Perinatal Depression: Hope for Moms and Families

Up to 1 in 7 women is affected by perinatal depression, a mood disorder that happens during pregnancy and after giving birth. The US Preventive Services Task Force issued a formal recommendation this month stating that counseling is effective for women at risk. This includes cognitive behavioral therapy (which involves patient education) and other forms of therapy. Without treatment, women and their families suffer. Mother-child bonding may be affected and children may have developmental delays and other health problems as they grow.

In the Media
Pam Belluck of the New York Times published an article on perinatal depression this week that featured a mother of 7 who didn’t experience perinatal depression until her sixth child. Although several readers argued that her depression was related to having multiple children and socio-economic pressures, many other women spoke up about their struggles with postpartum depression even when they had only 1 child, a supportive family network and stable financial status. It’s clear that consistent universal screening and intervention is key across all populations.

North Carolina Program
Family Connects Durham (previously called Durham Connects) is an innovative health program that provides free in-home visits by a registered nurse to parents of newborns in Durham County, North Carolina, regardless of income or education level. Because it’s available to everyone, it reduces the stigma that may be associated with certain programs. It’s also been shown to be effective and have significant ROI. According to the program website, each $1 of program costs resulted in about $3 in emergency cost savings.

My story
As a Durham resident, I was a recipient of this program a couple years ago and absolutely loved it. It connected me to vital resources that helped us transition through a stressful time as first time parents—living far away from our families and adjusting to the need to return to work after a fairly short parental leave.

Partnerships matter
I believe one of the key reasons this program is successful is because of the collaborative partnerships between various agencies AND the team which includes RNs with BSNs and bilingual staff.

According to the site, it’s “a program of the Center for Child & Family Health, in partnership with the Duke Center for Child and Family Policy, Durham County Department of Public Health, and Durham County Department of Social Services. It is funded by The Duke Endowment, Durham County Government, United Way of the Greater Triangle, as well as other local grants and partnerships.”

Resources & References:

Apps:
PPD ACT An app to collect data for research on postpartum depression and postpartum psychosis
Talkspace Online therapy that’s convenient and accessible on your phone, tablet or computer.

Podcast: “I’ve got the postpartum blues” Katies Crib

Patient handout on Medline Plus

PHQ-9 questionnaire

Postpartum Support International

US Preventive Services Task Force. Interventions to prevent perinatal depression: US Preventive Services Task Force recommendation statementJAMA. 2019;321(6):580-587.

Dodge, K, et al  “Implementation and Randomized Controlled Trial Evaluation of Universal Postnatal Nurse Home Visiting”, American Journal of Public Health 104, no. S1 (February 1, 2014): pp. S136-S143. DOI: http://dx.doi.org/10.2105/ajph.2013.301361

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