Interview with Gynecologist | Dr Roca

Please describe your background. I was born and raised in Miami and went to North Carolina for college and medical school in Virginia. After that, I did my residency at Jackson Hospital and joined Dr Philips where I have been since. 

What is your experience with postpartum depression? Being in the obstetric world, it is definitely something we see quite often. A lot of the time it goes unrecognized or gets missed. 

Whats a gynecologists role with a patient with postpartum depression? We are their first encounter in detecting it. Most women will have a routine appointment 6 weeks after delivery and at that point mood abnormalities should dwindle down. If it’s persisting, we have to start evaluating for postpartum depression. Most of us have questionnaires or surveys to evaluate. 

What signs/symptoms should patients look for before seeking help? To some degree, it is always overwhelming to have a newborn. When you start having uncontrolled crying, changes in eating or sleeping habits, thoughts of hurting baby or self patients should seek for help especially if it goes beyond something they can handle. 

Where should patients seek for help? Their obgyn should be their first point of contact postpartum and where they should share any signs. 

What resources are more affordable? There are some community groups through social media and some local groups organized by the hospital where moms go with newborns to share what they are feeling and realize it is not just them. Lots of women experience it. There are lots of hardships and a dark side to having a child. These groups can be a source of reassurance or encourage you to seek for additional help. 

What are things expecting mothers can do to maintain a healthy pregnancy and hormones balanced? Unfortunately pregnancy is a time where hormones are all over the place. You feel it from the very beginning and as pregnancy develops hormones shift and change. It’s very difficult to help regulate hormones themselves. Exercising and eating a well balanced diet as well as sources of meditation all help. They won’t eliminate and prevent it but helps to worsen. It doesn’t have to be something crazy like running a marathon but 10-15 minutes of a walk helps. 

What do you think of Carolina’s current diagnosis/treatment? In terms of diagnosis it does happen. Especially if there was a previous episode which Carolina had in 2016 or a history of depression and mood disorders. It is scary and glad it got caught before anyone got hurt. In terms of treatment, we are first line of treatment. I have no problem giving prescription but tell patients this isn’t a magic pill. It’s a combination of this and psychotherapy that has best way of helping with the depression. In terms of the treatments treated I’d say getting a second opinion is a good idea before moving forward with ECT or Ketamine. ECT has been around and used for multiple needs. It does work for some people and for some conditions it doesn’t work. It’s one of those things you want to explore. I’d maybe go with the ketamine before. 

What are your thoughts on expecting women receiving lots of supports/appointments and postpartum care including one visit 6 weeks post birth? Should something change and how? We schedule routine follow ups at 6 weeks. By that point, physical damage of incisions or lacerations will have healed. That is mainly what we are looking for. We always encourage patients to reach out before or after then. Our doors are open to them. That is our routine appointment. For the most part, that is fine. 

What is the role for a loved one in spotting postpartum depression ? Their role is huge. They are with us 24/7 and the first ones to see we aren’t being ourselves. Unfortunately because of stigma it makes it difficult and is a topic not a lot of people like to discuss. It’s a double-edged sword. It takes a brave person to confront the individual and cause any more hardships. It is important for them to verbalize their feelings.

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