Tag Archives: families

Postpartum Depression formal screening not worth the cost, BMJ study says

According to a recently published study in the British Medical Journal (BMJ), Postpartum Depression Screening is not…. brace yourselves. Worth the cost.

That’s right.

NOT.WORTH.THE.COST.

In their cost effective analysis, the researchers used “A hypothetical population of women assessed for postnatal depression either via routine care only or supplemented by use of formal identification methods six weeks postnatally, as recommended in recent guidelines.”

The conclusion was that overall not using a formal screening method was much more cost effective as it eliminated false positives.

So the mental health of a woman which will then affect her child, her family, her community, the world at large, are just not worth it to the National Health System of the UK. The EPDS scored out at about $67,000 per quality adjusted life years while no screening method scored at a price tag of just $20 – $30,000. No value for the money was found to exist when using the formal identification methods.

Did these researchers not read Murray & Cooper’s Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression which explores the effects of postpartum depression treatments on children?

There is SO much more at stake here than the dollar value to the National Health System.

There’s the potential for broken families. The potential for children growing into their own mental health issues, the potential for continued need for mental health treatment due to an undiagnosed episode of postpartum depression, potential for increased incarcerations due to untreated mental illness, continued sadness, the continued stigma, continued and perpetuated lack of education on the part of physicians in regards to Postpartum Mood Disorders.

The most interesting aspect of this study is that it focused on screening for Postpartum Depression in the Primary Care setting. Primary care physicians are not always comfortable or knowledgeable in screening for mental health issues. If a patient were to screen positive, that physician is then morally responsible for referring them to a specialist. Often times, at least here in the states, a Primary Care physician is unaware of where to refer a patient for help with a Postpartum Depression Disorder. Therefore, they become afraid of screening because they fear what will happen if a positive were to occur. What would they do with the patient? Where would they send them? How would they respond? Are they familiar enough with Postpartum Mood Disorders to recognize a false positive?

I think the key to the results of this study is not so much in blaming the high percentage of false positives but in urging that Primary Care physicians receive more training to enable them to recognize a false positive through more in depth questions after a positive is scored via the Edinburgh Postnatal Depression Scale.

original photo/graphic "Hand holding necklace" by K.Sawyer @flickr

A stronger safety net involving a stronger communication between midwives, Obstetricians, Pediatricians, and General Practitioners is so desperately needed to keep women from falling through the very big cracks which currently exist in the system.

Let’s think about this for a moment, shall we?

A woman gets pregnant. She sees a medical physician to get the pregnancy confirmed. Most mothers seek OB or midwife care for their entire pregnancy. Unless they’re depressed – depressed and mentally ill mothers are less likely to take good care of themselves during a pregnancy, making specialized care even more important even when baby is still in utero. Once mothers give birth, they are then shuttled off to the pediatrician’s office for the bulk of their medical contact. One six week or eight week visit to the midwife or OB to ensure mom is healing properly then an annual PAP visit unless something arises in between. Many Pediatricians focus on babies and not mother. But the tide is changing as more and more Pediatricians are taking into account the family lifestyle and well-being. My own Pediatrician does this and I absolutely adore her for it.

But overall, there is typically no continuity of care, no communication between physicians throughout the birth process. There should be. There needs to be. A woman deserves a team of support. She deserves to thrive. So do her children.

No matter what the cost.

Because once you fail woman and her children, you fail society.

Fail society and we fail to exist.

If we fail to exist….

Sharing the Journey with Ben Murphy

GQ or Maxim just not cutting it for you now that Junior’s arrived?

Then you may want to check out thefatherlife.com where Ben Murphy is one of the founding fathers. Yeah, I said it – FATHER. This totally hip online magazine is rockin’ to it’s own beat and marching along for modern dads daring to stay hip and balancing fatherhood. The Father Life is a mixture of fatherhood advice, life advice, and everything in between (including a couple of awesome articles by Shoshana Bennett on PPD just because folks in the forums were talking about it)

Ben Murphy, Ben Martin, Ben Loux, and Ryan Marshall are the brains behind this wonderful site and I came across it while searching for worthy and intelligent content on the web for fathers. So very impressed with what I saw, I emailed Ben (Murphy) for an interivew and here we are! I know, I know, June is over. It’s July. Trust me, you’ll be glad you read about this and I guarantee you’ll be emailing your husbands to tell them to check out this awesome site!

Tell me about The Father Life. What would a dad walk away with after reading your magazine?

Well, TheFatherLife.com is a men’s magazine created with dads in mind. When I became a father I noticed pretty quickly that all the men’s magazines on the market were for the bachelor set, while the parenting magazines were largely geared towards mothers. It blew my mind that there were no men’s magazines out there geared towards dads… so I got a couple of friends together and we created one!

Our magazine is all online (www.thefatherlife.com), all free, and updated with new articles every week. It’s designed for today’s modern dads who are every bit as involved with their families as they are with their careers and hobbies. A lot of these guys are family men who are also executives. They are also at-home-dads who’ve left the career ladder to spend time with their kids… So, our content is pretty well-rounded. Obviously, there’s a lot of fathering content, but it’s balanced by everything from sports, cars, and investing, to food, fashion, and music.

I want our readers to walk away from TheFatherLife.com encouraged to press on in this new ‘Fatherhood 2.0′ life that’s becoming the norm now for a lot of guys. It used to be that fathers brought home a paycheck and that was it… today’s fathers are turning that model on its head. As one of our readers put it to us a while back, “The Father Life is for guys who work hard, play hard, and father hard.”
How did The Father Life come to fruition?

It was really just seeing a huge void in the marketplace for good fathering media content — and thinking that we could in some way address it. We really started out to create the magazine that we wish was out there on the newsstands. And that is still our aim.  We figure that there are millions of other dads out there as well experiencing the same thing — and they’d probably be interested in a magazine like this!

The whole process has really evolved. I have a background in design and media, including some online magazine experience. So, I knew it was easy to do this in concept. I brought along my friend Ryan Marshall who has an extensive background in web design and my friend Ben Loux who has a background in Finance and Corporate Compliance. It helped that all three of us saw this need for fathering media. We’re all around 30 years old with careers and young families, so we have a lot in common. And we all knew each other from back in college so it was a really good fit.

The three of us started TheFatherLife.com as a quarterly publication so that we could fit it into our schedules. But it’s grown from there to where we’re currently publishing a number of new articles every week. That’s due in large part to how well-received the magazine has been as well as to bringing on Ben Martin, our Editor-In-Chief, last fall. He’s been able to focus solely on developing content and has done an absolutely tremendous job!

The newly updated version of our site is rolling out this August and will have a similar feel, but will allow us to really expand the reach of what we’re doing exponentially. I’m really excited about it! We’ll be posting new content almost daily when that site rolls out.

The success of the magazine has really been from our readership and from the writers who contribute content. The magazine exists on reader-generated content and it’s really been amazing! And our readers are incredible providing their feedback and ideas to help the magazine evolve…
Share with us how you approach fatherhood with your own family.

My wife and I have two young daughters and I’m really just focused on enjoying it. That’s easy to say in a vacuum – harder to execute in the whirlwind of every day life, but I just love my family and love the family life. Having kids puts everything else in perspective… It really is what sparked TheFatherLife.com.
In an interview at www.fatherville.com, you were asked to come up with one word to describe parenting and you responded “Marvelous Chaos.” Share with us what Marvelous Chaos means!

Things are crazy and never quite what you expect — and yet somehow everything falls in place and it’s more wondrous than you could have anticipated… it’s a joy of the unexpected that comes from having kids around.

I want to commend you on your Postpartum Depression articles by Shoshana Bennett as it is important for fathers to understand how they can help their partners during such a difficult time. Have you had any personal experience with Postpartum Depression or known anyone who has? If so, what were your feelings about the situation and what advice would you give to a father currently facing a similar situation?

I’ll be up front that I haven’t personally had interaction with postpartum, but the advice I would give is to be as supportive as you can… and get advice from other guys who have been in the same situation.

The thing I love about the Postpartum articles is that they’re one of the best examples of our readers shaping the content of the magazine. During a 6 month period we were seeing forum posts and receiving emails from guys who were saying, “this postpartum thing is crazy and I want to be supportive of my wife, but I don’t know where to start!” And so those articles emerged entirely from that dialogue.

If you could tell us about one of the most joyous moments you’ve experienced as a father, what would it be?

I think it’s when my kids are just lost in the moment and truly happy… the satisfaction of knowing that you somehow created a context in which they are just loving life and you are privileged to be there and enjoy that moment with them. I guess that’s a pretty abstract answer, but I hope it makes sense…

On the flip side, share with us one of the most challenging moments as a father.

I’m the type of guy who wants to do a lot of things and do them all well… I’m very ambitious and take pride in how I execute things. So, with a family, I don’t have time for everything and I have to set limits. Prioritizing my time for family and limiting my other interests is challenging. I assume all fathers go through this, and I think it’s just a time in one’s life when you start to finally figure out who you are and what’s worthwhile to you. My family comes first.

We all know we need to take some time for ourselves to keep our sanity and sense of self hanging around. What are some of the things you do to keep your sense of self and not lose yourself in your roles as a father and husband?

I’m an artist and I still work on my artwork whenever I make the time (www.benmurphyonline.com – be warned, it’s edgy). I also love outdoor sports and do as much trail running and mountain biking as I can. I like naps too; naps are wonderful!

But you’re right – as great as being a dad is, you can’t give yourself over to it entirely or you lose your sense of self. The same can be said for a career or anything else really. In the end, taking care of yourself helps you take care of those around you. And we try to encourage guys to still be themselves along with being great dads. We say, “Yes, It is possible to be a great guy AND a great dad!” And I hope that our content helps dads accomplish that…
Do you feel fathers are largely ignored by the media at large?

I don’t know – I wouldn’t say ignored. The media is driven by “what’s hot right now” and I’m not sure if fathering has been as hip until now… I feel that TheFatherLife.com is hitting at a time when the whole idea of a “dad demographic” is just starting to gain traction. And in a lot of ways TheFatherLife.com is and will be in the midst of shaping the new (and improved, I hope) perception of dads in popular culture. There are a lot of wonderful emerging dad blogs out there now as well as baby products for fathers (www.diaperdude.com is a good example) — that wasn’t true just a decade ago. A lot has really changed with the internet, and perhaps that’s driven some of this shift. I’m certainly noticing a lot more fathering content now in the media and I think it will continue to grow and improve.

Last but not least, if you had a chance to give an expecting father (new or experienced) just one piece of advice, what would it be and why?

To enjoy it. Just enjoy it. You only get to do it once, so make the most of it.