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The Red Tent: Support Groups for Childbearing Women Experiencing Anxiety and Depression

New and expectant mothers experiencing anxiety and depression are often isolated and alone; support groups provide hope for recovery.

Photo of Adrienne Griffen
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In no more than 3 sentences, please tell us who your idea is designed for and how it reimagines the new life experience.

Too often in the United States, new and expectant mothers are isolated and alone, far away from their mothers, grandmothers, aunts, sisters, and cousins. This social isolation can contribute to anxiety and depression, which affect 1 in 5 childbearing women and are the MOST COMMON complications of pregnancy and childbirth. Our support group model provides a low-cost community-based intervention that offers new mothers validation, normalization, and hope for recovery.

                                                ANXIETY and DEPRESSION


1 in 5 new or expectant mothers will experience anxiety or depression, making these illnesses the MOST COMMON complication of pregnancy and childbirth.

In the United States, most new mothers are far away from their own mothers, grandmothers, aunts, sisters, and cousins -- leaving them isolated and alone, which can exacerbate feelings of anxiety and depression.

At Postpartum Support Virginia, we have created a group model that provides much-needed support and connection for new and expectant mothers that is low-cost, community-based, and easily replicated.  We launched our first group in 2005; we've learned man lessons about running groups and have refined our model based on experience.  We now provide 20 groups throughout the state.

Our support group model provides much-needed validation, normalization, and hope for recovery.  Our support groups are

  1. FREE, easily accessible, on-going, and drop-in
  2. peer support groups that provide psycho-social support
  3. located in hospitals


This model works because it minimizes barriers to care, utilizes a team approach, and is hospital-based, offering groups at times and locations accommodating to new mothers and their infants.  

PSVa's support group model was recently featured by the 2020MomProject in its "Models That Made It" category.

At what stage is your idea?

  • Full-scale roll-out: I have completed a pilot and analyzed the impact of that pilot on the users I am trying to reach with my idea. I am ready to expand the pilot significantly.

What early, lightweight experiment might you try out in your own community to find out if the idea will meet your expectations?

Postpartum Support Virginia provides 20 FREE peer support groups for new and expectant mothers experiencing anxiety or depression. Our first group was launched in 2005; since then, we’ve learned many lessons about running groups and have refined our model based on experience. Our support groups are FREE, easily accessible, on-going, and drop-in; are peer support groups that provide psycho-social support; and are located in hospitals. This model works because it removes barriers to care.

What skills, input or guidance from the OpenIDEO community would be most helpful in building out or refining your idea?

We would love ideas about how to better integrate cultural components to provide support to childbearing women who identify themselves as ethnic minorities. For example, we recognize that some ethnic groups feel marginalized by the healthcare system or cannot access traditional mental health programs. How do we tailor social support groups to meet their needs? Where and when should we provide these groups so they are easily accessible?

Tell us about your work experience:

I started Postpartum Support Virginia after my life-changing experience with postpartum depression and anxiety. My previous work experience includes positions in the United States Navy, the United Nations, the IRS, and the White House.

This idea emerged from...

  • An organization or company

Are you an expecting, new, or experienced mom?

  • yes

Are you a healthcare practitioner?

  • no

Are you a current employee of UCB Pharmaceuticals or Sutter Health?

  • no

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30 comments

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Photo of Michelle Gilliland
Team

My name is Michelle Gilliland and I experienced severe PPD almost 28 years ago,for which I was hospitalized for 3 weeks.When I emerged back into the "Real world" outside of the hospital,The support group and phone support I received were extremely crucial to my recovery.I then became a "phone support" person and held two support group sessions in my home.I am an RN on a Mother/Newborn infant unit and am always on the lookout for patients in the early stages of PPD.NOBODY understands like another mother who has been through this illness.There has been SO MUCH more awareness of these mood disorders since back when I experienced it,and I feel very passionate about support groups/phone support.I am in awe of Adrienne for her dedication and work!

Photo of Kiera Jones
Team

The ability to connect with other mothers who are experiencing the same struggles, concerns, and intrusive negative thoughts is invaluable. It is SO important for mothers to understand that they are not alone and that postpartum depression and anxiety is treatable. Without this knowledge, mothers like me will listen to the lying, negative intrusive thoughts and believe that they are unable or unworthy of being a mother. Postpartum Support Virginia's free and peer-based support groups allow mothers to drop in for support when they are able. When mothers can speak with those who have or are struggling, they feel validation that they are not alone and hope that they too can get better. In some of the support groups that I attended, it was so interesting to see how supportive people are of each other yet how hard they are on themselves. It takes some time, but eventually many women begin to extend the same level of empathy and compassion that they give to others, to themselves as well.

Photo of Mandolin Restivo-Walsh
Team

Excellent program!

Photo of ellwood1
Team

My name is Inna Thomka and being a mother and a mental health professional, I am very passionate about PSVA’s mission of ensuring that a support group is available to expectant or new mothers, regardless of age, race, socioeconomic status and geographic location, who are experiencing symptoms of pre or post-partum depression and or anxiety. Having a safe environment to share thoughts and feelings, receive support and validation, as well as be connected to services and resources is an essential part of the process of healing and recovery for mothers and their loved ones!

Photo of Megan Monsky
Team

Support groups provide a lifeline to moms suffering postpartum depression. Society portrays the birth of a baby as one of the most happy times in a woman's life, but for many, it is a time of fear, hopelessness, and anxiety. Women suffering from PPD feel alone, embarrassed, and don't know where to turn for help. Supports groups are a great way to help mom's cope, understand that they are not alone, and help them on the path to recovery!

Photo of Diana Mcspadden
Team

Such a great idea. During my own PMAD experience I loved the theraputic support group I attended; however, it included all people with depression, substance abuse, and anger management issues. Having a peer led, and peer attended support group allows women to open up in ways that they may not otherwise. Having specialized groups around military, teen moms, and ethnic groups may be beneficial in the same way. I would love to see moms from differenet communities trained to lead these groups, or supported in other ways by Postpartum Support Virginia so that it would be possible for them to lead their specialized peer groups: transportation assistance, childcare, and technology support for virtual/web-based groups come to mind.

Photo of Katie Shaw
Team

When I had my son 9 years ago, I felt like a complete failure. I was new to motherhood, second guessed everything I did, and cried multiple times throughout the week (and this was 3 months postpartum). Thankfully, I was part of a local mom's group who distributed one of PSVA's fliers and one night decided I needed to get some help. I called the number and spoke to Adrienne and she hooked me up with a support group in the local hospital. The support group was life changing for me. Even 9 years later, I still remember the second time mom who just nodded her head while I talked and how just this simple gesture made me feel less alone. And just hearing the stories from other moms made me realize that I wasn't a bad mom and I wasn't going to ruin my baby. I was only able to go 3 or 4 times before I had to go back to work (and there were no evening groups at the time) but this group showed me that I wasn't a failure and that I was going to be ok.

Photo of Mary Beth Waite
Team

When I had my daughter 8 years ago I was a comple mess filled with anxiety and exhausted. I met a mom who asked me to go with her to a Postpartum Support Virginia group. It changed both of our lives. We received support from many moms we met and we also learned of resources and providers of mental health services in our community who helped us on our path to recovery. The biggest thing for me that helped was learning I wasn’t alone and that there was a way to get help and feel better.

Photo of JJ
Team

I have seen first hand the importance of these groups supporting new mothers. I am one of the co-leaders for a hospital-based group and I wish I knew about these type of groups when I experienced postpartum depression with my first child. It is wonderful to watch these women realize that they are not alone and learn that there are resources available to help guide them through this challenging time.

Photo of Jay West
Team

As a pediatrician, I am excited to see programs supporting new mothers. I have seen the positive impact this support can have on the health and well being of children and families.

Photo of Kate Rushton
Team

Hi Adrienne Griffen !

The refinement phase closes on Nov 5 at 3:00pm PST. I look forward to seeing your updates. Please reach out to me if you have any questions at all.

Photo of Kate Rushton
Team

Hi Adrienne and Olivia,

I hope you are having a nice weekend.

When you press the ‘Edit Contribution’ button on your idea submission you will be able to see the questions for the refinement phase when you scroll down. You can only do this if you are signed into your OpenIDEO account.

I look forward to seeing how your idea develops. What is unique/new about the service you will provide? What sets it apart from other services?

Could there be a way of using their program to improve mental wellness in under represented groups with chronic disease?

There are a few ideas from previous challenge that might be a source of inspiration in the refinement phase:

Cobuy - Group buying software that helps people buy good food at good prices, together. - https://challenges.openideo.com/challenge/food-waste/top-ideas/cobuy-group-buying-software-that-helps-people-buy-good-food-at-good-prices-together - really highlights their Unique Selling Point.

Libraries as Financial Literacy Hubs - https://challenges.openideo.com/challenge/financial-empowerment-challenge - Establishing an Effective Financial Literacy Program for the Patrons of Oakland Public Library - has clear user scenarios

Photo of Kate Rushton
Team

I wonder if Milana PeBenito has any thoughts on this idea.

Photo of Siyu Ding
Team

What a great idea

Photo of Anlan
Team

Hi Adrienne and Olivia,

I like your idea and the potential it can have on new mothers. Also, it is interesting to see that you have gone strong for more than ten years, and that makes me feel better when I think that the problem of anxiety among new mothers is already receiving attention. You also talked about the ease of replicating your business model, could you explain this process, a little bit?

Photo of Olivia Hinebaugh
Team

I think this is such an important idea. I'm with you in the refinement phase (and also in Virginia). I'll be eager to see how your project progresses!

Photo of Kate Rushton
Team

Hi Adrienne,

Congratulations on making it to the refinement phase!

Please tag me here with questions using '@' followed by my name (Kate Rushton).

Photo of Jennifer Doebler
Team

I so agree that the mythology around being a new parent is potent and potentially hurtful to the new parents who have anxiety and depression added to their overwhelm. Thank you for making a space for them to get support without judgement. It is very inspiring that you have grown this organization since 2005. The concept I have listed is similar in logistics, but focused more on helping new parents better understand what infants need for healthy development so they can enjoy their babies more. I wonder if mothers with postpartum depression would also be helped by learning a little bit more about their new infants. In addition to the mood disorder, the very real challenges of crying babies and nursing, etc. can be a lot for anyone. Sometimes with a little more information, parents can relax a bit, which might support their anxiety/depression. A little like the depression-sleep conundrum. Which do you treat first? Just an idea for an additional component of your program... Best of luck to you in this important work you are doing!

Photo of Adrienne Griffen
Team

Hi Jennifer

Totally agree that helping new parents understand their baby can be helpful. New parents have an expectation that they will totally love their baby and understand what baby needs -- and when this doesn't happen immediately, it can add to feeling overwhelmed and out of control.

We love it when moms bring their babies to our support groups so we can validate that they are doing a good job caring for this little person, that keeping another human being alive is hard work, and that love isn't always instantaneous.

During pregnancy, the whole focus is on labor and delivery. No one can imagine what it is like to have a newborn, be sleep-deprived, be in pain/discomfort. It's similar to when someone is engaged -- all they can focus on is the wedding -- never mind what it is like to be married.

Photo of Roksana Khalid
Team

Nice idea!
How would you encourage women to attend?

Photo of Adrienne Griffen
Team

HI Roksana

We encourage women to attend through many different approaches:

1. Information about postpartum depression and the local support group is included in hospital discharge packets for maternity patients.

2. We talk with obstetricians and pediatricians -- who see moms on average 30 times during pregnancy and first year postpartum -- and teach them how to discuss these illnesses with new and pregnant moms and share information about our support groups.

3. Hospitals include information about the support groups on their websites, social media platforms, newsletters, etc.

4. We also educate birth and postpartum professionals -- such as doulas and lactation consultants -- about these illnesses so they can help new moms and refer them to our support groups.

Would love any other ideas that you have!

Photo of DeletedUser
Team

DeletedUser

well done Adrienne . This is very good work i wish u all the best,and for the different ethnic groups catered for.

Photo of Drake Van Egdom
Team

I want to create a support group for new mothers and fathers and I have a couple questions about your program. How do you identify people to join your program? Do you think mothers are hesitant to be diagnosed or be in your program? There is definitely a stigma towards perinatal mood and anxiety disorders.

Have you thought about a more general support group for new and expectant mothers? All mothers can feel lonely or isolated from society after having a child. Other mothers can provide an atmosphere of acceptance and belonging.

I really like your community-based program.

As far as your cultural problems, I read a book called "The Spirit Catches You and You Fall Down" by Anne Fadiman that tells the story of a Hmong in the U.S. healthcare system. The book opened my eyes to the cultural differences of daily life, especially in the complex U.S. hospitals.

I think you should talk to a group of the ethnic minority to find their opinion on the matter. Every cultural group in each community has a different context. You should be asking your questions to individuals from these groups. Whenever possible, include them in your design process.

Photo of Adrienne Griffen
Team

HI Drake

Most of our group attendees self-identify, although some are referred to our groups by their therapist or psychiatrist.

You are absolutely right -- there is a great deal of stigma about perinatal mood and anxiety disorders. Having a new baby is supposed to be the happiest time in a woman's life, right? Women are reluctant to acknowledge that it can be difficult. And some women don't even realize that they are struggling -- they think that all new moms are overwhelmed and anxious and exhausted.

A woman will see a healthcare providers on average 30 times during a routine pregnancy and first year postpartum. Yet no one is responsible for talking about PMADs or screening for them. So we encourage all maternal-child healthcare providers to educate women about PMADs:
OB/GYNs: at least once during first and third trimesters, along with postpartum fivsit
PEDIATRICIANS: at all well-baby checks (2, 4, 6, 9, and 12 months)
HOSPITAL STAFF: prior to discharge, include information in maternity discharge packets

There are lots of support groups for new moms -- many hospitals and churches provide them -- and they are important for women to connect with each other during this transition. Some of my closest friends are women I met at New Moms Groups.

We at Postpartum Support Virginia provides groups particularly for those suffering anxiety and depression. These groups provide a safe place for women to talk about their feelings without judgment.

Thanks for the book suggestion -- I will definitely look it up!

Good luck with your group -- happy to help in any way.

Photo of Kate Rushton
Team

Hi Adrienne!

Are there certain ethnic groups you are especially keen to reach out to?

Photo of Adrienne Griffen
Team

Primarily African-American and Hispanic (although lots of different sub-groups)

Photo of Anna Lee
Team

I love this; the parts that really stood out to me are the fact that these groups are on-going, drop-in and located in the hospital. I believe that one of the barriers to accessing mental health care is just the enormous amount of cognitive load that people experiencing depression face just getting through the day. Planning days ahead, researching, calling and making appointments <-- these are huge hurdles for any overwhelmed parent of a newborn, not to mention those suffering from depression. So simply by opening a door and saying "come in" in the hospital, when a new mom is still there after giving birth, or when they are visiting for a well visit, removes a big barrier.

Regarding your question about how to meet the needs of ethnic minorities, of course it depends a lot on the specific cultures represented in your community, and also the socio-economic class, as these are factors that significantly affect 1) the specific financial, geographic and temporal barriers to entry (does she have child care, a way to get to the hospital, does she have to take time off of work?) 2) attitudes towards mental health (for ex, many Chinese view mental health "deficiencies" with shame and are reluctant to admit or discuss it, however this view changes drastically depending on age, region, socio economic class and how "traditional" the individual and her family are.) and 3) attitudes towards the role of healthcare providers vs. peers in providing advice (for ex, some (but not all -- depends again on what age, region, socio-economic class) traditional Chinese might feel very averse to discussing "personal" issues with a gathering of "complete strangers," but might feel more open to discussing things with a "professional, highly-trained doctor" in response to an "official diagnosis". There are so many variables to approaching outreach and addressing needs of cultural minorities that in order for the approach to scale, I think it may be useful to step back and think in broader categories -- for example how a trained moderator might moderate peer-to-peer discussions in a way comfortable for both "low context" vs. "high context" cultures (https://en.wikipedia.org/wiki/High-context_and_low-context_cultures, and see writings by Edward Hall). Or consider how outreach communication might be different for "low context" vs. "high context" cultures (the former might respond better to detailed posters, brochures and websites in the appropriate language, the latter might respond better to a private call at home, or a gentle private word from a sympathetic nurse). So an outreach program that considerately includes multiple onboarding modalities, followed up with a sensitive moderator or being matched up with a "buddy" in the peer group , might address many of the culturally specific needs of minorities.

Photo of Adrienne Griffen
Team

HI Anna

Thanks so much for your thoughtful response!

You are absolutely right that we need to make it as easy as possible for new moms to get help. We know it's hard to get out the door with a new baby; we know it's hard to get somewhere if you are anxious or depressed; so we know it's DOUBLY hard for new moms experiencing postpartum depression to get anywhere!

Thank you for your insights about how the Chinese view mental health issues. The same view is held by other Asian cultures as well as Hispanic communities. Some languages don't even have a translation for the word "depression." We know that many Spanish-speaking women will describe their symptoms as somatic (headache, stomachache, "attach of the nerves") rather than emotional.

I LOVE the suggestion of pairing someone with a "buddy" who might be able to navigate some of the culturally-specific needs of minority moms.

I also want to be very careful not to put cultural differences on people based solely on how they look. For example, just because someone looks Asian doesn't necessarily mean that she carries a lot of culturally-based issues or expectations.

I'm trying to develop an approach that encourages our volunteers to step back and consider that EVERYONE comes with a basket of expectations / needs, whether they are cultural or something else. For example, while I am not an ethnic minority, I am the oldest daughter in my family, which comes with its own set of issues and expectations (eager to please, rule-abiding, organized and efficient, doesn't need help with anything, etc, etc). So maybe what we need to ask is something like...."What else is going on here that we don't see on the surface?"

Lots to think about!

Photo of OpenIDEO
Team

Congratulations on being our Featured Contribution!

Photo of Kate Rushton
Team

Thank you for telling us about the great work you are doing, Adrienne!

I am tagging some people here who might have some ideas on how to better integrate cultural components to your program to provide support to childbearing women who identify themselves as ethnic minorities - Elsie Amoako who is developing Mommy Monitor Drake Van Egdom Bettina Fliegel