Facts on Postpartum Depression and My Responsibility as a Childbirth Educator

4 Nov


I attended the 2012 Lamaze Conference this year in Nashville. I gained a great deal of insight on a number of topics, but the one that won’t leave me alone was the lecture I sat in on postpartum depression taught by Genae Strong, PhD, CNM, RNC-OB, IBCLC 

Having dealt with postpartum depression with both my children, and as Lamaze certified childbirth educator, I was curious to see what would be shared. I’ll be honest, the information surrounding PPD left me unsettled.

Did you know?  

  • PPD is a potentially debilitating mood disorder usually detected between 2-6 weeks after birth. (Zauderer, 2009)
  • 10-25% of women are affected during their pregnancy or postpartum period with PPD. (Bansil et al, 2010)
  • PPD is the most under-diagnosed obstetrical complication in the United States. (Earls, 2010)
  • The mother generally doesn’t have an actual estimation of the severity of her illness.
  • “PPD is a treatable mood disorder but it is not preventable.” – Genae Strong, PhD, CNM, RNC-OB, IBCLC  (Please note, there is a difference in prevention vs. preparation.)

Higher Risk Factors for PPD include (but not limited to): 

  • Smoking
  • Bottle feeding
  • History of depression
  • A family history of PPD
  • A previous episode of PPD

What’s the difference between Maternal Blues (MB) and PPD

MB includes: 

  • 50-80% of mothers experience MB (almost every mother)
  • Appears within the first few days – 2 weeks
  • Mood swings
  • Feeling sad, anxious or overwhelmed
  • Crying spells
  • Loss of appetite
  • Trouble sleeping

PPD includes:

  • 13-20% of mothers experience PPD
  • Usually detected between 2-6 weeks after birth
  • Little interest or pleasure in doing things
  • Feeling down, depressed or hopeless
  • Disturbed sleep patterns
  • Not wanting to socialize or join in – social isolation

(Womenshealth.gov)

PPD has long-term effects on the infant, including (but not limited to):

  • Sleeping difficulties
  • Eating difficulties
  • Unusual sensory sensitivities
  • Depression
  • Social withdrawal
  • Anxiety
  • Separation distress
  • Extreme inhibition
  • Shyness

(Conroy, 2012)

As a childbirth educator I need to:

  • Teach the difference between what normal and abnormal emotional and physical responses in the postpartum period look like.
  • Encourage women who stop smoking during pregnancy to continue with their efforts.
  • Encourage breastfeeding.
  • Encourage women to attend at least one postpartum care visit with a health worker.
  • Provide handouts with local support information for mothers and families.
  • Describe treatment methods for PPD (both medical and non-medical methods) and encourage their use.
  • Carefully express the reality that PPD touches not only the mother, but the most vulnerable victim – the child.

For more resources, please visit Postpartum Progress.

To screen yourself for PPD, please visit: Postpartum Support

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11 Responses to “Facts on Postpartum Depression and My Responsibility as a Childbirth Educator”

  1. doulab November 4, 2012 at 9:53 am #

    Excellent, thank you for addressing this very important subject. As a CBE and doula I encourage moms (and dads) to-be to have a “Postpartum Plan”. Everyone is focused on the birth plan but equally important is a postpartum plan – setting up support systems to help in those first few weeks.

    • Joy November 4, 2012 at 7:56 pm #

      I love the idea of a postpartum plan. Great tip!

  2. Rachel van buren November 4, 2012 at 10:05 am #

    Well written, you have awesome goals!
    Like you, I’m left unsettled with the statics presented regarding PPD.
    I firmly disagree with statement that PPD is not preventable. I suffered after baby #4 with it, and with hindsight in my favor, I have many options to prevent it next time. For example, placenta encapsulation, working through known issues I have BEFORE birth (with a therapist) , proper diet, exercise, and a full on support team and POST birth plan. I fully believe that for most women prevention can be successful!

    • Joy November 4, 2012 at 1:34 pm #

      We’ll have to agree to disagree on the wording here. I see everything you listed, “placenta encapsulation, working through known issues I have BEFORE birth (with a therapist), proper diet, exercise, and a full on support team and POST birth plan” as treatments of PPD.

      While everything you listed is supremely important in combating PPD they do not guarantee the absolution of PPD.

      I hope you can understand where I’m coming from. If we approach PPD as preventable then we diminish society’s responsibility to address this and instead leave up to the mother to just simply do more.

      • Rachel November 4, 2012 at 2:57 pm #

        Yes, you make a wonderful point! My intention was certainly not to polarize the issue of PPD. It’s not all or nothing. We are all wired differently, and have different life experiences which may have a bearing as to our individual postpartum emotional health. What I should have said the first time around is that I would love to see more emphasis on POSSIBLE prevention. It may not work for everyone, but I have seen first hand preventative measures taken with a successful outcome.

      • Joy November 4, 2012 at 3:08 pm #

        To be totally candid right now, the more I think about it, the less I’m connected with the researchers statement and the idea of treatment vs. prevention being all or none. I think you’re right in the sense of it’s how we approach it ourselves.

        The only thing that I do want to be cautious on is the trap that doing enough things prevents it when sometimes it truly is a chemical/hormonal imbalance that we cannot control.

      • Rachel November 4, 2012 at 6:09 pm #

        “The only thing that I do want to be cautious on is the trap that doing enough things prevents it when sometimes it truly is a chemical/hormonal imbalance that we cannot control.”
        -YES! That’s right! Imagine how she would feel after taking all precautionary steps, only to be blindslided with PPD anyway – what would that do to her self worth? Perhaps she would feel defective, or like a failure, maybe even broken. That would only compound a serious situation.
        As a PP doula I will be sure to encourage mom to set realistic expectations.

  3. TheFeministBreeder (@FeministBreeder) November 4, 2012 at 12:18 pm #

    I always talk to my clients about the post-birth plan too, and I talk to them about how they’re feeling at the postpartum visit and beyond. I make sure they know going into the birth that parenthood will be a major adjustment, they’re going to need help, and they need to pay attention to their mood and how THEY are feeling. It’s so important for us, as doulas/educators to pay attention to this issue. We often get to know our clients better than their providers do, so we have a unique opportunity to provide support and referrals.

    • Joy November 4, 2012 at 7:55 pm #

      Absolutely true, Gina!

  4. doulab November 5, 2012 at 11:52 am #

    Is it possible to get a copy of the “poster”??

    And YES, Gina — “we have a unique opportunity to provide support and referrals.”

  5. Joy January 21, 2013 at 12:00 pm #

    Oh my goodness, YES! People underestimate the severity and frequency of PDD. I was diagnosed with it recently and am now able to take steps towards improvement. The only issue for me though, is that my insurance doesn’t cover my appts. Is this common?

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