March 16, 2022
Does postpartum depression (PPD) happen only to women with a history of depression or mental illness? No. This misinterpretation can often lead women to not seek medical help or to avoid reporting symptoms to their doctors. The fact is that PPD is common and often missed or even dismissed. Early education, detection and screening are vital in identifying and treating PPD.
Most women experiencing feelings of depression or helplessness will often present themselves in a different manner in front of professionals or their doctors. Many of these women, while hiding their symptoms, are often hoping for someone to ask how they are feeling. Some women have a fear that someone may question their ability to manage or take care of their child, or, at worst, remove their child if they admit they are suicidal or having feelings of hurting themselves. We must do a more adequate job as a medical community to get the information out there and readily available that this is a common, treatable occurrence and that these mothers are not alone.
Postpartum depression can occur during pregnancy, after the birth of the child, and even months after the child is born. Signs and severity of symptoms vary from person to person, often making it difficult for doctors to identify this successfully through discussion or interview alone. Screening tools can be used to help the mother better identify and articulate how she is feeling, as well as provide the doctor with some more sustainable information that the mother may or may not have shared otherwise. While many doctors’ offices do routine screens for PPD, others often will only screen if the doctor recognizes a need through a routine visit. When we make screening a common practice and talk openly about PPD to all expecting moms, then the negative stigma will diminish and break down the barriers for discussions in this area. By providing quality care for these new moms, we in turn are also providing the best outcomes for the infant also affected by PPD.
PPD can often impact the infant during this very crucial time between mother and child. The relationship formed between the infant and mother during the child’s first weeks and months can greatly affect the child’s mental health and development. When this relationship is stressed and driven by anxiety or depression, the effects on the child can be lasting and difficult to mend. PPD does not discriminate among at risk, low income, first-time mothers, or mothers of multiple children. PPD can happen during one pregnancy and then not the next. PPD can be short-lived for some and take longer periods of treatment for others. Since PPD can look very different, we must educate all types of healthcare facilities on the importance of screening as a tool to help us better identify those in need.
One type of PPD screen is the Edinburgh Postnatal Depression Scale. This screen is a self-report, 10-item questionnaire that is easy to administer and score. This screen can help provide a culture of open communication between mother and physician. The state of Kansas is moving towards a universal best practice for women’s health care providers. A startup project towards this end was initiated through the United Methodist Health Fund several years ago at the community level, providing support and training for primary care providers, early childhood agencies, and community mental health centers. The Edinburgh Postnatal Depression Scale as a part of this project has successfully been adopted in primary care in many Kansas counties, including Marion, Harvey, and McPherson during the last few years and continues to grow. Facilitating screenings for pregnant women and new mothers, along with another screen that helps assess the social-emotional development of children, we are creating a sustainable system that educates, identifies, supports and treats pregnant women, new mothers and young children for a positive impact on our entire community.