ProDoula

Maternal mental health emergencies.

I am a postpartum doula, not a birth doula. So my phone usually doesn’t ring at 4:30am. That was clue number one that something was wrong.

My second clue?

The panicked voice of a close family member on the other end of the line, imploring me to help. Help with what? Another close family member of ours experiencing a psychotic episode that had seemingly come out of nowhere.

As an experienced postpartum doula, I should have some idea of what to do in a mental health crisis, right?

Not necessarily.

In practice, I could spot all the signs of a maternal mental health emergency. But in reality, I was unprepared for what to do to get my family member immediate help.

So, let’s talk about maternal mental health emergencies. Not just the 1 in 7 statistics we are all familiar with. Not the multitude of perinatal mood and anxiety disorders that exist beyond postpartum depression.

Let’s talk about maternal mental health emergencies.

Let’s prepare ourselves by utilizing this online resource.

If you walked into a client’s home tomorrow to discover an emergent mental health crisis – signs of postpartum psychosis such as paranoia or hallucinations, fear that a client may harm themselves or their baby – what would you do?

First, make sure that your business intake forms are set up to gather information about your client’s spouse, partner, or emergency contact. If you truly fear for your client’s safety or the safety of their baby, you need to be able to get in touch with their partner ASAP. This means having a work number and cell phone number where they can be reached. If there is no partner in the picture, gather information for an emergency contact, even if they don’t live locally.

When you suspect a maternal mental health emergency with your client, this is the first person you should call.

Second, take a good, long look at your resource list and make sure that it includes emergency resources. A therapist experienced in perinatal mood disorders or a great postpartum support group are wonderful things to have on that list.

But they are not going to help you in a true maternal mental health emergency.

Sometimes you can’t reach the partner. And sometimes even if you can, the partner may still turn to you about who to call next. So, who do you call in an emergency?

One great resource is ​Postpartum Support International​, which has a warmline you can always call.

They might be able to direct you to the appropriate local resources if you’re not sure where else to turn. Where I live, we are fortunate to have a perinatal mood disorder clinic with an inpatient ward for postpartum parents in crisis.

Do you have something like this in your area?

Do you know how to get in touch with them?

Many cities also have mobile crisis units that can come to your client’s home to assess them and determine if they need immediate help. These mobile crisis units send out professionals who are trained in mental health emergencies and can often be a better option for your client than calling police or walking into an ER (which short of these other resources, sometimes is what you must do in a true emergency).

Knowing that options like this exist can be a literal lifesaver for your clients experiencing maternal mental health emergencies.

And finally, if you’ve never given any real thought to what you would say to a client in the midst of a maternal mental health emergency, I challenge you to spend several minutes today doing just that. Do you have the language at your fingertips to have a hard conversation with a client?

Do you have the relationship with your client so that they trust you with these hard things? Ask yourself that one more time.

Because let’s be real here. If you spend your time as a postpartum doula focused on ​tasks​ – floors to be swept, laundry to be folded, dishes to be washed – you are missing the bigger picture of what we really do.

Instead, focus on your ​client​.

Be their person – the one they talk to about the BIG things, the one they trust with the really hard stuff. And then know what to do when they turn to you in crisis; when those maternal mental health emergencies reveal themselves.

Kelly Rutan is a ProDoula Certified Postpartum & Infant Care Doula, as well as a member of the ProDoula Training & Development Team. She is the co-owner of ​Doulas of Raleigh​.