Maria just had her fourth child. Her older children have been very involved in helping care for the baby. Maria’s husband has been taking the older children out over the weekends to give Maria some rest. The baby is doing wonderfully, but Maria is not. She used to be cheerful and talkative; now she says little, her expression unchanging.

A visitor from Great Expectations worries about postpartum depression and conducts an assessment. Maria’s score indicates that she would benefit from professional help, but Maria doesn’t want to talk to anyone else. She says that she doesn’t have time and that her visitor is enough.

Maria’s visitor is gentle and patient. They talk about how to get enough sleep and how to ask Maria’s family for support. The visitor broaches the subject  each week and listens for any change in Maria’s thinking. After a month, Maria says she is ready to talk to a therapist. Her visitor has already prepared referrals to two Spanish-speaking therapists who both accept Medicaid. Maria completes one appointment and schedules another, happy for the help.

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