“I’m always thankful for people who share their stories because it’s lending a voice to this issue and really elevating it on a more public-facing platform. It helps normalize these conversations.”
– Ria Rodney, Director of Nurture NJ
Interview with Ria Rodney
Ria Rodney is a public health advocate and inaugural director of Nurture NJ in the Office of the New Jersey First Lady Tammy Murphy. Ria plays a major role coordinating the statewide universal home visiting program, as well as supporting diversity and inclusion training for hospital staff, perinatal workforce education, maternal mental health initiatives, rural healthcare access, and expansion of the maternal health workforce to include midwives and doulas. With degrees in social work and nursing, she focuses on addressing health disparities. Ria spoke to us about maternal mental health challenges and solutions.
What’s the one thing you wish people knew about maternal mental health?
I wish more people knew that many women experience postpartum depression and mood changes both with pregnancy and with having a newborn. It’s not just isolated cases.
I don’t think the information is getting out there that the risk window for feeling postpartum mental health symptoms is a year after a baby’s birth. Because we get so many images in our culture of positive parenting and positive bonding, this period can be very difficult for families who might still feel stressed, or distraught, or have trouble bonding several weeks or months after the arrival of their newborn.
And because having a newborn in the house is a big transition, it’s not just the person who gave birth but also the partner who can go through a lot of changes and emotions at the same time. Many people don’t realize that dads can also experience depression, but the estimate is that 1 in 4 dads have some type of postpartum depression or mood disorder.
Would you say there’s anything that’s new or trending in how people think about or talk about maternal mental health?
A positive development is that more people are sharing their stories through social media. There’s a universal quality to it — with people of different ethnic, socioeconomic, and religious backgrounds all talking about their experiences. Say you have somebody in their twenties or thirties writing a post about being sleep-deprived or having trouble making friends with other parents. They’ll go to bed and wake up the next day and see a thousand comments supporting them. I’m always thankful for people who share their stories because it’s lending a voice to this issue and really elevating it on a more public-facing platform. It helps normalize these conversations.
Sharing stories can also address the education gap or people’s lack of understanding of mental health risk factors. For example, someone could have a baby and be experiencing symptoms of postpartum depression but be unaware that’s what it is. But then they go online and see other families posting their stories and they wonder, “Oh, my goodness. Is this what I have?” Then they go to the doctor with their phone and ask, “Do I have postpartum depression? Is this the baby blues?” Social media has been very helpful in getting conversations started as people learn more about what parenting looks like in the postpartum window.
What are challenges and barriers to addressing maternal mental health?
One barrier is accessing care. Where would you get these services? Do you want to work with a therapist or a psychiatrist or do you join a mom’s group that just offers support? Different people need different types of support, and it can be overwhelming for a person to navigate what support might look like for them.
Stigma definitely plays a role in preventing people from seeking mental health services. There is this need to fit the picture of perfect parenting, always bonding with your infant and having a wonderful experience. There is also a concern over, “What will people think or what response might I get if I say I’m having a difficult time?” Culture impacts how people get services, so people might say, “Oh, in my culture, we wouldn’t see a therapist.”
I encourage families that don’t feel ready to pursue clinical or therapeutic services to consider making use of their religious community or reaching out to people they feel safe speaking to in their community. This offers a good start while they navigate the system. My hope is that through Nurture NJ we will provide more education on the services that are available through our state, so we can break down silos and get families what they need in a timely manner.
What are some solutions or exciting innovations happening now that could address maternal mental health?
I am very excited about universal home visiting. It’s going to be a game changer for our families. The nurses doing home visits have had extensive training, including on cultural competency and how to screen for mental health issues. They’re also able to refer families to mental health-related services. The timeliness of the visit is so critical — you are having a nurse come to your home just two to three weeks after your delivery, checking in on you and really meeting you where you are. Most parents don’t go for the postpartum wellness check until six weeks after delivery, so we’re cutting these wait times in half.
We acknowledge that some families are hesitant to get involved with these services, especially if they had negative experiences with the healthcare system in the past or experienced some kind of trauma. But we’ve ensured there are a lot of ways to make home visiting comfortable for families. We share pictures of our nurses so you can see who’s coming into your home. Or you can choose to do a telephone or Zoom screen with the nurse.
Another exciting innovation is that in New Jersey we are scaling up our perinatal workforce, meaning we’re going to have more doulas, community health workers, and perinatal clinical therapists in the community. As I mentioned, the one-year window is very high-risk for postpartum mental health complications and the leading cause of morbidity and mortality for parents in this period is substance abuse and mental health. This is a challenge for many families and in response we’re shifting our approach so it’ won’t be punitive if you tell your clinician that you have substance misuse disorder. I think this level of disclosure is something many families fear but we’re training our clinicians to treat this as any other medical issue, like hypertension or diabetes. If you say you misuse substances, how can we treat this as a true medical issue to keep mom, baby, and family safe?
Is there any additional good news for moms you’d like to share?
I am really excited that we now have an FDA-approved medication for postpartum depression. This is going to be a great tool for moms. In addition to talk therapy and following up with their doctors, they can get that extra level of support as they adjust to having a baby at home. And knowing it’s safe to take, that it won’t hurt mom or the baby, it’s going to be great.