CLEVELAND: A new study by researchers at University Hospitals of Cleveland's Rainbow Babies & Children's Hospital and Case Western Reserve University offers a possible solution to address postpartum depression. Published in the March issue of Pediatrics, the study results indicated that, regardless of whether new mothers have relatively mild cases of the blues or incapacitating episodes of major depression, pediatricians can and should play a key role in keeping these women from slipping through the cracks.
"Despite the fact that mothers want to turn to their pediatricians to talk about stress and depression, they fear being judged," says study co-author Amy Heneghan, MD, a Rainbow pediatrician and assistant professor of pediatrics at Case. "Our research shows how very important it is for the pediatrician and the mother to develop a trusting relationship so that she will have an opportunity to talk about things that cause family stress."
Postpartum depression occurs in up to 15 percent of all new moms. Symptoms can appear within days of the delivery and can persist for up to a year.
Researchers conducted focus groups with mothers of young children to learn how they felt about the stresses of parenting, their own mental health concerns, and how pediatricians might help them address those concerns. For many mothers of young children, the pediatrician is the only health professional they see with any regularity.
In the focus groups, women said they were open to talking with pediatricians about their problems - but said that a trusting relationship needs to be established first. Some women said they were reluctant to admit that they felt depressed, fearing that they would be judged as unfit mothers. The researchers used these and other findings to develop a guide to help mothers address their mental health needs.
"Pediatricians can be part of the solution for getting depressed moms the treatment they need," Dr. Heneghan says. "The women in our study suggested some very simple things that pediatricians can do to help moms who are struggling."
The women in the study were all aware that their emotional well-being affected their children. Other themes that emerged from the study were:
Mothers believed in the importance of accepting responsibility for monitoring their own well being and that of their child.
Mothers expressed the need to share parenting experiences, stressors, and depressive symptoms with someone (most preferred to speak with family or friends rather than with their child's pediatrician).
Open communication with a pediatrician who listens well was perceived by mothers in all groups as very important.
They trust pediatricians with their child's health, but many mothers were hesitant to discuss their own stress or depressive symptoms.
Mothers from all socioeconomic groups expressed fear of judgment and possible referral to child protection if they talked about depression and stress.
If they felt their pediatrician "knew them well, mothers were more likely to discuss their own emotional health.
Researchers found the mothers to be generally receptive to the idea of open communication with their pediatricians and expressed interest in receiving supportive written communication about parenting stress and depressive symptoms from pediatricians.
"These qualitative data are valuable in developing an intervention to help pediatricians assist mothers at risk," Dr. Heneghan says. "Pediatricians need to learn how to feel confident about having a discussion with a mother in language that is comforting, to be aware of worrisome signs and symptoms of depression in mothers, and of the consequences of untreated maternal depression."
The study was funded by the Robert Wood Johnson Foundation and the Children's Research Foundation of Rainbow Babies and Children Hospital. Established in 1972, The Robert Wood Johnson Foundation, based in Princeton, N.J. is the largest
philanthropy devoted exclusively to health and health care in the United States.