It’s perinatal depression.
Yes, it’s true…the number one complication of childbirth is perinatal depression/anxiety (or perinatal mood/anxiety disorder [PMAD] in clinical terms). Those of us in the maternal health field in the state of California are especially aware of May as being designated Maternal Depression Awareness Month. During this time, advocates, specialists, volunteers, and lobbyists are all working to destigmatize and to educate the public about the number one complication of childbirth…perinatal depression.
Perinatal depression affects at least 20% of all childbearing women, the percentage being higher in many populations (including teen moms and those facing poverty). And what is “perinatal”? As mentioned in previous articles, this term refers to the time period from conception, through pregnancy, up through the first year after giving birth. Women are at risk for developing perinatal depression if they have a family history of mood/anxiety disorders, a personal history of depression/anxiety episodes, and other factors, including a sensitive response to the delicate interplay of hormones around reproductive life events. A sensitive response to hormonal fluctuations can in turn affect the balance of serotonin and other neurotransmitters in the brain that regulate mood. Symptoms typically include extreme fatigue, insomnia, appetite loss, guilt/feelings of hopelessness or sense of inadequacy as a mother, and in some cases, intrusive thoughts and suicidal ideation. Sleep deprivation can exacerbate these symptoms as well.
Oftentimes, maternal depression is misconstrued in the media, with traumatic stories of women killing their children predominating the headlines. Many of the horrifying events categorized on television as “maternal or postpartum depression” are really postpartum psychosis, a separate illness categorized by losing touch with reality and delusions/hallucinations. Although postpartum psychosis is a very real and true medical crisis, it is NOT maternal depression. Postpartum psychosis, although very serious and life-threatening, is relatively rare (1 in 1,000 births) compared to perinatal depression (20% or more of pregnant and postpartum women). Perinatal depression does not include the psychotic features that are present in perinatal psychosis.
The subject of perinatal depression/anxiety is a very intricate and complicated one, an area of cutting edge research and science. PMADs are the subject of multi-day conferences and workshops, and those of us in the field are excited about the new discoveries being made every day to help women and their families with recovery.
With swift treatment, a woman can expect full recovery and anticipate positive outcomes for herself and her family. The converse is also true for those who do not get treatment (typically psychotherapy, social support system, self-care regimen, and when indicated, medication management)—without treatment, problems can develop with the attachment of mother and baby, impaired neurodevelopment of the baby, worsening symptoms and stress for the mother/family, along with a host of other serious issues that are beyond the scope of this article. The key piece to remember is that with help, a woman will recover. She is not alone. And it is not her fault (this is the Postpartum Support International [PSI] universal message).
I would like to draw to your attention to the many events and groups of people who are working in the state of California to bring maternal depression awareness to the forefront. Please see the following websites for more information:
- Postpartum Support International: www.postpartum.net The largest non-profit in the world dedicated to support for the pregnant/postpartum mom and her family; support groups and resources available with lists of trained perinatal practitioners; trainings available. National Warmline: 1-800-944-4PPD
- CaPSI: PSI in the state of California…warmline for moms and those who love them; resources and support available in English and Spanish 1-855-227-7462 or firstname.lastname@example.org
- 211: resources available for the perinatal population in Greater Los Angeles and other geographical areas
- California Maternal Mental Health Collaborative: maternalmentalhealth.org legislation, lobbying, advocacy (collaboration of several task forces in state)
- Los Angeles County Perinatal Mental Health Task Force: maternalmentalhealthla.org
- Inland Empire Perinatal Mental Health Collaborative: embracingfamilies.blogspot.com
- Postpartum Health Alliance of San Diego: postpartumhealthalliance.org
- Postpartumprogress.com – nationally recognized blog; support and advocacy
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