It took four maternal suicides in
Chicago in 2002 and the case of Andrea Yates, who killed her
children, to get people talking about postpartum depression.
"This topic gets its most exposure when
there's a horrific event," says Diane Semprevivo of the Women's
Behavioral Health Services Department of Advocate Good Samaritan
Hospital in Downers Grove. "People didn't talk about this a lot at
that time. Somehow these women fell through the cracks."
Each year, more than half of women who
have recently given birth suffer from postpartum mood changes.
Postpartum mood and anxiety disorders impair 15 to 20 percent of
new mothers and postpartum psychosis strikes 1 or 2 in 1,000 women
"This is the most common OB
complication," Semprevivo says.
Although Semprevivo acknowledges
there's still a lot of work to do in treating PPD, new legislation
introduced in Illinois and in the U.S. Senate may help more women
get the treatment they need.
U.S. Sen. Dick Durbin (D-Ill.)
introduced the Mom's Opportunity to Access Help, Education and
Support for Postpartum Depression, or MOTHERS Act, to help new moms
by providing education and screening on PPD that can lead to early
identification and treatment. The legislation focuses on expanding
research to improve and discover new treatments, diagnostic tools
and educational materials for healthcare providers.
"I've been surprised in talking to
women, how many women face this and many are without a helping
hand," Durbin says.
Durbin's legislation focuses on
educating healthcare providers outside the hospital about the signs
and symptoms of PPD. "Many women don't see their own doctors for
months after they leave the hospital, but they do see a
pediatrician and it's obvious that we need to alert pediatricians
about this," Durbin says.
Sen. Don Harmon (D-Oak Park) sponsored
the Perinatal Mental Health Disorders and Treatment Act, which was
signed into law in August. This act also focuses on educating
healthcare providers about screening and treatment for PPD.
Most women expect having a baby to be a
wonderful, joyful experience. And for many women, it is. But others
may find their new life to be nothing like what they expected. They
may feel hopeless and sad. Some feel like they're babysitting-they
don't bond with the baby.
"It's important to differentiate baby
blues from postpartum depression. The huge difference is that the
predominant mood in the blues is happiness," says Rebecca
Christophersen, psychiatric mental health nurse practitioner at the
University of Illinois at Chicago. "Postpartum depression women
usually feel extremely sad, numb, despondent. They can't feel any
joy. They feel inadequate and guilty."
Women with PPD may also have disturbing
thoughts of wanting to hurt their baby. Although with PPD the
majority of women never act on these thoughts, the new moms are
often afraid to share this information for fear their child will be
taken away from them, Christophersen says.
PPD can manifest itself any time within
the first year after giving birth, as hormones shift due to
childbirth and nursing. Up to 20 percent of women have suffered
from some level of PPD by the time their child is 6 months old,
Christophersen says. That's why early screening of women before
they leave the safety net of the hospital is critical.
Some hospitals, including Advocate Good
Samaritan in Downers Grove, have instituted a screening program for
new moms. A short questionnaire allows medical staff to identify
women who may be at risk for depression and refer them to
"You've got a critical time when
they're in the hospital," Semprevivo says. Advocate Good Samaritan
has educated the nursing staff and will ask Semprevivo to speak
with the mom and her family if she is deemed at risk for PPD.
"I've had a pretty good response from
the women. They're glad we have the (PPD support) group and that we
screen and talk about it," Semprevivo says. "Look at the image of
motherhood-I don't know too many who experience what we portray. So
we have this woman who's crying, can't eat, can't sleep, they feel
like why isn't it like this for me. So just the idea that somebody
spoke about it and they have a number to call if something comes
Helping moms who are suffering from PPD
can have long-range benefits for her whole family, says Linda
Gilkerson, an early intervention specialist at The Erikson
Institute in Chicago.
"Mothers who are depressed show more
negative and sad facial expressions to their children and babies
mirror this back," Gilkerson says. This can result in a fussy baby
and a mom who feels even more at a loss when it comes to dealing
with the child. Maternal depression can result in babies with
feeding, sleeping or comforting issues, or children with behavioral
Dads also need to be educated about PPD
since they're often the ones in closest contact with the moms.
"Most dads don't usually see it," says
Dr. Shannon Gritzenbach, medical director for women's behavioral
health at Advocate Good Samaritan Hospital. "The majority of time,
it's me calling the dad and saying 'Your wife's really sick and you
need to step up to the plate.'
"There's a big stigma that women should
be able to do this. I try to get around this with the husband by
explaining that this is a medical illness-you need to treat this
like diabetes," Gritzenbach says. "What a double whammy this
is-mental illness and the stigma of a bad mother."
Treatment for PPD can include helping a
woman build a support network around her and working with her to
learn to ask for help, as well as cognitive behavioral therapy and
"How it's treated is totally up to the
woman. Unless she's suicidal or has plans to hurt the baby, she
can't be forced into treatment against her will," Gritzenbach says.
"Treatment generally depends on the severity and what's available.
Medication may be a good option for women who don't have access to
Women should be comfortable with the
person treating them and find someone who specializes in women's
mental health. "Listen to your intuition, call and screen the
clinic ahead of time," Gritzenbach advises.
For women who are mildly to moderately
depressed, psychotherapy can be worthwhile. It can be as simple as
talking to the husband to get more support and to learn relaxation
techniques, such as breathing skills. Sometimes a few sessions with
a therapist is all a woman needs, Gritzenbach says.
For women with more severe depression,
who may also be experiencing high anxiety or obsessive compulsive
thoughts and behaviors, medication may be the best form of
treatment. Antidepressant medications such as Zoloft or Prozac can
provide relief to moms with PPD, while still allowing them to nurse
their baby safely. It may take time for the benefits of the
medication to kick in, and the first one doesn't always work, so
women may have to work with the doctor to get the best
But the most important part of
treatment is diminishing the shame a woman feels about having PPD,
Gritzenbach says. "This is a medical illness. It's not uncommon and
you're not alone. They don't have to feel this way. There is
One way to decrease the shame and
isolation women with PPD may feel is to talk about this illness and
bring it out of the shadows.
"How do you change this? You have to
educate and talk and talk about this," says Semprevivo. "Education
has a lot of power. Women need to encourage their health care
providers to discuss this with them-you should be screened
prenatally and if you're not you have to be proactive and find out
"And we need to educate our patients and healthcare providers,"
Semprevivo says. "We have to call our congressmen and support this
Liz DeCarlo is the senior editor at Chicago Parent.
Contact Liz at firstname.lastname@example.org
See more of Liz's stories here.
Liz DeCarlo is the former senior editor at Chicago Parent.
See more of Liz's stories here.
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