Postpartum Depression

Postpartum Depression

Author:  Caroline Stewart, RN

Postpartum depression (PPD) is a significant health problem affecting almost 600,000 U.S. women annually. PPD is the most common complication of childbearing women, and it is estimated that approximately 15% of pregnant women are diagnosed with PPD within their first year of having a child. Though the etiology of postpartum depression is unknown, it is thought to have many factors, including genetic disposition and extreme emotional changes from physical and emotional adjustments at birth. Risk factors include stress, low socioeconomic status, low level of social support, history of depression, and complications such as preterm birth. 

However, a lack of knowledge about PPD can be a barrier to treatment for many mothers, and they may feel reluctant to discuss their feelings. The postpartum period is often associated with physical and emotional challenges that can be overwhelming and lead to feelings of anxiety, depression, exhaustion, and frustration. The challenge is properly diagnosing new mothers to ensure they receive proper treatment based on their symptoms.

Postpartum depression has many of the same symptoms as “baby blues,” which is common from days 2 to 10 after delivery. Emotions stemming from “baby blues” could include sadness, fear, anger, or anxiety. A mother could feel angry with the new baby, her partner, or her other children. Furthermore, a mother may cry for no reason or may have trouble sleeping, eating, or making decisions. The mother may also doubt if she can handle caring for her baby. “Baby blues” may come and go in the first few days after childbirth but will usually resolve with a few days or a couple of weeks without any treatment.

However, PPD is a more severe depressive mood disorder that develops in the first year after child birth. It can start as early as the second or third day after birth but can take as long as a year to develop. This can affect a woman’s ability to take care of herself and/or her child. PPD manifests as intense sadness, lack of interest, lack of concentration, fatigue, insomnia, social isolation, and suicidal ideation. Postpartum depression is a midway of the severity continuum of postpartum psychiatric disorders.

The American College of Obstetricians and Gynecologists (ACOG) recommends that all women be screened for anxiety and depression during the perinatal period and at least once during the postpartum period. ACOG recommends psychotherapy or pharmacologic therapy—or a combination of the two—as an effective treatment for PPD. Furthermore, the U.S. Preventive Services Task Force supports screening pregnant and postpartum women for depression and ensuring the availability of adequate resources for diagnosis, treatment, and follow-up. The thorough assessment of risk factors for PPD during pregnancy while monitoring depressive symptoms during both the pregnancy and the postpartum period will lead to better endings for women and their families.

Often it is not easy for a mother to discuss her feelings after birth. Many new mothers feel inadequate or guilty when experiencing sadness and frustration over childbirth. A comprehensive screening process for new mothers admitted to the hospital includes being asked about any history of anxiety/depression, which should trigger a consult from a social worker. The social worker then provides the mother with a list of resources and signs to look out for perinatal mood disorders. Woman’s Hospital Social Services (225-924-8456) has several support groups and resources available to mothers including: Woman’s MOM2MOM Support Group and Postpartum Support International.