Postpartum Depression Information and Resources
A Resource for Community Health Nurses
The "baby blues." So common is a period of early postpartum emotional vulnerability that it is almost considered normal. Only when the blues escalate to disaster, as in recent reports of maternal infanticide, does the subject catch the attention of the public. Unfortunately, the subject is often neglected by health care practitioners as well.Postpartum mood disorders have classically been viewed on a continuum from the postpartum blues to classic depression to frank psychosis. More recently, Obsessive Compulsive Disorder (OCD) and panic disorders have also been recognized as manifesting initially in the postpartum period (Beck, 1999). The etiology is not clearly defined (Epperson, 1999), but most authors (Miller, 2002; Wisner, Parry and Piontek, 2002) tie the postpartum blues to the abrupt change in hormone levels after childbirth. It is difficult, however, to attribute a depression or psychosis that occurs after six to eight weeks postpartum entirely to "hormones." An underlying, perhaps previously unrecognized, psychopathology (depression, bipolar disorder) may co-exist, allowing the hormonal shifts to precipitate problems in the postpartum period.
The community health nurse (CHN) is in a unique position to detect, care for and refer the peripartum woman who is at risk for, or develops, a postpartum mood disorder. Unlike primary obstetrical and/or pediatric caregivers, the CHN has the opportunity to see the client in her home environment and to assess her functional status. This is particularly true in the postpartum period when up to six weeks may elapse after hospital discharge before office follow-up is scheduled. This six-week period immediately after delivery is a particularly vulnerable time for the woman at risk for mood disorders. Postpartum mood disorders are frequently unrecognized until significant disintegration of the woman's ability to cope is noted. By that time, irreparable harm may have occurred to the mother/child relationship. Unfortunately, the current health care system is poorly equipped to support the unique mental health needs of the new mother. Mental health care is generally poorly funded, and in women receiving public assistance for pregnancy-related care, symptoms may not be recognized prior to the loss of benefits. It is estimated at only 20 percent of women who need mental health services in the postpartum period actually receive help. Nevertheless, there is a significant amount of resources available to women in print media as well as on the Internet. A recent (7/03) Google search for postpartum depression revealed 83,800 web sites addressing this topic.
The purpose of this portion of the site is to provide the CHN with the means to access professional literature as well as professional and lay resources for their clients who are at risk for, or are experiencing, postpartum mood disorders. Links from this page provide additional information on postpartum blues, postpartum depression and postpartum psychosis, as well as a professional bibliography, a lay reading list, professional referrals and support groups and links to Internet resources.
POSTPARTUM DEPRESSION RESOURCES