Category Archives: research

Health care practitioners discourage disclosure of Postnatal Depression

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Picture by Flickr

Picture by Flickr

In a study published yesterday, UK researchers reviewed the disclosure of Postnatal Depression from three different vantage points – the mother, the GP, and home health visitors.

The results are chilling.

The mothers reported making a conscious decision regarding their decision to disclose symptoms of Postpartum Depression which is not terribly shocking because I went through the same thing. It is most definitely a conscious decision and a difficult one at that.

The chilling result lies within the response of the Health Practioners  “described strategies used to hinder disclosure and described a reluctance to make a diagnosis of postnatal depression, as they had few personal resources to manage women with postnatal depression themselves, and no services to which to refer women for further treatment.”

I feel as if I’ve been punched in the gut. I want to cry, scream, yell, stomp my feet. But I know that won’t change what’s going on over there and even over here because I’m sure this attitude is very pervasive in the medical community here in America as well.

Where’s the responsibility of the medical professional who turns a blind eye to the struggling new mother and actually uses strategies to prevent her from admitting she’s having a hard time? How does that serve anyone but the selfish nature of that physician? What happened to the Hippocratic Oath and “Do no Harm?”

If we pretend a problem doesn’t exist, it doesn’t go away. What if we pretended cancer was all in our heads and didn’t offer chemo, radiation, or other therapies? Would it go away or would it sit and fester, eventually killing us and hurting those around us? I think we all know that answer. It is no different with Postpartum Mood Disorders. Left untreated a new mother may even slip into Psychosis as she tries to rationalize intrusive thoughts or fall even deeper into depression and attempt to take her own life or even worse, that of her infant’s.

With all the online resources, training, and knowledge at the fingertips of even lay-people such as myself, there is no excuse for medical professionals to ignore this condition anymore. Any medical professional in my opinion who would implement strategies to hinder disclosure of symptoms should be stripped of the right to practice medicine. It’s wrong and it should NOT be acceptable. Mothers deserve to be treated honestly and with respect. They need to be given a safe place in which they are able to admit any emotional trauma or difficulty they are having. Giving them this space will foster the growth of trust and compassion rather than continue to grow the cold shoulder on which they have apparently been leaning upon.

So what can we do about this? Write about it like Katherine Stone, myself, Cheryl Jazzar, and others. SPEAK like Natalie Dombrowski, become active in online peer support like Tonya Rosenberg, talk to another mom and let her lean on you. Let her know you too have been there. Talk with doctors or their nursing staff about your experience and how important their role in discover and recovery can be. Write your Senator in support of The MOTHER’S Act as this wil laid in the growth of knowledge and support among the medical professional as well as research regarding how to bring the new mother and medical professional together. Sharing your story is the best thing a survivor can do. Our voices woven together can be the strongest advocate for increased treatment and acceptance. Won’t you lend us yours?

Prenatal Depression restricts fetal growth

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In a new study published today at ScienceDirect, researchers concluded that Prenatal Depression restricts fetal growth. They also state that up to 18% of all pregnant women experience depression but when focusing specifically on lower socio-economic status and minority moms, the risk more than doubles to 40%. Babies born to depressed moms are more likely to have a smaller head circumference, low birthweight, arrive prematurely, and experience a certain level of growth retardation within their first year of life.

Many mothers, doctors, and family members will buy into the myth that all pregnant mothers are happy. Obviously the numbers beg to differ as do the mothers who experience depression during pregnancy. Moreso than mothers with Postnatal Mood Disorders, pregnant mothers struggling with depression or other mental illness face quite the quandary in seeking treatment. Many find themselves dismissed by their doctors or faced with taking anti-depressants which will affect their fetus as all medications do cross the placenta.

As with any decision, we must always remember to make an educated decision with the support of your physician and other professional advice. There are also risks v. benefits to consider. Yes, there are risks associated with taking medicine during pregnancy but most studies out there do not put this risk at a much higher rate than mothers who do not take anti-depressants.

There are resources for mothers and professionals alike to refer to when faced with this situation:

Mother Risk: A project of the Toronto Hospital for Sick Children, they are staffed and well informed regarding medications, herbs, etc, in pregnancy and the postpartum breastfeeding period.

University of Illinois @ Chicago Women’s Mental Health Program is designed to meet the unique needs of women with psychiatric disorders and life problems including during pregnancy and postpartum.

The Emory Women’s Mental Health Program, established in 1991, primarily focuses on the evaluation and treatment of emotional disorders during pregnancy and the postpartum period. The clinical program is complemented by both clinical and laboratory research into the causes of these conditions and their treatment.

I also want to take this opportunity to promote an upcoming teleclass over at Pampered Pregger and Beyond with Tiffani Lawton and Shoshana Bennett. The class starts tomorrow at 11am EST and will be taking an in depth look at her new book, Pregnant on Prozac. I would highly recommend participating if this topic is near and dear to your heart. Registration at the site is not required but the call is a long distance one. Callers will be muted during discussion and unmuted for Q&A so if you have little ones running around, don’t worry – they won’t be interrupting the flow. For more information, click here.

Blogs as Peer Support for PPD

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With the recent release of the study regarding how helpful peer support is for women with Postpartum Depression, I thought it would be interesting to take a look at blogging as a form of peer support. The source of inspiration for this piece? An article by Kristin Schorsch over at the South Town Star about blogging and PPD in which yours truly is featured along with Natalie Dombrowski.

Many of the women I know who have blogs and have recovered from Postpartum Depression have found their blogging habit to be a powerful source of support. Those who read them undoubtedly feel the same way, finding strength and hope in the words that part ways with those of us who have been through the very dark in which they now find themselves enrobed.

For me, there was relief in knowing I had my blog to lean on and that through my blog I was potentially helping other families survive the very same thing I struggled against. I credit my blogging as a tremendous part of not experiencing PPD the third time around. After all, I had numerous risk factors according to several different studies and statistics.

My first risk factor lied within being a two time survivor. A third episode lies in a nearly 100% risk range. Studies have also shown that women who give birth to boys are more likely to experience Postpartum Depression than mothers who give birth to girls. My third child? A boy. I also had extenuating stressors – a marriage that was dashed onto the rocks at just 3 months postpartum after giving birth to Cameron and financial stressors to boot. Last but not least, women who experience severe pelvic pain during pregnancy are also more likely to suffer from Postpartum Depression. And guess what? I had severe pelvic pain with all three but it was the worst with Cameron. Relying solely on numbers, I should have suffered from Postpartum Depression with Cameron. Yet I didn’t.

Why?

I had peer support, social support, medication, education, blogging, meetings, advocacy, and preparation on my side.

But hey, I had all that too you say. And I still ended up suffering. Unfortunately this is where it gets tricky. What works for one woman in one situation may not work for another woman in her situation.

Why? We don’t necessarily know. What we do know is that communication with other women and TRAINED medical professionals is key to recovery. This is where I get on my soapbox.

The MOTHER’S Act would allow for research funding so we might be able to find these things out. It would also allow funding for additional social and community support programs to be implemented across the country so that no family would have to suffer silently. It would allow for women to speak up without fear about their intrusive thoughts, to admit they are not happy at a time when they feel they should be. It would educate caregivers so no more women would have to be fear being dismissed when they do speak up, as I was. It would decrease potentially lethal cases of untreated Postpartum Depression and catch episodes of Postpartum Psychosis before they reached the breaking point.

The MOTHER’S Act would finally allow for the recognition of Postpartum Mood Disorders as a true illness, allowing for the flow of ideas and treatment options between patients and clinicians to open up. It would allow us to finally create treatment networks between Pediatricians, OB’s, Therapist, Psychologists, and Psychiatrists, keeping women from slipping through the cracks and confused about which medical professional to talk with regarding their emotions.

The passage of the MOTHER’S Act would allow those of us who have survived and those of us who are still struggling to finally begin to live over the rainbow, where we deserve to live. Where there is finally acceptance, happiness, and true hope instead of disapproval, sadness, and despair that permeates the lives of so many women and families fighting to rid themselves of the beast of Postpartum Depression.

Off the soapbox now.

I blog to provide the land over the rainbow for myself and for others. We’ve fought hard enough against the rain on our own. Nothing more, nothing less. Providing hope to those who struggle behind me, those deserving of a helping hand as they claw furiously against the muddy wall of the hole they now find themselves lost inside.

We all deserve the rainbow.

Postpartum depression: Studies show peer support, trained nurses can help

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This is AWESOME news! (Although I could have told you this long ago – tis nice to have an official study to refer to now!)

TORONTO – Postpartum depression affects about 13 per cent of women in the first year after childbirth, but two new studies – one in Canada, one in the United Kingdom – have found that early identification and intervention can help new mothers who are at risk.

The result was fewer depressive symptoms in the months that followed childbirth, according to results published Friday in BMJ Online.

The Canadian study was led by Cindy-Lee Dennis, an associate professor at the University of Toronto, who had previously found that mothers receiving peer support over the telephone were significantly more likely to continue to breastfeed.

“Women just loved this telephone-based support, and I thought, well, what other conditions might this type of support be beneficial for? And so I then related this model to postpartum depression.”

The study involved 701 women in the first two weeks after giving birth who were identified as being at high risk for postnatal depression, scoring greater than nine using a measure known as the Edinburgh postnatal depression scale.

Volunteers to provide them with peer support over the telephone were recruited by putting up flyers in places like community centres and daycare centres and by putting ads in local newspapers in seven Ontario health regions.

To be a peer volunteer, women had to have experienced postpartum depression and recovered. They also took a four-hour training session, for which Dennis developed a training manual.

“What I had the peer volunteers do was let the mother lead the discussion and the conversation and I had the peer volunteers provide useful suggestions,” said Dennis, who holds a Canada research chair in perinatal community health.

The volunteers provided emotional support, validated the new mother’s experience, told the mother about strategies to make her feel better, or where she could seek help if needed.

“We found that mothers who received this telephone-based peer support were at half the risk of developing postpartum depression,” Dennis said.

Postnatal depression was defined as a score of greater than 12 on the Edinburgh postnatal depression scale. At 12 weeks, 14 per cent of women in the intervention group had postnatal depression, compared to 25 per cent in the control group that didn’t have a volunteer telephone partner.

In the other study, Jane Morrell, a health services researcher at the University of Huddersfield, trained “health visitors” – community nurses – to assess a mother’s mood and identify depressive symptoms at six to eight weeks postnatally using the Edinburgh scale. They were also taught specialized skills so they could offer “talking therapy.”

More than 4,000 new mothers took part in the trial, and those who had visits from the specially trained health visitors saw them for an hour a week for eight weeks.

“Irrespective of the kind of therapies or interventions that were offered to the women, the health visitors’ skills in the intervention group were associated with greater improvement in the intervention group than in the control group at six months postnatally,” Morrell said in an interview.

“This improvement was maintained at 12 months postnatally.”

Morrell said that in general, people don’t know enough about postnatal depression.

“Women and their partners need to be better educated about this, ideally during pregnancy,” she said.

“The moms need to be not afraid to ask for help when they’re suffering with symptoms postnatally. And there needs to be much more thorough training for health-care professionals.”

Dennis, meanwhile, said that several health regions that took part in the study plan to maintain their volunteers to continue the postnatal peer support work.

And Dennis is completing work on an economic evaluation of the trial so that health regions will know more about the costs of developing such a program and screening mothers for postpartum depression.

(source: http://www.canadaeast.com/wellness/article/542159)

New Study looks at PPD Screening & Well Child Visits

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A study published in The Annals of Family Medicine focused on The Validity of a 2 step screen and the PHQ-9.

The results found that the 2 step screen was sensitive and the PHQ-9 was highly specific towards identifying Postpartum Depression. Women completed screening at 0 months, 1 month, 2 months, 4 months, 6 months, and 9 months postpartum.

Now if only general family doctors and pediatricians would actually implement this and we could get a solid referral system together for the moms who screen positive for Postpartum Depression, we’d be much better off!

The complete study is available here.