After giving birth to her third child in four years, Felicia, a child care worker from Phoenix, was overwhelmed.She persevered, despite being exhausted and emotionally disconnected from her new baby boy while also struggling to care for her other kids. Her traditional Mexican family said it was normal for new moms to be tired. But she knew better—the debilitating, roller coaster of emotions she was experiencing couldn’t be normal.
“It was awful. I couldn’t even breastfeed my son because I was so stressed and emotional,” she said. “I’d cry the whole time, and that made me feel guilty because I remember how much I enjoyed time with my first baby.”
Felicia, 29, was diagnosed with postpartum depression (PPD), which affects about one in eight women after the birth of a child. It’s different than regular “baby blues,” because it lasts longer than the first two weeks after childbirth. While changing hormones can contribute to PPD, so can societal factors. Research shows mothers from lower socioeconomic backgrounds—who often live with chronic stress—are twice as likely to suffer from PPD. The doctor prescribed medication to treat Felicia’s depression and sleep issues, but the pills clouded her already fragile psyche.
With little hope, she discovered an outreach center for impoverished families. Sunday school director Ericka Martinez was trained as a community health worker by the University of Houston to administer a home-based intervention called PST4PPD, or the “problem solving tools” intervention. During five sessions at Felicia’s home, together they focused on developing problem-solving skills and improving self-confidence. Solving problems is like fitting pieces into a puzzle. You need to look at one piece at a time.
“You have to take baby steps to gain confidence instead of looking at one big problem,” said Martinez, who’s worked at Neighborhood Ministries for 16 years. “By accomplishing small goals everyday, you can make a real difference in your daily life.”
The two-year research project, developed and led by associate professor McClain Sampson at the UH Graduate College of Social Work in partnership with Urban Strategies, had impressive results. Depression levels were cut in half among the 75 Hispanic women who completed the intervention in five cities, including Houston. Depression went down consistently every session, and a sense of self-competency went up.
“Mothers with postpartum depression often go untreated because of stigma or lack of access to treatment. The peer-to-peer aspect of having health workers based in the community and from the same culture lowers the stigma,” said Sampson, director of the Center for Latina Maternal & Family Health Research. “Barriers to getting help can include cost, transportation and child care. The home-based nature eliminates those barriers.”
Felicia had been neglecting her own wellbeing, sometimes not bathing for days. “I couldn’t take care of myself when I thought I wasn’t taking good enough care of my kids,” she thought.
Setting simple goals like taking a shower or a nap, while choosing to forego less essential tasks such as cooking a three-course meal for her family every night was empowering, she said. The less there was to juggle, the more control she had. Felicia even stopped taking sleeping pills en route to what she calls a “complete turnaround.”
“I was sleeping better when I could process my issues out loud and then look at the worksheet and checklist to see realistic goals and needs,” she said. “The intervention stopped me from overwhelming myself with all the nonessential stuff.”
The intervention, typically given in Spanish, doesn’t require a credentialed mental health counselor to administer, making it attractive to community organizations that often lack resources. Martinez, after all, is a Sunday school director with no previous mental health experience… except her own. She too suffered from postpartum depression for several years. She uses her own experience to better identify with struggling new moms.
“So much of working through depression is being able to have a fresh perspective. To have the moms view me as someone they could check in with and give them the footing they needed felt really good,” said Martinez. “UH is at the center of solving real problems for real people. This is what I hope a university would be about.”