Defining maternal mental health

Having a child can often be tied to joy and happiness, but there is another side that many new moms are going through – balancing their own mental health while they adjust to this new world they find themselves in. When we talk about maternal mental health, we often focus on postpartum depression, but it’s also important to consider the whole cycle of being a mom and the different effects this new role can have on mental health.

In this episode of Lincoln Absence Advisor, we are joined by Lincoln’s consulting physicians, Dr. Amy Feitelson, a psychiatrist, and Dr. Jennifer King, a family practice physician, as well as Marissa Mayfield, product lead for our statutory products. Together, we discuss and define maternal mental health. From observation to experience, we dive in to various aspects and explore how employers can help new moms in their workforce cope with the additional stress they may be experiencing.

AM-LAAMH-AUD002   02/24  Z01   LCN-6420977-022224
©2024 Lincoln National Corporation. All rights reserved. 

Transcript

Karen Batson: 0:00

Hi everyone. I'm Karen Batson marketing manager at Lincoln Financial Group. Over the course of the year we've all discussed many aspects of mental health. We've also talked about the pressures on women in the workplace over the last year and many aspects of maternity leave. So for this episode, we're bringing aspects of all those conversations together. I'm joined by Dr. Amy Feitelson, a psychiatrist and consulting physician for Lincoln, Dr. Jennifer King, a family practice physician, who also consults with Lincoln, and Marissa Mayfield product lead for our leaving statutory products. And we discuss the many aspects of maternal mental health. So take a listen, and I hope you enjoy the episode. Hi, everyone. Thank you so much for joining us on Lincoln Absence Advisor. I appreciate your time being here.

Dr. Amy Feitelson: 0:48

Oh, thank you, Karen.

Marissa Mayfield: 0:49

Thank you, Karen.

Dr. Jennifer King: 0:50

Thank you, Karen. Happy to be here.

Karen Batson: 0:52

So we're here to talk about kind of a big topic. And we have a few questions about it about maternal mental health. You know, we've talked about mental health in a lot of our different content lately, but I really want to focus in on the maternal aspect. But before we dive into very specific questions, I thought we would do some introductions, maybe what you do and and how you're connected to this subject. Dr. King, would you like to start?

Dr. Jennifer King: 1:21

Of course, Hi, thank you for having me. I'm Dr. Jennifer King, and I'm a family practice physician. And I take care of a lot of women patients. So I see them with, you know, maternal mental health during their pregnancy, well actually even before when they're thinking about getting pregnant, when I want to start having these conversations, about next steps in preparing for even trying to get pregnant to make sure we're the healthiest person we can be. And then through their pregnancy. And then after their pregnancy, I'll still see them and sometimes they see their kids, because they also do pediatrics. So it's kind of nice to be able to take that journey with the patient, especially as a family practice physician, because I feel close to them. And I might, you know, they feel like I'm in their corner.

Karen Batson: 2:03

Yeah, Dr. Feitelson how about you?

Dr. Amy Feitelson: 2:05

I'm good. Thank you for inviting us to this show. This is really such an important topic. So I'm a psychiatrist. And I've always worked in various, well, I've worked in various settings, private practice community health centers, currently consulting to a Community Health Center, which is primary care group. So it's an integrated practice and also consider disability for women who are going through or all people that are going through some difficult times in their life. So as a psychiatrist, I would see people over the course sometimes of their lifetime, because they have ongoing issues. Sometimes I meet them at various stages of their life. And it could be as they're contemplating pregnancy for women. It could be because of infertility issues, miscarriage Peri partum issues, they've had some ongoing issues before in their life, and now they're pregnant, and they want to make sure they're at their best stage, and also meeting women after they delivered in various circumstances and need some help. So when I think of maternal health, I think it was more of a lifecycle issue rather than a specific event.

Karen Batson: 3:13

So Marissa! Third guest, how would you like to introduce yourself?

Marissa Mayfield: 3:17

Sure. So Hello, everyone, my focus is within Lincoln is managing some of our paid family leave programs and statutory disability programs. And so certainly, I tend to come on this podcast to talk more about those topics. But today, from a maternal mental health perspective, I am a mother of three children. I have a relatively recent child that was born prematurely. And so I have added to my kind of experience as a mom being a current NICU mom. And so I know firsthand and have experienced, you know, some of the challenges that come along with mental struggles related to maternal events. And at this point, because of the current circumstances that my family is working through, I have interfaced with a lot of different moms as friends and in different community circles. And so I've seen more firsthand and have a very much an eyes wide open kind of experience now of what it really looks like when someone is going through more difficult challenges related to a maternal event. And so it's just a now a topic of interest and passion of mine, given kind of what I've experienced as of late over the last few months.

Karen Batson: 4:31

So getting your experience how would you define maternal mental health as kind of a general phrase or wording?

Marissa Mayfield: 4:39

Sure, absolutely. So I will say this purely from more of a practical standpoint, I will leave all of the formal considerations to Amy and to Jennifer. But really, I think it runs the gamut, you know, with maternal events in particular, there is such a degree of mental strain that women have to work through and that's because of physical demands in changes to your body changes to your surroundings. So there's the physical, emotional components of it, really trying to juggle ongoing responsibilities with work and life. And so when you add that in with, you know, other children and just, you know, all the things that women have to deal with just in day to day life, having to bear all of those responsibilities, sometimes burdens, it depends, it can cause that strain on women. And so for some it can present as kind of anxious scenarios, maybe they're feeling depressed, or to more formal diagnoses where you know, there are true disruptions in life that they are working through and need to be able to kind of account for through different interventions. So I definitely think it's a spectrum. And I know that we'll talk about that throughout the course of this time together. But I think for most women, you're dealing with some degree of that, because of the demands that come with being a mom or being in preparation of, of trying to become a mom, I think all those things kind of work together.

Karen Batson: 6:03

Now, Dr. King, or Dr. Feitelson, would you add on to that definition or things that you think of when it comes to maternal mental health?

Dr. Jennifer King: 6:10

Absolutely, because I think when you talk about maternal, it's very broad, right? We're talking about people maybe that adopted or someone that became a caretaker of a family member you know, suddenly that they weren't expecting, I'm mostly talking about children, of course, but I guess you would, you know, it would be their parents, too, if a parent had to move in with you. And all of a sudden, you have new responsibilities that go along with that, or even a marriage where someone brought some children in, and now you become a mom that you hadn't been in the past. So I agree with what Marissa saying. And I would just broaden it a little bit to cover all of the maternal aspects of being a woman, I guess, in that pretty wide open constraint, like you said, family members, friends are things that have happened that all of a sudden, you're in that caretaker role that you weren't prior.

Dr. Amy Feitelson: 6:56

Absolutely, and I also because you've covered things so nicely on any individual level. I also wanted to broaden it to other societal issues, that there's communities that have more challenges than others. And that could be concrete areas geographically, or it could be LGBQT, it could be people that are adopting, or even men who are adopting or, you know, having children. So, you know, we're we're talking about huge swaths of our community that are going through some challenges with what we're calling maternal health, but also has to do with the cycles of children preparing to have children having children, the aftermath of having children. And as we know, our current crisis with COVID has increased those challenges both on a medical level, but also on a mental health level, the isolation that's increased because maybe some of those caregiver helpers that might have moved in can't, you know, people haven't seen families that would ordinarily be able to support and give advice, helpful advice, that there just can't be there or not even able to bond initially with the baby because of having COVID during at delivery.

Karen Batson: 8:09

Now, I think you all touched upon kind of the lifespan of a mom, right, in dealing with pregnancy, and it affecting your mental health. And I'm wondering if we can dig into that a little bit more, I think very common postpartum is talked about, but I'm wondering if we can kind of dig into kind of each phase right preconception to while you're pregnant to to the postpartum? And what elements of maternal mental health affect each phase? So starting with, like, preconception, what kind of definition would we have of maternal mental health of what moms are dealing with?

Dr. Amy Feitelson: 8:45

Well, you know, there's women who have been having ongoing mental health issues, they're thinking about pregnancy in terms of, should they continue with their medication? What should how should they prepare, there's women that it may not be such a medication issue, but they're concerned about their own background be it trauma or just how they were they were raised. And you know, can they be good, quote, unquote, good mothers. And there's some psychological issues to work through, even with couples ahead of time to figure out how they're going to work together as that having a child will, you know, change the roles in their relationship. So there's a lot of psychological and medical factors that come into a preconception.

Dr. Jennifer King: 9:25

And I think, along with what Dr. Feitelson's saying that the preparation can be a large part of getting ready to to conceive because there are women that have been on long term medications and some are safe and some aren't. And like Dr. Feitelson was saying they get concerned about why I've been on this medication for a long time. What happens when I go off? How will I deal with it? It's really been helping me so that is something that we discuss in my practice. What can we do? How can we prepare what's safe, what's not safe? What plan B's do we have in case the medication that you're on you can't take, what are we going to do to pick up the slack for your needs. So super important before the pregnancy occurs, and also so that the mom can have, you know, not be concerned about the pregnancy and medications, and did I do something to the baby because of the medications. So that's something that I tried in my practice to really get ahead of before a patient finds out, she's pregnant so that those issues can be addressed.

Marissa Mayfield: 10:23

And I would just add that what I've seen, and certainly it's been, my experience is, you know, every woman that is going through, you know, deciding to have a child or having different circumstances that bring them to that point, every woman has a backstory of kind of what brought them to that point. So whether that's just complete bliss, about their circumstances, to some that are going in more concern, because maybe they lost a child, or they had a child that was premature, or, you know, that has been a circumstance that is happening to someone close to them. And those things happen, I think a lot more frequently than people realize. And then also people that have had challenges and getting pregnant. So whatever that narrative is, in their minds, certainly contributes to kind of their orientation to the pregnancy, whether that's trying to get pregnant or being in that place, you know, whatever that story is, that narrative has a contributing factor, whether that be a positive or something, maybe that's more negative, or causing more adverse considerations for them, all of that plays into how they are going to be able to kind of manage all of those mental considerations in that scenario.

Dr. Amy Feitelson: 11:36

And that's such an important point Marissa, I totally agree. Because in order for women to be as prepared and healthy as they can be, we need to be open to all those stories. And you know, we can't make assumptions, you know. And then if we make assumptions, that it's bliss all the time, then there's gonna be a large amount of people that are not going to get the help and treatment that they need. So thank you, that was such an important point.

Karen Batson: 12:04

Now do we find that everyone is on these moms are open to things that they've gone through, or will it take time to have conversations kind of going off of you don't know what you what someone's going through, as they're going through this conception? Will they always be open to everything that they have been going through and having those conversations as they maybe are preparing for that pregnancy?

Dr. Jennifer King: 12:25

Well, I think this is where my primary care comes in, you know, hopefully, we have a an established relationship with the patient. And we have that in the medical records, they've been open about discussing the difficulties in the past, or any traumatic events that have happened in the past, so that we can address that. And I can make sure they get to the right person. medical personnel for help if that person isn't me, about how to deal with some of the things that I've been through. And hopefully, if they're not a new patient, to me, hopefully we've addressed some of that already. When the event happened, at least that's my goal. You know, having that relationship with the patient, you hopefully over time to continue to...and they build a trust with you that will be my goal is that that's come up. If it hasn't come up, and you don't know what that is, that's where it becomes tough. And then hopefully their ob gyn can step in, because maybe they were involved in whatever had happened prior. And hopefully they step in and can either help personally, or refer the patient to the correct person for for help.

Dr. Amy Feitelson: 13:21

Yeah, and I just as you're talking, I'm realizing I left out such an important area of substance abuse, that women might feel shame at disclosing use of opioids or benzos. I mean, let alone cigarette smoking. I mean, that just requires having an open and accepting stance with people so that you can help them you know, it's a time of that women will avoid having even prenatal care if they have substance abuse, because they don't want to disclose. So that aspect of the relationship that you know that even if you've met them the first time, everything is helpful to know and, you know, try to establish that sort of atmosphere that you're there to help not there to decide which is shameful behavior or not.

Dr. Jennifer King: 14:09

Along those lines, if a patient has had a relationship with medical personnel that they're not, they don't feel that openness, or that they could be open, I would suggest they try to find a better match. Because there are lots of physicians. And so if you feel that you're not being accepted, or what you're saying isn't being heard, I would encourage people to keep looking to try to find someone that you're comfortable with because it'll just be so much better for the patient if they feel that they can be open. Not on the first just understand it takes time and it takes time to build a relationship. Just saying that I want patients to feel like there's lots of options. If you had have a first office visit with a physician and you don't think it's the right fit for you. That's okay. Go ahead and keep looking and find someone so that you can be open and hopefully discuss some of the issues that are concerning you regarding what's going to be happening you know, upcoming, you know, mentally, especially during this, you know, pre pregnancy, pregnancy and post pregnancy time.

Karen Batson: 15:10

Very good point. Now moving towards where the woman is pregnant? Are there new aspects of mental health that mom might be going through?

Dr. Jennifer King: 15:20

Marissa?

Marissa Mayfield: 15:25

Absolutely. It's interesting, even though my whole mothering from like a pregnancy perspective, I've closed that chapter of my life at this point. But I feel like I've been more of a veteran, I guess, having children over the last several years. Absolutely. I think that it depends on on where you are, I think we have to have particularly consideration for first time moms, because first time moms going into pregnancy don't always know what to expect. And so if you're taking and you're gleaning guidance from others, whether it be from your medical provider, or from your friends, or you know, other folks trying to take all that information in to bounce it up against what you're experiencing, you might have some alignment there. And you might see some things where it's like, well, I didn't know that what I'm feeling, you know, I couldn't have anticipated that this is what it is, I think, for moms that have been through that cycle multiple times, maybe there's different considerations. But all in, you know, to me, what I've seen from my personal experience, and in, you know, talking with other friends and people that I've now come into connection with pregnancy kind of takes over your life to a certain degree for that period of time. So while you are new, maybe already a mom, you're likely someone that has a career or profession, you have other relationships for that period of time, the pregnancy, it's almost like it becomes that first thing that is a consideration that you really kind of filter the rest of your life through. But you can't make your whole life just about your pregnancy. So there's always this delicate balance between how can I, you know, continue to be well physically, mentally, make sure that my child is well, while I also attend to other things. And I think that can oftentimes create a rub. And that's for mothers that are, you know, first going through this as a first time mom, and then others that even if you have done this multiple times, I think a lot of women still run into that. And you really need to look at the resources and how you go about supporting your mental health, given that that's what I think a lot of women end up encountering.

Dr. Amy Feitelson: 17:37

Yeah, no, it's a completely new experience. And it's, you know, it's one that people can tell you things, you could read books, but you know, your body, that there's things that you may not expect at all, I mean, Jennifer could talk more about the physical aspects, but you know, women may just feel more vulnerable during those during this time, they never had high blood pressure. Now they do or they had, they never had diabetes, and now they're being told they have some form of diabetes, and they have to think about their choices with food and, you know, and how much rest they need. And, you know, it's already becoming a very different type of, like you say, relationship with others with work into themselves, issues that might have been percolating, might start coming more to the fore, you know, anxiety, even and, you know, they talk about postpartum depression, but really, a lot of emotions are starting now. You know, a lot of the hormone shifts, which are maybe dramatic around delivery, but are still occurring, and different, you know, changes in the, in your body that, you know, it's like changing the kind of activities you're doing and your stamina, and maybe your focus, and people are expecting you to do exactly what you've been doing before, at work at home. So there may, as we kind of hinted before, people may not be so aware of what they're feeling during that time, you know, because of just feels like things are happening. And they may not, you know, be understanding that their anxiety is increased, or they're getting down on themselves, or, you know, these other type of things, or that past history is now coming more to the fore. So I think reducing the stigma of all this, you know, is is really a task, you know, for everyone involved, so that women can pay attention to these things, you know, so that it's become like a regular thing to think about your own set of emotions and mental health and you know, that it shouldn't be something that's like, Oh, I just got past delivering. I don't have postpartum depression, great. You know, it's, it's, it's really, you know, it's a, it's, it's something to be mindful of, and like I say, if there if there's any way to keep reducing the stigma in the workplace, that would be wonderful.

Karen Batson: 19:48

So kind of leading to postpartum, typical mental health issues that might come along there. Now that you're moved to this third phase of balancing your own mental health. What can we describe there? In the definition?

Marissa Mayfield: 20:01

Well, I'll start just more from some of the practical considerations, and then you can kind of go from there. So there's a few things. Again, I think a lot of it comes down to the shift in demands that happen as you're having a child. So, you know, immediately postpartum, you're dealing with physically the demands of healing and being able to kind of return back to maybe not your, your normal self, but to what feels like some degree of normalcy. Because I think it takes a while for your body to fully get back to kind of that pre pregnancy state. But you've got the physical demands on your own body, you've got the demands of caring for a new child, and you know, all of the things that come along with that there's a ton of unknowns, you're, you're meeting that person for the first time, and you have to learn your child, and what all the different needs that they will have. There's even things around breastfeeding. I mean, that that's a huge challenge for a lot of moms from a mental perspective, because there's different kind of schools of thought they're in different kind of plans, a lot of times that women have, but a lot of time your plan doesn't necessarily line up with what happens in actuality, and the actual demands of having to do that. So I know that even for me, personally, that has been a challenge. Being able to meet all of the other needs of your life and of your child in addition to being that food source for the child is also a big thing. And then just physical exhaustion. So I think a lot of those things are physical, but then they have kind of an impact on your mental considerations. And so then again, it's how can you care for yourself, prioritize yourself, while you're also adjusting to some of those broader new responsibilities that you have postpartum

Dr. Jennifer King: 21:43

I agree, along with what Marissa is saying the lack of sleep really weighs heavily on mental health. Usually, people have shorter tempers, they get frustrated, more easily depressed or anxious. And taking care of a newborn. If it's your first newborn, a lot of my patients aren't sure if they're doing things correctly. And breastfeeding is really huge. They're not sure the baby's latching, they're not sure the baby's getting enough food, they have a lot of questions. Definitely one of the questions I ask them is about their support system, because we have single moms out there that don't have a lot of support, so no one's getting up in the night except them. And then, you know, hopefully, I can step in, or hopefully the company can, we talked about EAP programs, we haven't, but EAP programs maybe can help get some support for us for single moms. But then sometimes, there was a family, but then again, no one's helping. So Marissa's, right, a lot of it falls on the mom, because she's the food source. So she's exhausted, she doesn't feel great. There's a lot of hormones going on, there's a lot of changes in your body, sometimes you're not your best self. And mentally, it really starts to weigh on you. And it can, you know come out as depression or anxiety or both, or other mental health conditions and really needs to be taken into account and awareness at both your OB's office and maybe at your primary care's office. So that someone's besides yourself is looking out for those aspects of what could be happening with you.

Dr. Amy Feitelson: 23:11

It's such an important points to make that people don't know what to expect. And also that things may not be in their control as much as they had been, you know, 15 to 20% of women are considered high risk in some physical way. But that pertains then to their risk of developing mental health issues throughout the pregnancy and later. You know, having a stat c-section is is traumatic, you know, I was talking to my daughter who's in the midst of her ob gyn residency, and she was describing the scene that can happen, and it's definitely a traumatic experience. And that contributes to you know contributes to the psychological issues later. And even physical issues later, as we know, mind body works together and the types of stress chemicals that get going affects our mood and such. And then, you know, even having prior miscarriages is you know, that that factors into it, because people worry, you know, it's like, you know, nothing's ever safe ever, nothing's ever really a given, you know, and so, you know, some women become highly anxious and really unable to leave their baby with anybody. Even if they had extra support. Support for all these factors could be in the form of like, say, lessening the stigma so that they can get help. There's all kinds of thoughts about what could help, you know, some cognitive behavioral therapy, you know, could help with the anxiety. There could be just pure information, you know, like, as Jennifer and Marissa was talking about, like, what to expect and about breastfeeding, and what do you do with a baby that's crying and in or has collic and such? All that's very helpful. Then of course, there can be medication that helps as well. I know we talked about, you know, how does this all get discovered by the practitioner. And that's something I'll have to ask, Jennifer, because I know that the six week check might be a little late to talk about mental health issues.

Dr. Jennifer King: 25:13

doing. And so I would definitely try to, you know, recommend that maybe there's a follow up sooner, and if it can't be with your ob, then maybe it's with your primary care physician, you know, and maybe you think everything's going great, it's still okay to follow up, you know, and check in with your, with your physician. And, you know, it could even be a phone call, or a nurse at a doctor's office could call that someone that's checking in to make sure that you're doing okay, because it is overwhelming, there's a lot of different different aspects going on. And we've got to make sure that the mom and the baby are healthy. And sometimes it helps if we reach out to them, or to the to the patient so that they you said, there's no stigma that why I need to call my doctor, right, I don't feel right or something doesn't feel right that I don't, I'm embarrassed, maybe they don't want to talk about it,

Karen Batson: 26:07

Which seems to go back to what you were saying earlier that development of trust, having that trust with even your primary, at least there's someone to proactively set time up with or ask questions or call. And that goes back to that beginning phase of really making sure you have the right people in the right corners for you, I would think.

Dr. Jennifer King: 26:25

it's true. And I always say private, especially primary care, it takes a village. So I, you know, I always want people to have, obviously I need specialists because there's things that I don't do in my practice, but a lot of people that are kind of watching out for the patient. So and that is usually other health care providers, but it's also mental health providers. Sometimes it's social workers, so that they know that there are services available for them if they need it.

Karen Batson: 26:50

How many moms though go by with without being treated for mental health issues they might be gaining through through pregnancy and having a child or adoption, or any of those other scenarios that we talked that brings them into this maternal role?

Dr. Amy Feitelson: 27:06

Well, some studies have shown us It bears out when you're doing the work is that, you know, there may be 50 to 70% of women that do not get the treatment they need, and about 40% of women may reach out and even then may not get the treatment they need. I mean, you know, that insurance is a barrier, people taking insurance is a barrier, getting appointments, and that's just for people without trying to adjust having a small child or a baby to...you know how do you get to the appointments, and you're taking a baby probably takes three hours to figure out how to get the baby in the car. Everything all else. So you know, there's there's a lot of things that that could be helpful towards being more flexible with new moms, or even repeat moms, you know that, because as you have more children a little harder to get out of house. You know, I think flexibility, flexibility, flexibility on everybody's part...work, clinicians, and the people around them too. I mean, you had mentioned Marissa, that you're getting to know the baby having relationship with so it's just an excellent point, you know, that you're feeling. But you're also building relationship with yourself. Because it's like, it's like, I'm not I'm not the person I was three days ago. It's like, you know, different different priorities, different issues, different obligations.

Dr. Jennifer King: 28:27

I think if COVID did anything, or we'll say it did something positive, we have now more zoom availability for medical personnel. And Dr. Feitelson brings up a lot of really good points. There's a lot of bariiers that just have to do with insurance getting somewhere, it's going to be 120 degrees today in Arizona, and no one wants to put their baby in the car, and no on e wants to go outside. So there there are a lot of barriers to trying to be somewhere to see someone. So hopefully we'll have more availability through zoom calls. And to be more accessible for medical providers for the mom.

Karen Batson: 29:03

Yeah, talking about kind of the leave products and maternity leave, in particular, which we talk about a lot on this podcast show. Does it help with maternal mental health reasons? It does that come into view when we're looking at that as a product?

Marissa Mayfield: 29:18

So I would say that in certain circumstances, yes. So certainly, if you have a disabling condition, you know, or other medical scenario, that's like a serious health condition, you could have access to some degree of benefits to help with being out on leave. Maybe you need leavers and accommodation to support you through that scenario. So I think for some women, yes, certainly, as long as they can meet some of those criteria. I think more broadly, however, you know, looking at employer practices is is really important, you know, because for some women, it's going to mean that you just need more flexibility in your schedule. That may not necessarily trigger some leave event. But you being able to have more flexibility to tailor either your work schedule or the demands of your job to the current circumstances that you're working through, I mean, that that can make a huge difference in, in the case of someone that is dealing with either a very serious scenario, like in my case, having a premature baby in the NICU and having to return to work and all those I mean, that's, that's a very complicated scenario, you could have someone that has, you know, maybe less pervasive challenges going on, but they still need some degree of support. So I think it's a combination of looking at formal leave policies, in addition to just an employer's practices in their culture around supporting mothers throughout this journey, and how they can help them to be able to deal with their demands of life,

Dr. Amy Feitelson: 30:52

Can they go over the benefits they might have, as soon as they disclose their pregnancy?

Marissa Mayfield: 30:59

Sure.

Dr. Amy Feitelson: 30:59

So it's not all left to the time of delivery.

Marissa Mayfield: 31:02

Absolutely. And employers really should be publishing that type of information front and center. So in intranet sites, and other places where benefit information is visible, it's important that they post along where they put different health information. And other benefits also include information around their leave policies, so that people can use that information to also plan because I think planning is a big part of this as well. You know, when your plan works out to me, that seems to help to reduce some of the mental challenges someone might encounter versus when maybe there is not a plan in place, or if that plan gets disrupted for one reason or another. So having that information available for people to proactively work through was important as well as it's a good point, Amy.

Dr. Jennifer King: 31:47

And I think this is where your ob gyn or your and or your primary care physician can be an asset for you. So helping with that, you know, if you need special accommodations, that they're helping you attain those, if they're available. Like you said it, you know, there's certain criteria that a company puts together, but there may be some flexibility in that in case there was a baby in the NICU, or, you know, you know, delivery that was early, so they're really your, I think biggest assets to help get any accommodations that you might need, that would be maybe outside the realm of what was covered, or specifically written.

Dr. Amy Feitelson: 32:22

Doing the disability work, which is, reaches across the country, you know, so I have the privilege of understanding what happens in different states, different communities, different settings, and the amount of social support would go a long way to decrease the disability aspect, you know, that, you know, there's some, like I say, medical conditions that are disabling, but a lot of the social support would go a long way in, you know, helping women not feel like they have a disabling condition, you know, this is part of what's happening, having a baby and, you know, integrating a baby into your life and, and having the challenges. And like I say, the more supportive person has, the better they are. So you know, how much the employer could help with that would go a long way.

Karen Batson: 33:09

Well it's interesting, is a nice lead into my next question one of in the, in a podcast that we did on his maternity leave enough. And it was very evident in this conversation with moms going through different experiences on maternity and their own aspects on what they do with insurance, that there's so much going through a mom's mind, just the the amount of things that you're focusing on, which I think we've had great examples throughout this conversation, how do we help them focus on maternal mental health? Because it seems like it's such an important aspect of, of your overall health? How do we help them balance that, and the solutions that might be available to them?

Dr. Amy Feitelson: 33:50

From an employer point of view is that what your asking Karen?

Karen Batson: 33:52

Employer or community I think, either aspect.

Dr. Amy Feitelson: 33:56

As I think, as Jennifer was was saying, is having and Marissa was, is having all the options out there, you know, having, you know, EAP support, you know, we've listened to the previous podcast and learned that they might even help with childcare, which is amazing, you know, that it would just be offered, as you know, these are, you know, some things you can do through zoom or come in, or, you know, that it's a benefit for you, please use it, you know, not that you have to call up and say, I don't feel well, I don't you know, because people will think like, well, they're not going to hold my job for me if I'm calling and saying these things. So, you know, I think, you know, just making it available like you do free coffee, you know, would go a long way.

Dr. Jennifer King: 34:44

Well, I think two different forms that would be available for our employees to be able to learn about the benefits. So you know, a podcast, a video, besides forms, so different ways of getting the information out there, and maybe when Employees become pregnant, maybe there was like a kind of a welcome to benefits you know, email that goes out to them that just maybe bullet points, just you know, instead of all HR paperwork is, is seems to be a lot and in depth. And it's lots of papers and people kind of overwhelmed. So maybe just even, you know, an employer can send out a, you know, an email, you got to be careful, because if the, there's a problem with a pregnancy, you know, and like you said, it's not always joyous at first. So you'd have to be very understanding and do it in the right manner. But they could maybe get something out to the employee to them personally, about, you know, about bullet pointing some things that are available to them, because I think especially the EAP program, maybe they're not aware that that would be helpful, or that's available. And I know sometimes with that, there's concern about whether that's actually going to be private. And so some employees don't use it as much as they should, like we were talking about before in the previous podcast, they may be to help a childcare. Yeah, so just maybe, you know, here's some things that are so short and easy to read, as well as maybe are also, like I said, on a video, so that when you're feeding your baby, you could maybe, you know, watch it at the same time, as opposed to just getting things through the written word.

Marissa Mayfield: 36:17

And I would just add that, when I think about at the employer level, really, the manager has a lot of, I think influence in what the employees experience is, whether that be positive or maybe not so positive when they become pregnant. So certainly manager sensitivity training about how to even approach conversations related to pregnancy. So, you know, certainly you're not asking any questions to try to dig anything up or try to investigate somebody, but as there is a certain point where that employee is going to disclose that information to you. And how do you take that information? How do you be a kind of an advocate for the the resources that are available through the company and making sure that managers are aware of themselves so that they can also relay that to the employees, as well as how they just have regular dialogue with the employee. What I've appreciated with my management here at Lincoln is they've given me the space to talk about as much or as little as I want to talk about related to my current circumstances. And so really being able to have that sensitivity to the employee. For some people, they want to talk about their pregnancy, whether it's, you know, all the great things that they're experiencing, maybe some of the challenges. And so being able to be engaged in those type of conversations and having a comfort level versus if someone is not interested, you know, being sensitive to that as well. And so helping employer managers feel empowered to know what they should and shouldn't do and how they can really be a support to that employee throughout the full journey. Because even when they return to work, there's, this is a different person than the person before the pregnancy. So how can we continue on with that relationship and fostering that relationship with that employee? And I think the managers have a key role in that. And I don't know that they always realize that and so I think that's an important takeaway for employers.

Karen Batson: 38:12

Now, last question, for you guys. Um, if there was one bit of information that you want to relate to our listeners about maternal mental health as your parting words, what would they be?

Dr. Amy Feitelson: 38:23

Oh, that's a challenging question.

Dr. Jennifer King: 38:27

I think for myself, it would be that there are resources available, please try not to feel alone. And reach out to your ob for questions, concerns, reach out to your manager, reach out to HR, reach out to the EAP program, reach out to your primary care physician, we did talk about I know there's some barriers with insurance and traveling. But please don't give up if you feel like you need help, because there is help available out there for you. Even though it might be difficult or seem like like I said, a barrier to get to it is available. And because of zoom calls, it's probably becoming more available. So if you're going if you're going through some challenges mentally, physically, also, don't forget about your primary care physician, like I talked about, and we can help with some of these things. But please don't feel that you're alone. And please try to reach out to some of the services, like I said, that are available.

Dr. Amy Feitelson: 39:17

Yeah, I think, you know, just to tag on to what Jennifer was saying that everyone is that is, is their unique set of circumstances, their own person. There's no ideal pregnancy experience, postpartum experience. Everyone has their own story and to please trust yourselves in that to recognize that because you're feeling like it's it's your experiences, deviating from something that was idealized does not mean that there's anything wrong with the way you're handling things. But talking with somebody else would just be helpful in getting more support.

Marissa Mayfield: 39:52

And I would just add that I think as best as you can to approach mental health for maternity from a proactive perspective and from a positive perspective, really looking at this as a way to maintain your overall wellness. So it's not even that you necessarily have to have a problem that you're trying to address. But how can you just maintain just that kind of positive and just flourishing environment from a mental perspective, as you're going through all these different life changing events, certainly, there's always going to be support there to address more either acute challenges that you're having or, you know, specific issues related to mental health. But there is a way to be able to be proactive about it to ensure that you maintain a positive kind of mind state as it relates to your entire experience related to maternity. So I would certainly call that out. Because I don't know that a lot of people think about it becomes more of an afterthought. And I think just getting out in front of it could make a big difference for a lot of people.

Dr. Jennifer King: 40:57

That's a great point.

Karen Batson: 40:58

Well, thank you very much for joining us. I really appreciate your time and really loved our conversation. Oh,

Dr. Amy Feitelson: 41:05

Thank you.

Marissa Mayfield: 41:06

Thank you.

Dr. Amy Feitelson: 41:07

Pleasure, pleasure, talking with you all on hearing all the different perspectives. It's great, thank you.

Karen Batson: 41:12

Thank you everyone for listening. And a special thank you to Dr. Amy Feitelson, Dr. Jennifer King and Marissa Mayfield for joining me today. We hope you liked today's episode and you will tell us by rating us sharing the episode or subscribing to Lincoln Absence Advisor on Apple Spotify or wherever you get your podcasts.

Disclosures: 41:32

The information contained in this podcast is for general use and is not a substitute for the advice of an attorney or your human resource professional. Lincoln Financial Group is the marketing name for Lincoln national Corporation and its affiliates. Affiliates are separately responsible for their own financial and contractual obligations.