Keeping Moms and Babies Together
The Day Hospital is the nation’s first perinatal partial hospital program treating pregnant women and new mothers with depression, anxiety or other emotional distress, with their babies in a warm, nurturing setting. The concept of keeping mothers and babies together during treatment was unique when the Day Hospital opened in 2000.
Mood and anxiety disorders are the most common complication of childbearing. These experiences can leave many expecting and new mothers feeling alone and desperate.
Psychiatric services can help, but these patients need treatment from health care providers with experience caring for pregnant women and in an environment that keeps mothers and babies together.
Facts about postpartum depression (PPD)
- Major depression is the most common postpartum complication women experience, affecting approximately 15 percent of women having a baby.
- The days and weeks after a baby is born is the most common time for a woman to be admitted to a psychiatric facility.
- Untreated PPD can negatively impact a baby's emotional and cognitive functioning, interferes with mother and baby bonding, and predicts future emotional and behavioral problems when the baby starts school.
- Poor nutrition.
- Use of nicotine, alcohol and drugs.
- Premature delivery.
- Low birth weight.
- Negative health behaviors which impact the health of mother and baby.
In the Day Hospital, every woman's program is tailored specifically to her unique needs and can include:
- Group, individual and family therapy to encourage the development of positive coping skills.
- Assessment of the mother-baby unit and the family.
- Medication assessment.
- Infant massage.
- Educational support.
- Nutrition consultation.
- Lactation consultation.
- Support for bonding and connecting with their babies.
- Health education on such topics as transition to motherhood, caring for a baby, and relaxation techniques.
- Personalized outpatient care plan to follow after discharge.
The average length of stay for a patient at the Day Hospital is approximately 10 days.
A typical treatment day at the Day Hospital is separated into structured time blocks such as:
- Patients arrive, check in with the staff, settle infants in the nursery with the nursery program assistant.
- Patients meet for a morning psychotherapy group that includes of a review of each patient's progress on the previous day's goals and an in-depth discussion of role transitions and interpersonal issues.
- Patients separate for individual psychotherapy and medication management appointments.
- Patients gather again for group relaxation training and/or infant massage.
- Patients meet for an afternoon psychotherapy group.
- In 2003, Dr. Margaret Howard, director of the Day Hospital, was recognized as one of five national recipients of the annual Eli Lilly Welcome Back Award, which recognizes innovation in the recognition and treatment of depression.
- In 2004, the Day Hospital program was featured at the 2nd Congress for the International Association for Women’s Mental Health.
- In 2005, the Joint Commission recommended that the Day Hospital apply for its nationally competitive Codman Award because of the program’s attention to patient care and seamlessness of care.
- Clinicians have had research and articles published in the following professional publications: American Journal of Obstetrics & Gynecology, American Journal of Psychiatry, Archives of Women’s Mental Health, Journal of Clinical Psychiatry, Journal of Nervous and Mental Disease, Medical Care of the Pregnant Patient, New England Psychologist, and Psychiatric Services.
- Local, regional, national and international consumer media outlets have sought out the Day Hospital staff for their expertise on postpartum depression and other perinatal mood disorder issues.
In addition, the Day Hospital is a site for several past and ongoing National Institute of Mental Health (NIMH) funded research projects involving perinatal mood disorders, perinatal loss, and comparative treatment approaches with postpartum women.
"The Day Hospital was my 'saving grace' during this most difficult postpartum time. The group therapy and one-to-one therapy gave me the optimism and hope that things would get better. Every day is still a battle for me, but I use the techniques and skills that I learned at the Day Hospital."
“I don’t know where I would be today had I not found this program. I can’t say enough good things about it! Your staff is wonderful, and I think it works so well because you operate as a team … keep up the good work.”
“I liked knowing that I wasn’t alone with these feelings … the other women had them, too.”
“Coming to this program is the best thing that could have happened to me in that moment of my life when I was feeling so alone, lost and desperate. I profusely thank all the staff, not only for me but especially for my baby, because you gave me strength to take care of him.”
“I don’t know where I’d be without all of you. I’m feeling great and enjoying every day with my family. A few months ago, I thought I’d never feel myself again. The enclosed photo is to show you who you’ve really helped – my kids now have the mother they deserve back. My family owes so much to all of you. We just wanted you all to know how important the work you do is.”
“Overall the program was excellent and has gone a long way toward helping me get back on my feet. Both the concept of the program and the implementation of it are wonderfully innovative and needed and should be used as a model on other hospitals.”
“I’ve never felt lucky to live in RI until I became pregnant and realized I could have my baby at Women & Infants Hospital – the fact that a program like this (and as good as this) exists proves my point.”“This program is very well thought out and organized. All of the skills I have learned have been very helpful. It is reassuring to know that there is so much support out there for new moms.”
“I just wanted to thank everyone here for the help I’ve received. It was a great experience being able to meet other women in similar situations and having people who actually care and feel my pain. I would do it again if I had to.”
“Gracias por el gran soporte que ustedes ofrecen a las mujeres … gracias, gracias to all.”
It's More than the Baby Blues
Every woman faces adjustments when she becomes a mother, but for 10 to 20 percent of women, the emotional and psychological changes brought on by pregnancy and childbirth are more than they can handle alone.
In these cases, women may be depressed or anxious; they may cry easily or wonder if something is wrong with them. It’s more than the baby blues, and can severely impact a family’s life or even endanger the woman and others. Depression, psychosis or anxiety can make it hard for a woman to:
- Take care of herself, her baby or other children.
- Bond or engage with her baby.
- Function at home or at work.
Although depression and anxiety are the most common reasons women seek help at the Day Hospital, staff can also treat women with obsessive compulsive disorder, post-traumatic stress disorder and other mood disorders.