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Health Policy Brief

Mandating National Education, Screening, or Public Awareness

Campaigns for Postpartum Depression

Postpartum depression appears in 10-20% of women who have recently given birth5. Many women are unaware that they are experiencing symptoms and are left unidentified and untreated.

Postpartum Depression is defined as a period after childbirth, miscarriage, or stillbirth when one suffers from depression due to hormonal, psychological, environmental changes3. It has overwhelming effects on the child’s physical, psychological and emotional advancement3.

Background

“In the U.S., the vast majority of postpartum

women with depression are not identified or treated…”

- Northwestern Medicine lead study author Katherine L. Wisner, M.D.

Issue

It is not uncommon for women to be unaware of the postpartum depression symptoms that they are experiencing. These symptoms include: Worrying that you might hurt your baby, feeling disconnected from your newborn, trouble sleeping when your baby sleeps, feeling guilty about not being a good mother, and mood swings3. For women who have experienced postpartum depression once the chances of developing it again increase to 41%1.

Postpartum depression appears in

10-20%

of women.

By: Phylicia Morgan

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Statistics

The above figure is from the Center of Disease Control and Prevention Pregnancy Risk Assessment Monitoring System (PRAMS) it displays the percent of women who reported frequent postpartum depressive symptoms2. In addition to this, a new 10,000 patient study published in JAMA Psychiatry found that every 1 in 7 women will self report experiencing postpartum depression6.

Risk factors of postpartum depression include being a teen mom, premature labor and delivery, having twins or triplets, birth complications, and having an infant hospitalized all increase the risk of suffering from postpartum depression3. Most commonly postpartum depression is African Americans, teen mothers, smokers, victims of physical abuse, the publicly insured, single mothers, low socioeconomic status, and those that are less well educated4.

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Current Policy

Policy Recommendation

1 American Psychological Association (2015). Postpartum Depression. Retrieved from http://www.apa.org/pi/women/programs/depression/postpartum.aspx

2 Centers for Disease Control and Prevention [CDC]. (2015). What is PRAMS?. Retrieved from http://www.cdc.gov/prams/ 3 Centers for Disease Control and Prevention [CDC]. (2013). Depression Among Women of Reproductive Age. Retrieved from http://www.cdc.gov/reproductivehealth/depression/ 4 Hitti, M. (2008). CDC Says Teenage Moms Among Groups With High Postpartum Rates. WebMD Health News. Retrieved

from http://www.webmd.com/depression/postpartum-depression/news/20080410/postpartum-depression-how-common 5 NIHCM Foundation. (2010). Identifying and Treating Maternal Depression: Strategies & Considerations for Health Plans. NIHCM Foundation Issue Brief. Retrieved from http://www.nihcm.org/pdf/FINAL_MaternalDepression6-7.pdf 6 Paul, M. (2013). Surprising Rate of Women Have Depression After Childbirth. Northwestern University. Retrieved from http://www.northwestern.edu/newscenter/stories/2013/03/surprising-rate-of-women-have-depression-after- childbirth.html 7Paul, R., Stephen, D., John, W. (2015). State Mandate Regarding Postpartum Depression. Retrieved from http://ps.psychiatryonline.org/doi/pdf/10.1176/appi.ps.201300505

References

In an effort to utilize all the available preventative services available, I believe we should implement a policy that requires states to educate, and screen free of charge. It would be difficult to require all states to implement mandated screening, but at the very least states should be required to inform women of the potential dangers of postpartum depression in addition to the affordability and availability of services to screen and prevent it. By implementing a policy that requires all states to administer educational information on postpartum depression at a minimum or a policy mandate for screening, we can track and treat suffering women. Education information can be supplied through pamphlets and/or counseling. Knowledge and understanding of the risks of postpartum depression will allow for greater support and adherence to the inevitable nationwide policy for postpartum depression screening in the US. The best way to ensure adherence to this requirement is for congress pass a bill requiring all states at a minimum to administer educational information or a policy mandate for screening. The weight falls on the shoulders of congress to implement such policy.

The Patient Protection and Affordable Care Act makes preventative care services include screening for maternal depression and provides support for mothers at risk and their families accessible for all across the U.S.5. Currently only 13 states in the U.S. are recognizing and addressing the severity of postpartum depression7. They have enacted some type of postpartum mental health policy that can include a number of aspects including, but not limited to education, screening, or a public awareness campaign10. Of those 13 states, only four states including Illinois, Massachusetts, New Jersey, and West Virginia mandate screening for postpartum depression10. The ultimate goal is to implement a nationwide policy for postpartum depression screening. However, it is important to create realistic and achievable goals for our nation.