Captoria Porter first realized she was experiencing postpartum depression after her sixth child was born.
“I really don’t know how I slipped into it,” said the Country Club Hills, Illinois, resident. “I guess I was overwhelmed with the fact I was going to have a sixth child, and I was having a few marital issues then.”
Up to 20% of women experience symptoms of prenatal or postpartum depression, and that translates to 1 in 5 new moms in Illinois. An article in the Journal of the American Medical Association found that women who screened positive for depression were more likely to be younger, African American, publicly insured, single and less well-educated with more depressive episodes beginning postpartum (40.1%), followed by during pregnancy (33.4%) and before pregnancy (26.5%).
Porter found help through the national Mothers & Babies program, which is based on cognitive behavioral therapy and provides online resources and (since the pandemic) virtual home visits with trained paraprofessionals to provide services to families around maternal mental health. The intervention aims to reduce stress and improve mood in pregnant women and new mothers and has been highlighted as one of the most effective interventions for the prevention of postpartum depression.
It’s that same population that Sunnyside for Moms wants to help too. Sunnyside is an online app that screens pregnant and postpartum women from low-income Chicago neighborhoods for depression. It was created by two members of the University of Illinois Center on Depression and Resilience: Jenna Duffecy, associate professor of clinical psychiatry in UIC’s Department of Psychiatry, and Pauline Maki, professor of psychiatry, psychology and obstetrics and gynecology, and director of the Women’s Mental Health Research Program, also in the Department of Psychiatry.
The app aims to help pregnant women of color who are showing signs of depression but haven’t reached the point of clinical depression.
“We know that there are lots of barriers to women accessing traditional mental health services,” said Darius Tandon, associate professor of medical social sciences at Northwestern University Feinberg School of Medicine.
Language barriers, stigma around seeing a mental health provider and lack of availability of mental health providers, Tandon said, are why programs like Mothers & Babies offer intervention through home visits.
“In the same vein as UIC, what we’re both trying to do is figure out ways of getting mental health services and supports to women who need them, without really relying on that external referral to a mental health provider.”
The Sunnyside app offers a variety of interactive features, including video vignettes, where users can practice cognitive behavioral skills like autogenic breathing (an exercise that relaxes the body) and progressive muscle relaxation (an exercise that aids in changing physiological components of anxiety). Sunnyside also provides information about pregnancy management and how to cope more effectively — from managing outside relationships as a first-time mother to interacting in the workplace during pregnancy and postpartum.
“Sunnyside is addressing some of those pregnancy issues as a way of modeling ways of coping,” Duffecy said about the Illinois Department of Public Health-funded app. “So that hopefully as you move through pregnancy and postpartum that you’re prepared on how to manage tough things.”
Sunnyside for Moms is free through IDPH via 866-364-MOMS and at UIC clinics during routine prenatal and postpartum visits. Before or during check-in, the patient answers questions online. Women who are showing mild to moderate symptoms of depression or generalized anxiety disorder are informed that they fall within a range of symptoms, and their provider initiates a conversation about Sunnyside. A social worker then enrolls the woman who is expressing depressive symptoms in Sunnyside.
“It’s a new kind of evolution in the way that people are diagnosed,” Maki said. “We’re not just screening for depression. We are screening for post-traumatic stress disorder risk, we’re screening for substance use disorder, we’re screening for suicidal ideation, and this is for every woman at her first prenatal visit, and also at her postpartum visit. And that’s how we identify, clinically, who we think might benefit from Sunnyside.”
A recent paper in the Archives of Women’s Mental Health by Tandon showed that delivering therapy virtually to pregnant women with paraprofessionals generated similar reductions in depressive symptoms as in-person therapy from mental health professionals (nurses, social workers).
Porter said the resources provided during Mothers & Babies gave her the tools to bounce back with her sixth child and again when she experienced postpartum depression with her last child.
“The first time I had postpartum, I didn’t believe I had postpartum,” she said. “I actually thought that was just something white people go through. I didn’t believe that was a thing in Black culture. I would have never have known that had I not done the class with the Mothers & Babies program.”
“Hopefully, Sunnyside, itself, makes a big difference, but I think it’s also sort of a foot in the door, in terms of saying, ‘It’s OK to get help for your mental health,’” Duffecy said. “It’s not scary. It’s not bad. It can be really useful.”