Depression After Childbirth

We've written about postpartum depression previously, but it's a topic worth covering repeatedly.

A recent survey found that many Oklahoma women suffer from depression after childbirth. These results are likely very similar to what would be found in other areas too. Here is the text of a press release from the Oklahoma Department of Health, with commentary added:

One in four (25%) new mothers in Oklahoma report symptoms of maternal depression after giving birth, according to a recent study conducted by the Oklahoma State Department of Health (OSDH).

Using the Pregnancy Risk Assessment Monitoring System (PRAMS), an ongoing statewide survey of maternal behaviors and experiences, OSDH officials found that 40% of Oklahoma mothers did not discuss postpartum depression, or PPD, with their health care provider.

Of special concern were adolescent mothers, who were 2.5 times more likely to indicate symptoms of PPD as mothers age 35 and older.

“These findings are of major concern to health care professionals and should place families on alert to watch out for signs and symptoms of depression in new mothers,” said Secretary of Health and Commissioner of Health Dr. Michael Crutcher.

The symptoms of postpartum depression include:

• loss of interest in pleasure in life;
• change in appetite;
• less energy and motivation to do things;
• having a hard time falling asleep, staying asleep, or sleeping more than usual;
• increased crying and tearfulness;
• feeling worthless, hopeless or overly guilty;
• feeling restless, irritable or anxious;
• and having unexplained weight loss or gain.
• Additional symptoms include feeling like life isn’t worth living,
• having thoughts of hurting yourself or worrying about hurting the baby,
• or someone else hurting the baby.

Among the stressors found to increase the risk of depression symptoms are:

• arguing with a partner more than usual during pregnancy,
• having bills one cannot pay, and
• having an unintended pregnancy.
  

Additional highlights from the Oklahoma PRAMS survey on PPD include the following:

• Women ages 20 to 24 were twice as likely to indicate symptoms of depression when compared to women 35 or older.
• Women with infants placed in the Neonatal Intensive Care Unit (NICU) were at a higher risk for depression.
• Mothers are at special risk for postpartum depression when caring for infants born prematurely or infants with special health care needs.
• Women who did not receive a postpartum checkup were also at a higher risk for symptoms of postpartum depression when compared to women who did receive their postpartum checkup.
  

To address PPD, public health officials recommend the following:

Ask your daughter's doctor to screen your pregnant daughter for maternal depression before birth at a late-term prenatal visit.

Ask your daughter's doctor to screen your daughter for maternal depression at each doctor visit during the first year after the birth of her child.

Make sure your daughter understands the importance of returning for her postpartum checkup around six weeks after delivery.

If your daughter has an infant in the NICU, search for support groups near your home and in the hospital, and research more information on PPD.

Ask your Medicaid provider if there are any maternal and infant health licensed clinical social work services available to your daughter.

Ask your doctor, nurse, and hospital staff for education about PPD awareness, referrals for treatment and follow-up care.

Encourage new mothers with signs and symptoms of depression to call the PSI national hotline 1-800-944-4PPD. Information is also available at http://www.postpartum.net.

Ask your daughter's school counselors what support they can provide for pregnant and postpartum adolescents to cope with the stress of motherhood, schoolwork and feelings of isolation.