Post-partum Depression

Post-partum depression (also called post-natal depression) is not the same as the “baby blues,” which affects 70 - 85 percent of new mothers. Post-partum depression typically occurs from three days to six weeks after the baby’s birth, but can develop any time during the first year after delivery. The mother frequently struggles with feelings of sadness, anxiety, fatigue and restlessness.

Serious Health Consequences for Moms and Babies

Left untreated, post-partum depression poses serious health consequences for the women, their children and their families. Not only are these mothers at a higher risk of developing future episodes of depression, but the condition can negatively affect interactions between the mother and child. Children of depressed mothers are at risk of language deficits, social difficulties and attention problems.

Moms Avoid Anti-Depressive Drugs

Post-partum depression is generally treated with anti-depressant medications. However, “50 percent of mothers will not take a pharmacological treatment for post-partum depression, often due to concerns about medication side effects or passing the medicine to infants in breast milk,” says Dr Cindy-Lee Dennis, a perinatal researcher and associate professor at the University of Toronto, Ontario.

Mothers of lower socio-economic status, unmarried or very young (or all three) are at higher risk of developing post-partum depression than other women, and new mothers from some ethnic groups have difficulty in admitting depression or seeking help.

“We need an alternative to pharmacological interventions,” Dennis says

A Medication-Free Method

Her review of nine randomized controlled trials conducted in the United States, the United Kingdom, Canada and Australia suggests that providing a supportive environment could be a medication-free way to alleviate depression symptoms in new mothers.

The studies covered 956 women with symptoms of post-partum depression and found that mothers who received any type of psychosocial or psychological intervention had a 30 percent lower risk of still having depressive symptoms within the first year after the birth.

In other words, counseling and the friendly support of other mothers was a real help in combating new mothers' depression.

“Women prefer to talk to someone to help them work through their depression … Mother-to-mother or peer support is extremely important in the postpartum period. It provides realistic social norms of what it is like to be a mother,” Dennis says.

Although the clear link between a lack of social support and post-partum depression has been known for some time, Dennis says, “few well-designed studies have evaluated the effect of support groups and counseling in alleviating new moms’ depressive symptoms.”

All the participants in the nine studies received face-to-face counseling and psychological interventions such as cognitive behaviour therapy (CBT), apart from one group which received peer support phone calls.

Counseling, Peer Support and Psychological Interventions

Counseling, peer support and psychological interventions all appeared to be similarly effective in reducing symptoms.

Not only that, but they are what the new mothers actually want, Dennis says.

“These psychosocial and psychological interventions are consistent with mother’s treatment preferences . . . If treatment is linked to the women’s perceptions as to why they are depressed and they are interested in the type of treatment offered, they are more likely to be compliant.”

The review, Dennis C-L, Hodnett E. Psychosocial and psychological interventions for treating postpartum depression. appears in the Cochrane Database of Systematic Reviews 2007, Issue 4.

Dr Cindy-Lee Dennis and her baby

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