Pauline (00:00)

Welcome back everybody. If you are new here, I'm Pauline Walfisch. I am here with my faithful co-host Megan Nelson and a really special guest today. So Megan, would you introduce our guests?

Megan (00:15)

Absolutely. Hi everyone. So you know that

Perinatal mood and anxiety disorders, or what you might hear us say, PMADs, that they're the most common complication of childbirth, but so many new parents suffer in silence, confused about whether their experience is normal or not. So today's guest has spent over 25 years fighting for marginalized communities and families, but her work shifted following the birth of her son. After surviving severe postpartum depression and anxiety, she turned

Her lived experience into action by drafting legislation that became New York State law requiring birthing hospitals to screen for perinatal mood and anxiety disorders. She went on to co-found the first perinatal partial hospital program of its kind in New York State and has since built a career focusing on policy, clinical care, and advocacy around the perinatal mental health. Please welcome today's guest, Paige Bellenbaum.

Welcome Paige. Nice to have you today.

Paige Bellenbaum, LCSW (01:19)

It's such a pleasure to be here with you both. I'm really excited for today's conversation.

Pauline (01:24)

Paige and I first met, I guess back in like it must have been around 2009, 2010, when the Motherhood Center was just getting started. And I was working in a perinatal outpatient program and Paige came with Dr. Burndorff.

Paige Bellenbaum, LCSW (01:42)

You got it.

Pauline (01:43)

And they were talking about this new partial hospital program that they were opening in the city just for pregnant and postpartum women. And we were like drooling over the idea and the and the possibility that something would exist for the people that we were serving. And I like fell in love with Paige and her passion right there in the halls of the outpatient clinic. So it has been a privilege to get to

watch her career really thrive and all of the amazing things that you have done for perinatal mood and anxiety disorders and the people who live with them. So thank you and thanks for being here. But let's get started. How do you describe to people like what a PMAD is

Paige Bellenbaum, LCSW (02:32)

What does it mean? What is it? And I

and Pauline, thanks so much for your kind words. And I remember that first moment vividly. And I'm so glad that we have been able to work together so collaboratively over the years. So, what

Pauline (02:44)

Yeah.

Paige Bellenbaum, LCSW (02:45)

an important place to start. What are perinatal mood and anxiety disorders? Acronym for that, PMADs. Interesting to note though, the conversation is changing around what we actually call these conditions. It seems

Pauline (02:59)

Mm-hmm.

Paige Bellenbaum, LCSW (03:00)

to be moving a

Little bit over to perinatal mental health conditions, perinatal mental health. So if I use that interchangeably throughout our conversation today, that is why. But for the sake of sticking with PMADs, I like to think of it as an umbrella. And underneath it sits a series of different diagnoses that a pregnant and or postpartum person can experience in the perinatal period, right? And important to note that when we're speaking of perinatal.

We're talking about from the moment of conception all the way to one year postpartum. Caveat to that though. Somebody can still struggle beyond the one year if they haven't received appropriate treatment and care.

Megan (03:44)

And also after a miscarriage

as

well.

Paige Bellenbaum, LCSW (03:46)

Absolutely, thank you for that, Megan. So the conditions that we consider to fall under the PMAD umbrella are perinatal depression, perinatal anxiety, perinatal obsessive-compulsive disorder, perinatal post-traumatic stress disorder, bipolar disorder, and perinatal psychosis. Now, as we know, and many of your listeners know, there are different symptoms that go along with each and every one of these different diagnoses. But I think just to take a step

Back, what's important to note is that statistically, about one in five women and birthing people experience a PMAD. And what I always like to say, and I don't have research to back it up, so that's my qualifier. qualitatively speaking, just through experience, and when we take into consideration that 75 to 80 percent of all women and birthing people do not come forward and talk about what's going on with them because of the shame and stigma

that surrounds.

Perinatal mental health, I would say it's probably more like one in three. And we know

Pauline (04:49)

Yeah.

Paige Bellenbaum, LCSW (04:49)

that PMEDs are the number one complication associated with childbirth, as Megan said. And we also know they're the leading cause of maternal mortality in this country and here in New York. So hopefully that provides a little bit of context for all our listeners.

Pauline (05:05)

Yeah.

because this is the work that we do all of the time, right? We're really familiar with that. But that statistic I I think the general population doesn't realize just how much, right? So the numbers that we you use is one in five, probably more than that. Depending on the research studies, sometimes they have a different one in six, but

In general we use one in five, probably more because it's one in five that we've detected or that people have disclosed. even in those one in five not everybody gets help. Or they get some help, but not enough help.

Megan (05:43)

And it's one

in five pregnancies, not people. Many people have more than one pregnancy.

Paige Bellenbaum, LCSW (05:49)

and what we know to be true about PMADs is that if you do experience one during an initial pregnancy or a postpartum, you're at a significantly higher risk of developing one again. so all important things to consider when we're having this conversation.

Pauline (06:04)

Yeah. And

the number one complication and the number one cause of death, right? We talk about maternal mortality and there's all fancy statistics, but that really just means moms who died.

you know, I I think back it's been it's been a minute since I was in the OB's office for

taking care of pregnancy. But I know they screened for diabetes, they checked my blood pressure. again, we have come a far way, so I know that more and more are screening for P MATS. But I don't I still don't think it gets us quite as much attention as gestational diabetes.

Megan (06:47)

No, I was screened twice

for gestational diabetes and once for a PMAD

Paige Bellenbaum, LCSW (06:51)

Yeah, you're absolutely correct. And one study I saw, the combination of gestational diabetes and hypertension rates combined do not equal that to the rates of women who experience PMADs. And the other thing I would say, based on HEDIS measures from a couple of years back, the statistics even around screening was for Medicaid patients, like sixteen to seventeen percent were being screened.

And for women with commercial plans, it was even lower, from like nine to eleven percent. So yes, you are right, Pauline. We have come a significant way from certainly when I had my first child 20 years ago, I'm dating myself here, and yet we still struggle to close the gap in care and support for pregnant and postpartum people.

Pauline (07:43)

Yeah.

And that that PMAD term which

we started this before the term PMAD even caught on, right? Because it used to just be postpartum depression. And then we're everybody was like, wait a minute, there is so much more than depression. And that's how this like umbrella term moved from postpartum depression to PMAD. But even if under that, there's postpartum psychosis, which isn't

is very different than depression and anxiety. And so it's under this umbrella term. Kind of fits. Sometimes maybe. And so I think really talking about mental health in the perinatal period is so important. You know, even I know in a recent training we did, we talk about adjustment disorders that don't fall under the criteria of a major depressive disorder, but still have an impact.

on folks, especially new parents, and somebody who's like, I never heard an adjustment disorder be considered a PMAD and we're talking about depression and anxiety in the perinatal period. So it it's such a I mean, mental health is broad. It can look so many different ways.

Paige Bellenbaum, LCSW (08:55)

It can, and I think it's really important that you identify where we originated, right? Because there are still a lot of people who will refer to the term postpartum or postpartum depression as a catch-all. And as we started with, we understand that there are several different conditions that fall under the umbrella of PMADs. And when we call everything postpartum depression, then we are missing a large number of different diagnoses.

And I also want to clarify, especially with everything that's going on in the news, when we

Pauline (09:30)

Yeah.

Paige Bellenbaum, LCSW (09:30)

refer to perinatal or postpartum psychosis as postpartum depression, then we are risking combining these two conditions and creating an even larger wedge in fear for people who might be experiencing perinatal depressive symptoms. Of if I come forward and say I have postpartum depression or I'm having these.

They might think that that's what I'm capable of. So the distinction

Pauline (09:58)

Yeah.

Paige Bellenbaum, LCSW (09:58)

between these illnesses really is key.

Pauline (10:01)

Yeah. And

I know that I I think maybe you're involved in some of the the action behind it, trying to get a DSM five diagnosis specifically for postpartum psychosis. So for the non therapist who might be listening, DSM five is like the the encyclopedia of all mental health conditions. And postpartum

psychosis doesn't exist in it right now.

Megan (10:26)

DSM

five.

Paige Bellenbaum, LCSW (10:27)

There you

go, bringing it as show and tell.

Megan (10:29)

Yes.

Well flipped through, right? Yeah. I'm interested to know how you see it being in the the DSM five, how that would change things.

Paige Bellenbaum, LCSW (10:39)

I think it would change things because we would have a scientific and psychiatric term for it. I think when we have specific diagnostic criteria, we'll be able to catch it more. I think a lot of you know, when we look at the numbers of psychosis cases, first of all, it's an area that's completely understudied, but we see numbers like one in two per 1000 births. Now, having worked at the motherhood center

started that program so many years ago, as a perineal partial hospital program, we were really a feeder and step-down from inpatient psychiatric units. So patients that were actively psychotic but stabilized, patients that were suicidal or had an attempt were coming to us for that higher level of care because they weren't appropriate for an outpatient setting. They needed more. So just based on 10 years of being in that environment.

I would say at any given moment we might have five to seven people in a cohort that experienced perinatal psychosis. So I think having an appropriate diagnosis so that people can receive that diagnostically. You know, even looking at what's going on in the news right now, having something that has been accepted as an actual diagnosis would help us start to understand the condition better.

And it would also allow us to capture the true number of people that actually struggle from this condition.

Pauline (12:11)

Yeah.

I think

it's under recognized. And I think so many more people have some spectrum of a psychotic symptom because it is a spectrum that either providers don't catch, they don't talk about, they keep it hidden and they never tell anybody that they were having that happen.

or that like so many women who have postpartum psychosis, providers, loved ones, clergy are always searching for some other reason that this thing could be happening. And so giving it more of legitimate name could give people an

it an okay to be able to diagnose something.

Paige Bellenbaum, LCSW (13:01)

Absolutely.

Megan (13:02)

And change

treatment too. When we think about like Europe and

I know it's not everywhere, but there are centers like mom and baby centers for treating postpartum psychosis and other disorders where that it's accepted that this is something to treat really mindfully and that started with having this diagnosis, right? It's it starts with saying, okay, we're going to recognize this and then put money into it. You know, when you don't have that, it's like

Who puts money into

Paige Bellenbaum, LCSW (13:36)

so appreciative, Megan, that you brought that up because as much as we have made progress here in the US over the past several years, when you look at other countries like Europe and several countries in Europe, they have these mother baby units that you speak of. And not only are they recognizing this very specific disorder of perineatal psychosis, but they are true mother baby units. So that means that mothers are getting inpatient long

Term psychiatric care with their baby, and there's a focus on dyad, attachment, and bonding. And we don't have that level of care here in the US. We have, I believe, five inpatient women's inpatient psychiatric facilities that have a perinatal component, totaling, I think, maybe 26 beds in all, if you add it up. So we are woefully behind our European counterparts when it comes to

effectively treating this illness in a way that allows for that connection between mom and baby to continue to develop in one of the most critical times.

Pauline (14:44)

Yeah,

yeah. I remember being at a PSI conference, I think it was the time where we actually toured the first mother baby perinatal unit at UNC, which I was so impressed, like they do allow the baby to come to visit, but it's it's not what they have in Europe where the baby's there all of the time. anyway, we were in one of the breakout rooms and somebody raised their hand. They're like, I'm from Canada,

We are allowed to admit moms for sleep. And everybody in their room was like, that's amazing, Because here in the US, like the criteria for inpatient treatment is danger to self or others. And up until there, for many people, like you're on your own. And so what happens if we actually change the criteria for inpatient treatment to

An illness that requires intense monitoring and care and not necessarily about danger.

But we're not there yet. You're working on it though.

Paige Bellenbaum, LCSW (15:48)

Someday I have hope, I do have hope that in my lifetime, in all our lifetimes, that we will see that. I know that there are obstacles, but I believe those obstacles can be overcome. And I think this is such a pivotal moment for everyone in the face of perinatal mental health, especially acute perinatal mental health. and I do hope that, with everything that's happening, that there is hope, there is a silver lining that we will really start to pay attention.

attention to the complexity of this illness in particular and that

Pauline (16:18)

Yeah.

Paige Bellenbaum, LCSW (16:18)

we will follow through with programming, with systems change. That is my hope.

Pauline (16:23)

And you are doing a lot to make that happen. I don't want to skip over your story because I think it's it's so meaningful for people to understand who you are, what happened to you, and how that put you on the trajectory to where you are today. So

Can you share with us how you how this became so important?

Paige Bellenbaum, LCSW (16:49)

Yeah, so I've already dated myself in our conversation. So twenty years ago I gave birth to a beautiful, healthy boy. and when I look back in retrospect now, I realize my anxiety developed during pregnancy. I was that person who was calling my midwife multiple times a day because I didn't feel the baby move, or her favorite was, my right breast is no longer tender, I think that maybe I'm I'm losing the baby. So I was

Completely fixated on all of these things that I couldn't see happening in my body.

Pauline (17:22)

Yeah.

Paige Bellenbaum, LCSW (17:22)

And then by the time he got there, my anxiety developed further, as well as the depression. So I was not sleeping, I was not eating, I had lost most of my baby weight within the first month or so after he was born. I was convinced that he was gonna die, that something terrible was gonna happen to him. And so I would say.

The anxiety led immediately after he was born. He wasn't sleeping enough. He wasn't eating enough. He was sleeping too much. And then it really plunged into a pretty dark depression where I didn't feel connected to him. I felt like I'd made a huge mistake. I wanted my old life back. I wanted to buy a one-way ticket and fly away to a country and never come back because I felt like my son and my husband would be much better off without me.

I stopped being able to really take care of myself and was just barely able to take care of him. And then it began to drop further into suicidal ideation. So ways that I could not be here anymore. And it all culminated one day where I had decided to leave the house. I hadn't been out in a really long time, and it was we were in an apartment in the East Village without air conditioning. It was like not

95

degrees out, and remember pushing my son in the stroller and it was kind of gray and overcast, and everything just felt so bland. And as I got closer to the sidewalk's edge, I saw this bus coming out of the corner of my eye. And I had this enormous urge to throw myself in front of the bus. It took everything I had to not follow through. And I remembered that as the bus passed slowly, not so slowly, I saw a

Reflection of myself in the window, and I did not recognize that person at all. I didn't know

Pauline (19:12)

Mm-hmm.

Paige Bellenbaum, LCSW (19:13)

who it was. And I knew that I absolutely needed help. And what's interesting about my story, and this applies to clinicians everywhere, you know, regardless of your licensure or degree, I was a trained clinical social worker that was able to identify mental health conditions in other people. But when it happened to me, I had no idea.

What it was.

So I got help. I went to the only treatment facility in New York City at the time that specialized in perinatal mental health. I started therapy, I started medication. I'd say, you know, within four months, six months, I was starting to feel like myself again. And it was at that point where I got pissed.

Because I had been speaking to a whole lot of other mothers out there that were in it, that were struggling, that had struggled, and th there was

Way more shame and stigma back then than there is now. And I was like, what is going on? That we are not talking about this. So I started researching legislation. Is there any state, is there any city that's doing education around perinatal mood and anxiety disorders? And I ended up drafting model legislation on screening that I took to a state senator who I'd done some policy work with in the past, because that was really my background.

as

a social worker was an advocacy and policy work and I was like, listen, this happened to me. It's happened to a large percentage of women that I have spoken to and we need to do something about it. And she said, let's do it. So we spent about four years getting that bill

ready for introduction and then it was finally signed into law in twenty fourteen. But that really started my unflappable commitment to ensuring that other women do not have to struggle silently as I did.

I kept all of that a secret for almost nine months. I mean I didn't feel like a secret to me. I felt like everyone around me could tell that I was absolutely decompensating. But you know it's just such a remote

Reminder that people don't know what to do, right?

Megan (21:27)

Yeah.

Paige Bellenbaum, LCSW (21:28)

My husband didn't really know what to do. He didn't know what was normal and what wasn't. You only have one six-week visit with your OBGYN. And at that point, I just wanted to get out of there.

Pauline (21:40)

And they wanna talk about birth control.

Paige Bellenbaum, LCSW (21:42)

we want to talk about things, yeah.

Megan (21:43)

Yeah, I mean I asked a doctor

at six weeks, eight weeks, one year, like, hey, do you know someone I could talk to? And they say, No. I don't. So it it really and this was a while ago, fourteen years ago, but hopefully now maybe it's a little different. But

Pauline (22:04)

Yeah.

Paige Bellenbaum, LCSW (22:04)

Yeah.

Pauline (22:06)

Did anybody ever I mean you said you didn't recognize what was happening to you? Did anybody in your family, friends, did anybody say like how first like did they ask how you were? Everybody asked about the baby. Did anybody ask how you were doing? And did anybody say like what's going on?

Paige Bellenbaum, LCSW (22:29)

So one of my symptoms, if you will, is that I really didn't want to be around anybody.

I didn't really want anyone coming over. I didn't want anyone to see me that way. I didn't I just had no interest in in, you know, pursuing any relationships. And so my parents certainly thought something was up, but people think it's baby blues, right? This is just part of the transition to motherhood. And this

Love my mom and and she would always say this too, shall pass, which still rings in my ears is like the thing you never want to say to somebody who's struggling, right? Because it completely eliminates and annihilates the moment they're in in that moment.

Pauline (23:14)

Yeah.

Paige Bellenbaum, LCSW (23:15)

she she didn't know any better, right? Like nobody knew any better. There was one woman, a friend of ours, who came over to visit once, and she was like, I don't think you're okay. and told my husband, and she

Was the only person who I felt really saw me. I will never forget that, right? Even though that might not be a wonderful thing to hear, I felt like somebody saw me for the first time. And in that I found a little bit of resolve to move towards doing something about it.

Pauline (23:48)

Yeah.

Was there a reason why you didn't tell anybody or why you kept it a secret for so long?

Paige Bellenbaum, LCSW (23:57)

Shame, judgment. I was fearful of what people would think of me. I was in such a deep relationship with my anxiety, along with the depression. you know, anxious about and maybe even a little paranoid, like what will people think if they know I'm having these thoughts or

really embarrassed, feeling like a failure, feeling like I'm not cut out for this, right? That my duty as a mother to be able to do this thing that women have been doing since the beginning of time that I was failing at. also like nobody was talking about it. So I felt like I was the only person, as still 20 years later, so many women do. It's just me.

Pauline (24:38)

Yeah.

Paige Bellenbaum, LCSW (24:39)

I'm alone in this, nobody else is struggling. And I also kind of felt

But like how could people not notice

I felt so different, but in that, I share this in reflection to the work I went on to do clinically, even women who might appear to be the most put together. I remember women would enter, you know, at the Motherhood Center and sit on the sofa and would be like so well put together and be like, Is that a reporter? Like, who is that? That was our illest patient. So this pressure to perform and to look a certain way so that nobody will

Know this deep secret that you're carrying, which I think you know, so so many women can relate to. But those were all a lot of the reasons why, and denial, right? What we know about PMADs, and I think this is important because I run into this a lot clinically as well, is I did have good days sprinkled around. And when you have good days or a good few days, it makes it that much harder.

Harder to think there's actually something wrong. Because when you have the good day, you're like, I'm feeling better, it's done, it's over, it's in the past, that sucked. And then three days later, you're back at the bottom of the barrel again. So, so that inconsistency, which I think is important for us to note with PMADs, and how easy it can be, like, well, if I actually had depression, I'd be depressed every single day all the time. So, again, even as a clinician, you forget what you know.

when you yourself are struggling with mental health conditions. So I think all of these reasons, yeah, they they contributed to me staying silent.

Megan (26:19)

And depression

doesn't always feel like what we think it should feel like. You

Paige Bellenbaum, LCSW (26:24)

Yeah.

Megan (26:24)

especially you being a clinician, that can I I think there's a can be some denial that comes in. It's like it couldn't possibly happen to me. I know what this looks like. And then yeah.

Pauline (26:38)

you can't see it when you're in it. And so that's why you know, in the work that we do, we talk with pregnant people all the time about like, let's make a plan for a postpartum they're often like, No, no, I got it, it's gonna be fine. It's like, Well, let's just make a plan now so that if things go awry, you don't have to think about it. Because once you're

you're in it. You can't it's really hard to

see the forest through the trees, right? and it becomes your normal.

And I think for the people around you also, it's harder to see the difference because it's been this like for many people, not everybody, but for many people, it's like this slow progression.

And it's not just you were fine yesterday and today you have a rash all over your body, right? It's there's no physical symptom that you can check off on a list. It's and so it makes it complicated for providers to recognize, families to recognize. it's not a one, two, three checklist. It is listening, asking questions, being curious.

Building that relationship where you might have felt safe enough to share those deep, dark feelings that held a lot of shame and guilt. that doesn't happen in a three minute appointment with a provider who just comes in and and leaves. It takes it takes time.

Paige Bellenbaum, LCSW (28:13)

Yeah, and if I bring all of that as I always do, how it informs my work as an advocate, as an educator, as a clinician, you know, I do a lot of training and psychoeducation now with Postpartum Support International and beyond.

when it comes to screening and talking about best practices in screening, I'm always careful to acknowledge, that providers that come in contact with perineal people, let's say OBGYNs, for example, I'm very mindful of the fact that they are like boom boom boom all day, patient after patient. This is our healthcare system. And so I am cognizant of the fact and empathetic to the fact that it can be difficult to have a

Full-on conversation, and at the same time, they're very simple things that we can do as a provider to grease the wheels, if you will, and open the door and allow it to feel more safe for somebody to be honest, Even if it's just starting with a couple facts of normalization. One of the things that we're going to be doing in our work together while you prepare for baby is staying on top of your physical health, which is critical, but your mental health is just as important. And one of the ways that

We're going to keep an eye on it. Is that I have assessment that I use with all of my patients a couple times throughout their pregnancy just to check in and see how they're feeling. I want you to know that even though we don't think postpartum depression or anything is going to happen to us, it actually happens to one in five new and expecting mothers. So it's really important that if a mom is struggling with her mental health, the sooner that we can identify it, the sooner we can get.

her the help and care she needs and deserves.

So would it be okay with you if we took a few minutes to do this assessment together? it took me what two minutes? Not even one minute maybe to deliver that message and then go through the questions.

Pauline (30:07)

Yeah.

Megan (30:08)

Which is so different from normalizing I feel like so much focus has been on normalizing how hard it is. And it is. Being a parent is very hard and your life changes, but saying like, it's normal to not get sleep, or it's normal to, be sad, or it's normal to feel overwhelmed. Well

Let's talk about it instead. You know, what does that actually look like for you? Feels really different than just validating how hard it is.

Pauline (30:33)

Yeah. And you're you're right. Our system is not set up to allow that kind of thing to happen so easily. And there are things that hopefully we can continue to do so that providers feel like they can take the time to ask those questions.

And what I've heard from I'm sure you've heard this from OBs is if they do ask the questions, they know what to do.

Paige Bellenbaum, LCSW (30:59)

Yes.

Pauline (31:00)

with the

answers that they get. They know where to send somebody. it is a terrible feeling to identify a problem and then not know what to do about it because there are no resources available.

Paige Bellenbaum, LCSW (31:11)

Right.

Absolutely. And and also, you know, it's interesting over the years I've really changed my tune around whose job is this anyway. And I used to be, you know, ten, fifteen years ago, very much on the side of OBGYNs, it's your job. You have to do this. You're the you are the discipline that comes in contact. You need to screen, you need to educate, you need to do all of that. And I have sensed while I still absolutely think that this work.

Belongs in that space, have become such a fan and supporter of models that now exist to integrate behavioral health care. So the collaborative care model, integrated care, where we have behavioral health professionals embedded in an obstetric practice that are responsible for psychoeducation, screening, short-term

Pauline (32:06)

Yes.

Paige Bellenbaum, LCSW (32:06)

and long-term therapy, referral resources, and that takes the onus off.

The OBGYN to have to cover all of those pieces along with what they're trained to do. So I'm really hopeful that we see these models take off. And you know, interestingly enough, OMH, New York State Office of Mental Health, they really have been committed to improving perinatal mental health outcomes and was proud to be one of the leaders on a report that was released at the end of last year, New York's maternal mental health recommendation.

And report. And one of the initiatives coming out of that is to fund collaborative care models across the state. And so they're in a funding round right now to provide small startup grants to 17 OBGYN practices across the state to be able to bring in a behavioral health care manager, have a prescriber that can help give them direction and consultation on prescription and med management.

And we have billing codes to go along with it, right? So these are these are not impossible models to recreate everywhere so that we start to better fill those holes and gaps in care.

Pauline (33:25)

Yeah.

Wouldn't that be amazing?

Megan (33:30)

It's that wrap around program

seeing something from many different angles all under one roof, then you're less someone's less likely to fall through the cracks. And it's not it's not that much more expensive. I mean, I don't fund programs, but

You know, these are all things that we have already. They're th they're behavioral health experts, there are p pediatricians, there are OBGYNs. We can have them close together.

Paige Bellenbaum, LCSW (33:55)

Yes.

Pauline (33:56)

Right.

I mean, I think if they can figure out how to do a three hour glucose test and keep somebody in the office and test their blood every hour, we can figure out how to screen somebody for depression and anxiety in pregnancy and postpartum.

Paige Bellenbaum, LCSW (34:11)

And there you go, Pauline, like what a great window of opportunity, If we had a video that, you know, was a requirement for patients to watch while they were waiting for their glucose exam. If it became standard practice to provide people with a brochure or a pamphlet, I know these things aren't gonna capture everyone and they're not, you know, that alone might not make a significant difference, but you have somebody in your office for however many hours sitting there, why don't we take advantage of that?

Window of times exactly and provide some psychoeducation. That would be a wonderful window.

Pauline (34:47)

where there's a will, there's a way. And Paige

Paige Bellenbaum, LCSW (34:49)

Right.

Pauline (34:50)

has the will, as

Megan (34:50)

Ha ha

Pauline (34:51)

do many of us. So we are all working together so that no mom is like, nobody ever told me this could happen.

Megan (35:00)

So Paige, what is the thing going back before this was your role, your career, like it is now, what's the one thing that no one told you that you wish you had known?

Paige Bellenbaum, LCSW (35:16)

Well, interestingly enough.

It's what I what I sought out to do and am currently doing. I'll answer that in a two-pronged way, personally and professionally. I wish personally that somebody had seen me, laid eyes on me, and said, I know what you're going through, you're not alone. This happens to so many people. I've got your back. This concept that I always share with new mothers.

That I think gives them a sense of relief because it's what they long for. I see never is there ever a time in our life where we desire to be mothered more than when we are becoming a mother. And God, I just wanted to I wanted the proverbial mother to scoot me up on her lap and hold me and rock me back and forth and tell me it was gonna be okay. And I have spent years of therapy working through giving myself that. So personally, that is what I wanted

Professionally, I wish that as a social worker who

is moving through the School of Social Work and getting my degree, that there was a course on perinatal mental health so that if it happened to me, I would know. Hence, fast forward, I'm teaching a class at the Silberman School of Social Work at Hunter College. It's one of the first perinatal mental health courses. There's very few in the country. we're in the process of trying to publish a book to accompany the course, and we're

turning it now into a year-long trajectory. So that social workers and hopefully other disciplines, right, will be able to access this education so that when they go into the field, they know what to do. And as we know, so many people that are drawn to this field do so because of their own lived experience. So you got a little bit more than one answer there. But that's what I that's what I wish someone had done for me in

Pauline (37:08)

Yeah.

Paige Bellenbaum, LCSW (37:08)

both of those ways.

Pauline (37:10)

So you said it and we're putting it out there.

Thank you so much for being here with us today and thank you for all of the work that you are doing. We are not gonna stop having babies.

Megan (37:24)

I am. I'm done.

Paige Bellenbaum, LCSW (37:25)

Me too.

Pauline (37:26)

not

we, the people in this room, we

the greater community the human race is gonna keep having

Megan (37:32)

The hum human race is not done. Yeah.

Pauline (37:36)

babies and we're not gonna stop until this is not a problem that people are doing.

Alone.

Paige Bellenbaum, LCSW (37:47)

Exactly. I wonderful, wonderful words. And I just want to thank you, Pauline and Megan, for being such wonderful co-hosts and for leading such an important conversation for everybody who's listening.

Pauline (37:59)

Thank you, Paige. And maybe we'll have you back another time to talk about some of your other parenting experiences.

Paige Bellenbaum, LCSW (38:06)

would love to, because now now one's twenty and one's seventeen, so I've got all kinds of observation.

Pauline (38:11)

Yeah, we're the we're

the been there done that moms.

Paige Bellenbaum, LCSW (38:14)

Yeah.

Megan (38:16)

yeah, I'm in

Paige Bellenbaum, LCSW (38:15)

But it feels like yesterday.

Megan (38:17)

the middle, so not quite to the the college age yet, Yeah.

Pauline (38:22)

You can see it on the horizon. Yeah.

Well, thank you so much.

It's been fun and we will definitely bring you back for some more.

Paige Bellenbaum, LCSW (38:32)

Sounds good. Thank you both.

Megan (38:34)

Thank you

Pauline (38:34)

Thanks,

Megan (38:34)

very much.

Pauline (38:34)

Paige.