Mom, Are You Feeling Blue Utah Women and Postpartum Depression

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Mom, Are You Feeling Blue? Utah Women and
Postpartum Depression
Joanne McGarry, BS Lois Bloebaum, BSN Laurie
Baksh, MPH December, 2006
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Postpartum Depression Focus Groups
Postpartum Major Depression is the most common
complication of childbirth1 Specifically, in
Utah postpartum depression affects more women in
their reproductive years than does gestational
diabetes (2.2),2 pregnancy associated
hypertension (5.6),2 and even preterm birth
(9.5),3 yet it receives much less detection,
treatment and research.4
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Utah PRAMS Data

• Background
• 24 of all Utah women who delivered a live
  birth reported feeling moderately depressed,
  very depressed or very depressed and had to get
  help during 2002-2003.5
• 62 of Utah women who delivered a live birth
  during 2000 reported low to moderate levels of
  depression.6
• Utah ranked highest among the six states
  compared.6

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Utah PRAMS Data

• 2004 PRAMS data includes updated PPD
• screening questions7
• 14.7 of PRAMS moms reported postpartum
  depression
• 39.9 of PRAMS moms reported seeking help

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Research Questions
1) What motivates women to seek help for
postpartum depression? -Are women aware of
postpartum depression resources in
Utah? -Where do these women seek
help? 2) What inhibits women from seeking help
for postpartum depression?
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Methods

• The study design was non-experimental that
  included the use of
• focus groups for gathering information in order
  to answer the research questions.
• Reproductive Health Program (RHP) staff conducted
  three focus groups with self-selected Utah women
  who
• Were 18-45 years old
• Had delivered a baby with in the past year
• Had reported feeling depressed
• There was a total of 24 participants

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What Motivates Mom to Seek Help?

• They were having a breakdown and felt like they
  were on the verge of losing it. They were so
  overwhelmed that they knew they needed help
• Experiencing postpartum depression before
• Because they wanted to be a good mom to their
  children

I have got to be a mom for my kids I needed to
be a good mom. I needed to get help for this.
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Where Does Mom Go for Help?

• Crisis line
• Therapists or Counselors
• Valley Mental Health
• LDS Social Services
• Internet
• OBGYN/Pediatrician

• Friends
• Health Care Professional
• Religious Leaders
• Family Support Center
• Support Group

The majority of those that sought help felt that
they came up against a variety of road blocks
that inhibited them from getting the help that
they needed.
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What Barriers Does Mom Face?

• Being repeatedly told by friends, relatives,
  spouses/partners that what they were experiencing
  was normal and not to worry about it
• Lack of money and/or insurance
• I didnt know if I had just the baby blues or
  postpartum depression. I would try and talk to
  somebody about it, and oh that happens to
  everybody, youll get over it. And here, 6
  months is coming up, when do you get over it?
• Talking about medication a participant said
  its 17 dollars for 2 weeks. Well 17 will buy
  some formula, some diapers, some wipes. 17 is a
  lot of money to me, so Ill just cry, ya know.

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Other Barriers

• Moms did not know where to go or who to talk to
• Moms were very concerned about what people would
  think
• I really didnt think that my OBG really was the
  person to go through. I dont
• know why.
• Three women conversed, Ya, most women are
  embarrassed. So they dont
• say anything. They worry about being judged.

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Other Barriers

• Did not want to tell others or admit to
  themselves
• Unable to recognize symptoms
• Wanted to bring it up but felt that the doctor
  was too busy
• Felt like there was nothing out there
• Feared getting their kids taken away
• Did not want to be prescribed medication
• Not comfortable with provider
• Embarrassed
• Did not want to go on record of having a history
  of a
• mental illness
• Gaps in the systemdoctor did not know who to
  refer to
• OB could not treat
• Cultural barriers

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Other Findings
Positive Husband/Partner Support A few of the
women felt that their husband/partner did try to
support them through their depression, even
though they were not sure how to respond to it.

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Other Findings

• Negative Husband/Partner Support
• The majority of the women lacked husband/partner
  support.
• No Acknowledgement/validation
• What do you have to be depressed about?
• Suck it up!
• Its all in your head, just get over it
• Women go through this all the time. Women have
  babies
• all the time.
• You really need to stop talking about this
  because its
• making it worse.
• get over it. The babys a month old!

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Messages to Mom

• The difference between PPD and Baby blues
• You are not aloneother women feel the same way
• You are not going crazy
• Available resources
• Who to turn to for supportestablish a support
  network
• before you get pregnant/deliver
• Dont let it go too far
• Dont beat yourself up

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Messages to Mom Cont.

• Admitting to your doctor that you are depressed,
  doesnt
• mean that your kids will be taken away, or that
  youre a bad
• mother
• Emphasis on PPD instead of the extremes
  (psychosis and
• baby blues) and the possibility of experiencing
  it
• Dont listen to everyone else telling you that
  youll be fine
• if you feel like you need help, get it.
• Be open about feelings
• Coping strategies

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Messages to Others

• PPD is real
• Other women suffer from this too
• Support
• Positive reinforcement
• Appreciation
• Positive attention
• How to help
• How to respond to depression
• Signs and symptoms of PPD

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Recommendations

• Promote thorough postpartum depression screening
  
• Encourage the involvement of husband/partner
• Raise Awareness of Postpartum Depression through
  education
• Increase the number of support groups

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Conclusion
Women are ready to take action they just need to
know where to go and who to talk to.
Referencing the focus group recruitment poster
that each of the women saw, a participant said,
Well look at all of us. We all saw something
about it and responded
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Conclusion
And another woman encouraged preventive measures
You always think I can handle a little more. I
can handle a little more. Im not in crisis. Im
not in crisis. Well, alleviate it before it gets
to that point and you wont harm your kids
It will take a network of collaboration to
raise awareness and to improve diagnosis and
treatment of postpartum depression but, the
impact on mothers and children by doing so may be
substantial, perhaps even lifesaving.
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Special Thanks to
Lois Bloebaum, Manager, Reproductive Health
Program Laurie Baksh, Data Manager, PRAMS Doug
Taren, MCH Certificate Program Director
References 1. Moses-Kolko, Eydie L., Roth,
Erika K. Antepartum and Postpartum Depression
Health Mom, Healthy Baby. Journal of the
American Medical Womens Association 59 (3),
181-191. 2. Utah Department of Health, Office of
Vital Records. Years 2000-2001. 3. Utah
Department of Health, Center for Health Data.
Utahs Indicator-Based Information System for
Public Health. Retrieved from
http//ibis.health.utah.gov/Query?requestSHOW_RES
ULT on February 9, 2005. 4. Johnson, Timothy R.,
Apgar, Barbara. Postpartum Depression Womens
Primary Health Grand Rounds at the
University of Michigan. The Female Patient.
Retrieved from http//www.obgyn.net/female/pa
tient/default.asp?pageleopold on October 25,
2006. 5. Utah Department of Health, Pregnancy
Risk Assessment Monitoring System (PRAMS). Years
2002-2003 6. Centers for Disease Control and
Prevention, Pregnancy Risk Assessment Monitoring
System. PRAMS and Postpartum Depression.
(2004)