking
moms began meeting. Vasquez joined this first group and loved it so
much that her life began to revolve around the weekly meetings. “It
was like, you put everything in a bottle and then once you get
there, you get better. You feel better because you talk,” she said.
Great Beginnings originated from a collaborative study between
UCSB, the Santa Barbara County Department of Public Health, and
CALM. Building on the successful Hawaii-based “Healthy Families”
home visitation program, the three parties chose 17 families with
risk factors for child abuse and neglect and randomly assigned them
to two separate groups. One group received home-visits, while the
other received just what was available to every other family in the
county. After a year, the group receiving home visits had
significantly fewer problems: Moms were less likely to have shaken
their babies, were less stressed, less depressed, and had better
support networks than moms who weren’t visited.
With those results in hand, CALM won a grant from the State
Office of Child Abuse and Prevention for a pilot study. Of the 17
other counties awarded the same grant, Great Beginnings
outperformed them all, said CALM Associate Director Deborah Holmes,
LCSW.
Researchers are learning more and more about the effects of
maternal depression on babies and children, said Holmes. Not only
are depressed moms more likely to abuse and neglect their children,
according to the National Institute of Child Health and Human
Development, their infants are often less securely attached than
those of non-depressed moms. Depressed moms miss their babies’
cues, for example. If enough cues are missed during the course of
some months, the baby will shut down out of hopelessness. Untreated
maternal depression is now recognized as a massive public health
issue.
Great Beginnings’ three full-time home visitors make about 150
visits per month to clients countywide. They become their clients’
advocate, mentor, and parenting coach; working to promote
attachment, they sometimes act as the baby’s interpreter — pointing
out cues the mom may be missing.
Vasquez knows she’s not 100 percent well, but she is grateful
for all that she’s overcome so far. Soto-Berry said Vasquez now
reaches out to the newer moms in the PPD support group, saying,
“Have you tried this?”
And it’s easier for her to be with her kids now, too. “Before,
when my kids were laughing or playing, it was pain for me, ’cause I
couldn’t stand the noise,” she said. “Now it’s like they’re
laughing and I’m laughing with them.”
