>>RICHARD DERMAN: Christiana Care is the largest hospital in the state of Delaware and we take
care of 70% of the covered lives in the state.
This is true of obstetric and gynecologic services as well.
Many folks in the United States don’t realize that obstetrician/gynecologists provide a
good deal of the primary care for women especially under the age of fifty.
And when somebody comes in thinking about becoming pregnant or is pregnant what a great
opportunity for primary and secondary prevention.
We see perinatal mental health services as being in the forefront of this opportunity.
>>MALINA SPIRITO: Any woman who is either currently pregnant or who has delivered within
the last year is eligible for services at Center for Women’s Emotional Wellness.
In addition we’ll also work with women who are currently planning a pregnancy and have
a history of mental health challenges.
>>PATIENT 1: I guess one of my concerns though is …
>>MALINA SPIRITO: The Center for Women’s Emotional Wellness is co-located within the
Ob/Gyn department at Christiana Care Health System to make it easier for women by having
us located in the same place where their coming for their prenatal treatment, the same place
where their coming for their ultrasounds.
>>PATIENT 1: I feel better that I don’t have to tell people that I’m going to some
clinic you know?
>>MALINA SPIRITO: So many of the women that I work with really need a place where they
can sort through their challenges with regard to parenting.
>>PATIENT 1: A lot of guilt.
I’m sort of petrified over the thought of my relationship changing with my son.
>>MALINA SPIRITO: Many women are embarrassed or afraid to ask for help.
They’re afraid to admit that something is wrong.
And one of the things that we really strive to do is to just to help normalize this experience
and to let them know just how widespread it is.
That in fact depression is the number one complication of childbirth and it’s also
one of the most highly treatable.
>>MEGAN O'HARA: Hi, I’m Megan.
>>MALINA SPIRITO: We see women both on the outpatient side for intake assessment and
psychotherapy as well as medication management.
And we also offer inpatient consultation and consultation services for our physicians and
residents here in the Ob/Gyn department.
>>PATIENT 2: Am I doing something wrong?
You know...because a mom should be able to calm her baby down.
That should be the one person that can calm her baby down.
>>MALINA SPIRITO: Our team is made up of three women of varying specialty.
I’m a licensed psychologist.
And then we also have a licensed clinical social worker who also provides ongoing outpatient
therapy and inpatient consultation.
And we also work with a board certified advanced practice nurse.
>>PATIENT 2: The pregnancy was hard...
>>MALINA SPIRITO: I am a direct employee of Christiana Care Health System housed within
the department of Ob/Gyn.
And I am a member of the medical-dental staff.
>>RICHARD DERMA: The idea of having set up our Center for Women’s Emotional Wellness
within the Christiana Care umbrella was very important for us because before that time
our private doctors and our doctors employed here were not actually doing the screening
for depression because we did not have the basis for referral of patients.
And now we do have a very finely integrated system.
>>MALINA SPIRITO: The on-call provider each day carriers the on-call phone.
So if a provider in the community is sitting with a woman in her office and she has concerns
that this woman needs treatment immediately she can call us on the provider line.
(Phone rings)
>>MALINA SPIRITO: Well, I’ve got some time this afternoon so is it OK if I come up to
see her in about an hour?
For any woman who we see who is a direct patient of one the Christiana Care obstetrical practices
we use the same electronic medical record which allows the Center for Women’s Emotional
Wellness to see how things are going with her obstetrical care.
>>PATIENT 2: That makes me feel a little bit better ‘cause I just….
>>MALINA SPIRITO: My experience has been that the obstetricians and gynecologists that we
work with have been really open to this model and have been extremely excited.
They see the need.
>>RICHARD DERMAN: We want to go ahead and have women and babies have the best outcome
in pregnancy.
We know that if women are depressed or suffer other mental health issues they don’t bond
with their baby, they don’t breastfeed effectively, there could be long term developmental issues
that we have to address.
This is just good preventive health.
It’s good healthcare.
Most importantly it’s what we ought to be doing.