Can Providers' Education about Postpartum Depression Increase the Acceptance Levels of Pediatrics Medical Providers to Screen Mothers for PPD?

Postpartum depression is one of the most common complications of childbearing with an estimated prevalence of 19.2% in the first three months after delivery (1). Depressive episodes (major and mild) may be experienced by approximately half of women during the first postpartum year (1). Characterized by depressed mood, loss of pleasure or interest in daily activities, feelings of worthlessness and guilt, irritability, sleep and eating disturbances (2), its etiology is multi-faceted and complex (3;4).

Often the time after birth is a filled with joy and happiness due to the arrival of a new baby. However, for some mothers the birth of a baby leads to some complicated feelings that are unexpected. Up to 85% of postpartum woman experience a mild depression called “baby blues” (Lowdermilk, Perry, Cashion, & Alden, 2012). Though baby blues is hard on these mothers, another form of depression, postpartum depression, can be even more debilitating to postpartum woman. Postpartum depression affects about 15% (Lowdermilk et al., 2012) of postpartum woman. This disorder is not only distressing to the mother but to the whole family unit. This is why it is important for the nurse to not only recognize the signs and symptoms of a mother with postpartum depression, but also hopefully provide preventative care for the benefit of everyone involved.

Postpartum psychiatric disorders, particularly depression, has become the most underdiagnosed complication in the United States. It can lead to increased costs of medical care, inappropriate medical care, child abuse and neglect, discontinuation of breastfeeding, and family dysfunction and adversely affects early brain development (Earls, 2010). Over 400,000 infants are born to mothers that are depressed. One of 7 new mothers (14.5%) experience depressive episodes that impair maternal role function. An episode of major or minor depression that occurs during pregnancy or the first 12 months after birth is called perinatal or postpartum depression (Wisner, Chambers & Sit, 2006). Mothers with postpartum depression experience feelings of extreme sadness, anxiety, and exhaustion that may make it difficult for them to complete daily care activities for themselves or for others (Postpartum Depression). The six stages of postpartum are denial, anger, bargaining, depression, acceptance and PTSD. These stages may affect any women regardless of age, race, ethnicity, or economic status. However only a physician can diagnose a woman with postpartum depression. It does not occur because of something a mother does or does not do, it’s a combination of physical and emotional factors. After childbirth, the levels of hormones in a woman’s body quickly drop; which may lead to chemical changes in her brain (Postpartum Depression). Unbalanced hormones may trigger mood swings.

The birthing process generally leaves women with overwhelming joy and happiness. However, some women do experience a period of postpartum blues lasting for a few days or at most a couple of weeks but goes away with the adjustment of having a baby (Postpartum Depression, 2013). A condition called Postpartum Depression Disorder (PPD) leaves a dark gray cloud over 10-20% of woman after birth that is recognized in individuals 3 weeks to a year after the delivery of their baby (Bobo & Yawn, 2014). PPD leaves new mothers feeling lonely, anxious, and hopeless (Bobo at el, 2014). Postpartum Depression is a cross cutting disorder that can affect any woman after the delivery of a baby regardless of race, socioeconomic status, age, or education level (Postpartum Depression, 2013). Although this disorder affects more than 10% of women the article Concise Review for Physicians and Other Clinicians: Postpartum Depression reports that less than half of women with PPD are actually diagnosed with this condition (Bobo at el, 2014). It is important that postpartum women and their support systems receive education on what PPD consist of and ways to recognize the signs and symptoms of PPD so that a diagnosis is not overlooked. Early diagnosis is important because early recognition and treatment of the disorder yields for better results when treating individuals with PPD. In this paper I will deliver information about PPD based on recent literature,

As mental health in America is finally being addressed and more research is seen, it is important to look at the potential causes or correlations that lead to common diagnoses for patients. According to Brummelte and Galea (2010), “depression affects approximately 1 in 5 people, with the incidence being 2-3x higher in women than in men.” Postpartum depression (PPD), a subset of this debilitating disease, has an estimated prevalence rate of 13-19% with another estimated 50% that are undiagnosed (O’hara and McCabe, 2013). As a whole, it has the same symptoms as major depressive disorder but diagnosis occurs within 0-4 weeks of giving birth (American Psychiatric Association, 2013). Part of this lack of diagnosis is due to a multitude of healthcare

Postpartum Depression also referred to as “the baby blues” is depression that is suffered by a mother following the birth of her child that typically arises from the combination of hormonal changes and fatigue, as well as the psychological adjustment to becoming a mother. Most mothers will feel depressed or anxious after the birth of their child, however it turns into postpartum depression when is lasts longer than two weeks, and if treatment is not sought after a month, it could continue to worsen severely.

There are times when new mothers are misdiagnosed and are given a lesser form of this depression. This is called having the baby blues, which is when a new mother experience’s mood swings, and anxiety. These symptoms can last one or two weeks after giving birth, where postpartum depression can continue on for months at a time. Even with baby blues having such a shorter time frame even after 2 weeks’ these new mothers are not being diagnosed correctly. In Mental Heath of Teen Mom Matters, Shiloh gives her experience “My son was crying and it was like the noise of scratching a chalkboard” (Reese p. 1) A new mom can face all these difficulties and my feel as though they do not have a maternal attachment to their

According to two recent studies, 7-13% of all postpartum women suffer from depression. Even more alarming, the prevalence of postpartum depression (PPD) in mothers who have pre-term infants rises to 30-40% according to a recent review (Robertson E, Grace S, Wallington T, Stewart DE., 2004; Schmied V, Johnson M, Naidoo N, et al., 2013). Mood and anxiety disorders, specifically PPD, are severe, yet common complications in women of reproductive age. Undertreated depression in postpartum women is associated with health risks for both the mother and infant, making the goal of euthymia a top priority in the care of postpartum women. Current practice regarding PPD focuses on the triad approach of early detection and prevention, the use of pharmacotherapy, and the use of psychotherapy. However, the treatment of mental illness during pregnancy requires weighing the benefits of pharmacological treatment for the mother, to the risk of the medications on the growth and development of the fetus as well as the theoretical risks associated with undertreated depression. However, many studies are showing that the risks of postpartum depression to both the mother and infant significantly outweigh the risks of pharmacological treatment during pregnancy. Also, due to the ethical issues surrounding trials of pharmacotherapy during pregnancy, further research to determine evidenced-based methods of treatment are still necessary. The most important intervention to date is a

42). The stress of caring for a newborn or even the circumstances surrounding labor and delivery may cause the first symptoms of PPD. Initial stressors related to labor, delivery, and bringing the baby home give way to new triggers (Dieta et al., 2007, 1516). Infant temperament can intensify or minimize a new mother’s PPD symptoms depending on the child’s sleep patterns, frequency of crying, being easygoing or demanding, and whether or not baby is socially reinforcing with smiles and coos (Perfetti et al., 2004, p. 57). Increasing guilt, overwhelmed feelings by child care responsibilities, and fear of being unable to cope can cause the mother to show less affection to her baby, and be less responsive to his cries (Kabir, 2006, p. 698). The infants in turn tend to be fussier and distant making less positive facial expressions and vocalizations (Beck C., 2006, p. 42). Hostile effects on the child continue throughout the first year after birth, but PPD places children of all ages at risk for impaired cognitive and emotional development as well as psychopathology (Beck C., 2006, p. 42).

Depression, in general, affects more than 340 million people around the world and is reported to be the highest cause of disability in high-income countries (Demissie). 15% to 85% of mothers can experience postpartum “blues” with postpartum depression rates between 11.7% and 20.4% in the United States alone (Ersek). This depression can occur at anytime from post-delivery up to one year (Ersek).

An article on postpartum depression states “70 to 80 percent of women who have given birth experience what are called the ‘baby blues’ or the ‘fourth-day blues’ “(Postpartum Depression). The “baby blues” and “fourth-day blues” have symptoms of mood-swings, unhappiness, anxiety, irritability, or restlessness and these symptoms will often go away or lessen without medical intervention (Postpartum Depression). If someone experiences these symptoms they are not automatically classified with having PPD.

Despite widespread recognition of the problem of maternal depression and the potential benefits of screening, screening for maternal depression is not a standard (New York State Department Of Health, 2016). This policy brief was written for healthcare providers who treat expectant and new mothers with goals to improve the screening and to increase the number of women receiving appropriate treatment in our community. The recommendations address measures to improve early identification of the condition and preventive/follow-up care delivery for women in prenatal to postpartum periods.

I agree with you that it is important to pay attention to a mother’s health and mental well-being. As you stated in your post regarding questions at the first visit, you included asking how the mother is doing emotionally. Assessing the health of the mother is a key component in the assessment of an infant, or child. Both the mental and physical health of the mother can have a profound effect on the child. Postpartum depression (PPD) occurs in 1 of 7 women, with symptoms starting anytime within the 1st year of life (American Academy of Pediatrics, 2016). Although women should have a scheduled follow-up with their obstetrician post-delivery, proper screening for PPD may not always be completed. The American Academy of Pediatrics recommends pediatricians

Mothers who have brought into this world a blessing have been preparing themselves for a big change in their life. They have been learning and educating themselves about how to be a good mother. Many mothers find it really hard to transition from being an independent woman without children to becoming a mother (Corrigan, Kwasky, & Groh, 2015). Adapting to motherhood can be a drastic change, and usually creates challenges that lead to feeling overwhelmed (Leger & Letourneau, 2015). When a newly mother begins experiencing stress or becomes emotional then there can be a possibility that they can encounter Postpartum Depression (Leger et al., 2015). Postpartum depression can be seen and experienced in many different ways, it all varies on every mother (Corrigan et al., 2015). Many different mental health issues can be seen including baby blues, postpartum depression, postpartum obsessive-compulsive disorder, and the most serious, postpartum psychosis (Tam & Leslie, 2001).

Postpartum depression (PPD) is a common and serious illness that affects 14% of women post childbirth.1 PPD is thought to evolve from neuroendocrine changes, such as pregnancy stress and personality predisposition.2 Women with PPD are likely to report symptoms that affect their physical functionality such as tiredness, headache, musculoskeletal problems, mastitis, perineal pain and dysuria.3 These symptoms make them prime candidates for Physical Therapy. There are also many psychosocial issues that coincide with PPD that can negatively impact