top of page

Hel-looo Birth World – the Sky is Blue: Part One of an interview with Walker Karraa MFA, MA CD(DONA)

Originally posted June 25, 2012.

How Long Must We Ask for Compassionate Care?

Why aren’t our childbirth websites and our perinatal mental health websites linked?

Part One of an interview with Walker Karraa MFA, MA CD(DONA)

Pregnant and postpartum women are particularly vulnerable to mood and anxiety disorders, and it is life threatening.”

I had the pleasure of interviewing Walker Karraa about her dual roles in maternal health: as a professional working in the birth world and also in maternal mental health, and about her work to develop awareness of the overlap of both fields and to bring them together. I want to add, she is a wonderful person, very kind and giving and very much a visionary.

Kathy: Walker, you are an activist and intellectual in the area of Maternal Mental Health: perinatal mental illness, birth trauma/PST/PTSD secondary to childbirth, women having a voice in their birth process and scientific research. Most recently, you were selected to serve as the President of Penny Simkin’s new organization PATTCh (Prevention and Treatment of Traumatic Childbirth).

You are someone who is bridging the different organizations serving women and families: the birth world and the perinatal mental illness world.

Nowadays,there are many of us out there who are spanning both worlds, with certifications/degrees/licensure both in birthing and in mental health.

Walker: There are a growing number of professionals spanning both worlds–that is what Penny Simkin and Phyllis Klaus’ new organization PATTCh is all about. We are a collective of cross-disciplines dedicated to the advancement of research, awareness, and education regarding PTSD secondary to childbirth. More to come on that!

There is also a growing understanding of the interplay of mental health and reproductive health along the reproductive life span in many areas. Dr. Michael C. Lu, for example, and his work on reproductive life course model of pre-conception and inter-conception health. Brilliant. Pre-conception and inter-conception are the next wave of clearer, and deeper understanding of body-brain interdependence. We need alot more support for our sisters at the other spectrum, those in menopause and post-menopause. So much to do!

Kathy: Tell me more about your involvement in bridging the gap between the birth world and the world of maternal mental health.

Well, I would say that it is an ongoing unfolding due to the courage and energy of a few. Here I think about the vision of Kimmelin Hull and Cara Terreri. I asked Cara if I could write about reproductive mental health for Giving Birth With Confidence. She not only accepted, she connected me with Kimmelin at Science and Sensibility.

Kimmelin and Cara exemplify bridging the gap. But first they knew there was a need. That “gap-awareness” moved the dialogue on the sites to include the full range of a woman’s experience—one that includes the overwhelming evidence of the role emotional wellness plays in healthy birth.

Beyond that, I have learned a lot about resistance. Someone told me recently that I could say the sky is blue and it would make people angry. Ha! Many of the folks reading this can probably relate. At first I was really shocked that questioning the status quo would be met by fellow advocates with such force!

I think I was mistaken in believing that women who had fought hard for the rights of birthing women would naturally accept the connection to maternal mental health.

Well, the sky is blue: Pregnant and postpartum women are particularly vulnerable to mood and anxiety disorders, and it is life threatening.

We all know the sky is blue, we all know that 1 in 7 of our clients is suffering a dark hell we would not wish on anyone. We know that one of the greatest barriers to treatment is stigma, stigma for all mental illnesses is huge, but for mothers, I believe it is the most damaging.

When I started advocating for perinatal mental illness in the birth community, I thought there were easy fixes, easy bridges such as posting resource links to Postpartum Support International, or the National Suicide Hotline on our birth organizations websites.

These were universally rejected. Still there is resistance. How many resources are there on our websites right now? Not only for women and families, but for our sister doulas and childbirth educators? They need accurate information and resources to help them help women. What are we afraid of?

I am learning that there are situations that are not going to change. Acceptance is crucial. Jane Honikman, founder of PSI, has been very influential in this learning for me. Knowing and not judging the resistance, is a key step to change.

From that knowledge we can learn that rather than trying to force a cruise ship to do a U-turn, we can spend our energy making new situations that have that change built in from the beginning.

Watch for Part Two of the interview coming out in a few days, in which Walker discusses how we can all work to bring the knowledge and work together in order to help our sisters.

Bio: Walker can be reached via her website She works as a birth doula specializing in supporting women with traumatic past. Walker is a regular contributor to the Lamaze blogs, Science and Sensibility and Giving Birth With Confidence. She is completing her doctorate at the Institute of Transpersonal Psychology. She lives in Los Angeles with her husband and two children.


Palladino, C. L., Singh, V., Campbell, J., Flynn, H., & Gold, K. J. (2011). Homicide and suicide during the perinatal period: Findings from the National Violent Death Reporting System. Obstetrics & Gynecology, 118(5). 1056-1063. doi: 10.1097/AOG.0b013e31823294da


bottom of page