Healthy Parenthood

Local therapists work to make maternal mental health a priority

Emily Sarah 1 Of 2 1

Bringing new life into the world is seen as one of the happiest of occasions, with the baby a source of joy to the new parents and extended family. So, when a few dark emotional clouds shade the new parents’ experience, it’s often difficult for them to admit it, even to themselves.

“Sometimes people don’t realize they are struggling,” says EMILY BARLAS (pictured right), a licensed clinical mental health counselor and certified perinatal health professional with Cape Fear Psychological Services. “One in seven women experience some sort of PMAD (Perinatal or Postnatal Mood and Anxiety Disorder). It’s the most common complication of childbirth and that’s why it is important to focus on mental health (related to pregnancy and childbirth). With treatment, PMADs are temporary. Without treatment, the condition can get worse.”

Barlas, who spent several years working with young adults in a university clinic setting, discovered her second calling working with young mothers soon after she became a mother five years ago. She’s been doing perinatal – defined as during pregnancy and just after the birth – and postnatal counseling for three years at Cape Fear Psychological Services, a practice owned by her father.

“A lot of parents might feel grief or loss about what they expected their pregnancy to be like,” she says. “People are starting to become more aware of perinatal mental health issues, but it’s still not talked about as much and there is still some stigma. I hope we can help change this.

What I love is helping women find themselves, working on their identity, and empowering them to integrate this new role, but it can be hard for new mothers to feel like themselves without treatment.”

Barlas’ colleague in peri- and postnatal counseling at Cape Fear Psychological Services is SARAH HESS (pictured left), a licensed marriage and family therapist. Hess, who has eight years of experience, joined the practice in June 2020, and, like Barlas, meets remotely with her clients.

Hess’ interest in helping adults navigate changes in family dynamics and in emotional issues led her to sub-specialize in working with mothers and their families, especially during and after pregnancy.

“I was interested in issues that relate to that: breastfeeding, as well as birthing choices: vaginal, cesarean, and emergency cesarean,” Hess says. “I feel there is, by and large, a lack of resources nationwide. The number of maternal deaths and complications (in the U.S.) is very disproportionate for a first-world country; it’s an epidemic. In the Wilmington area, there is only a handful of people who focus on these issues.”

Hess is also a certified Gottman Bringing Baby Home educator. She explains that GBBH is an evidence-based program to assist new and expectant parents with the transition to having a baby at home.

Before COVID, and before she affiliated with Cape Fear Psychological Services, Hess collaborated with Barlas to distribute information on peri- and postnatal mental health.

“Emily and I were in communication with one of the nurse practitioners at Glen Meade Center for Women’s Health and other maternal health providers,” Hess says, explaining that their goal was to reach as many expectant mothers as possible, regardless of socioeconomic level, with information about issues like mental health and lactation concerns.

“Women of color have worse (childbearing) outcomes than white women do,” Hess adds. “They have more problems before, during, and post-childbirth.”

Hess herself experienced issues during childbirth. She had a traumatic experience with her firstborn, who was delivered via emergency cesarean section and was a purplish-blue color at birth. Although the baby recovered, Hess suffered from PTSD because of the operation and the trauma.

Hormonal and physical changes, mood swings, relationship tensions: COVID-19 has made all the complications of pregnancy and new parenthood even more difficult.

“There definitely have been a lot of families who have struggled with the impacts of the pandemic: the partner not allowed to attend appointments or even go to the hospital with (the woman),” Hess says. “Maybe the baby was supposed to stay at Grandma’s, but now Grandma is part of a vulnerable population and can’t take the baby. A lot of families, especially first-time parents, have had their plans – even the format of their jobs – changed and they are having to pivot.”

Uncertainties and holes in the support network can contribute to depression, anxiety, isolation, and increased relationship difficulties, Barlas adds.

But while COVID shut the office door to patients, technology opened a window: the option of remote counseling sessions via phone or video.

“I can keep them where they are, which is simpler and safer,” Barlas says of telehealth sessions with clients. “I’m providing a connection for them, helping them feel less alone during a challenging time. Some of my clients do want to work in person, and we’re starting that this month. I would like to be able to see flexibility based on each client’s need.”

For the past three years, Barlas has hosted a Climb Out of the Darkness fundraising walk in Wilmington in partnership with Postpartum Support International. The mission: To reduce the stigma and raise awareness of peri- and postnatal mental health issues.

“I so enjoy working with pregnant women who have risk factors for PMAD and help set them up for success,” she says. “I might be with them on a screen days after the birth.”

To view more of photographer Terah Wilson’s work, go to

Want more WILMA? Click here to sign up for our WILMA newsletters and announcements.

Categories: Health