Postpartum Depression In America

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).

Obesity in pregnant women is a global concern. In The United States, obesity is a critical public health issue—one in every three women is obese (Masho, et al). This issue becomes crucial in the context that 36% of pregnant women in the United States are obese (Shub, et al). Studies show a strong association between maternal obesity and health risks during pregnancy and labor. In addition, a disconnect in perception and awareness exists such that most obese pregnant women who gain weight during pregnancy underestimate their Body Mass Index (BMI); and also have poor knowledge about the risk associated with obesity.

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.

Postpartum depression, which is the most prevalent of all maternal depressive disorders, is said to be the hidden epidemic of the 21st century. (1) Despite its high prevalence rate of 10-15% and increased incidence, postpartum depression often goes undetected, and thus untreated. (2) Nearly 50% of postpartum depression cases are untreated. As a result, these cases are put at a high risk of being exposed to the severe and progressive nature of their depressive disorder. (3) In other words, the health conditions of untreated postpartum depression cases worsen and progress to one of their utmost stages, and they are: postpartum obsessive compulsive disorder, postpartum panic disorder, postpartum post traumatic stress, and postpartum psychosis.

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,

Postpartum depression (PPD) affects at least 10-20% of new mothers. However, the true incidence may be much higher due to the fact that screening is not considered to be a standard practice, leaving PPD undetected and untreated in many women (Schaar & Hall, 2014). Postpartum depression not only negatively affects the mother; it also has a negative impact on the infant. For this reason, it is important for the health care providers caring for pregnant and postpartum mothers to screen them for risk factors associated with PPD, as well as educate them on ways to lessen their chances of getting PPD. It is also important for the health care providers to screen for PPD with a standardized tool like the Edinburgh Postnatal Depression Scale (EPDS), and to take action in treating it when it is suspected or diagnosed.

The Center for Disease Control estimates that 1 in 20 people suffer from depression (2014). Although widely recognized and somewhat easy to diagnose, depression is an ignored and almost hidden, disease. In women, the statistics are especially grim for those who are pregnant or were recently pregnant. A great number of women suffer from postpartum depression; an illness which is often overlooked, misdiagnosed and untreated. Postpartum depression (PPD) has been defined as an emotional disorder that occurs in an estimated 10-15% of all women after childbirth (Liberto, 2010). Postpartum depression not only impacts the mother, but can cause long-term psychological challenges for the baby and create emotional turmoil for all family members.

Postpartum depression (PPD) is a major event occurring in eight to fifteen percent of the woman population after delivering their child (Glavin, Smith, Sørum & Ellefsen, 2010). The symptoms and causes of PPD are similar to depression symptoms in other periods of life (Glavin et al., 2010). These symptoms may include feelings of helplessness and hopelessness, loss of interest in daily activities, sleep changes, anger or irritability, loss of energy, self-loathing, reckless behavior and concentration problems. These symptoms may lead to other factors that are detrimental to the child bearing and rearing family.

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

Postpartum depression (PPD) affects about eighty-five percent of new mothers and persists as long as a year after childbirth (Texas Medical Association, 2015). In spite of the scope of this problem and the benefits of screening women, it’s not standard procedure (New York State Department Of Health, 2016). This policy brief was written for healthcare providers that treat new mothers at risk for PPD with the goal of improving screening and the number of women receiving appropriate treatment. The recommendations address measures to improve early identification and follow-up care for women found to have PPD.

A woman’s body goes through many changes during pregnancy and after childbirth. Women can experience “postpartum baby blues” a few days after they deliver. During the postpartum baby blues, mothers may experience “depression, fatigue, insomnia, headache, anxiety, sadness, and anger” (Lowdermilk, Perry & Cashion, 2014). If the symptoms do not subside in a few weeks post-delivery, a mother may be diagnosed with postpartum depression (PPD). The estimated prevalence of mother experiencing postpartum depression is around 10-15% (Lowdermilk et al., 2014). Postpartum depression can affect a woman’s everyday life and how she responds to having a new baby in her life. She may not feel as though she can take care of her baby which can become a problem.

Postpartum depression is the most common psychological complexity that occurs after childbirth (Bakhshizadeh, 2013). This form of depression has been reported to be as high as 20% (Asltoghiria, 2012). The mother will begin to experience postpartum depression between the birth of the infant and 6 to 8 weeks later (Bhati, 2015). Depending on the person, the typical length of postpartum depression ranges anywhere from two weeks to two years in length (Posmontier, 2010). It is thought that postpartum depression affects mothers of multiples at a greater incidence than mothers whom birth just one child, and the chance increases with the number of children in a multiple birth. Evidence shows that the older the mother’s age at the time of birth, shows there is no notable increase in the risk of being diagnosed with postpartum depression. Another factor that is thought to have an influence on the diagnosis of postpartum depression is income within the household. A study shows that as income goes down, the risk of having

Inner-city women, teenaged mothers, mothers with lower levels of education, and mothers of preterm infants have higher reported rates of postpartum depression, although, postpartum depression is present across the spectrum of socioeconomic class, race, age, and for both first time mothers as well as mothers who have had previous births without depression (Wisner, Logsdon, & Shanahan, 2008). The costs of maternal depression are unknown, but the costs of depression in the United States in the year 2000 totaled $83.1 billion dollars (Santoro & Peabody, 2010). Postpartum depression can result in maladaptation to the mother-infant relationship, which can lead to negative effects on children, including: impaired mental and motor development, difficult temperament, poor self-regulation, low-self esteem, and behavior problems (Wisner, Logsdon, & Shanahan, 2008). All of these undesirable outcomes in children are no doubt adding to health care

Postpartum depression (PPD) exists as a part of the spectrum of major depression, coded with a modifier for postpartum onset which is defined as an episode of depression, mania, or

Feeley, N., Bell, L., Hayton, B., Zelkowitz, P., & Carrier, M. E. (2015). Care for postpartum depression: What do women and their partners prefer?. Perspectives in psychiatric care, 120-130.