When Maranda Bower first became a mother in 2009, she says she was wholly unprepared for the shock of the life change. Away from the support system she had previously relied on in life, social isolation fed symptoms of depression—and vice-versa.
"So much of the work of learning to be a mother is done behind closed doors," says Bower, now a postpartum bliss coach. "Instead of learning from the women around me, I was shut up into darkness and left to figure it out how to care for my body and my newborn alone."
Bower is hardly the only woman to feel that void, and she is now among the many women filling it as peer support professionals. Because if there is a silver lining to the prevalence of maternal mental health conditions, it is that there are thousands of women nationwide who are well-positioned to provide support, advice and encouragement that pulls from their own experiences.
Peer support professionals are women who have lived experiences in struggling with maternal mental health conditions and are trained to help others. It's an evidence-based practice recognized by the Centers for Medicare and Medicaid Service. In some countries this service is provided by mothers recruited by health care professionals to work as Peer Support Workers within the health system, but independent postpartum doulas, support groups and peer support coaches are also recognized forms of peer support for maternal mental health.
According to Motherly's Second Annual State of Motherhood Survey, the greatest segments of moms reported their "physical or mental health" is the area in life where they need the most support. Yet, traditional options for maternal mental health care are psychiatric or intensive talk therapy—which have their benefits, but only if women are able to access them. However, between actual "mental health support deserts" and other cost or time constraints, studies show the majority of perinatal mood disorders go untreated.
Aiming to address that, a new push would expand support for peer specialists who can fill professional service gaps, which would essentially create the "village" that mothers have recognized the importance of for generations. Starting in 2001, states began to make these relationships official by offering certifications for peer support specialists; as of 2016, there were more than 25,000 certified peer support specialists nationwide who are eligible to receive reimbursement from Medicaid.
"While therapy is an invaluable resource, for many women it is not enough, including myself," says Ann Kaplan, a mom of four and parent coach, who adds it was invaluable to see "what motherhood could be when I was supported, educated and validated" through other mothers' examples. That experience, in turn, informed Kaplan's three-prong approach to helping other moms find strategies for mental health, family management and parenting skills.
The positive impact of peer support is seen on multiple levels. Not only do statistics show that peer services cut hospitalizations in half and increase engagement in self-care, but using peer services in treatment has also been demonstrated to save states more than $5,000 per person.
Recognizing the power here, officials from the Substance Abuse and Mental Health Services Administration (SAMHSA) within the Department of Health and Human Services are calling "for using peer support specialists to help address shortages in the behavioral health workforce," according to a 2018 report issued to congressional committees.
Yet, even this has been met with some resistance. In 2017, the Peer Support Specialist Act, which would have improved financing and certification practices for peer support specialists, failed to pass in Congress. Increased funding is again on the table under the Mothers and Offspring Mortality and Morbidity Awareness Act, or MOMMA's Act, which was introduced to Congress in March 2019 and would offer grant money to support "maternal mental health."
A push to expand peer support programs is catching a bit more traction on state levels, such as in Colorado where legislators are due to consider a new bill that would further professionalize and expand access to peer support specialists. By improving access to programs that complement other subsets of health care, we are getting closer to offering the varied, destigmatized support that every mother deserves. Because, if there is one thing we can all agree on, it should be this: Women should have more support as they navigate the transition into motherhood—and the more qualified professionals who are able to help, the better.
To find peer support resources in your area ask your doctor or midwife. Some hospitals in the Unites States offer support groups and telephone counseling with trained peer support coaches. You can also use the map on the Postpartum Support International website to find peer support services in your state.