Every woman who has given birth knows all too well the hormonal ups and downs that make up the postpartum period. Life with a new baby can feel like a rollercoaster ride that we forget just in time to have the next child. In those sleep-deprived days of crying (both baby and mom) and constant baby care, many women experience some sort of “baby blues.”
However for many women, it’s more than that. According to a recent study, approximately 22 percent of women suffer from postpartum depression (PPD). That’s not just a few; that’s 22 out of every 100—nearly one-quarter of all women who have given birth. It’s your partner, your sister, your best friend, or your co-worker. Maybe it’s you.
Many of these women are not receiving adequate treatment for their depression, and the result can be damaging to both the mother and her child. The problem is two-fold; women are not being screened for depression risk during pregnancy and, in the postpartum phase, mothers are not being diagnosed and treated.
Further exacerbating the problem is that despite news coverage of tragic stories of women suffering from PPD, we still aren’t really talking about what we should be talking about regarding this issue. A recent New York Times series looks at the realities of postpartum depression and highlights the need for effective communication in and beyond the postpartum period.
Here are some warning signs of postpartum depression:
- Loss of appetite
- Intense irritability and anger
- Overwhelming fatigue
- Loss of interest in sex
- Lack of joy in life
- Feelings of shame, guilt or inadequacy
- Severe mood swings
- Difficulty bonding with your baby
- Withdrawal from family and friends
- Thoughts of harming yourself or your baby
There is also a more severe form of PPD called postpartum psychosis. Although uncommon, this condition requires immediate treatment and sometimes, hospitalization. Symptoms of postpartum psychosis include hallucinations, delusions, and paranoia.
Effective communication about PPD starts with health care providers. Providers need to listen to the mother, encourage her to share her feelings, and support her to seek treatment. However, this is not always easy. New mothers can feel isolated and overwhelmed with the responsibility of caring for a newborn. If women feel that they are being judged or dismissed for their feelings (“It’s just the baby blues”) they will not get the help that they need.
One option for providers is a screening tool, such as the Edinburgh Postnatal Depression Scale. Using such a tool allows a provider to ask questions during the first postpartum visit (usually at 6 weeks) to assess for signs of possible PPD. Pediatricians often see the baby earlier (usually at 2 weeks) and can also screen the mother and observe her with her baby.
The final component of addressing PPD is treatment referral, and this needs to be timely, efficient, and ultimately effective. A mother struggling with depression is not going to be helped by an outdated list of providers, a lack of response from agencies, or a delay in getting an appointment.
It may seem tough to face the idea that motherhood is anything less than glorious, but the more often we talk about the real aftereffects of childbirth, the easier it will be for women to seek treatment.
For support, mothers should check out the information on postpartum.net.
Providers, meanwhile, can seek guidance at www.mededppd.org/mothers/.
Gabrielle Hathaway has an M.S. in Health Communication from Boston University as well as a B.S. in Maternal/Child Health. She works part-time as an IBCLC for the Massachusetts WIC program and has a small private practice. She hopes to use her knowledge of children and public health to participate in health care policy development, reform, and administration. Gabrielle also serves as a reviewer for the Journal of Health Communication and enjoys reading and writing about health issues.