Doctors define the “perinatal period” as running from before conception, through a woman’s pregnancy, all the way to a year post-partum. It’s a time when women go through many changes physically - and mentally. But for women who struggle with mental health or substance abuse issues - these changes not only can affect the mother, but the child as well.
"This period is not protective by any means, and so women can have just as high of rates of depression, anxiety, or substance use disorders during the perinatal period," explains Dr. Christina Wichman, medical director of the Periscope Project.
She also notes that out of the 65,000 births in Wisconsin, it is estimated that approximately 15 percent of those mothers will suffer from some kind of mental health or substance use disorder during the perinatal period.
While many doctors specialize in the physical health of mothers – there is a drastic shortage of specialists in perinatal psychiatric care providers. In fact, Dr. Wichman is only one of three doctors in the state of Wisconsin that specialize in this field. She attributes this shortage to the lack of training and overlap in both psychiatry and OBGYN fields.
To address this need, the Medical College of Wisconsin and UW-Milwaukee have joined forces with the help of a grant from the United Health Foundation to launch a new primary and psychiatric health care program: the Periscope Project. This project is a free resource for health care providers who are managing women who have perinatal substance use or mental health disorders.
Through providing direct lines of communication for real-time consultations with a psychiatrist, community resources and other digital services, medical professionals say they can better serve mothers, reduce health disparities, and increase healthy birth outcomes.
"We've built the program step by step, item by item...to make it as streamlined, user-friendly and easy as possible, yet rigorous to be able to collect the data that we need to demonstrate the impact that the program has," explains Dr. Jennifer Doering, Associate Professor in the College of Nursing at UW-Milwaukee. UW-Milwaukee's role in the Periscope Project is the collection and analysis of teleconsultation, provider education and support data.
Dr. Wichman notes that for the past ten or twenty years, a mother who was struggling with depression had very limited treatment options. The "first principle to do no harm" to an infant often resulted in mothers being taken off of their medications, encouraged to go to therapy, or told to "buck it up."
"Really, the science (and research) has shown us at this point that these medications can be fairly safely utilized in pregnancy," says Dr. Wichman. "There's certainly risks to utilizing medications, but more importantly there's risks with no treatment."
Dr. Doering also notes that much of the focus in the past has been on screening for mental health conditions in pregnancy and postpartum. "Now we've identified the gap between screening and access to diagnostic evaluation and treatment," she says. Through greater access, the project aims to fill the "critical gap in Wisconsin."
While the Periscope Project highlights the importance of helping perinatal women, Doering and Wichman point out that healthier mothers also raise healthier babies.
"We know that infant mortality is absolutely related to maternal mental health," says Dr. Wichman. "So if we can positively impact maternal mental health within our city we would like to be able to see that infant mortality decrease as well."