It's no secret that many new moms experience mood and anxiety disorders such as postpartum depression (PPD), postpartum anxiety (PPA), and obsessive-compulsive disorder (OCD). What is clear is that there are mental health resources that could be provided to new moms, but aren't. It's time to change that.
According to the Illinois Department of Public Health, 10 to 20 percent of new moms will experience postpartum depression. A study in Pediatrics of more than 1,100 new mothers found that approximately 17 percent of moms showed symptoms of postpartum anxiety. The International OCD Foundation reports that up to three percent of childbearing women experience postpartum obsessive-compulsive disorder. These numbers make it clear that many pregnant and postpartum women are struggling with mental health issues.
Katherine Stone, the founder of Postpartum Progress, a national nonprofit which focuses on maternal mental health, wrote an article in Babble discussing this very topic. She reached out to the readers of her blog and found that many of them never received any kind of mental health screening during or after their pregnancies. Several of these women were struggling with mood disorders and had ended up seeking help on their own.
Here are three vital mental health resources that should be provided to all new moms, but currently aren't.
1. Mental Health Screening During Pregnancy
It is a myth that a mother's depression will only strike after the baby is born. According to Pediatrics, screening for mental health risk factors should be an integral part of routine prenatal care. It is important for doctors to become familiar with the patient's family support systems and other psychosocial factors such as poverty, mental health history, and history of substance use. Getting to know the parent(s) provides the doctor an opportunity to identify any high-risk conditions and anticipate the potential specialty care.
The Journal of the American Medical Association's (JAMA) 2016 update of the U.S. Preventive Services Task Force (USPSTF) recommendation on adult depression screening listed other risk factors for maternal depression that can be found during a routine screening. These include poor self-esteem, child-care stress, prenatal anxiety, life stress, decreased social support, single/unpartnered relationship status, history of depression, difficult infant temperament, previous postpartum depression, lower socioeconomic status, and unintended pregnancy.
2. Postpartum Mental Health Screening
Postpartum Progress suggested that all pediatricians and obstetricians should conduct postpartum depression screening. Florida counselor Ally Chase, agrees, telling me in an interview earlier this year that she believes new moms need better screening for mood and anxiety disorders at six and 12 week postpartum check-ups with the OB-GYN.
Screening tools such as the Edinburgh Postnatal Depression Scale (EPDS), Postpartum Depression Screening Scale (PDSS), and the Patient Health Questionnaire (PHQ-9) can be used to help diagnose a new mom suffering from PPD or PPA, yet many doctors choose not use these scales.
Officials in New York City aim to change this. Politico reported in late 2015, that due in part to NYC First Lady Chirlane McCray's mental health advocacy, the de Blasio administration would work with hospitals across New York City to increase the prevalence of prenatal and postpartum depression screenings.
3. Specialized Treatment Outside Of The OB-GYN & Pediatrician's Offices
A research study in Obstetrics & Gynecology found that universal postpartum depression screening was better received by health care specialists when the screening doctors were not required to develop the infrastructure necessary to respond to at-risk patients. The study found that more OB-GYNs and pediatricians would participate in this kind of screening if they were part of a mental health network where their at-risk patients could be immediately referred to a specialist within the network for further diagnosis and treatment.
OB-GYNs are often expected to be a woman's catch-all physician, but according to a Washington Post interview with Robert Wergin, president of the American Academy of Family Physicians, an OB-GYN's primary focus is on your reproductive system, and may be less attuned to other aspects of your health, including mental health. Additionally, pediatricians are often reluctant or unequipped to take on adult patients. Having a system in place where a patient can be referred to a specialist with immediate availability is key.