Overcoming Patient Resistance During the Perinatal Period

The simultaneous longing for privacy and support from others is the perfect recipe for resistance from new mothers because they commonly fear that they will be viewed as incapable, lazy, or bad if they require help or guidance. However, the reality is that all moms need help. From learning a new baby’s preferred soothing style to learning how to juggle multiple children, there is so much new material to master during pregnancy and early parenthood—no matter how many children a mother has.

However, new parents notoriously resist asking for any kind of help for many, many reasons. Perhaps most painfully, they fear being viewed or treated as an unfit parent. They also worry that their internal monologue, already plagued by doubt and what-ifs, will be validated if they ask for help. They feel guilty for imposing their problems on others. They worry that they will not live up to expectations. For all these reasons and more, they avoid asking for help and even deny or refuse help that is offered, no matter how badly it is needed.

Given the fear and vulnerability that drives a mother’s resistance, it is crucial for providers to remain affirmative but gentle when assessing mothers for mental health issues during the perinatal period. If you are a provider, this free Resistance to Disclosure worksheet can help you in this effort. And if you have clients going through this, you can share this free Overcoming Resistance worksheet to help them recognize and overcome the reasons for their reluctance, increasing the possibility that they will receive the help they need to begin feeling better.

One extremely powerful way to combat resistance is to normalize the act of help-seeking during the perinatal period. If you interact with and provide care for perinatal mothers in any capacity, you should normalize all mothers’ need for support, whether or not something is actually wrong. You can do so by encouraging all new mothers to seek resources for their mental health and emotional well-being, just as you would encourage all expectant mothers to seek prenatal care.

In particular, you should convey to mothers that:

• Seeking help for emotional health in the perinatal period is as normal as seeking assessment for an infant’s breastfeeding latch. We recommend initiating conversations about mental health as routinely as you would initiate conversation about the baby’s name or the mother’s expected due date.
• There are many options for support and levels of care, depending on whether a mother is mildly stressed or experiencing symptoms of a full-blown mood disorder.
• The perinatal period extends far beyond the first few days or weeks postpartum, and help is available to them at any time during the first year postpartum (or beyond).

You also want to normalize any discomfort or difficulties mothers are experiencing by conveying the message that feeling vulnerable is okay. Carefully communicate that similar to the discomfort of colic or sleep regression, the emotional discomfort of early parenthood is likely to ease with time. When you destigmatize the secrecy that exists around mental health issues in general, you increase women’s ability to access professional treatment and to seek support from friends and family.

At the same time, you want to take care to send the correct message—normalizing the fact that new mothers can expect some degree of discomfort and overwhelm during the perinatal period, but not too much. You want to communicate is that there is a threshold for what is considered normal perinatal distress. Even the most vigilant parents can fail to recognize when they have reached this threshold and crossed the line from transient stress to symptoms of a perinatal mood and anxiety disorder. For this reason, you want to emphasize that they seek help from a trained professional who is skilled at recognizing these subtle symptoms. These providers can help parents explore their individual thresholds for distress and determine what level of support is needed.

As a reminder, these free worksheets and The Perinatal Patient: A Compassionate Approach to Treating Postpartum Depression, Anxiety, and Related Disorders do not serve as diagnostic tools, but they do aim to empower providers to help mothers in distress as well as empower mothers to talk to someone who can help them sort out what they are experiencing.