Episode 2 - Jenny and Kerry

Jenny and Kerry talk about the experience of new and expectant parents, and families, during COVID-19. They reference the work of Albury Wodonga Health in offering support through the Perinatal & Emotional Health Program (PEHP) and Families where a Parent has a Mental Illness (FaPMI) program.

Resources:

Audio Transcription:

Leah Wiseman: Hi, I’m Leah Wiseman and welcome to Episode Two of our Albury Wodonga Health Wellbeing and Resilience podcast series - to help keep people connected, share our community stories of hope and resilience, and provide information about mental health and local services.

Our community has experienced a challenging and stressful start to the year, and many of us are in the midst of the most change and uncertainty we have ever experienced. For new parents, pregnant women, and families, it has been a particularly difficult time. Having a new baby already involves huge change, and having support from family and friends is really important to stay connected. Social isolation and a fear of spreading COVID has meant that many parents have experienced an increase in anxiety. Today I'm joined by Kerry Dolan and Jenny Ahrens.

Kerry Dolan: Hi I'm Kerry Dolan and I am a Perinatal Emotional Health Clinician for Albury Wodonga Health. I’m a registered nurse and midwife.

Jenny Ahrens: And I'm Jenny Ahrens and I'm working currently in a role that supports staff to work with families who are involved with the mental health service.

Leah Wiseman: Kerry, could you tell us a little bit about pregnancy and how it has been experienced for local families currently?

Kerry Dolan: Since we've known about the COVID-19, most women have started to feel a great sense of anxiety and concern about their health, and the health of their unborn babies. In our local area we've got wonderful midwives, GPs and Obstetricians and other health workers who are doing a fantastic job making sure that women are getting to each of their essential pregnancy visits, and making sure they're getting all the correct tests. Sometimes it's delivered differently so people will have an appointment by telehealth, or people will have a very short appointment followed up by a phone call, but it's very important that people get to all of their scheduled appointments. They also are doing even telehealth antenatal classes, so all of the services are available – they’re just been delivered a little bit differently. When you're 20 weeks, from 20 weeks on, the midwives at Albury Wodonga Health are available for calls 24-hours a day seven days a week. So if you've got any questions about your pregnancies, please call in.

Leah Wiseman: So, I mean pregnancy is already a really stress inducing and anxiety provoking time. Talking to women out there who are expecting a baby in the next little while, how are they feeling?

Kerry Dolan: A lot of people have been feeling very anxious and very worried. Particularly if it's your first baby, this is all new anyway and it's just because it's harder, because you have to work out how to do a telehealth call and look at how to contact the GP in different ways. Yeah, so the pregnancy has been a completely stressful time … it's stressful for women and it's stressful for their partners as well. Pregnant women are considered to be a vulnerable group, but they don't appear to get more severely unwell if they get a COVID-19 infection. The risk for you, and for your baby, is extremely small. The majority of pregnant women will only experience very mild to moderate symptoms and obviously that is just a very small amount of pregnant women, even worldwide at the moment. There's no evidence that there's an increased risk to your pregnancy or an increased risk of miscarriage. We do believe that there is a transition, sometimes between Mums and babies, but there's not been any increase in any problems for the babies or any birth defects. We expect that you'll give birth in the way that you plan - so if you were planning to have a vaginal birth, that's the way that we expect that it will happen. If you're planning a Caesarean, we expect that that will happen in that way. You'll be able to do skin to skin with your baby, as most parents are very keen to do, and you definitely can breastfeed your baby.

Leah Wiseman: Kerry, there's been a lot of talk in the media and certainly some stories about people concerned that they can't have their support person in the room. And you mentioned all the other things that would be as they normally would. Where are things at with the situation around having a support person present?

Kerry Dolan: Locally, and for more hospitals in Australia, certainly all the public hospitals in Australia, you can have one support person present. So whether it's your partner, your best friend, your mom, your sister, whoever it is, you have to designate a person that you would have present and they your person that can visit you while you're in hospital. People are very keen to get back home again soon, so the hospital works very hard to make sure they're home as soon as they safely can. I actually had a friend have a have a baby overnight and she had photos on Facebook this morning and she's got two other children so she's keenly waiting to get home to say them.

Leah Wiseman: So you've talked about the things that are the same. Is there anything else that's different around the experience in those initial stages of giving birth and being in hospital?

Kerry Dolan: Okay, if you're having any symptoms that would be suspicious of COVID-19 you'll be isolated within the hospital. It feels a bit scary because staff will be wearing protective equipment when they come into your room. Your visitor will need to wear that as well. Your support person or your designated visitor.

Leah Wiseman: Is there anything that's in place Kerry so that when people are in hospital they can still be having those connections outside their designated support areas.

Kerry Dolan: Yes there is. I'm glad that you mentioned that because Albury Wodonga Health have ensured that people can access Wi-Fi within the hospital. It's always been a bit touch and go - people might not have enough data - and so people are able to access the visitor Wi-Fi at Albury Wodonga Heath. It’ been a big help for using FaceTime or other video chats with families.

Leah Wiseman: And from your perspective Jenny, is there anything in particular around those early stages as a Mum different at the moment, or things that you would suggest that people have a think about given the current situation?

Jenny Ahrens: I think it's just being able to take this in our stride and just go. It's all gonna end up the same way and, you know, we will all get back together - it's just going to be a little bit different.

Leah Wiseman: And your experience is working with people, with adults in a family where there is a mental illness already diagnosed. Are they a particularly vulnerable group?

Jenny Ahrens: So, any sort of situation that puts more stress on a family when there's already someone who is struggling with some mental health problems, that increases the risk for that family. But there are some things families can do to make that risk less.

Some of the changes that have been happening in families have included a lot of changes in working arrangements, so there might be parents working from home, there might be parents who've lost their job, and also the issue of home schooling. I don't care what issues the family’s got - that is a real challenge for anybody.

One of the things that’s suggested is to stick to a routine. Sitting down and having a family meeting and getting a routine can be really helpful. You know, having a family all included and making people feel more comfortable that they know what's going to happen and when, then you can refer to that and say well actually you said we're going to be doing school time between these hours. So it helps the people feel more comfortable and relaxed and knowing what's going on, even though it's harder to establish those routines. And, within those routines, you know you can include things like time for fun activities with kids, which could be art and craft activities, exercise, going for a walk. That's particularly important when people are feeling a bit more stressed - to get out exercise - and you can do that without breaking any COVID rules and get out and go for a walk, or ride a bike, or if the weather's not good you can be inside doing yoga with Adrian or Joe Wiggs.

Kerry Dolan: I’ve heard Adrian described as the patron saint of isolation.

Jenny Ahrens: I heard that the other night, but those are free. Lots of people are enjoying them, doing them, and being yoga particularly that's very good for our mental health.

Kerry Dolan: Using apps for mindfulness is really helpful, and I just want to particularly call out to Smiling Mind which is a free Australian app. It's fantastic and there's lots of free COVID resources on there at the moment.

Jenny Ahrens: Because anxiety can be a lot higher during these times, you know there's a lot of health related anxiety, financial anxiety, anxiety about home schooling. And so using some of the techniques such as the Smiling Mind app can be very helpful. Also, taking note of your own thinking. When you're finding yourself having very negative thoughts, just try and think, basically it might be true but it isn't really helpful. So, what's another way that we can change that thought. So you might be thinking ‘I can never cope with this, I'll never get through this’ to ‘we will get through this, we will be able to be close to our family again, things will get back to some kind of normal again’. So, which is a much more positive way to think. Just keeping a positive aspect.

Kerry Dolan: I'd also encourage people to be particularly kind to themselves at the moment. I know that Russell and Rene talked about this in the last podcast about self-compassion, and being very much aware that while you're sitting at home with your new baby and feeling quite stressed because this is a huge big adjustment in your life, there's lots of women all around Albury Wodonga, all around Australia, all around the world who were actually going through very similar things. And it's part of our human condition, this is part of life that sometimes we will have hard times. We have to control what we can control within that, which can be doing some of that mindfulness, going for walks, making sure that you reach out and ask for help. Which might be just ringing up your mom or your best friend and sort of say, ‘having a really hard day, can you just talk to me for 10 minutes to get me through this’.

Leah Wiseman: Kerry, I did just want to ask there - you've talked about that self-compassion, but I guess for new parents, are there particular things that they do need to be aware of where it does go between being a normal reaction to an abnormal situation and something that they should tune into and probably, you know, reach out for some more professional help with?

Kerry Dolan: Certainly is Leah. What we would say is that most parents - most Mums - definitely would experience that baby blues. That's, you know, day three is the classic time that people say. But often in that first few weeks when you're home, you find it really hard, you know, you might be tearful at the drop of the hat. You might be quite overwhelmed. If that persists more than those first few weeks, and what we say if it's persisting for more than two weeks, that's when you should ask for help. And it's some things like feeling sad, not enjoying your life, not enjoying your baby, feeling anxiety, feeling your anxiety’s stopping you from doing things that you might want to, for example, one of the Mums was talking to recently just had been feeling so anxious about the COVID that she didn't want to go for walks and, you know, like, I was really encouraging her to go for walks and getting out and getting the exercise. Burning up some of that nervous energy. And that was really helpful for her.

If you're crying frequently, if you're not being able to get out of bed in the morning, not able to get out of the house, feeling really lonely and isolated, despite the fact that people are trying to, to ask to help you. If you're not concentrating, if you're not got very good appetite, if you're not sleeping, very lonely, some of the things that you should be concerned about and I will say, talk to your partner about it first, get some help at home. And then, if that's not helpful to reach out to your doctor, your midwife, or locally we are very lucky to have this wonderful perinatal emotional health program in Wodonga and Wangaratta through Albury Wodonga Health. And so we see people in their pregnancy, and also in within that first 12 months after the babies are born.

Leah Wiseman: So it’s those particular signs and then also how long they go on for?

Kerry Dolan: Yeah.

Leah Wiseman: Jenny, I was hoping you might be able to talk a bit more - you've described really well that using routine to put certainty into a pretty uncertain time at the moment, as well as some great ideas around yoga and mindfulness, is it anything else in terms of certainly the work you do at anytime, let alone at the moment with families where a parent has a mental illness?

Jenny Ahrens: I think that one of the most useful things I ever learnt from my family therapy training was the concept of ‘the good enough parent.’ And I think parents who have a mental health problem may feel this more. But all parents feel they should attain some sort of perfection, which is totally unrealistic, and I think that just being a good enough parent. So if your kids have a bit more screen time, try not to have too many more glasses of wine. And, you know, accept that things are different, and that we're actually all doing our best. I think that's a very useful way to think, and to try and keep a sense of humour. Like, we cannot be anxious when we're laughing so actually finding some humour in the situation. I know you know there are very serious things, and very serious consequences, but just when we can find that bit of humour, it really can lift how we're feeling.

Leah Wiseman: Absolutely. I like that. It's impossible to be anxious when you're laughing. Very true.

Jenny Ahrens: It just takes it away.

Leah Wiseman: We’ve talked about some really good strategies and ideas for expectant Mums and new Mums. What about, is there any particular advice that you would give for partners?

Jenny Ahrens: Yes, I think that partners, you know have a very sort of supportive role in these times, and it's just a bizarre time to be in and you worry about your partner, you're worried about the unborn baby, you're worried about you new child. Probably also most partners are quite concerned around finances at the moment. I think for partners, particularly with Dads, there's a very strong urge to be the provider and you know be back at work and making sure that you've got the money coming in. A lot of people I’m talking to - their partners are suddenly off work at the moment, or have lost their jobs after being excellent providers, and you know are off work for no fault of their own. Or they're working from home as Jen said before, and that takes a lot of adjustment to suddenly have someone there, but actually having to know that they need to work for eight hours a day, and how you organize that within the family it's quite difficult.

What I will say to you is that we know that around like one in 10 antenatal women can get anxiety or depression. One in seven after their babies are born. But probably about one in 10 to one in 20 Dads also get antenatal or postnatal anxiety or depression. So, Dads also, and partners also, need to be aware of those signs, and also need to reach out.

I wanted to just mention SMS for Dads, which can be used by Dads and partners, and grandparents and other support people. It's a program run through the University of Newcastle. And ads can sign up from 16 weeks of the pregnancy, and it will go through until 12 months after the baby's born. It's a really great program because it sends SMS to Dads around two to three times a week. And it helps Dads to be aware of where their babies at, also be aware of developing the parenting team, and also gets Dads to look at their own mental health and how they're going through the stressful times.

Leah Wiseman: Absolutely, it's good to look at that whole support network, especially at the moment. I know for me, my husband was only part of the support network that included friends and neighbours and family and all that kind of, you know, extended network. It's, I guess difficult at the moment when you can't be drawing on those extra, so there's extra supports and so there's extra pressure on that person who might also be working from home or who just lost their job or whatever so it's, it's important that we think about those other ideas.

Jenny Ahrens: Yeah, yeah just sort of having your mate at work, or your friend that you would normally go and have a drink with after work, available to sort of nut out your ideas about being a Dad. You know like, it's not necessarily something that you can work out with your partner it's, exclusive Dad stuff.

Kerry Dolan: We’re definitely better together.

Leah Wiseman: An important area of your practice is to support kids whose parents have a mental illness. Is there anything particularly at the moment that you would suggest and remind them and reassure them with?

Jenny Ahrens: Yeah, I think, you know, it is normal to feel a bit more anxious, at the moment. Kids are very much missing the social side of school, particularly they might think it's a great idea to be not having to go to school but very quickly that can wear off and they’re very much missing school. Part of it the routine. So, you know, I would say to there to participate in the routine, to have a secure and regular routine to follow, to keep up with your schoolwork, and to talk to Mum and Dad about what's bothering you. Because often, that's all it takes. Like there's a lot of information, we're hearing a lot of worrying information about COVID and about, you know what could happen. And while we need to keep informed, we also need to have a perspective and Mum and Dad can help you or your parents, your guardians can help you with that. If you're worried, talk to somebody. There's also some great resources for kids out there and at the end of the podcast, you can see that there will be available on the website.

Kerry Dolan: I’d like to also mention grandparents and extended families too.

I know that normally grandparents would be part of the pregnancy, perhaps going to some appointments, having baby showers. Hopefully we can do a lot of those virtually. Have house parties and baby showers. I hope grandmas are still out there crocheting rugs and, you know, getting the family heirlooms ready, and all that sort of stuff. But that's really hard when you don't get to go and visit your beautiful new grandchild at hospital. For a while after the baby's born, it's really great that Mums and Dads are in a little cocoon with their baby and keeping everyone safe. Make sure that you do keep in touch. Those regular phone calls. Those regular FaceTime times or whatever sort of video calls that you've got set up. If you can, you know, cook a casserole and pop it up Mum’s doorstep. And, you know, just check whether they need any jobs done because Mummy’s at the moment, trying to be in a cocoon and keep herself and the baby safe.

I will say Leah, that a lot of Mums are saying to me that that's actually been a really lovely place to be in cocoon with your baby, and have a chance to feel that you get to know your little person, and also not feel judged by - when you're learning to be a Mum and you're learning about your baby, and not feeling you have to compare yourself to every other Mum and what every other baby's doing. So for some mothers this has been a lovely time. For a lot of people it’s Mother's Day. Happy Mother's Day. Well done, please just do think about taking care of yourself at the moment. Make sure that you've been compassionate and just knowing that you're doing the best job that you can possibly be doing.

Jenny Ahrens: Bear in mind that good enough parents. Bear in mind that this will change. We're not stuck like this forever. And just to make the most of it while you can, you know, it can be a really positive time for families as well. You know where we spend more time together. Work together, see the good side of it as well.

Leah Wiseman: Thank you to our guests on today's episode of our Albury Wodonga Health, mental health podcast series - a sense of connection, mental health, well-being and resilience. You can find our contact details, an exhaustive resource list, and the entire podcast series at awh.org.au under the mental health tab.