Maternal Mental Health Program Aids Struggling Mothers

Written by: Larry Nagengast

Four months into her pregnancy, Alexandria Hood learned she had entered into a high-risk situation, both for her and her baby. That wasn’t the news the 29-year-old Millsboro woman wanted to hear, but she recognized that “things don’t always happen the way you want them to.”

Fortunately, her mother had learned about a relatively new program that could provide the support she needed – the Sonia Schorr Sloan Maternal Mental Health Program at Jewish Family Services (JFS) of Delaware.

She made an appointment with Dr. Angelica Montalvo-Artis, the clinical psychologist who directs the program, and began a journey that carried her through a difficult delivery in August, followed by another hospitalization, then visits with multiple pediatric specialists for her newborn daughter and a change in jobs as well.

In their first meetings, she said, Dr. Montalvo-Artis “really got to know me. She asked questions you don’t normally hear. She made me feel like I was being heard.” When the baby was born, Hood was aware that she could experience postpartum depression, but Dr. Montalvo-Artis did not dismiss those concerns. “I was scared. I was nervous, with this little human being to take care of,” Hood says. “She helped me as a person, as a new mom, to build confidence in myself.”

Alexandria Hood’s experience exemplifies a key goal the Sonia Schorr Sloan Maternal Mental Health Program has for its clients. “We want to wrap them in support,” therapist Rebekah Mo says.

Since its launch in 2021, the program has steadily grown – serving nearly 100 women in 2023, ranging from pregnancy through two years after birth. The program was named in honor of Sonia Schorr Sloan, an iconic Delawarean who passed away in 2019. She was a civil rights activist, Democratic party strategist, and non-profit fundraiser; she was a fierce advocate for juvenile justice, women’s rights, and other causes.

Maternal mental health has become a hot topic in the last decade, and it’s no longer focused exclusively on postpartum depression, Dr. Montalvo-Artis says. The JFS staff, with a psychologist, a therapist and mental health counselors, plus a physician’s assistant on call, can provide support for diverse perinatal and postpartum issues, including depression, anxiety, obsessive compulsive disorder, panic disorder, psychosis, bipolar disorder, and post-traumatic stress disorder through a combination of individual therapy and support groups.

The JFS program addresses a significant community need. Before it was launched, there were fewer than 10 licensed providers in the state who accepted most insurance plans and had specialty training through Postpartum Support International. With support from the Sonia Schorr Sloan Memorial Fund, the JFS program can serve moms with no insurance or limited coverage and there is no charge for participation in support groups.

According to JFS, one in five pregnant and new mothers experiences a perinatal mood and anxiety disorder (PMAD) and that figure rises to two in five among Black, Hispanic, and Asian American women. Three out of four women who experience PMADs do not get treatment, either because of a lack of awareness or a lack of insurance.

“A lot of women go through this completely alone, but you don’t have to,” Dr. Montalvo-Artis says. “And, no, you don’t have to wait for a certain level [of anxiety or depression] before seeking help. Women should know that anything that’s impairing their day-to-day functions is worth checking in on.”

Postpartum depression and its related conditions have many signals, but many women either do not recognize them – or ignore them – after they leave the embrace of doctors and pediatric nurses when they bring their babies home.

“It can be a sense of overwhelming, things piling on top of another, anxiety over the baby’s health, feelings of not being a good enough mother, a good enough wife,” Mo says. “You could have a racing heart rate, feel panicky, jittery, or unable to get out of bed, losing interest in the things you once cared about.”

“If you’ve never had issues before, if you’ve never had to navigate the healthcare system, all of this can be very scary,” Dr. Montalvo-Artis says.

Since it is operating a relatively new program, Jewish Family Services is putting an emphasis on outreach, a step that’s doubly important, Mo says, because some obstetrician-gynecologists don’t screen patients for postpartum depression, sometimes because they don’t know where to make referrals. The agency’s outreach is targeting many of the touchpoints encountered by new and expectant mothers: pediatricians, doulas, lactation consultants, childcare centers, preschools, even massage and physical therapists.

Healthcare providers are the primary connectors in linking new and expectant moms with the program, Dr. Montalvo-Artis says. She emphasizes the importance of those providers using a “warm handoff” to make that connection – making the call to set up the first appointment, for example, rather than just giving the mom a phone number or email address and hoping they follow through.

Besides in-office and online individual therapy and support groups, JFS will take its maternal mental health program off-site when there is a request. In 2023 it ran a community support program at the Gaudenzia Claymont Center for Pregnant and Parenting Women, a center for women recovering from substance abuse. JFS also has an ongoing relationship with DAPI- Delaware Adolescent Program, Inc., a program for new and expectant teen mothers.

Whether a mom’s needs are long or short-term, whether they’re covered completely or partially by insurance, or not at all, the program strives to “meet them where they’re at” and develop an appropriate treatment plan, Mo says.

“Moms feel heard, they feel understood, and that they matter,” Dr. Montalvo-Artis says.

More Moms’ Stories

Twenty weeks into her first pregnancy, Cristiane Bond received stunning and disturbing news. The child she was carrying would be born with a congenital heart disease. When her daughter Clara arrived in July, she not only had a condition known as heterotaxy syndrome – essentially, the location of key portions of her heart were the opposite of what they should be – but she was also born without a spleen, making her more susceptible to infections. Within days of her birth, Clara was undergoing heart surgery, then another for a gastrointestinal infection … and there is at least one more surgery on the horizon, next summer at Children’s Hospital in Boston.

“I had no hope whatsoever…. I had postpartum depression. I was very confused,” Cristiane recalled. Members of Baby Clara’s cardiac care team at Nemours Children’s Hospital connected her with Jewish Family Services.

Through weekly meetings with a JFS therapist and regular participation in a support group, the 34-year-old resident of Elkton, Maryland, has learned to cope with her own depression and anxiety and has developed a better understanding of Clara’s complex health issues.

“Small things would become big things for me. I put a lot of guilt and shame on myself,” she said. “I’m better now at managing relationships. I have more awareness, knowing what makes me feel the way I do, how to cope with it.”

After struggling for several years with depression and other mental health issues, Mary Stucky wasn’t sure what to expect when she learned in the spring of 2023 that she was pregnant. Thanks to positive prior experiences with Jewish Family Services’ outpatient mental health treatment program, the 23-year-old Newark woman knew where to turn.

She transitioned into JFS’s Maternal Mental Health Program, where she has received one-on-one counseling, assistance with managing her medications and the opportunity to participate in a support group with new and expectant mothers.

“It has helped me a lot,” she says, not only the individual therapy sessions but also the support group. “It helps to connect with other mothers who are struggling,” she said in December as she awaited the birth of her baby daughter. “I get to share my stories, hear other moms’ stories. They sympathize with depression. They help me.”

Although the cost of her treatment is covered by Medicaid, Stucky said it’s good to know that the program will serve women who don’t have insurance. That’s one reason she has recommended JFS to other new and expectant moms.

She’s also pleased that, with her boyfriend injured and out of work, the program helped her find a stroller for the baby.

“I have their phone number. I can call or text anytime,” she said. “JFS will be there for me for as long as I need them.”

For more information about the Sonia Schorr Sloan Maternal Mental Health Program, visit www.jfsdelaware.org/maternal-mental-health, or call JFS Delaware at 302-478-9411.

This article also appeared in The Cape Gazette in two parts, which can be found here and here.