Pregnancy can be a trying time for many women.
Women who are pregnant or just delivered are changing physically, hormonally, emotionally and socially. While pregnancy and birth are joyful occasions, it can also be accompanied by worry, anxiety and even depression.
The federal Agency for Healthcare Research and Quality estimates that as many as 13 percent of women suffer either major or minor depressive episodes during the often emotionally and physically challenging perinatal period.
Perinatal Resource Offering Mood Integrated Services & Evaluation (PROMISE) clinic of University of Colorado OB-GYN provides on-site screening, treatment, emotional support and community referrals for women who are receiving pregnancy care with us and who may be experiencing perinatal mood disorders.
“Perinatal” pertains to the period surrounding the time of birth, from the 20th week of gestation to the 28th day of newborn life.
The clinic reflects a steadily growing recognition in the medical community that pregnancy and the period after delivery can be difficult times for women, says Cheryl Chessick, MD, assistant professor of psychiatry and director of the Women’s Studies and Treatment Program at UCD’s Depression Center, who helped launch the project.
“Women who are pregnant are often going through a huge role transition,“ says Chessick.
“The clinic is a place where patients have a relationship with the perinatal providers they trust,” says Erica Schwartz, CNM, MSN, DNP, director of Midwifery Services at the College of Nursing. “They don’t have to go off-site, so the idea of getting psychiatric care is not as daunting.”
The providers obtain a comprehensive timeline of the patient’s “mood history” to identify each patient’s risk factors, such as family history, abuse, limited social support, thyroid problems and other chronic diseases and conditions.
Patients are screened for depression, thoughts of suicide and bipolar disorder. Those who screen positive get a referral to Chessick, Schwartz or the practice’s OB-GYN provider for an interview.
Patients’ treatment plans, which may include counseling or therapy recommendations, are individualized and based on their emotional needs.
A small team of CU providers runs one-hour sessions at the clinic. Chessick provides therapeutic oversight and helps personally with complicated cases.
The clinic also continues to forge relationships with community mental health services and clinics, University of Colorado Hospital’s Outpatient Psychiatric Practice, The Children’s Hospital and other providers so women have continuing access to care.
Debbie Carter, MD – Psychiatry
Bethany Ashby, PsyD – Psychology
Christine McDunn, PsyD – Psychology
Cate Campisi, MSN, RN, PMHNP-BC – Psychiatric Nurse Practitioner
