The Pediatricians' Role in Postpartum Depression
New mothers who have severe postpartum depression may need to look no further than their new baby's doctor to get some help, a new study shows.
Pediatricians can play an important role in early detection and referral of postpartum depression, according to a new study.
The study, "Detection of Postpartum Depressive Symptoms by Screening at Well-Child Visits," found that severe postpartum depression in new mothers can be detected at well-child visits throughout the first year of their baby's life, by pediatricians using a standardized questionnaire.
"Postpartum depression is a relatively common problem -- it affects 10 to 15 percent of women. There's been a bit of interest in screening for it in OB-GYN offices at the 4-6 week postpartum visit, but quite a few women may not attend [that visit] or may not be feeling depressed at that point," says Dr. Linda H. Chaudron, study author and Assistant Professor of Psychiatry, Pediatrics, and Ob/Gyn at the University of Rochester Medical Center. "Many OB-GYNs don't do a formalized screening anyway, and since pediatricians have a focus on the family as well as the child, we thought that it would be helpful to use the pediatrician well child visit as an opportunity to screen moms and see if we could help them in that venue."
"The feedback I got from clinicians doing this is that the questionnaire allows an opening for discussion about how the mom is doing, it gives an opportunity for clinicians to have a more objective measure of how the mom is doing so they may feel more comfortable asking these questions, and it also can help the clinician track how the moms is doing. They can ask, 'was her feelings just a one-time thing, or is she continuing to have problems?' It gives an opening for monitoring to see if this is going away or is continuous," Dr. Chaudron says.
Dr. Chaudron thinks there are several reasons why many cases of postpartum depression are going undetected now, including that many women don't go back to their OB-GYN for that 4-6 week appointment because they're feeling good and don't need to go back. And then when they do, there's not a standardized process to screen, Dr. Chaudron says -- some clinicians will only ask one question, some won't ask any at all -- because it's not a routine part of their care. And often, she says, women don't recognize their symptoms so they're not apt to ask if what they're experiencing is normal for a new mom, or if it's depression creeping in.
New moms should be on the lookout for certain symptoms, says Dr. Chaudron. "If you're feeling particularly sad and down, if you're feeling particularly anxious, if you're having recurrent thoughts or fears (particularly around the baby), if you're having problems falling or staying asleep (and not because the baby is waking you up), if you don't have an interest in eating or if you're eating all the time, if you're not able to concentrate, if you're having any thoughts of harming yourself or harming the baby or if you've had a history of depression before -- if any of these symptoms go on for more than two weeks, that's a concern."
Dr. Chaudron says she would like to see a movement toward a universal screening tool for postpartum depression, but acknowledges there are a lot of questions still to be answered.
If you're having concerns about your health or worries that you may be suffering from postpartum depression, talk to your doctors -- your OB-GYN, your general practitioner or your pediatrician should be able to offer you guidance on what to do.
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