The U.S. Census Bureau reports that 361,481 babies are born each day around the world. That works out to be 251 babies born worldwide per minute. In the U.S., 3.9 million babies were born in 2012. Chances are then that you know a mother who would benefit from knowing she is not alone, if she struggles with depression or sadness after giving birth. As many as one in seven new mothers experience postpartum depression in our country. All experience sleep deprivation and many have difficulty sleeping due to anxiety.
Depression and other maternal mood disorders adversely impact the mother’s quality of life, transition to parenthood and the infant’s health and development. Symptoms can present anytime during the pregnancy and in the 12 months following birth.
According to Denise Mann of WebMD.com in her 2005 feature about Brooke Shields’ struggle with postpartum depression, “More incapacitating than the ‘baby blues,’ postpartum depression is marked by severe sadness or emptiness, withdrawal from family and friends, a strong sense of failure, and even thoughts of suicide. These emotions can begin two or three weeks after birth and can last up to a year or longer if untreated.”
Another actor, Hayden Panettiere, as recently as last month, was quoted by Kelly Lawler of USA Today, as explaining,
“I can very much relate. It’s something a lot of women experience. When (you’re told) about postpartum depression you think it’s ‘I feel negative feelings towards my child, I want to injure or hurt my child’ — I’ve never, ever had those feelings. Some women do. But you don’t realize how broad of a spectrum you can really experience that on. It’s something that needs to be talked about. Women need to know that they’re not alone, and that it does heal.”
According to Lawler, “Panettiere went on to lament the fact that postpartum depression is often so misunderstood, by women and the people around them.”
We often hear that social media can foster a sense of isolation, but in the case of combatting postpartum depression, the launching of the social media campaign by Postpartum Support International on May 7, 2015 and use of the hash tag #PPMD, may be helping mothers connect and get the treatment and support they need. The social media and community awareness campaign is called “You are not alone.”
Another solution being put forward is better engaging stakeholders, leveraging opportunities, and utilizing quality improvement strategies to assure that maternal depression is recognized and addressed within primary care via the establishment of maternal mental health screening, assessment, referral and treatment in obstetric, family medicine, and pediatric health care settings. A public health initiative, this idea applies the life course model by promoting early recognition and treatment for maternal depression, which impacts health outcomes for both mother and child, and elevates public health impact through its two-generation approach.
Quality improvement includes initiating training programs to heighten the sensitivity of primary care providers about maternal mental health care through professional development. (Law enforcement and legal experts are another key stakeholder group.) Some of the barriers to the diagnosis of depression and other maternal mood disorders are the reliance of primary care providers, such as doctors, nurses and nurse practitioners on observation alone. Another is that some primary care providers are unsure how to respond if they do spot signs of depression or sadness in new mothers.
To address these barriers, Perinatal/Infant Mental Health Program Specialist Kelly Stainback-Tracy, MPH, PT of Denver Health, presenting at the September 2015 annual Public Health of the Rockies conference in Vail suggested that these three areas are key to attend to:
- Screening, assessment and addressing maternal mental health and well-being
- Developing workforce competence among primary care providers and OB/GYNs (e.g. Healthy Team Works)
- Developing a referral network and list of community resources for primary care providers and new mothers
Locally in Colorado, the Children’s Hospital offers a free weekly mom-to-mom support group, as well as individual counseling, couples counseling, group therapy and mother-infant support billed through insurance for mothers in the postpartum period. The program is called Healthy Expectations.
Exacerbating the mental health struggles that some new mothers face is the lack of available Family and Medical Leave Insurance (FAMLI) for all families in our state. According to the FAMLI Act Coalition in 2015, 63% of Coloradans lack paid medical leave to welcome a new baby or recover from a personal illness. This insurance allows families to take care of themselves and their family responsibilities without putting their employment at risk. This November the FAMLI Act Coalition will once again meet with the Colorado Department of Labor & Employment to discuss possible legislation that might be put forward in 2016 to put in place this important insurance for Coloradans to better look out for children and new mothers, among other family members.
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