A woman wearing a tan shirt holds an infant baby close to her chest. The baby is wearing a white onesie and yellow overalls.
A mother holds her newborn baby close to her chest. Perinatal mood and anxiety disorders (PMAD) affect approximately 20 to 25 percent of mothers in the U.S., and many Nebraska non-profits are worried about rural women not having access to help. Photo courtesy of Canva.

When Emily Seddon had a traumatic birth experience with her first child, the Omaha woman said it took a mental toll.

Seddon, now associate director for the Omaha Better Birth Project, said she assumed she was just struggling with this change in her life, but it wasn’t until three years later, in therapy, that she would realize she had suffered from postpartum depression. 

Unfortunately, Seddon’s story is not unique. Perinatal mood and anxiety disorders (PMAD) affect approximately 20-25 percent of mothers according to the Anxiety and Depression Association of America. Perinatal is in reference to the time before and after birth. The association says these disorders are the number one complication of pregnancy and childbirth and can affect any woman. 

In Nebraska, women living in rural areas have less access to resources and support for the perinatal mood and anxiety disorders. According to the U.S. Health Resources and Services Administration, 88 of Nebraska’s 93 counties are mental health professional shortage areas.

But local providers are coming together to bridge the gap and provide equal access to women regardless of their location in the state and proximity to care. 

About a year ago, a Nebraska chapter of Postpartum Support International was formed. 

Jamie Heng, a local perinatal mental health provider and vice president of the Nebraska chapter, said the group’s main focus is building up membership, especially across the state. 

“We want to create a connection where we make sure that we are bringing training and education to those individuals as needed and then they can have that connection back to us,” Heng said.

Those currently involved are located in urban areas of the state. Heng said one of the group’s biggest challenges is having a lack of knowledge about what the current conditions are for people suffering the PMADs in rural areas. 

“Those of us serving on the board, we’re all located in Lincoln and Omaha, so that’s part of our struggle,” Heng said. “That’s where we need people out there to be part of our organization to be able to learn what some of their challenges are so that we can help start identifying what some resources need to be.”

Gering native Brooke Raines said she changed career paths and became a Licensed Independent Mental Health Practitioner (LIMHP) after experiencing postpartum depression and anxiety with her second child. Working in an area of the state with many rural communities, she said the biggest struggle is having enough providers to serve those populations.

“We are needing more mental health counselors, there are not enough out there,” Raines said. “There are waiting lists everywhere and even when we don’t have a waiting list, it takes a good month or two to get into most places.”

Heng said the lack of mental health providers prohibits the providers from specializing in things like PMADs. Because of this, mental health providers in rural areas are unable to provide specialized perinatal mental health care to women in need. 

“They’re one among so many and so they have to have more of a general knowledge on a lot of different mental health topics, which makes it harder for you to specialize,” Heng said. “Therefore in working with those individuals, they may not have as much specialty training in perinatal mental health because they’re serving such a large population.”

After her traumatic birth experience, Seddon became passionate about doula care, which led her to work with the Omaha Better Birth Project. The local nonprofit works to decrease inequities in childbirth by providing assistance to low-income and teen families in the Omaha area.

Seddon said receiving help from a therapist was crucial in her healing journey when she suffered from a PMAD after the birth of her son.

“Unfortunately, I feel like with a lot of mental health disorders, when you’re in the thick of it, you can’t see it,” Seddon said. “I could not recognize it in myself. In fact, it was probably not until my son was like, three, that I started going to therapy and was able to recognize it.”

Seddon attributes her PMAD to the traumatic birth experience she had with her son. Despite having support from friends and family, Seddon said it wasn’t the type of support she needed. 

“I think it was a combination of the hormonal change, but also grieving this process that I thought was gonna go one way and went 180 degrees the other way,” Seddon said. “And I have support … but my family couldn’t help me. The things they said just weren’t enough. They weren’t there and they didn’t know.”

Support groups can be good healing agents for individuals facing mental health disorders, said Amanda Schraut, a medical social worker with Nebraska Medicine who runs Lean In, a free parenting Zoom support group.

“People can see themselves in the group, they can hear things, they can experience strength and hope differently than if it’s just one on one,” Schraut said. “What I hear from moms is that it’s just really nice to know that they’re not alone, things often get better and if things aren’t feeling better, there’s a lot of good support and it’s OK to ask for help.”

While they have not yet had anyone outside of Omaha participate, Schraut said the benefit of Zoom is that all Nebraskans are welcome to participate. 

Those who think they may be experiencing a PMAD can view this infographic to access a free screening test and a list of resources available in Nebraska. Additionally, providers, survivors or anyone interested can reach out to the Nebraska chapter to get involved and help raise awareness for PMADs. 

For Seddon, the feeling of being alone consumed her, however, she said despite the hardship she faced, she counts herself lucky. 

“I was at home alone with this child that cried and I was crying, it was just a mess,” Seddon said. “I just had that feeling of utter helplessness. I’m extremely lucky that my outcome was as positive as it was.

“We see families that go through this on a routine basis, where the outcome isn’t as positive. As an upper-middle-class, white woman that has, supposedly, all of the benefits and resources at my disposal … I can’t imagine what it would be like to go through that experience and not have the privilege that I did.”

Bailey is a senior journalism major at the University of Nebraska-Lincoln with minors in film studies and sociology. She has a passion for telling stories through all mediums. Currently, she works as a social media and graphic design intern at University Career Services. After graduation, she hopes to pursue a full-time role as a social media manager.