In the United States, Depression with Peripartum Onset (Postpartum Depression) affects between 8.9 and 37% of women during the first year postpartum. Symptoms associated with depression can develop during pregnancy or in the weeks or months following birth. Symptoms associated with depression, such as anxiety, hallucinations, and psychosis pose an increased risk to both mother and newborn.
Postpartum depression can have many negative effects on both mother and baby including risk of harm to self or the infant, increased risk of suicidal ideation, increased risk of homicidal ideation (specifically directed toward infant), increased negative interactions between mother and baby that use hostile or coercive strategies, disengagement from their infant, and decreased positive attention (such as praising and playing). Women with Perinatal Depression are also at increased risk of preterm birth, delivering newborns with low birth weight, early cessation of breastfeeding, and less preventative health services (vaccinations). These risks, in turn, negatively impact the child’s cognitive and emotional development.
Fortunately, science is getting better at recognizing the early warning signs and symptoms associated with depression, especially in women who are pregnant or have recently given birth. Screening tools such as the Edinburgh Postnatal Depression Scale are frequently being distributed by healthcare providers in Labor and Delivery Wards within hospital settings, primary care offices, and pediatrician’s offices.
New research suggests that screening tools are an effective way to identify women with increased risk of developing symptoms that may later meet full diagnostic criteria for Major Depressive Disorder. Current depressive symptoms such as
• Sadness
• decreased enjoyment of previously enjoyable activities
• feelings of worthlessness
• changes in sleep
• changes in weight/appetite
• irritability
may present an increased risk of development of additional symptoms. Other risk factors include:
• previous depressive episode
• history of physical/sexual abuse
• unplanned/unwanted pregnancy
• other stressful life events
• lack of social support
• lack of financial support
• intimate partner violence
• pregestational/gestational diabetes
• complications during pregnancy (premature contractions)
• adolescent parenthood
• low socioeconomic status
• family history of depression/mood disorder
• other genetic factors
The U.S. Preventative Services Task Force recently released a draft publication of results associated with preventative care for identified “at risk” individuals. Researchers found evidence that certain treatments, such as Cognitive Behavioral Therapy and Interpersonal Therapy, could significantly prevent the development of depressive symptoms. Other treatments such as physical exercise, education, and pharmacotherapy (anti-depressants) did not significant prevent development of perinatal depression. Additionally, the task force determined that that there was no evidence to suggest that cognitive behavioral therapy or interpersonal therapy was related to any risk of harm to mother or (unborn) infant.
If you or someone you know is living with symptoms associated with depression or any of the risks, there is support available. Please call us at (215) 487-1330 or email us at Greenridge@intercommunityaction.org for more information about our counseling services.
Author: Jessica Henninger, M.A., M.S.
References:
American Psychological Association (2013). Diagnostic and Statistical Manual of Mental Disorders, (5th ed.). Washington, DC
Draft Recommendation Statement: Perinatal Depression: Preventive Interventions. U.S. Preventative Task Force. August 2018. Retrieved from https://www.uspreventativeservicestaskforce.org/Page/Document/draft-recommendation-statement/perinatal-depression-preventive-interventions
