How Can Physicians Support Postpartum Mental Health?

Est. Reading Time: 4 Minutes

Since 1990, the Baby Blues comic strips have humorously addressed the day-to-day triumphs and struggles of being new parents.

Postpartum depression, of which the comic’s title is appropriately derived, was only widely recognized in the medical community a few years before the comic strip’s first publication. Although our understanding of mental health problems and their seriousness has increased considerably over the past twenty years, emphasis on postpartum mental health still lags. According to the Centers for Disease Control and Prevention (CDC), one in eight mothers will “report symptoms of depression after giving birth” and over half of them will go untreated.

The symptoms of postpartum depression and other mental health conditions, which may include fatigue, apathy, and thoughts of suicide, can be severe enough to disrupt the mother’s life. A study published in Sage Journals has found that children of mothers living with postpartum depression are less likely to receive their vaccines and attend regular wellness visits, and more likely to end up in the emergency room. Empowering women and their partners with the right support is critical to their well-being and the healthy growth and development of their children.

Thus, it is important to tackle a few common patient misconceptions about postpartum mental health conditions with the right support.

Misconception #1: A mother’s mental health condition isn’t necessarily harmful to her

Postpartum mental health issues are common pregnancy complications but patients may not know that they should treat them with the same level of seriousness as any other mood disorder. In a study published in Health Affairs, Maternal Mortality Committees (MMRCs) across 14 U.S. states determined that out of 421 deaths between 2008 and 2017 from pregnancy-related complications, 11 percent of them were attributed to mental health conditions. The MMRCs further determined that, out of that 11 percent, 63 percent of the women had died from suicide. When the data was further broken down by condition, researchers found that most of the women who had died by suicide had a preexisting case or history of depressive disorder (72 percent).

Although roughly 13 percent of women experience symptoms of depression after having a baby, one in eight women say their doctor did not ask them about the state of their mental health during their postpartum visits. The American College of Obstetrics and Gynecology (ACOG) Committee on Obstetric Practice recommends that all women’s health physicians screen their patients for postpartum mental health conditions, including postpartum depression, at least once during the perinatal period. Helping patients understand that postpartum mental health conditions can be quite serious and that treatment is critical to improving the symptoms can help encourage follow-up appointments.

Misconception #2: The conditions only affect the mother

When patients think about mental health issues, such as postpartum depression, they often, and understandably so, focus solely on the mother. Many of them don’t recognize that the sleep deprivation and hormonal changes that can come with being a father also put the other parent at risk for developing a mood disorder. In fact, one study found that paternal postpartum depression, or PPD, may affect nearly eight out of 10 fathers.

Unfortunately, men are less likely to report their symptoms because of the stigma that surrounds men and mental health, so there is limited research available on PPD among fathers. However, a few studies note that PPD may manifest differently in men and women. Men with PPD are more likely to exhibit “irritability, indecisiveness, and restricted range of emotion.” Another study published by the American Academy of Pediatrics (AAP), suggested that PPD was “independently associated with increased rates of child emotional or behavioral problems.” Therefore, it’s critical to screen the father for mood disorders, as well as the mom, during postpartum visits. The mother’s partner should also understand that experiencing a postpartum depressive episode is not uncommon and that mental health treatment can help.

Misconception #3: Postpartum depression affects all women equally

Although postpartum depression doesn’t discriminate, studies suggest it’s more likely to affect women of color and women of lower socioeconomic status. In a study by the CDC, non-Hispanic Black, American Indian and Alaskan Native, and Asian and Pacific Islander women in low-income communities were more likely to experience postpartum depression. Despite the prevalence of mental health issues in their communities, only about four percent of Black women and five percent of Latina women in low-income areas received mental health treatment.

Moreover, Black and Latina women who initiated treatment for postpartum depression were far less likely to receive “follow-up or continued care compared with white women who initiated treatment.”

Additionally, some women have a predisposition to developing postpartum depression. According to the Eunice Kennedy Shriver National Institute of Child Health and Development, women who are experiencing problems with their partners, dealing with financial difficulties, having multiple children at once, or do not have a strong support system are more likely to develop symptoms of postpartum depression.

For women with postpartum mental health issues, local and online resources can make a big difference. Calling 211 can help locate free resources specific to your community, such as prenatal care and financial assistance outside of government programs like the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

Finally, providers must offer support and gain the trust of their patients. Having a trusting relationship with the patients and their partners is crucial to having open discussions about postpartum care. Patients who trust their physicians are more likely to communicate honestly about their symptoms and follow through with their advice. With the right help and awareness, patients and partners experiencing postpartum mental health conditions will have the security of knowing they aren’t alone.

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