Tuesday, January 27, 2009

Mom-to-mom support helps postpartum depression: study

I am such a proponent of peer support before, during and after birth. I hope that women, doctors, and families will rally around realistic expectations and providing support and care for new mothers in the months following childbirth.

Last Updated: Friday, January 16, 2009 | 3:49 PM ET
Ideally, women and their partners would be educated about postpartum depression during pregnancy, a British researcher says. (Kin Cheung/Associated Press)

Counselling may not only help in treating postpartum depression but also in preventing it, new research suggests.

Postpartum depression affects about 13 per cent of women in the first year after childbirth worldwide.

In Friday’s issue of the British Medical Journal, one British and one Canadian study found early identification and intervention may help new mothers who are at risk for the condition.

Prof. Cindy-Lee Dennis of the University of Toronto led the Canadian study of 701 women in Ontario who were considered at high risk for postnatal depression in the first weeks after giving birth, based on their scores of a nine-point measure called the Edinburgh postnatal depression scale.

Dennis and her colleagues found mothers who received telephone-based support from fellow mothers reduced the risk of developing the disorder by half.

Suggestions volunteered

Postnatal depression was defined as a score of greater than 12 on the scale. At 12 weeks, 14 per cent of women in the intervention group had postnatal depression, compared to 25 per cent of women in the control group who didn't have a volunteer telephone partner.

"What I had the peer volunteers do was let the mother lead the discussion and the conversation and I had the peer volunteers provide useful suggestions," said Dennis, who holds a Canada research chair in perinatal community health.

The volunteers were women who had recovered from postpartum depression. They took a four-hour training course and offered emotional support and strategies to help the mothers feel better or seek help if needed.

In the British study, Jane Morrell, a health services researcher at the University of Huddersfield, trained community nurses to assess a mother's mood and identify symptoms of depression at six to eight weeks after the subjects gave birth using the same scale that Dennis used.

The trial included more than 4,000 mothers in England who were randomly assigned to either a cognitive behavioural approach or visits from the community nurses.

Participants were followed up for 18 months and assessed every six months using a questionnaire sent in the mail.

More convenient treatment

Mothers visited by the counsellors who showed depressive symptoms at six weeks were 40 per cent less likely to have depressive symptoms at six months than those receiving usual care, the team found.

The improvements lasted until 12 months after birth.

Ideally, women and their partners would be educated about postpartum depression during pregnancy, Morrell said.

"The moms need to be not afraid to ask for help when they're suffering with symptoms postnatally. And there needs to be much more thorough training for health-care professionals."

In an editorial accompanying the studies, Dennis also called for more education to help women recognize the symptoms.

Dennis is also seeking a co-ordinated approach by midwives, doctors, and nurses to identify postnatal depression, and more convenient and accessible treatment for new mothers.

With files from the Canadian Press

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