In 2006, a few months after giving birth to her son, Max, Paige Bellenbaum was walking down Avenue B in Manhattan. A bus drove past, and out of nowhere, Bellenbaum was overwhelmed with the impulse to throw herself and her baby under it. She didn’t; she stared at herself in the bus’s window as it drove past, then immediately got in a taxi and took herself to the Payne Whitney Psychiatric Center, where she was diagnosed with severe postpartum depression.
By trade, Bellenbaum was a social worker, but she couldn’t see in herself the same markers of mental illness she’d been trained to identify. Postpartum depression affects as many as 15% of women in America, but it’s rarely discussed: The U.S.’s stingy parental-leave policies compound a cultural expectation that new motherhood should be joyous and breezy, when rather, it’s often overwhelming and isolating.
Bellenbaum is now the program director of The Motherhood Center of New York, a first-of-its-kind clinic that opened to patients on March 14. Staffed by physicians and social workers, the center will treat new and expecting mothers in a range of services and specialize in the treatment of perinatal mood and anxiety disorders (PMADs). An intensive weekday program will be available to women experiencing the most severe symptoms; mothers seeking aid on a weekly basis will have access to outpatient services that include therapy, support groups, and couples’ therapy.
It’s perhaps telling that the idea for The Motherhood Center originated not in the U.S.–the only developed country in the world lacking a paid parental-leave policy–but in Australia, where new mothers are supported financially for 18 weeks after the birth of their child. (It’s no Estonia, where new mothers receive 87 weeks of paid leave, but it’s still better than nothing.)
In early 2014, The Motherhood Center’s founder Billy Ingram left his job as the CFO of Frontier Healthcare, a New York-based medical group, with the idea of founding his own startup. Ingram, who is Australian, learned from two friends of a program run through the Masada Private Hospital in Melbourne: A week-long, in-patient treatment course for mothers and babies up to 24 months old, in which nurses would get the infants on more regular sleep cycles while mother receive counseling, and are transitioned into caring for the baby in a supported environment. It was a very popular program and reimbursed by insurance; Ingram tells Fast Company that he decided to try to establish something similar in America.
“I thought that perhaps, something like this already existed,” he says. “But what I found was not only does this not exist, but the level of care and awareness that existed in Australia and most of Europe doesn’t really exist here in the treatment options. The screenings are haphazard and spotty and the awareness of the specific nature and incidence of PMADs is very poor in America.”
In New York, Ingram began to meet with various nonprofits, including Postpartum Support International and the Postpartum Resource Center of New York. Through those meetings, he met Catherine Birndorf, a well-known reproductive psychiatrist in New York, who was supportive of the idea, and now serves as the center’s medical director. The two started consulting about the project, and Birndorf suggested to Ingram that he look into the Women & Infants Hospital in Rhode Island, affiliated with Brown University’s medical system and established in 2000 as the first specific perinatal partial hospitalization program in the U.S. (Partial hospitalization programs fall in between inpatient and outpatient programs and generally involve five to six hours of on-site care, five days a week.) Prior to meeting with the hospital’s director, Margaret Howard, Ingram had been considering developing an overnight, in-patient facility for mothers in New York, but after his visit to Rhode Island, decided that the partial-hospitalization model offered more flexibility in terms of licensing and services offered.
However, the Motherhood Center of New York differs from Rhode Island’s model in two crucial ways: it offers an on-site nursery where licensed childcare workers take care of infants while mothers attend sessions, and the center will operate completely independently of any medical institution. Driving that decision, Birndorf tells Fast Company, is the desire to make the center accessible to as many women as possible.
Hospitals in the city are often proprietary and prefer to keep patients in their own systems; by operating independently, the Motherhood Center will transcend those organizational lines. “We’re interested in collaboration and open doors,” Birndorf says. The center is also negotiating with insurance companies; for now, it’s accepting patients on an out-of-network basis as it undergoes the process of getting into various networks (including Medicaid), and for patients without out-of-network benefits, the center staff will negotiate single-case agreements for reimbursements–something Ingram says is likely to be successful because the center offers services unavailable elsewhere nearby.
Anyone seeking an appointment at The Motherhood Center can call the center and arrange for a consultation; no formal referral is necessary, though Birndorf says that she, Ingram, and Bellenbaum, through their combined networks of contacts in the OB/GYN and pediatric fields, have been actively working to get the word out about the center’s services, aiming to supplement the health care treatment the women are already receiving through a more targeted and holistic approach to mental health care.
The Motherhood Center is also working on establishing a connected 501(c)(3) nonprofit arm, which, Birndorf says, will be able to raise money to offset the cost of offering services at free or reduced rates for low-income or uninsured women, who are often immigrants or unemployed. “We’re committed to getting funding so we can continue to offset costs for people who can’t pay,” Birndorf says.
The accessibility of The Motherhood Center to all folds in neatly with a greater state- and city-wide push for more awareness around maternal depression. Motivated by her own experience with PMADs, Bellenbaum reached out to New York State Senator Liz Kruger, who, along with Assembly Member Richard Gottfried, drafted a bill in 2014 recommending education and screening for maternal depression. When New York City’s First Lady, Chirlane McCray, introduced the comprehensive mental health plan, ThriveNYC, in November 2015, universal depression screenings for all new and expectant mothers was one of the top-line goals. Bellenbaum was one of the keynote speakers at the rollout event for ThriveNYC; Ingram and Birndorf were in the audience and afterward went up and asked her if she wanted to get involved with the Motherhood Center (Birndorf, as it turns out, had treated Bellenbaum for her depression back in 2006). Bellenbaum came on board as program director in early 2016.
Though the center is still very new, Birndorf says that interest in its services has been high. “We’ve been flooded with phone calls,” she says. Even though the Trump administration is reportedly considering introducing the U.S.’s first paid-leave policy, time off is not enough: Women who are suffering from PMADs require specialized, dedicated treatment. And with insurance coverage likely being cut off for millions of Americans, organizations like the Motherhood Center, which have as their mission serving people based on need, not their ability to pay, will remain crucial. The conversation around maternal depression, Birndorf says, needs to continue to grow. “That’s why when you have celebrities like Brooke Shields writing a book about it in 2005, or Hayden Panettiere and Drew Barrymore and Chrissy Tiegen speaking out about it, it’s like: keep talking–someone’s got to keep this on the map,” Birndorf says. “And we’re not going away: we’re a brick and mortar place where people can have these conversations.”