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

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.”

Walker Karraa, MFA, MA, CD(DONA)

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 walkerkarraa.com  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



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

  • Hi Kathy,
    Thanks for this interview. This work is so important. It’s hard to believe that anyone would dispute it. Dealing with perinatal mental health is essential to the health of the mother and the child. I look forward to part 2.
    Carolyn Stone recently posted..Summer Time (and the living is easy?)My Profile

    • Thanks so much Carolyn! I am so thrilled at the feedback here. And Kathy is leading much of this fight and has been for years. I would love to know your feedback on next installation (I get specific!)

  • Hi Carolyn – thank you for your input. I know, I think it’s odd that there could possibly be a dispute about this, but apparently it was a big deal even to have a mental health blogger on the Lamaze blogs. Kathleen Kendall-Tackett was the first then Walker then me. Seems obvious from the mental health profession side.
    Kathy Morelli recently posted..Hel-looo Birth World – the Sky is Blue: Part One of an interview with Walker Karraa MFA, MA CD(DONA)My Profile

  • Hi Kathy,
    I am so happy to see a dialogue is started. Also that resources are coming for our family’s. Being a Doula and Massage Therapist having a list of resources for my client’s is so important. Thank you! Looking forward to part two of the interview!

    • Hi Rachel – thanks so much for your thoughts! I think there are alot of us out there who are trained as birth workers, bodyworkers and in mental health and there is a great deal of cross-over! It’s all in service of women & families! thanks for stopping by!

  • Hi, Kathy,
    Such a timely article. Shows we have much work to do on building bridges for change and reducing the stigm regarding mental illness.
    Arlene H. Johnson
    Arlene H. Johnson recently posted..Top Ten Ways to Help Your MarriageMy Profile

  • Yes, it’s really hard to believe that this willful denial of perinatal mental illness would exist. How frustrating! I’m glad you and others are working to bridge this gap.
    Rachelle Norman recently posted..Skin Hunger and Caregiving Through MusicMy Profile

  • I completely agree with Walker. Dealing with high risk pregnant women on prescribed bed rest (and having had 2 high risk pregnancies myself!!) has been an eye opening experience. It blows my mind how the notion that a woman’s state of mind has nothing to do with the outcome of her pregnancy just doesn’t cross many cliniicans’ minds. Statistics show that women who have high risk pregnancies resulting in bed rest are up to 8 time more likely to experience perinatal mood disorders. Yet, high risk pregnant women are often the most overlooked! Once the bed rest is over and the baby is delivered, especially if the baby is healthy, everyone is so busy “high-fiving” that they fail to look at the shell-shocked mama. And while she is ecstatic to have her baby, she cannot deny the feelings of despair she is having over her pregnancy experience (in particular, feeling robbed of the pregnancy experience or feeling like she failed as a woman for having to go on bed rest in the first place!). But does she say anything? Good heavens no, Because the common response is, “What are you complaining about? You’ve got a healthy baby!”

    We have to acknowledge that even when things appear to be “great” there can be underlying sadness, despair, shock or even trauma as a result of unexpected events. It can be the result of something as “simple” as needing forceps to deliver to something as traumatic as post partum hemorrhage. The bottom line is that as birth professionals, we have to acknowledge and be on the lookout for a woman’s emotional response to her experience. We may think that all is well, but if she is processing the experience differently and we don’t ask, we may be missing really important cues to potentially serious mental health disorders.
    Darline Turner-Lee recently posted..Mamas on Bedrest: Drinking Water Helps Prevent Preterm Labor!My Profile

    • Hi Darline – thanks for such an astute response! I love that birth professionals from different fields of concentration are coming to the same conclusion, as we can see what is right in front of us. Keep up your wonderful supportive work! Take care, Kathy
      Kathy Morelli recently posted..Hel-looo Birth World – the Sky is Blue: Part One of an interview with Walker Karraa MFA, MA CD(DONA)My Profile

    • Dear Darline,
      Thank you for your comment. Your experience and knowledge is so important! I so appreciate your work, and reminding me to not forget the invisibility of mom’s on bed rest. Marginalization takes many forms. The statistics on women of color and perinatal mood and anxiety disorders is just as alarming. Invisible. What do you think it is? Fear of mental illness? That’s what former first lady Rosalynn Carter says in her brilliant book “Within Our Reach”–she shares that she thinks we are afraid mentally ill people will be violent.

      And your speaking to the high-five post delivery is haunting. There are footprints on the bones of women who lay horizontal and hyper vigilant to the health and well being of themselves and their baby.

      We need more solid qualitative data on this, don’t you think? The phenomenology of bed-rest is so unexplored.

      I truly appreciate your comment and let’s find ways to create something together with everyone on this thread!

  • Being a visionary isn’t for everyone…in fact, few can hang in there long enough to call themselves (or be called by others) a visionary. Walker absolutely fits the bill; she’s willing to call a spade a spade even when she knows her forthright assessment will stir the waters. Walker is the kid who boldly proclaims the Emperor’s paradin’ down main street sans clothing. Unabashedly honest, it is this type of person who prompts the rest of us to open our eyes and recognize blatant truths before us.

    Isn’t that how important changes have almost always been achieved throughout history?
    How many of us are willing to stick our necks out there, proclaim a spade to be exactly what it is, and propose thoughtful, alternate solutions?

    One of the greatest shortcomings among human beings, I think, is apathy. And yet, I am glad to know people like Walker Karraa are doing their damnedest to shirk apathy and instigate change.

    • Hi Kimmelin – I am so honored to have YOU, the former editor of Science & Sensibility. haunting my blog! I hope you are well! Yes, I agree, Walker is truly a visionary and I love her dearly.
      And you are certainly helping Sisyphus roll the boulder up the mountain! thanks for your comments and I miss you, you helped me so in April! You did a tough job for a long time! take care, Kathy

    • An honor. Thank you. But you, dear Kimmelin, like everyone on this site and so many others all over the planet know that there is more to be done in the trenches of what isn’t pretty, or easy, or known yet. Women bleed and grieve usually all alone, and then it spills out onto the next generation. Every time we break into a dozen invisible pieces we should know there is a soft place for all of ourselves to land, and be recognized, respected and reflected by others.

      Spaces like this blog are those pieces of refuge!

    • Walker,

      Your kind words are heartwarming, and yet I feel as though I have only provided the portal through which you have opened up your time and thoughts to share with women everywhere. Your work and voice on Giving Birth with Confidence has moved beyond simply defining postpartum disorders — you strive to show authentic experiences, real stories, real women. Given the nature of our intended audience on the blog, I am hopeful that we are reaching women in need of finding their own voice by assimilating with others. So, thank YOU for your perseverance and passion. It’s infectious — keep spreading it!

      • Hi Cara – I am thrilled to have you stopping by my humble abode! You, too, supported Walker in her quest to help others, as you are also doing. Your work expands the positive energy field of the earth!

  • Ashley:

    I can’t wait to see the part two of the interview. For sure that there a lot of insights that I can get from it.
    Ashley recently posted..piano music books for beginnersMy Profile

  • […] can read more about Walker Karraa in an in-depth interview her and about Heidi Koss in an article about EMDR for birth trauma […]

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