Share Your Maternal Mental Health Story
Maternal Mental Health disorders, like anxiety, panic, birth PTSD, depression, and psychosis impact up to 1 in 5 of us, or up to 50% of those of us living in poverty. For a number of reasons, most women are never diagnosed & never receive treatment, or are diagnosed much later then they should be.
TheBlueDotProject is a social media community providing moms inspiring and real messages about how hard motherhood can be. TheBlueDotProject also hosts the U.S. Maternal Mental Health Awareness Week campaign the first week each May.
TheBlueDotProject is a project of 2020 Mom, whose mission is to close gaps in maternal mental health (MMH) care. Our vision is that all women be informed about maternal mental health disorders, and when needed, receive treatment that meets their personal needs.
By sharing your #MyMMHStory below, you are providing 2020 Mom access to stories to share with law makers and the media, however you will still be given the opportunity to decline to share certain details of your story or your name, if a specific journalist or law maker is interested in speaking with you.
Sign in to Google
to save your progress.
Learn more
* Required
My Role
*
Survivor (Woman who suffered from a diagnosed/likely MMH Disorder)
Father
Other:
Required
Your First and Last Name
Your answer
The City of MMH Baby's Birth
*
Your answer
The State of MMH Baby's Birth
*
Your answer
Your Current City
*
Your answer
Your Current State
*
Your answer
Tell Us Your Story
Your answer
Check all that apply
I had depression during pregnancy
I had depression during the postpartum period
I had general anxiety during pregnancy or the postpartum period
I had scary "intrusive" thoughts during pregnacy or the postpartum period
I had psychosis during pregancy
I had pscyhosis during the postpartum period
I had birth related PTSD
Other:
Race/Ethnicity
*
Caucasion/White
African American/Black
Asian
American Indian or Alaskan Native
Hispanic or Latina
Native Hawaiian or Pacific Islander
Prefer not to state
Other:
Required
E-mail address
Your answer
Cell Phone
Your answer
Anything Else we Should Know?
Your answer
Thank you for participating and helping us drive change.
If you are still potentially suffering from an MMH disorder we urge you to seek help. Contact your doctor or Postpartum Support International at
www.postpartum.net
for a warm line text option.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of 2020 Mom Project.
Report Abuse
Forms