Postpartum Depression

Postpartum Depression in Montana

Montana

Postpartum depression is depression that occurs following pregnancy and delivery. It is one of the most common medical complications during the six months following childbirth and is associated with adverse outcomes for both mother and child. 

Postpartum depressive symptoms include feeling sad, pessimistic or angry, crying more often, difficulty sleeping, feeling disconnected from the baby and worrying about hurting the baby. The primary risk factors for postpartum depression include previous depression, anxiety and mood disorders. Other risk factors include stress during pregnancy (including emotional, financial, partner-related or traumatic stress), traumatic birth experience, not breastfeeding, early cessation of breastfeeding or negative early breastfeeding experiences.

Symptoms of maternal depression during early infant development could lead to long-term problems for the child, such as impaired cognitive and language development, behavioral issues and poor sleep quality.

The prevalence of postpartum depression is higher among:

• American Indian/Alaska Native and Asian/Pacific Islander women compared with non-Hispanic white women.
• Mothers younger than 24 years old compared with older mothers.
• Mothers with lower educational attainment compared with those with higher educational attainment. 
• Unmarried mothers compared with married mothers.
• Mothers who smoked during the postpartum period compared with those who did not smoke.
• Mothers who gave birth to low birthweight infants and infants requiring neonatal intensive care unit (NICU) admission compared with those who did not.
• Mothers who had three or more stressful life events in the year before birth compared with those who did not.

Postpartum depression may be prevented through supportive and psychological care following childbirth. This includes home visits, peer support and interpersonal therapy.

The American College of Obstetricians and Gynecologists recommends that providers screen for postpartum depression and anxiety during a comprehensive visit following delivery. Additional follow-ups several weeks or months after further significantly reduce the risk of depression. Screenings and the resulting care were found to be cost-effective in improving quality of life for affected individuals.

Healthy People 2030 has an objective to increase the proportion of women who are screened for postpartum depression at their postpartum checkup.

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Stewart, Donna E., and Simone Vigod. “Postpartum Depression.” Edited by Caren G. Solomon. New England Journal of Medicine 375, no. 22 (December 2016): 2177–86. https://doi.org/10.1056/NEJMcp1607649.

Watkins, Stephanie, Samantha Meltzer-Brody, Denniz Zolnoun, and Alison Stuebe. “Early Breastfeeding Experiences and Postpartum Depression.” Obstetrics & Gynecology 118, no. 2 (August 2011): 214–21. https://doi.org/10.1097/AOG.0b013e3182260a2d.

Wilkinson, Andra, Seri Anderson, and Stephanie B. Wheeler. “Screening for and Treating Postpartum Depression and Psychosis: A Cost-Effectiveness Analysis.” Maternal and Child Health Journal 21, no. 4 (April 2017): 903–14. https://doi.org/10.1007/s10995-016-2192-9.