What is Perinatal Depression

Anyone can develop a mental illness at any stage of the life cycle; however certain environmental and physiological changes can increase this vulnerability. Women often go through one of these changes in their lives as a result of pregnancy, one of the mental illnesses experienced by women is the time before and following pregnancy, known as the perinatal period; a stage during which the risk of developing depression increases significantly.

For a long time, postpartum depression is the most common and discussed mental ill-health in new mothers, but there is little to no discussion about this topic “perinatal depression”. Perinatal depression is a collective term used for both prenatal depression (that is before the birth of the baby) and postpartum depression (after the birth of the baby).

Depression is a prolonged period of low mood, hopelessness, and anxiety and is the most common perinatal mental health issue, with studies finding incidence to be as high as 18 percent in pregnant women. The risk of depression increases further following the birth of the child, particularly in the six weeks following delivery, known as the post-partum period (PPP). Within this period, the tenth to nineteenth days after birth is when the mother is most at risk of developing a mental illness.

Why Perinatal Depression needs to be Identified and Treated

The term ‘Baby Blues’ is often used to refer to changes in emotion experienced by mothers after birth. However, perinatal depression is a crucial issue that causes an increased risk of suicide. This risk can last long beyond the delivery of the child, with studies finding the period of nine to twelve months following pregnancy is the time of highest incidence of suicide. Recent research has shown that suicide is the leading cause of death of mothers in the year following birth. More research, intervention, and awareness are needed for this mental health issue, as it is often neglected and misunderstood.  

Furthermore, postnatal depression can be complex and often forms part of postpartum psychosis, which is a serious mental health issue that can also involve acute hallucinations, delusions, and anxiety. Perinatal depression can have an adverse impact on the health of the child, for example, increased risk of early delivery and low birth weight as well as mental health issues in childhood and later life.

Risk Factors for Perinatal Depression

1. Prior Mental Illness: All pregnant women are vulnerable to developing depression at some point in the perinatal period. However, those women who have had mental illness before pregnancy, such as bipolar disorder are at higher risk of developing perinatal depression.
2. Traumatic Birth: A mother is more likely to develop postpartum depression if the birth was particularly traumatic, such as cesarean section, labor complications, and hemorrhages. This can also include giving birth to a child who is dangerously underweight or has potential health issues.
3. Young Age: Mothers in adolescence (13-19) are most vulnerable to perinatal depression, with mothers in their thirties being less likely to develop perinatal depression.

How to reduce Perinatal Depression and Suicide

 

Mothers with prior mental illness

These women need a close midwife and professional mental health support across the perinatal phase and especially in the post-partum period when they are most at risk. The treatment method can be administering antipsychotic and mood-stabilizing medication, usually using medications that were used when the mother experienced mental health issues earlier in their life. This process must be particularly sensitive as the mother may be reluctant to reveal their mental health history due to stigma and concern that their child may be taken from their custody. Psychological talking therapies are often best utilized here, such as cognitive-behavioral therapy.

Identifying mothers who report thoughts of violence or self-harm

Mothers that feel separated from the child are more likely to develop postnatal depression and postpartum psychosis. Support is needed here to ensure mothering skills are developed and the mother is confident in caring for the child and forming a secure and healthy attachment. Research has shown breastfeeding to be crucial in this process, which acts as a protective factor in the risk of postnatal depression. This is essential for mothers who do not have supportive environments at home.

Assisting the mother in forming healthy eating and sleeping patterns in late pregnancy and early postpartum period, as good nutrition acts as a protective factor and insomnia increases the risk of perinatal depression. This will aid in the mental and physical recovery of the mother and a healthier attachment to the child.

Written by: George Hatton