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Postpartum depression

From Wikipedia, the free encyclopedia
Not to be confused with Postpartum blues.

Postpartum depression
Other namesPostnatal depression
Postpartum Depression Venus, a representation of the loss and emptiness felt after childbirth
SpecialtyPsychiatry
SymptomsExtreme sadness, low energy, anxiety, changes in sleeping or eating patterns, crying episodes, irritability[1]
Usual onsetA week to a month after childbirth[1]
CausesUnclear[1]
Risk factorsPrior postpartum depression, bipolar disorder, family history of depression, psychological stress, complications of childbirth, lack of support, drug use disorder[1]
Diagnostic methodBased on symptoms[2]
Differential diagnosisBaby blues[1]
TreatmentCounselling, medications[2]
Frequency~15% of births[1]
Articles related to
Pregnancy and mental health
Overview

Postpartum depression (PPD), also called perinatal depression, is a mood disorder which may be experienced by pregnant or postpartum individuals.[3] Symptoms include extreme sadness, low energy, anxiety, crying episodes, irritability, and changes in sleeping or eating patterns.[1] PPD can also negatively affect the newborn child.[4][2]

The exact cause of PPD is unclear, however, it is believed to be due to a combination of physical, emotional, genetic, and social factors such as hormone imbalances and sleep deprivation.[1][5][6] Risk factors include prior episodes of postpartum depression, bipolar disorder, a family history of depression, psychological stress, complications of childbirth, lack of support, or a drug use disorder.[1] Diagnosis is based on a person's symptoms.[2] While most women experience a brief period of worry or unhappiness after delivery, postpartum depression should be suspected when symptoms are severe and last over two weeks.[1]

Among those at risk, providing psychosocial support may be protective in preventing PPD.[7] This may include community support such as food, household chores, mother care, and companionship.[8] Treatment for PPD may include counseling or medications.[2] Types of counseling that are effective include interpersonal psychotherapy (IPT), cognitive behavioral therapy (CBT), and psychodynamic therapy.[2] Tentative evidence supports the use of selective serotonin reuptake inhibitors (SSRIs).[2]

Depression occurs in roughly 10 to 20% of postpartum women.[9] Postpartum depression commonly affects mothers who have experienced stillbirth, live in urban areas and adolescent mothers.[10] Moreover, this mood disorder is estimated to affect 1% to 26% of new fathers.[3] A different kind of postpartum mood disorder is Postpartum psychosis, which is more severe and occurs in about 1 to 2 per 1,000 women following childbirth.[11] Postpartum psychosis is one of the leading causes of the murder of children less than one year of age, which occurs in about 8 per 100,000 births in the United States.[12]

Signs and symptoms

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Symptoms of PPD can occur at any time in the first year postpartum.[13] Typically, a diagnosis of postpartum depression is considered after signs and symptoms persist for at least two weeks.[14]

Emotional

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  • Persistent sadness, anxiousness, or "empty" mood[13]
  • Severe mood swings[14]
  • Frustration, irritability, restlessness, anger[13][15]
  • Feelings of hopelessness or helplessness[13]
  • Guilt, shame, worthlessness[13][15]
  • Low self-esteem[13]
  • Numbness, emptiness[13]
  • Exhaustion[13]
  • Inability to be comforted[13]
  • Trouble bonding with the baby[14]
  • Feeling inadequate in taking care of the baby[13][15]
  • Thoughts of self-harm or suicide[16]

Behavioral

[edit]

Neurobiology

[edit]

fMRI studies indicate differences in brain activity between mothers with postpartum depression and those without. Mothers diagnosed with PPD tend to have less activity in the left frontal lobe and increased activity in the right frontal lobe when compared with healthy controls. They also exhibit decreased connectivity between vital brain structures, including the anterior cingulate cortex, dorsal lateral prefrontal cortex, amygdala, and hippocampus. Brain activation differences between depressed and nondepressed mothers are more pronounced when stimulated by non-infant emotional cues. Depressed mothers show greater neural activity in the right amygdala toward non-infant emotional cues as well as reduced connectivity between the amygdala and right insular cortex. Recent findings have also identified blunted activity in the anterior cingulate cortex, striatum, orbitofrontal cortex, and insula in mothers with PPD when viewing images of their infants.[18]

More robust studies on neural activation regarding PPD have been conducted with rodents than humans. These studies have allowed for greater isolation of specific brain regions, neurotransmitters, hormones, and steroids.[18][19]

Onset and duration

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Postpartum depression onset usually begins between two weeks to a month after delivery.[20] A study done at an inner-city mental health clinic has shown that 50% of postpartum depressive episodes began before delivery.[21] In the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) PPD is not recognized as a distinct condition but rather a specific type of a major depressive episode. In the DSM-5, the specifier "with peripartum onset" can be applied to a major depressive episode if the onset occurred either during pregnancy or within the four weeks following delivery.[22] The prevalence of postpartum depression differs across different months after childbirth. Studies done on postpartum depression amongst women in the Middle East show that the prevalence in the first three months of postpartum was 31%, while the prevalence from the fourth to twelfth months of postpartum was 19%.[23] PPD may last several months or even a year.[24]

Consequences on maternal and child health

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Postpartum depression can interfere with normal maternal-infant bonding and adversely affect acute and long-term child development. Infants of mothers with PPD have higher incidences of excess crying, temperamental issues, and sleeping difficulties. Issues with sleeping in infants may exacerbate or be exacerbated by concurrent PPD in mothers. Maternal outcomes of PPD include withdrawal, disengagement, and hostility. Additional patterns observed in mothers with PPD include lower rates of initiation and maintenance of breastfeeding. [25]

Children and infants of PPD-affected mothers experience negative long-term impacts on their cognitive functioning, inhibitory control, and emotional regulation. In cases of untreated PPD, violent behaviors and psychiatric and medical conditions in adolescence have been observed. [25]

Suicide rates of women with PPD are lower than those outside of the perinatal period. Fetal or infant death in the first year postpartum has been associated with a higher risk of suicide attempt and higher inpatient psychiatric admissions. [25]

Postpartum depression in fathers

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Paternal postpartum depression is a poorly understood concept with a limited evidence-base. However, postpartum depression affects 8 to 10% of fathers.[26] There are no set criteria for men to have postpartum depression.[26] The cause may be distinct in males.[27] Causes of paternal postpartum depression include hormonal changes during pregnancy, which can be indicative of father-child relationships.[26] For instance, male depressive symptoms have been associated with low testosterone levels in men.[26] Low prolactin, estrogen, and vasopressin levels have been associated with struggles with father-infant attachment, which can lead to depression in first-time fathers.[26] Symptoms of postpartum depression in men are extreme sadness, fatigue, anxiety, irritability, and suicidal thoughts. Postpartum depression in men is most likely to occur 3–6 months after delivery and is correlated with maternal depression, meaning that if the mother is experiencing postpartum depression, then the father is at a higher risk of developing the illness as well.[28] Postpartum depression in men leads to an increased risk of suicide, while also limiting healthy infant-father attachment. Men who experience PPD can exhibit poor parenting behaviors, and distress, and reduce infant interaction.[29]

Reduced paternal interaction can later lead to cognitive and behavioral problems in children.[30] Children as young as 3.5 years old may experience problems with internalizing and externalizing behaviors, indicating that paternal postpartum depression can have long-term consequences.[10][3] Furthermore, if children as young as two are not frequently read to, this negative parent-child interaction can harm their expressive vocabulary.[3] A study focusing on low-incom e fathers found that increased involvement in their child's first year was linked to lower rates of postpartum depression.[31]

Adoptive parents

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Postpartum depression may also be experienced by non-biological parents. While not much research has been done regarding post-adoption depression, difficulties associated with parenting post-partum are similar between biological and adoptive parents.[32] Women who adopt children undergo significant stress and life changes during the postpartum period, similar to biological mothers. This may raise their chance of developing depressive symptoms and anxious tendencies.[33] Postpartum depression presents in adoptive mothers via sleep deprivation similar to birth mothers, but adoptive parents may have added risk factors such as a history of infertility.[33]

Issues for LGBTQ people

[edit]

Additionally, preliminary research has shown that childbearing individuals who are part of the LGBTQ community may be more susceptible to prenatal depression and anxiety than cisgender and heterosexual people.[34]

According to two other studies, LGBTQ people were discouraged from accessing postpartum mental health services due to societal stigma adding a social barrier that heteronormative mothers do not have. Lesbian participants expressed apprehension about receiving a mental health diagnosis because of worries about social stigma and employment opportunities. Concerns were also raised about possible child removal and a parent's diagnosis including mental illness.[34] From the studies conducted thus far, although limited, it is evident that there is a much larger population that experiences depression associated with childbirth than just biological mothers.

Causes

[edit]

The cause of PPD is unknown. Hormonal and physical changes, personal and family history of depression, and the stress of caring for a new baby all may contribute to the development of postpartum depression.[35][36]

Evidence suggests that hormonal changes may play a role.[37] Understanding the neuroendocrinology characteristic of PPD has proven to be particularly challenging given the erratic changes to the brain and biological systems during pregnancy and postpartum. A review of exploratory studies in PPD has observed that women with PPD have more dramatic changes in HPA axis activity, however, the directionality of specific hormone increases or decreases remain mixed.[38] Hormones that have been studied include estrogen, progesterone, thyroid hormone, testosterone, corticotropin releasing hormone, endorphins, and cortisol.[6] Estrogen and progesterone levels drop back to pre-pregnancy levels within 24 hours of giving birth, and that sudden change may cause it.[39] Aberrant steroid hormone-dependent regulation of neuronal calcium influx via extracellular matrix proteins and membrane receptors involved in responding to the cell's microenvironment might be important in conferring biological risk.[40] The use of synthetic oxytocin, a birth-inducing drug, has been linked to increased rates of postpartum depression and anxiety.[41]

Estradiol, which helps the uterus thicken and grow, is thought to contribute to the development of PPD.[37] This is due to its relationship with serotonin. Estradiol levels increase during pregnancy, then drastically decrease following childbirth. When estradiol levels drop postpartum, the levels of serotonin decline as well. Serotonin is a neurotransmitter that helps regulate mood. Low serotonin levels cause feelings of depression and anxiety. Thus, when estradiol levels are low, serotonin can be low, suggesting that estradiol plays a role in the development of PPD.[42]

Profound lifestyle changes that are brought about by caring for the infant are also frequently hypothesized to cause PPD. However, little evidence supports this hypothesis. Mothers who have had several previous children without experiencing PPD can nonetheless experience it with their latest child.[43] Despite the biological and psychosocial changes that may accompany pregnancy and the postpartum period, most women are not diagnosed with PPD.[44][45] Many mothers are unable to get the rest they need to fully recover from giving birth. Sleep deprivation can lead to physical discomfort and exhaustion, which can contribute to the symptoms of postpartum depression.[46]

Risk factors

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While the causes of PPD are not understood, several factors have been suggested to increase the risk. These risks can be broken down into two categories, biological and psychosocial:

Biological

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The risk factors for postpartum depression can be broken down into two categories as listed above, biological and psychosocial.[50] Certain biological risk factors include the administration of oxytocin to induce labor. Chronic illnesses such as diabetes, or Addison's disease, as well as issues with hypothalamic-pituitary-adrenal dysregulation (which controls hormonal responses),[47] inflammatory processes like asthma or celiac disease, and genetic vulnerabilities such as a family history of depression or PPD. Chronic illnesses caused by neuroendocrine irregularities including irritable bowel syndrome and fibromyalgia typically put individuals at risk for further health complications. However, it has been found that these diseases do not increase the risk for postpartum depression, these factors are known to correlate with PPD.[47] This correlation does not mean these factors are causal. Cigarette smoking has been known to have additive effects.[48] Some studies have found a link between PPD and low levels of DHA (an omega-3 fatty acid) in the mother.[51] A correlation between postpartum thyroiditis and postpartum depression has been proposed but remains controversial. There may also be a link between postpartum depression and anti-thyroid antibodies.[52]

Psychosocial

[edit]

The psychosocial risk factors for postpartum depression include severe life events, some forms of chronic strain, relationship quality, and support from partner and mother.[64] There is a need for more research regarding the link between psychosocial risk factors and postpartum depression. Some psychosocial risk factors can be linked to the social determinants of health.[50] Women with fewer resources indicate a higher level of postpartum depression and stress than those women with more resources, such as financial.[65]

Rates of PPD have been shown to decrease as income increases. Women with fewer resources may be more likely to have an unintended or unwanted pregnancy, increasing the risk of PPD. Women with fewer resources may also include single mothers of low income. Single mothers of low income may have more limited access to resources while transitioning into motherhood. These women already have fewer spending options, and having a child may spread those options even further.[66] Low-income women are frequently trapped in a cycle of poverty, unable to advance, affecting their ability to access and receive quality healthcare to diagnose and treat postpartum depression.[66]

Studies in the US have also shown a correlation between a mother's race and postpartum depression. African American mothers have been shown to have the highest risk of PPD at 25%, while Asian mothers had the lowest at 11.5%, after controlling for social factors such as age, income, education, marital status, and baby's health. The PPD rates for First Nations, Caucasian, and Hispanic women fell in between.[65]

Migration away from a cultural community of support can be a factor in PPD. Traditional cultures around the world prioritize organized support during postpartum care to ensure the mother's mental and physical health, well-being, and recovery.[8]

One of the strongest predictors of paternal PPD is having a partner who has PPD, with fathers developing PPD 50% of the time when their female partner has PPD.[67]

Sexual orientation[68] has also been studied as a risk factor for PPD. In a 2007 study conducted by Ross and colleagues, lesbian and bisexual mothers were tested for PPD and then compared with a heterosexual sample group. It was found that lesbian and bisexual biological mothers had significantly higher Edinburgh Postnatal Depression Scale scores than the heterosexual women in the sample.[47] Postpartum depression is more common among lesbian women than heterosexual women, which can be attributed to lesbian women's higher depression prevalence.[69] Lesbian women have a higher risk of depression because they are more likely to have been treated for depression and to have attempted or contemplated suicide than heterosexual women.[69] These higher rates of PPD in lesbian/bisexual mothers may reflect less social support, particularly from their families of origin, and additional stress due to homophobic discrimination in society.[70]

Different risk variables linked to postpartum depression (PPD) among Arabic women emphasize regional influences.[71]  Risk factors that have been identified include the gender of the infant and polygamy.[71] According to three studies conducted in Egypt and one in Jordan, mothers of female babies had a two-to-four-fold increased risk of postpartum depression (PPD) compared to mothers of male babies.[71] Four studies found that conflicts with the mother-in-law are associated with PPD, with risk ratios of 1.8 and 2.7.[72]

Studies have also shown a correlation between postpartum depression in mothers living within areas of conflicts, crises, and wars in the Middle East.[23] Studies in Qatar have found a correlation between lower education levels and higher PPD prevalence.[72]

According to research done in Egypt and Lebanon, rural residential living is linked to an increased risk. It was found that rural Lebanese women who had Caesarean births had greater PPD rates. On the other hand, Lebanese women in urban areas showed an opposite pattern.[72]

Research conducted in the Middle East has demonstrated a link between PPD risk and mothers who were not informed and who are not given due consideration when decisions are made during childbirth.[72]

There is a call to integrate both a consideration of biological and psychosocial risk factors for PPD when treating and researching the illness.[50]

Violence

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A meta-analysis reviewing research on the association of violence and postpartum depression showed that violence against women increases the incidence of postpartum depression.[73] About one-third of women throughout the world will experience physical or sexual violence at some point in their lives.[74] Violence against women occurs in conflict, post-conflict, and non-conflict areas.[74] The research reviewed only looked at violence experienced by women from male perpetrators. Studies from the Middle East suggest that individuals who have experienced family violence are 2.5 times more likely to develop PPD.[72] Further, violence against women was defined as "any act of gender-based violence that results in, or is likely to result in, physical, sexual, or psychological harm or suffering to women".[73] Psychological and cultural factors associated with increased incidence of postpartum depression include family history of depression, stressful life events during early puberty or pregnancy, anxiety or depression during pregnancy, and low social support.[47][73] Violence against women is a chronic stressor, so depression may occur when someone is no longer able to respond to the violence.[73]

Diagnosis

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Criteria

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Postpartum depression in the DSM-5 is known as "depressive disorder with peripartum onset". Peripartum onset is defined as starting anytime during pregnancy or within the four weeks following delivery.[22] There is no longer a distinction made between depressive episodes that occur during pregnancy or those that occur after delivery.[75] Nevertheless, the majority of experts continue to diagnose postpartum depression as depression with onset anytime within the first year after delivery.[54]

The criteria required for the diagnosis of postpartum depression are the same as those required to make a diagnosis of non-childbirth-related major depression or minor depression. The criteria include at least five of the following nine symptoms, within two weeks:[75]

  • Feelings of sadness, emptiness, or hopelessness, nearly every day, for most of the day, or the observation of a depressed mood made by others
  • Loss of interest or pleasure in activities
  • Weight loss or decreased appetite
  • Changes in sleep patterns
  • Feelings of restlessness
  • Loss of energy
  • Feelings of worthlessness or guilt
  • Loss of concentration or increased indecisiveness
  • Recurrent thoughts of death, with or without plans of suicide

Differential diagnosis

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Postpartum blues

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Main article: Postpartum blues

Postpartum blues, commonly known as "baby blues," is a transient postpartum mood disorder characterized by milder depressive symptoms than postpartum depression. This type of depression can occur in up to 80% of all mothers following delivery.[76] Symptoms typically resolve within two weeks. Symptoms lasting longer than two weeks are a sign of a more serious type of depression.[77] Women who experience "baby blues" may have a higher risk of experiencing a more serious episode of depression later on.[78]

Psychosis

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Postpartum psychosis is not a formal diagnosis, but is widely used to describe a psychiatric emergency that appears to occur in about 1 in 1000 pregnancies, in which symptoms of high mood and racing thoughts (mania), depression, severe confusion, loss of inhibition, paranoia, hallucinations, and delusions begin suddenly in the first two weeks after delivery; the symptoms vary and can change quickly.[79] It is different from postpartum depression and maternity blues.[80] It may be a form of bipolar disorder.[81] It is important not to confuse psychosis with other symptoms that may occur after delivery, such as delirium. Delirium typically includes a loss of awareness or inability to pay attention.[78]

About half of women who experience postpartum psychosis have no risk factors; but a prior history of mental illness, especially bipolar disorder, a history of prior episodes of postpartum psychosis, or a family history put some at a higher risk.[79]

Postpartum psychosis often requires hospitalization, where treatment is antipsychotic medications, mood stabilizers, and in cases of strong risk for suicide, electroconvulsive therapy.[79]

The most severe symptoms last from 2 to 12 weeks, and recovery takes 6 months to a year.[79] Women who have been hospitalized for a psychiatric condition immediately after delivery are at a much higher risk of suicide during the first year after delivery.[82]

Childbirth-Related/Postpartum Posttraumatic Stress Disorder

Parents may suffer from post-traumatic stress disorder (PTSD), or suffer post-traumatic stress disorder symptoms, following childbirth.[83] While there has been debate in the medical community as to whether childbirth should be considered a traumatic event, the current consensus is childbirth can be a traumatic event.[84] The DSM-IV and DSM-5 (standard classifications of mental disorders used by medical professionals) do not explicitly recognize childbirth-related PTSD, but both allow childbirth to be considered as a potential cause of PTSD.[84] Childbirth-related PTSD is closely related to postpartum depression. Research indicates mothers who have childbirth-related PTSD also commonly have postpartum depression.[83][85] Childbirth-related PTSD and postpartum depression have some common symptoms. Although both diagnoses overlap in their signs and symptoms, some symptoms specific to postpartum PTSD include being easily startled, recurring nightmares and flashbacks, avoiding the baby or anything that reminds one of birth, aggression, irritability, and panic attacks.[86] Real or perceived trauma before, during, or after childbirth is a crucial element in diagnosing childbirth-related PTSD.[87]

Currently, there are no widely recognized assessments that measure postpartum post-traumatic stress disorder in medical settings. Existing PTSD assessments (such as the DSM-IV) have been used to measure childbirth-related PTSD.[83] Some surveys exist to measure childbirth-related PTSD specifically, however, these are not widely used outside of research settings.[86]

Approximately 3-6% of mothers in the postpartum period have childbirth-related PTSD.[83][84][88][89] The percentage of individuals with childbirth-related PTSD is approximately 15-18% in high-risk samples (women who experience severe birth complications, have a history of sexual/physical violence, or have other risk factors).[83][89] Research has identified several factors that increase the chance of developing childbirth-related PTSD. These include a negative subjective experience of childbirth, maternal mental health (prenatal depression, perinatal anxiety, acute postpartum depression, and history of psychological problems), history of trauma, complications with delivery and baby (for example emergency cesarean section or NICU admittance), and a low level of social support.[85][90]

Childbirth-related PTSD has several negative health effects. Research suggests that childbirth-related PTSD may negatively affect the emotional attachment between mother and child.[88] However, maternal depression or other factors may also explain this negative effect.[88] Childbirth-related PTSD in the postpartum period may also lead to issues with the child's social-emotional development.[88] Current research suggests childbirth-related PTSD results in lower breastfeeding rates and may prevent parents from breastfeeding for the desired amount of time.[89]

Screening

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Screening for postpartum depression is critical as up to 50% of cases go undiagnosed in the US, emphasizing the significance of comprehensive screening measures.[91] In the US, the American College of Obstetricians and Gynecologists suggests healthcare providers consider depression screening for perinatal women.[92] Additionally, the American Academy of Pediatrics recommends pediatricians screen mothers for PPD at 1-month, 2-month, and 4-month visits.[93] However, many providers do not consistently provide screening and appropriate follow-up.[92][94] For example, in Canada, Alberta is the only province with universal PPD screening. This screening is carried out by Public Health nurses with the baby's immunization schedule. In Sweden, Child Health Services offers a free program for new parents that includes screening mothers for PPD at 2 months postpartum. However, there are concerns about adherence to screening guidelines regarding maternal mental health.[95]

The Edinburgh Postnatal Depression Scale, a standardized self-reported questionnaire, may be used to identify women who have postpartum depression.[96] If the new mother scores 13 or more, she likely has PPD and further assessment should follow.[96]

Healthcare providers may take a blood sample to test if another disorder is contributing to depression during the screening.[97]

The Edinburgh Postnatal Depression Scale is used within the first week of the newborn being admitted. If mothers receive a score less than 12 they are told to be reassessed because of the depression testing protocol. It is also advised that mothers in the NICU get screened every four to six weeks as their infant remains in the neonatal intensive care unit.[98] Mothers who score between twelve and nineteen on the EPDS are offered two types of support.[99] The mothers are offered LV treatment provided by a nurse in the NICU and they can be referred to the mental health professional services. If a mother receives a three on item number ten of the EPDS they are immediately referred to the social work team as they may be suicidal.[98]

It is critical to acknowledge the diversity of patient populations diagnosed with postpartum depression and how this may impact the reliability of the screening tools used.[91] There are cultural differences in how patients express symptoms of postpartum depression; those in non-western countries exhibit more physical symptoms, whereas those in Western countries have more feelings of sadness. Depending on one's cultural background, symptoms of postpartum depression may manifest differently, and non-Westerners being screened in Western countries may be misdiagnosed because their screening tools do not account for cultural diversity.[91] Aside from culture, it is also important to consider one's social context, as women with low socioeconomic status may have additional stressors that affect their postpartum depression screening scores.

Prevention

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A 2013 Cochrane review found evidence that psychosocial or psychological intervention after childbirth helped reduce the risk of postnatal depression.[100][101] These interventions included home visits, telephone-based peer support, and interpersonal psychotherapy.[100] Support is an important aspect of prevention, as depressed mothers commonly state that their feelings of depression were brought on by "lack of support" and "feeling isolated."[102]

Across different cultures, traditional rituals for postpartum care may be preventative for PPD but are more effective when the support is welcomed by the mother.[103]

In couples, emotional closeness and global support by the partner protect against both perinatal depression and anxiety. In 2014, Alasoom and Koura found that compared to 42.9 percent of women who did not get spousal support, only 14.7 percent of women who got spousal assistance had PPD.[104] Further factors such as communication between the couple and relationship satisfaction have a protective effect against anxiety alone.[105]

In those who are at risk counseling is recommended.[106] The US Preventative Services Task Force (USPSTF) conducted a review of evidence which supported the use of counseling interventions such as therapy for the prevention of PPD in high-risk groups. Women who are considered to be high-risk include those with a past or present history of depression, or with certain socioeconomic factors such as low income or young age.[107]

Preventative treatment with antidepressants may be considered for those who have had PPD previously. However, as of 2017, the evidence supporting such use is weak.[108][109]

Community perinatal mental health teams were launched in England in 2016 to improve access to mental healthcare for pregnant women. They aim to prevent and treat episodes of mental illness during pregnancy and after birth. Researchers found that in areas of the country where teams were available, women who had previous contact with psychiatric services (many of whom had a previous diagnosis of anxiety or depression) were more likely to access mental health support and had a lower risk of relapse requiring hospital admission in the year after giving birth.[110][111]

Treatments

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Treatment for mild to moderate PPD includes psychological interventions or antidepressants. Women with moderate to severe PPD would likely experience a greater benefit with a combination of psychological and medical interventions.[112] Light aerobic exercise is useful for mild and moderate cases.[113][114]

Therapy

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Both individual social and psychological interventions appear equally effective in the treatment of PPD.[115][116] Social interventions include individual counseling and peer support, while psychological interventions include cognitive behavioral therapy (CBT) and interpersonal therapy (IPT).[117][118] Support groups and group therapy options focused on psychoeducation around postpartum depression have been shown to enhance the understanding of postpartum symptoms and often assist in finding further treatment options.[119] Other forms of therapy, such as group therapy, home visits, counseling, and ensuring greater sleep for the mother may also have a benefit.[13][5][120] While specialists trained in providing counseling interventions often serve this population in need, results from a recent systematic review and meta-analysis found that nonspecialist providers, including lay counselors, nurses, midwives, and teachers without formal training in counseling interventions, often provide effective services related to perinatal depression and anxiety.[121]

Psychotherapy

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Psychotherapy is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome problems. Psychotherapy can be super beneficial for mothers or fathers that are dealing with PPD. It allows individuals to talk with someone, maybe even someone who specializes in working with people who are dealing with PPD, and share their emotions and feelings to get help to become more emotionally stable. Psychotherapy proves to show efficacy of psychodynamic interventions for postpartum depression, both in home and clinical settings and both in group and individual format.

Cognitive behavioral therapy

[edit]

Internet-based cognitive behavioral therapy (CBT) has shown promising results with lower negative parenting behavior scores and lower rates of anxiety, stress, and depression. CBT  may be beneficial for mothers who have limitations in accessing in-person CBT. However, the long-term benefits have not been determined. The implementation of cognitive behavioral therapy happens to be one of the most successful and well-known forms of therapy regarding PPD. In simple terms, cognitive behavioral therapy is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. While being a wide branch of therapy, it remains very beneficial when tackling specific emotional distress, which is the foundation of PPD. Thus, CBT manages to further reduce or limit the frequency and intensity of emotional outbreaks in the mothers or fathers.

Interpersonal therapy

[edit]

Interpersonal therapy (IPT) has shown to be effective in focusing specifically on the mother and infant bond.[122] Psychosocial interventions are effective for the treatment of postpartum depression. Interpersonal therapy otherwise known as IPT is a wonderfully intuitive fit for many women with PPD as they typically experience a multitude of biopsychosocial stressors that are associated with their depression, including several disrupted interpersonal relationships.

Medication

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A 2010 review found few studies of medications for treating PPD noting small sample sizes and generally weak evidence.[117] Some evidence suggests that mothers with PPD will respond similarly to people with major depressive disorder.[117] There is low-certainty evidence which suggests that selective serotonin reuptake inhibitors (SSRIs) are an effective treatment for PPD.[123] The first-line anti-depressant medication of choice is sertraline, an SSRI, as very little of it passes into the breast milk and, as a result, to the child.[5] However, a recent study has found that adding sertraline to psychotherapy does not appear to confer any additional benefit.[124] Therefore, it is not completely clear which antidepressants, if any, are most effective for the treatment of PPD, and for whom antidepressants would be a better option than non-pharmacotherapy.[123]

Some studies show that hormone therapy may be effective in women with PPD, supported by the idea that the drop in estrogen and progesterone levels post-delivery contributes to depressive symptoms.[117] However, there is some controversy with this form of treatment because estrogen should not be given to people who are at higher risk of blood clots, which include women up to 12 weeks after delivery.[125] Additionally, none of the existing studies included women who were breastfeeding.[117] However, there is some evidence that the use of estradiol patches might help with PPD symptoms.[126]

Oxytocin is an effective anxiolytic and in some cases antidepressant treatment in men and women. Exogenous oxytocin has only been explored as a PPD treatment with rodents, but results are encouraging for potential application in humans.[38]

In 2019, the FDA approved brexanolone, a synthetic analog of the neurosteroid allopregnanolone, for use intravenously in postpartum depression. Allopregnanolone levels drop after giving birth, which may lead to women becoming depressed and anxious.[127] Some trials have demonstrated an effect on PPD within 48 hours from the start of infusion.[128] Other new allopregnanolone analogs under evaluation for use in the treatment of PPD include zuranolone and ganaxolone.[126]

Brexanolone has risks that can occur during administration, including excessive sedation and sudden loss of consciousness, and therefore has been approved under the Risk Evaluation and Mitigation Strategy (REMS) program.[129] The mother is to be enrolled before receiving the medication. It is only available to those at certified healthcare facilities with a healthcare provider who can continually monitor the patient. The infusion itself is a 60-hour, or 2.5-day, process. People's oxygen levels are to be monitored with a pulse oximeter. Side effects of the medication include dry mouth, sleepiness, somnolence, flushing, and loss of consciousness. It is also important to monitor for early signs of suicidal thoughts or behaviors.[129]

In 2023, the FDA approved zuranolone, sold under the brand name Zurzuvae for treatment of postpartum depression. Zuranolone is administered through a pill, which is more convenient than brexanolone, which is administered through an intravenous injection.[130]

Breastfeeding

[edit]

The use of SSRIs for the treatment of PPD is not a contraindication for breastfeeding. While antidepressants are excreted in breastmilk, the concentrations recorded in breastmilk are very low. [131][132] Extensive research has shown that the use of SSRI's by women who are lactating is safe for the breastfeeding infant/child.[131][132][133] Regarding allopregnanolone, very limited data did not indicate a risk for the infant.[134]

Other

[edit]

Electroconvulsive therapy (ECT) has shown efficacy in women with severe PPD who have either failed multiple trials of medication-based treatment or cannot tolerate the available antidepressants.[112] Tentative evidence supports the use of repetitive transcranial magnetic stimulation (rTMS).[135]

As of 2013, it is unclear if acupuncture, massage, bright lights, or taking omega-3 fatty acids are useful.[136]

Further information: Oxytocin treatment for postpartum depression

Resources

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International

[edit]

Postpartum Support International[137] is the most recognized international resource for those with PPD as well as healthcare providers.[138] It brings together those experiencing PPD, volunteers, and professionals to share information, referrals, and support networks.[138] Services offered by PSI include the website (with support, education, and local resource info), coordinators for support and local resources, online weekly video support groups in English and Spanish, free weekly phone conferences with chats with experts, educational videos, closed Facebook groups for support, and professional training of healthcare workers.[139]

United States

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Educational interventions

[edit]

Educational interventions can help women struggling with postpartum depression (PPD) to cultivate coping strategies and develop resiliency. The phenomenon of "scientific motherhood" represents the origin of women's education on perinatal care with publications like Ms. circulating some of the first press articles on PPD that helped to normalize the symptoms that women experienced.[140] Feminist writings on PPD from the early seventies shed light on the darker realities of motherhood and amplified the lived experiences of mothers with PPD.

Instructional videos have been popular among women who turn to the internet for PPD treatment, especially when the videos are interactive and get patients involved in their treatment plans.[141] Since the early 2000s, video tutorials on PPD have been integrated into many web-based training programs for individuals with PPD and are often considered a type of evidence-based management strategy for individuals.[142] This can take the form of objective-based learning, detailed exploration of case studies, resource guides for additional support and information, etc.[141]

Government-funded programs

[edit]

The National Child and Maternal Health Education Program functions as a larger education and outreach program supported by the National Institute of Child Health and Human Development (NICHD) and the National Institute of Health. The NICHD has worked alongside organizations like the World Health Organization to conduct research on the psychosocial development of children with part of their efforts going towards the support of mothers' health and safety.[143] Training and education services are offered through the NICHD to equip women and their healthcare providers with evidence-based knowledge of PPD.[144]

Other initiatives include the Substance Abuse and Mental Health Services Administration (SAMHSA) whose disaster relief program provides medical assistance at both the national and local level.[145] The disaster relief fund not only helps to raise awareness of the benefits of having healthcare professionals screen for PPD but also helps childhood professionals (home visitors and early care providers) develop the skills to diagnose and prevent PPD.[145] The Infant and Early Childhood Mental Health Consultation (IECMH) center is a related technical assistance program that utilizes evidence-based treatment services to address issues of PPD. The IECMH facilitates parenting and home visit programs, early care site interventions with parents and children, and a variety of other consultation-based services.[146] The IECMH's initiatives seek to educate home visitors on screening protocols for PPD as well as ways to refer depressed mothers to professional help.

[edit]
  • [1] www.nichd.nih.gov/ncmhep
  • [2] www.nichd.nih.gov
  • [3] www.samhsa.gov
  • [4] www.samhsa.gov/iecmhc

Psychotherapy

[edit]

Therapeutic methods of intervention can begin as early as a few days post-birth when most mothers are discharged from hospitals. Research surveys have revealed a paucity of professional, and emotional support for women struggling in the weeks following delivery despite there being a heightened risk for PPD for new mothers during this transitional period.[147]

Community-based support

[edit]

A lack of social support has been identified as a barrier to seeking help for postpartum depression.[148] Peer support programs have been identified as an effective intervention for women experiencing symptoms of postpartum depression.[149] In-person, online, and telephone support groups are available to both women and men throughout the United States. Peer support models are appealing to many women because they are offered in a group and outside of the mental health setting.[149] The website Postpartum Progress provides a comprehensive list of support groups separated by state and includes the contact information for each group.[150] The National Alliance on Mental Illness lists a virtual support group titled "The Shades of Blue Project," which is available to all women via the submission of a name and email address.[151] Additionally, NAMI recommends the website "National Association of Professional and Peer Lactation Supports of Color" for mothers in need of a lactation supporter.[152] Lactation assistance is available either online or in-person if there is support nearby.[152]

Personal narratives & memoirs

[edit]

Postpartum Progress is a blog focused on being a community of mothers talking openly about postpartum depression and other mental health conditions associated.[153] Story-telling and online communities reduce the stigma around PPD and promote peer-based care. Postpartum Progress is specifically relevant to people of color and queer folks due to an emphasis on cultural competency.[154]

Hotlines & telephone interviews

[edit]

Hotlines, chat lines, and telephone interviews offer immediate, emergency support for those experiencing PPD. Telephone-based peer support can be effective in the prevention and treatment of postpartum depression among women at high risk.[155] Established examples of telephone hotlines include the National Alliance on Mental Illness: 800-950-NAMI (6264),[156] National Suicide Prevention Lifeline: 800-273-TALK (8255),[157] Postpartum Support International: 800-944-4PPD (4773),[158] and SAMHSA's National Hotline: 1-800-662-HELP (4357).[159] Postpartum Health Alliance has an immediate, 24/7 support line in San Diego/San Diego Access and Crisis Line at (888) 724–7240, in which you can talk with mothers who have recovered from PPD and trained providers.[160]

However, hotlines can lack cultural competency which is crucial in quality healthcare, specifically for people of color. Calling the police or 911, specifically for mental health crises, is dangerous for many people of color. Culturally and structurally competent emergency hotlines are a huge need in PPD care.[154]

Self-care & well-being activities

[edit]

Women demonstrated an interest in self-care and well-being in an online PPD prevention program. Self-care activities, specifically music therapy, are accessible to most communities and valued among women as a way to connect with their children and manage symptoms of depression. Well-being activities associated with being outdoors, including walking and running, were noted amongst women as a way to help manage mood.[161]

Accessibility to care

[edit]

Those with PPD come across many help-seeking barriers, including lack of knowledge, stigma about symptoms, as well as health service barriers.[155] There are also attitudinal barriers to seeking treatment, including stigma.[149] Interpersonal relationships with friends and family, as well as institutional and financial obstacles, serve as help-seeking barriers. A history of mistrust within the United States healthcare system or negative health experiences can influence one's willingness and adherence to seek postpartum depression treatment.[162] Cultural responses must be adequate in PPD healthcare and resources.[148] Representation and cultural competency are crucial to equitable healthcare for PPD.[163] Different ethnic groups may believe that healthcare providers will not respect their cultural values or religious practices, which influences their willingness to use mental health services or be prescribed antidepressant medications.[162] Additionally, resources for PPD are limited and often don't incorporate what mothers would prefer.[161] The use of technology can be a beneficial way to provide mothers with resources because it is accessible and convenient.[161]

Epidemiology

[edit]

North America

[edit]

United States

[edit]

Within the United States, the prevalence of postpartum depression was lower than the global approximation at 11.5% but varied between states from as low as 8% to as high as 20.1%.[164] The highest prevalence in the US is found among women who are American Indian/Alaska Natives or Asian/Pacific Islanders, possess less than 12 years of education, are unmarried, smoke during pregnancy, experience over two stressful life events, or have full-term infant is low-birthweight or was admitted to a NICU. While US prevalence decreased from 2004 to 2012, it did not decrease among American Indian/Alaska Native women or those with full term, low-birthweight infants.[164]

Even with the variety of studies, it is difficult to find the exact rate as approximately 60% of US women are not diagnosed and of those diagnosed, approximately 50% are not treated for PPD.[164] Cesarean section rates did not affect the rates of PPD. While there is discussion of postpartum depression in fathers, there is no formal diagnosis for postpartum depression in fathers.[165]

Canada

[edit]

Canada has one of the largest refugee resettlement in the world with an equal percentage of women to men. This means that Canada has a disproportionate percentage of women who develop postpartum depression since there is an increased risk among the refugee population.[166] In a blind study, where women had to reach out and participate, around 27% of the sample population had symptoms consistent with postpartum depression without even knowing.[167] Also found that on average 8.46 women had minor and major PPDS was found to be 8.46 and 8.69% respectively. The main factors that were found to contribute to this study were the stress during pregnancy, the availability of support after, and a prior diagnosis of depression were all found to be factors.[168] Canada has specific population demographics that also involve a large amount of immigrant and indigenous women which creates a specific cultural demographic localized to Canada. In this study, researchers found that these two populations were at significantly higher risk compared to "Canadian-born non-indigenous mothers".[168] This study found that risk factors such as low education, low-income cut-off, taking antidepressants, and low social support are all factors that contribute to the higher percentage of these populations developing PPDS.[168] Specifically, indigenous mothers had the most risk factors than immigrant mothers with non-indigenous Canadian women being closer to the overall population.[169]

South America

[edit]

A main issue surrounding PPD is the lack of study and the lack of reported prevalence that is based on studies developed in Western economically developed countries.[170] In countries such as Brazil, Guyana, Costa Rica, Italy, Chile, and South Africa reports are prevalent, around 60%. An itemized research analysis put a mean prevalence at 10-15% percent but explicitly stated that cultural factors such as perception of mental health and stigma could be preventing accurate reporting.[170] The analysis for South America shows that PPD occurs at a high rate looking comparatively at Brazil (42%) Chile (4.6-48%) Guyana and Colombia (57%) and Venezuela (22%).[171] In most of these countries, PPD is not considered a serious condition for women and therefore there is an absence of support programs for prevention and treatment in health systems.[171] Specifically, in Brazil PPD is identified through the family environment whereas in Chile PPD manifests itself through suicidal ideation and emotional instability.[171] In both cases, most women feel regret and refuse to take care of the child showing that this illness is serious for both the mother and child.[171]

Asia

[edit]

From a selected group of studies found from a literature search, researchers discovered many demographic factors of Asian populations that showed significant association with PPD. Some of these include the age of the mother at the time of childbirth as well as the older age at marriage.[172] Being a migrant and giving birth to a child overseas has also been identified as a risk factor for PPD.[172] Specifically for Japanese women who were born and raised in Japan but who gave birth to their child in Hawaii, USA, about 50% of them experienced emotional dysfunction during their pregnancy.[172] All women who gave birth for the first time and were included in the study experienced PPD.[172] In immigrant Asian Indian women, the researchers found a minor depressive symptomatology rate of 28% and an additional major depressive symptomatology rate of 24% likely due to different healthcare attitudes in different cultures and distance from family leading to homesickness.[172]

In the context of Asian countries, premarital pregnancy is an important risk factor for PPD. This is because it is considered highly unacceptable in most Asian cultures as there is a highly conservative attitude toward sex among Asian people than people in the West.[172] In addition, conflicts between mother and daughter-in-law are notoriously common in Asian societies as traditionally for them, marriage means the daughter-in-law joining and adjusting to the groom's family completely. These conflicts may be responsible for the emergence of PPD.[172] Regarding the gender of the child, many studies have suggested dissatisfaction with an infant's gender (birth of a baby girl) is a risk factor for PPD. This is because, in some Asian cultures, married couples are expected by the family to have at least one son to maintain the continuity of the bloodline which might lead a woman to experience PPD if she cannot give birth to a baby boy.[172]

The Middle East

[edit]

With a prevalence of 27%, postpartum depression amongst mothers in the Middle East is higher than in the Western world and other regions of the world.[23] Despite the high number of postpartum depression cases in the region in comparison to other areas, there is a large literature gap in correlation with the Arab region, and no studies have been conducted in the Middle East studying interventions and prevention to tackle postpartum depression in Arab mothers.[173] Countries within the Arab region had a postpartum depression prevalence ranging from 10% to 40%, with a PPD prevalence in Qatar at 18.6%, UAE between 18% and 24%, Jordan between 21.2 and 22.1, Lebanon at 21%, Saudi Arabia between 10.1 and 10.3, and Tunisia between 13.2% and 19.2%, according to studies carried out in these countries.[72][174]

There are also examples of nations with noticeably higher rates, such as Iran at 40.2%, Bahrain at 37.1%, and Turkey at 27%. The high prevalence of postpartum depression in the region may be attributed to socio-economic and cultural factors involving social and partner support, poverty, and prevailing societal views on pregnancy and motherhood.[72] Another factor is related to the region's women's lack of access to care services because many societies within the region do not prioritize mental health and do not perceive it as a serious issue. The prevailing crises and wars within some countries of the region, lack of education, polygamy, and early childbearing are additional factors.[72][174][23] Fertility rates in Palestine are noticeably high; higher fertility rates have been connected to a possible pattern where birth rates increase after violent episodes. Research conducted on Arab women indicates that more cases of postpartum depression are associated with increased parity.[71] A study found that the most common pregnancy and birth variable reported to be associated with PPD in the Middle East was an unplanned or unwanted pregnancy while having a female baby instead of a male baby is also discussed as a factor with 2 to 4 times higher risk.[72]

Europe

[edit]

There is a general assumption that Western cultures are homogenous and that there are no significant differences in psychiatric disorders across Europe and the USA. However, in reality, factors associated with maternal depression, including work and environmental demands, access to universal maternity leave, healthcare, and financial security, are regulated and influenced by local policies that differ across countries.[175] For example, European social policies differ from country to country contrary to the US, all countries provide some form of paid universal maternity leave and free healthcare.[175] Studies also found differences in symptomatic manifestations of PPD between European and American women.[176] Women from Europe reported higher scores of anhedonia, self-blaming, and anxiety, while women from the US disclosed more severe insomnia, depressive feelings, and thoughts of self-harming.[175] Additionally, there are differences in prescribing patterns and attitudes towards certain medications between the US and Europe which are indicative of how different countries approach treatment, and their different stigmas.[175]

Africa

[edit]

Africa, like all other parts of the world, struggles with the burden of postpartum depression. Current studies estimate the prevalence to be 15-25% but this is likely higher due to a lack of data and recorded cases. The magnitude of postpartum depression in South Africa is between 31.7% and 39.6%, in Morocco between 6.9% and 14%, in Nigeria between 10.7% and 22.9%, in Uganda 43%, in Tanzania 12%, in Zimbabwe 33%, in Sudan 9.2%, in Kenya between 13% and 18.7% and, 19.9% for participants in Ethiopia according to studies carried out in these countries among postpartum mothers between the ages of 17–49.[177] This demonstrates the gravity of this problem in Africa and the need for postpartum depression to be taken seriously as a public health concern in the continent. Additionally, each of these studies was conducted using Western-developed assessment tools. Cultural factors can affect diagnosis and can be a barrier to assessing the burden of disease.[177] Some recommendations to combat postpartum depression in Africa include considering postpartum depression as a public health problem that is neglected among postpartum mothers. Investing in research to assess the actual prevalence of postpartum depression, and encourage early screening, diagnosis, and treatment of postpartum depression as an essential aspect of maternal care throughout Africa.[177]

Issues in reporting prevalence

[edit]

Most studies regarding PPD are done using self-report screenings which are less reliable than clinical interviews. This use of self-reporting may have results that underreport symptoms and thus postpartum depression rates.[178][164]

Furthermore, the prevalence of postpartum depression in Arab countries exhibits significant variability, often due to diverse assessment methodologies.[72] In a review of twenty-five studies examining PPD, differences in assessment methods, recruitment locations, and timing of evaluations complicate prevalence measurement.[72] For instance, the studies varied in their approach, with some using a longitudinal panel method tracking PPD at multiple points during pregnancy and postpartum periods, while others employed cross-sectional approaches to estimate point or period prevalences. The Edinburgh Postnatal Depression Scale (EPDS) was commonly used across these studies, yet variations in cutoff scores further determined the results of prevalence.[72]

For example, a study in Kom Ombo, Egypt, reported a rate of 73.7% for PPD, but the small sample size of 57 mothers and the broad measurement timeframe spanning from two weeks to one year postpartum contributes to the challenge of making definitive prevalence conclusions (2). This wide array of assessment methods and timing significantly impacts the reported rates of postpartum depression.[72]

History

[edit]

Prior to the 19th century

[edit]

Western medical science's understanding and construction of postpartum depression have evolved over the centuries. Ideas surrounding women's moods and states have been around for a long time,[179] typically recorded by men. In 460 B.C., Hippocrates wrote about puerperal fever, agitation, delirium, and mania experienced by women after childbirth.[180] Hippocrates' ideas still linger in how postpartum depression is seen today.[181]

A woman who lived in the 14th century, Margery Kempe, was a Christian mystic.[182] She was a pilgrim known as "Madwoman" after having a tough labor and delivery.[182] There was a long physical recovery period during which she started descending into "madness" and became suicidal.[182] Based on her descriptions of visions of demons and conversations she wrote about that she had with religious figures like God and the Virgin Mary, historians have identified what Margery Kempe was experiencing as "postnatal psychosis" and not postpartum depression.[183][184] This distinction became important to emphasize the difference between postpartum depression and postpartum psychosis. A 16th-century physician, Castello Branco, documented a case of postpartum depression without the formal title as a relatively healthy woman with melancholy after childbirth, remained insane for a month, and recovered with treatment.[181] Although this treatment was not described, experimental treatments began to be implemented for postpartum depression for the centuries that followed.[181] Connections between female reproductive function and mental illness would continue to center around reproductive organs from this time through to the modern age, with a slowly evolving discussion around "female madness".[179]

19th century and after

[edit]

With the 19th century came a new attitude about the relationship between female mental illness and pregnancy, childbirth, or menstruation.[185] The famous short story, "The Yellow Wallpaper", was published by Charlotte Perkins Gilman in this period. In the story, an unnamed woman journals her life when she is treated by her physician husband, John, for hysterical and depressive tendencies after the birth of their baby.[186] Gilman wrote the story to protest the societal oppression of women as the result of her own experience as a patient.[187]

Also during the 19th century, gynecologists embraced the idea that female reproductive organs, and the natural processes they were involved in, were at fault for "female insanity."[188] Approximately 10% of asylum admissions during this period are connected to "puerperal insanity," the named intersection between pregnancy or childbirth and female mental illness.[189] It wasn't until the onset of the twentieth century that the attitude of the scientific community shifted once again: the consensus amongst gynecologists and other medical experts was to turn away from the idea of diseased reproductive organs and instead towards more "scientific theories" that encompassed a broadening medical perspective on mental illness.[188]

Society and culture

[edit]
[edit]

Recently, postpartum depression has become more widely recognized in society. In the US, the Patient Protection and Affordable Care Act included a section focusing on research into postpartum conditions including postpartum depression.[190] Some argue that more resources in the form of policies, programs, and health objectives need to be directed to the care of those with PPD.[191]

Role of stigma

[edit]

When stigma occurs, a person is labeled by their illness and viewed as part of a stereotyped group. There are three main elements of stigmas, 1) problems of knowledge (ignorance or misinformation), 2) problems of attitudes (prejudice), and 3) problems of behavior (discrimination).[192] Specifically regarding PPD, it is often left untreated as women frequently report feeling ashamed about seeking help and are concerned about being labeled as a "bad mother" if they acknowledge that they are experiencing depression.[192] Although there has been previous research interest in depression-related stigma, few studies have addressed PPD stigma. One study studied PPD stigma by examining how an education intervention would impact it. They hypothesized that an education intervention would significantly influence PPD stigma scores.[192] Although they found some consistency with previous mental health stigma studies, for example, that males had higher levels of personal PPD stigma than females, most of the PPD results were inconsistent with other mental health studies.[192] For example, they hypothesized that education intervention would lower PPD stigma scores, but in reality, there was no significant impact, and also familiarity with PPD was not associated with one's stigma towards people with PPD.[192] This study was a strong starting point for further PPD research but indicates more needs to be done to learn what the most effective anti-stigma strategies are specifically for PPD.[192]

Postpartum depression is still linked to significant stigma. This can also be difficult when trying to determine the true prevalence of postpartum depression. Participants in studies about PPD carry their beliefs, perceptions, cultural context, and stigma of mental health in their cultures with them which can affect data.[170] The stigma of mental health - with or without support from family members and health professionals - often deters women from seeking help for their PPD. When medical help is achieved, some women find the diagnosis helpful and encourage a higher profile for PPD amongst the health professional community.[170]

Cultural beliefs

[edit]

Postpartum depression can be influenced by sociocultural factors.[170] There are many examples of particular cultures and societies that hold specific beliefs about PPD. Malay culture holds a belief in Hantu Meroyan; a spirit that resides in the placenta and amniotic fluid.[193]

When this spirit is unsatisfied and venting resentment, it causes the mother to experience frequent crying, loss of appetite, and trouble sleeping, known collectively as "sakit meroyan". The mother can be cured with the help of a shaman, who performs a séance to force the spirits to leave.[194]

Some cultures believe that the symptoms of postpartum depression or similar illnesses can be avoided through protective rituals in the period after birth. These may include offering structures of organized support, hygiene care, diet, rest, infant care, and breastfeeding instruction.[8] The rituals appear to be most effective when the support is welcomed by the mother.[103]

Some Chinese women participate in a ritual that is known as "doing the month" (confinement) in which they spend the first 30 days after giving birth resting in bed, while the mother or mother-in-law takes care of domestic duties and childcare. In addition, the new mother is not allowed to bathe or shower, wash her hair, clean her teeth, leave the house, or be blown by the wind.[195]

The relationship with the mother-in-law has been identified as a significant risk factor for postpartum depression in many Arab regions. Based on cultural beliefs that place importance on mothers, mothers-in-law have significant influences on daughters-in-law and grandchildren's lives in such societies as the husbands frequently have close relationships with their family of origin, including living together.[174]

Furthermore, cultural factors influence how Middle Eastern women are screened for PPD. The traditional Edinburgh Postnatal Depression Scale, or EPDS, has come under criticism for emphasizing depression symptoms that may not be consistent with Muslim cultural standards. Thoughts of self-harm are strictly prohibited in Islam, yet it is a major symptom within the EPDS. Words like "depression screen" or "mental health" are considered disrespectful to some Arab cultures. Furthermore, women may under report symptoms to put the needs of the family before their own because these countries have collectivist cultures.[174]

Additionally, research showed that mothers of female babies had a considerably higher risk of PPD, ranging from 2-4 times higher than those of mothers of male babies, due to the value certain cultures in the Middle East place on female babies compared to male babies.[72]

Media

[edit]

Certain cases of postpartum mental health concerns received attention in the media and brought about dialogue on ways to address and understand more about postpartum mental health. Andrea Yates, a former nurse, became pregnant for the first time in 1993.[196] After giving birth to five children in the coming years, she had severe depression and many depressive episodes. This led to her believing that her children needed to be saved and that by killing them, she could rescue their eternal souls. She drowned her children one by one for an hour, by holding their heads underwater in their family bathtub. When called into trial, she felt that she had saved her children rather than harming them and that this action would contribute to defeating Satan.[197]

This was one of the first public and notable cases of postpartum psychosis,[196] which helped create a dialogue on women's mental health after childbirth. The court found that Yates was experiencing mental illness concerns, and the trial started the conversation of mental illness in cases of murder and whether or not it would lessen the sentence or not. It also started a dialogue on women going against "maternal instinct" after childbirth and what maternal instinct was truly defined by.[197]

Yates' case brought wide media attention to the problem of filicide,[198] or the murder of children by their parents. Throughout history, both men and women have perpetrated this act, but the study of maternal filicide is more extensive.

See also

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References

[edit]
  1. ^ a b c d e f g h i j "Postpartum Depression Facts". NIMH. Archived from the original on 21 June 2017. Retrieved 11 June 2017.
  2. ^ a b c d e f g Pearlstein T, Howard M, Salisbury A, Zlotnick C (April 2009). "Postpartum depression". American Journal of Obstetrics and Gynecology. 200 (4): 357–364. doi:10.1016/j.ajog.2008.11.033. PMC 3918890. PMID 19318144.
  3. ^ a b c d Carlson K, Mughal S, Azhar Y (2010). "Focusing on depression in expectant and new fathers: prenatal and postpartum depression not limited to". Psychiatric Times. 27 – via Gale Academic Onefile.
  4. ^ Grace SL, Evindar A, Stewart DE (November 2003). "The effect of postpartum depression on child cognitive development and behavior: a review and critical analysis of the literature". Archives of Women's Mental Health. 6 (4): 263–274. doi:10.1007/s00737-003-0024-6. PMID 14628179. S2CID 20966469.
  5. ^ a b c Stewart DE, Vigod SN (January 2019). "Postpartum Depression: Pathophysiology, Treatment, and Emerging Therapeutics". Annual Review of Medicine. 70 (1): 183–196. doi:10.1146/annurev-med-041217-011106. PMID 30691372. S2CID 59341428.
  6. ^ a b Soares CN, Zitek B (July 2008). "Reproductive hormone sensitivity and risk for depression across the female life cycle: a continuum of vulnerability?". Journal of Psychiatry & Neuroscience. 33 (4): 331–343. PMC 2440795. PMID 18592034.
  7. ^ "Perinatal Depression: Prevalence, Screening Accuracy, and Screening Outcomes". Agency for Health Care Research and Quality. Archived from the original on 11 November 2013.
  8. ^ a b c Dennis CL, Fung K, Grigoriadis S, Robinson GE, Romans S, Ross L (July 2007). "Traditional postpartum practices and rituals: a qualitative systematic review". Women's Health. 3 (4): 487–502. doi:10.2217/17455057.3.4.487. PMID 19804024.
  9. ^ Cunningham FG, Leveno KJ, Bloom SL, Dashe JS, Spong CY, Hoffman BL, Casey BM, eds. (2022). Williams obstetrics. McGraw-Hill's AccessMedicine (26th ed.). New York: McGraw Hill Medical. ISBN 978-1-260-46273-9.
  10. ^ a b Carlson K, Mughal S, Azhar Y (2023). "Postpartum Depression". StatPearls. Treasure Island (FL): StatPearls Publishing. PMID 30085612. Retrieved 18 September 2023.
  11. ^ Seyfried LS, Marcus SM (August 2003). "Postpartum mood disorders". International Review of Psychiatry. 15 (3): 231–242. doi:10.1080/09540260305196. PMID 15276962.
  12. ^ Spinelli MG (September 2004). "Maternal infanticide associated with mental illness: prevention and the promise of saved lives". The American Journal of Psychiatry. 161 (9): 1548–1557. doi:10.1176/appi.ajp.161.9.1548. PMID 15337641. S2CID 35255623.
  13. ^ a b c d e f g h i j k l m n o p The Boston Women's Health Book Collective: Our Bodies Ourselves, pages 489–491, New York: Touchstone Book, 2005
  14. ^ a b c d e f g h WebMD: Understanding Post Partum Depression "The Basics of Postpartum Depression". Archived from the original on 15 April 2015. Retrieved 9 April 2015.
  15. ^ a b c d e f g h "Depression Among Women | Depression | Reproductive Health | CDC". www.cdc.gov. Archived from the original on 16 April 2017. Retrieved 15 April 2017.
  16. ^ Wisner KL, Sit DK, McShea MC, Rizzo DM, Zoretich RA, Hughes CL, et al. (May 2013). "Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings". JAMA Psychiatry. 70 (5): 490–498. doi:10.1001/jamapsychiatry.2013.87. PMC 4440326. PMID 23487258.
  17. ^ Morof D, Barrett G, Peacock J, Victor CR, Manyonda I (December 2003). "Postnatal depression and sexual health after childbirth". Obstetrics and Gynecology. 102 (6): 1318–1325. doi:10.1016/j.obstetgynecol.2003.08.020. PMID 14662221. S2CID 39467608.
  18. ^ a b Pawluski JL, Lonstein JS, Fleming AS (February 2017). "The Neurobiology of Postpartum Anxiety and Depression" (PDF). Trends in Neurosciences. 40 (2): 106–120. doi:10.1016/j.tins.2016.11.009. PMID 28129895. S2CID 28613743.
  19. ^ Workman JL, Barha CK, Galea LA (February 2012). "Endocrine substrates of cognitive and affective changes during pregnancy and postpartum". Behavioral Neuroscience. 126 (1): 54–72. doi:10.1037/a0025538. hdl:2429/66579. PMID 21967374. S2CID 207642327.
  20. ^ Chen PJ. "Postpartum Depression". Pregnancy Guide. Hospital of the University of Pennsylvania. Archived from the original on 25 February 2012. Retrieved 22 October 2008.
  21. ^ Yonkers KA, Ramin SM, Rush AJ, Navarrete CA, Carmody T, March D, et al. (November 2001). "Onset and persistence of postpartum depression in an inner-city maternal health clinic system". The American Journal of Psychiatry. 158 (11): 1856–1863. doi:10.1176/appi.ajp.158.11.1856. PMID 11691692.
  22. ^ a b "Depressive Disorders", Diagnostic and Statistical Manual of Mental Disorders, DSM Library, American Psychiatric Association Publishing, 18 March 2022, doi:10.1176/appi.books.9780890425787.x04_depressive_disorders, ISBN 978-0-89042-575-6, retrieved 2 December 2024
  23. ^ a b c d Alshikh Ahmad H, Alkhatib A, Luo J (August 2021). "Prevalence and risk factors of postpartum depression in the Middle East: a systematic review and meta-analysis". BMC Pregnancy and Childbirth. 21 (1): 542. doi:10.1186/s12884-021-04016-9. PMC 8343347. PMID 34362325.
  24. ^ "Canadian Mental Health Association > Post Partum Depression". Archived from the original on 21 October 2010. Retrieved 13 June 2010.
  25. ^ a b c Pearlstein T, Howard M, Salisbury A, Zlotnick C (April 2009). "Postpartum depression". American Journal of Obstetrics and Gynecology. 200 (4): 357–364. doi:10.1016/j.ajog.2008.11.033. PMC 3918890. PMID 19318144.
  26. ^ a b c d e Scarff JR (May 2019). "Postpartum Depression in Men". Innovations in Clinical Neuroscience. 16 (5–6): 11–14. PMC 6659987. PMID 31440396.
  27. ^ Goodman JH (January 2004). "Paternal postpartum depression, its relationship to maternal postpartum depression, and implications for family health". Journal of Advanced Nursing. 45 (1): 26–35. doi:10.1046/j.1365-2648.2003.02857.x. PMID 14675298.
  28. ^ Paulson JF, Bazemore SD (May 2010). "Prenatal and postpartum depression in fathers and its association with maternal depression: a meta-analysis". JAMA. 303 (19): 1961–1969. doi:10.1001/jama.2010.605. PMID 20483973. S2CID 27189811.
  29. ^ Suto M, Isogai E, Mizutani F, Kakee N, Misago C, Takehara K (August 2016). "Prevalence and Factors Associated With Postpartum Depression in Fathers: A Regional, Longitudinal Study in Japan". Research in Nursing & Health. 39 (4): 253–262. doi:10.1002/nur.21728. PMID 27209152.
  30. ^ "NewsCAP: Study finds postpartum depression also affects fathers". The American Journal of Nursing. 118 (11): 12. November 2018. doi:10.1097/01.naj.0000547646.08156.11. PMID 30358579. S2CID 53025016.
  31. ^ Cassella C (2 March 2021). "Dads Who Take a More Hands-on Role Their Kid's First Year Have Better Mental Health". ScienceAlert. Retrieved 10 January 2024.
  32. ^ Foli KJ, South SC, Lim E, Jarnecke AM (August 2016). "Post-adoption depression: Parental classes of depressive symptoms across time". Journal of Affective Disorders. 200: 293–302. doi:10.1016/j.jad.2016.01.049. PMC 4887416. PMID 27155072.
  33. ^ a b Mott SL, Schiller CE, Richards JG, O'Hara MW, Stuart S (August 2011). "Depression and anxiety among postpartum and adoptive mothers". Archives of Women's Mental Health. 14 (4): 335–343. doi:10.1007/s00737-011-0227-1. PMC 3433270. PMID 21725836.
  34. ^ a b Kirubarajan A, Barker LC, Leung S, Ross LE, Zaheer J, Park B, et al. (September 2022). "LGBTQ2S+ childbearing individuals and perinatal mental health: A systematic review". BJOG. 129 (10): 1630–1643. doi:10.1111/1471-0528.17103. PMID 35048502. S2CID 246064324.
  35. ^ "Postpartum Depression". medlineplus.gov. Retrieved 25 September 2020.
  36. ^ "NIMH" Perinatal Depression". www.nimh.nih.gov. Retrieved 25 September 2020.
  37. ^ a b Schiller CE, Meltzer-Brody S, Rubinow DR (February 2015). "The role of reproductive hormones in postpartum depression". CNS Spectrums. 20 (1): 48–59. doi:10.1017/S1092852914000480. PMC 4363269. PMID 25263255.
  38. ^ a b Kim S, Soeken TA, Cromer SJ, Martinez SR, Hardy LR, Strathearn L (September 2014). "Oxytocin and postpartum depression: delivering on what's known and what's not". Brain Research. Oxytocin in Human Social Behavior and Psychopathology. 1580: 219–232. doi:10.1016/j.brainres.2013.11.009. PMC 4156558. PMID 24239932.
  39. ^ "Postpartum depression". womenshealth.gov. 9 April 2018. Retrieved 20 November 2019.
  40. ^ Thippeswamy H, Davies W (June 2021). "A new molecular risk pathway for postpartum mood disorders: clues from steroid sulfatase-deficient individuals". Archives of Women's Mental Health. 24 (3): 391–401. doi:10.1007/s00737-020-01093-1. PMC 8116278. PMID 33219387. S2CID 227076500.
  41. ^ a b Kroll-Desrosiers AR, Nephew BC, Babb JA, Guilarte-Walker Y, Moore Simas TA, Deligiannidis KM (February 2017). "Association of peripartum synthetic oxytocin administration and depressive and anxiety disorders within the first postpartum year". Depression and Anxiety. 34 (2): 137–146. doi:10.1002/da.22599. PMC 5310833. PMID 28133901.
  42. ^ Trifu S, Vladuti A, Popescu A (2019). "Neuroendocrine Aspects of Pregnancy and Postpartum Depression". Acta Endocrinologica. 15 (3): 410–415. doi:10.4183/aeb.2019.410. PMC 6992410. PMID 32010366.
  43. ^ Nielsen Forman D, Videbech P, Hedegaard M, Dalby Salvig J, Secher NJ (October 2000). "Postpartum depression: identification of women at risk". BJOG. 107 (10): 1210–1217. doi:10.1111/j.1471-0528.2000.tb11609.x. PMID 11028570. S2CID 23118990.
  44. ^ Paschetta E, Berrisford G, Coccia F, Whitmore J, Wood AG, Pretlove S, et al. (June 2014). "Perinatal psychiatric disorders: an overview". American Journal of Obstetrics and Gynecology. 210 (6): 501–509.e6. doi:10.1016/j.ajog.2013.10.009. PMID 24113256.
  45. ^ Howard LM, Molyneaux E, Dennis CL, Rochat T, Stein A, Milgrom J (November 2014). "Non-psychotic mental disorders in the perinatal period". Lancet. 384 (9956): 1775–1788. doi:10.1016/s0140-6736(14)61276-9. PMID 25455248. S2CID 11378573.
  46. ^ "Postpartum Depression Facts". www.nimh.nih.gov. Retrieved 20 November 2019.
  47. ^ a b c d e f g Ross LE, Dennis CL (April 2009). "The prevalence of postpartum depression among women with substance use, an abuse history, or chronic illness: a systematic review". Journal of Women's Health. 18 (4): 475–486. doi:10.1089/jwh.2008.0953. PMID 19361314.
  48. ^ a b c d e McCoy SJ, Beal JM, Shipman SB, Payton ME, Watson GH (April 2006). "Risk factors for postpartum depression: a retrospective investigation at 4-weeks postnatal and a review of the literature". The Journal of the American Osteopathic Association. 106 (4): 193–198. PMID 16627773.
  49. ^ McCurry MD, D'Agostino GD, Walsh JT, Bisanz JE, Zalosnik I, Dong X, et al. (June 2024). "Gut bacteria convert glucocorticoids into progestins in the presence of hydrogen gas". Cell. 187 (12): 2952–2968.e13. doi:10.1016/j.cell.2024.05.005. PMC 11179439. PMID 38795705.
  50. ^ a b c Yim IS, Tanner Stapleton LR, Guardino CM, Hahn-Holbrook J, Dunkel Schetter C (28 March 2015). "Biological and psychosocial predictors of postpartum depression: systematic review and call for integration". Annual Review of Clinical Psychology. 11 (1): 99–137. doi:10.1146/annurev-clinpsy-101414-020426. PMC 5659274. PMID 25822344.
  51. ^ Hibbeln JR (May 2002). "Seafood consumption, the DHA content of mothers' milk and prevalence rates of postpartum depression: a cross-national, ecological analysis". Journal of Affective Disorders. 69 (1–3): 15–29. doi:10.1016/S0165-0327(01)00374-3. PMID 12103448.
  52. ^ Horsager R, Hoffman BL, Santiago-Muñoz PC, Rogers VL, Worley KC, Roberts SW (15 October 2014). Williams Obstetrics Study Guide (24th ed.). New York: McGraw-Hill Education Medical. ISBN 978-0-07-179327-8.
  53. ^ a b c d e f g h i Beck CT (1996). "A meta-analysis of the relationship between postpartum depression and infant temperament". Nursing Research. 45 (4): 225–230. doi:10.1097/00006199-199607000-00006. PMID 8700656.
  54. ^ a b c Stuart-Parrigon K, Stuart S (September 2014). "Perinatal depression: an update and overview". Current Psychiatry Reports. 16 (9): 468. doi:10.1007/s11920-014-0468-6. PMC 4920261. PMID 25034859.
  55. ^ Mukherjee S, Coxe S, Fennie K, Madhivanan P, Trepka MJ (January 2017). "Stressful Life Event Experiences of Pregnant Women in the United States: A Latent Class Analysis". Women's Health Issues. 27 (1): 83–92. doi:10.1016/j.whi.2016.09.007. PMID 27810166.
  56. ^ Mukherjee S, Coxe S, Fennie K, Madhivanan P, Trepka MJ (March 2017). "Antenatal Stressful Life Events and Postpartum Depressive Symptoms in the United States: The Role of Women's Socioeconomic Status Indices at the State Level". Journal of Women's Health. 26 (3): 276–285. doi:10.1089/jwh.2016.5872. PMID 27875058.
  57. ^ a b Robertson-Blackmore E, Putnam FW, Rubinow DR, Matthieu M, Hunn JE, Putnam KT, et al. (October 2013). "Antecedent trauma exposure and risk of depression in the perinatal period". The Journal of Clinical Psychiatry. 74 (10): e942–e948. doi:10.4088/JCP.13m08364. PMID 24229763.
  58. ^ a b Benedict MI, Paine LL, Paine LA, Brandt D, Stallings R (July 1999). "The association of childhood sexual abuse with depressive symptoms during pregnancy, and selected pregnancy outcomes". Child Abuse & Neglect. 23 (7): 659–670. doi:10.1016/S0145-2134(99)00040-X. PMID 10442831.
  59. ^ Lev-Wiesel R, Chen R, Daphna-Tekoah S, Hod M (January 2009). "Past traumatic events: are they a risk factor for high-risk pregnancy, delivery complications, and postpartum posttraumatic symptoms?". Journal of Women's Health. 18 (1): 119–125. doi:10.1089/jwh.2008.0774. PMID 19132883.
  60. ^ Howell EA, Mora P, Leventhal H (March 2006). "Correlates of early postpartum depressive symptoms". Maternal and Child Health Journal. 10 (2): 149–157. doi:10.1007/s10995-005-0048-9. PMC 1592250. PMID 16341910.
  61. ^ "Postpartum Depression Facts". www.nimh.nih.gov. Retrieved 20 November 2019.
  62. ^ Figueiredo B, Dias CC, Brandão S, Canário C, Nunes-Costa R (2013). "Breastfeeding and postpartum depression: state of the art review". Jornal de Pediatria. 89 (4): 332–338. doi:10.1016/j.jped.2012.12.002. hdl:10216/102955. PMID 23791236.
  63. ^ Hossain SJ, Roy BR, Hossain AT, Mehrin F, Tipu SM, Tofail F, et al. (July 2020). "Prevalence of Maternal Postpartum Depression, Health-Seeking Behavior and Out of Pocket Payment for Physical Illness and Cost Coping Mechanism of the Poor Families in Bangladesh: A Rural Community-Based Study". International Journal of Environmental Research and Public Health. 17 (13): E4727. doi:10.3390/ijerph17134727. PMC 7370050. PMID 32630173.
  64. ^ Brummelte S, Galea LA (January 2016). "Postpartum depression: Etiology, treatment and consequences for maternal care". Hormones and Behavior. 77: 153–166. doi:10.1016/j.yhbeh.2015.08.008. PMID 26319224. S2CID 15205497.
  65. ^ a b Segre LS, O'Hara MW, Losch ME (2006). "Race/ethnicity and perinatal depressed mood". Journal of Reproductive and Infant Psychology. 24 (2): 99–106. doi:10.1080/02646830600643908. S2CID 144993416.
  66. ^ a b Segre LS, O'Hara MW, Arndt S, Stuart S (April 2007). "The prevalence of postpartum depression: the relative significance of three social status indices". Social Psychiatry and Psychiatric Epidemiology. 42 (4): 316–321. doi:10.1007/s00127-007-0168-1. PMID 17370048. S2CID 20586114.
  67. ^ Singley DB, Edwards LM (2015). "Men's Perinatal Mental Health in the Transition to Fatherhood". Professional Psychology: Research and Practice. 46 (5): 309–319. doi:10.1037/pro0000032. S2CID 21726189.
  68. ^ Ross LE, Steele L, Goldfinger C, Strike C (2007). "Perinatal depressive symptomatology among lesbian and bisexual women". Archives of Women's Mental Health. 10 (2): 53–59. doi:10.1007/s00737-007-0168-x. PMID 17262172. S2CID 44227469.
  69. ^ a b Maccio EM, Pangburn JA (1 May 2011). "The case for investigating postpartum depression in lesbians and bisexual women". Women's Health Issues. 21 (3): 187–190. doi:10.1016/j.whi.2011.02.007. PMID 21521621.
  70. ^ Ross LE (2005). "Perinatal mental health in lesbian mothers: a review of potential risk and protective factors". Women & Health. 41 (3): 113–128. doi:10.1300/J013v41n03_07. PMID 15970579. S2CID 38024879.
  71. ^ a b c d Qandil S, Jabr S, Wagler S, Collin SM (November 2016). "Postpartum depression in the Occupied Palestinian Territory: a longitudinal study in Bethlehem". BMC Pregnancy and Childbirth. 16 (1): 375. doi:10.1186/s12884-016-1155-x. PMC 5124263. PMID 27887649.
  72. ^ a b c d e f g h i j k l m n Ayoub K, Shaheen A, Hajat S (30 July 2020). "Postpartum Depression in The Arab Region: A Systematic Literature Review". Clinical Practice and Epidemiology in Mental Health. 16 (Suppl-1): 142–155. doi:10.2174/1745017902016010142. PMC 7536723. PMID 33029191.
  73. ^ a b c d Wu Q, Chen HL, Xu XJ (April 2012). "Violence as a risk factor for postpartum depression in mothers: a meta-analysis". Archives of Women's Mental Health. 15 (2): 107–114. doi:10.1007/s00737-011-0248-9. PMID 22382278. S2CID 33870094.
  74. ^ a b Western D (1 January 2013). "A Conceptual and Contextual Background for Gender-based Violence and Depression in Women". Gender-based Violence and Depression in Women. SpringerBriefs in Social Work. New York: Springer New York. pp. 13–22. doi:10.1007/978-1-4614-7532-3_3. ISBN 978-1-4614-7531-6.
  75. ^ a b Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Arlington, VA: American Psychiatric Association. 2013.
  76. ^ "The Basics of Postpartum Depression". Archived from the original on 15 April 2015. Retrieved 9 April 2015.
  77. ^ Wisner KL, Parry BL, Piontek CM (July 2002). "Clinical practice. Postpartum depression". The New England Journal of Medicine. 347 (3): 194–199. doi:10.1056/NEJMcp011542. PMID 12124409.
  78. ^ a b American Psychiatric Association (2013), Diagnostic and Statistical Manual of Mental Disorders (5th ed.), Arlington: American Psychiatric Publishing, p. 186, ISBN 978-0-89042-555-8, archived from the original on 25 October 2017
  79. ^ a b c d Jones I, Chandra PS, Dazzan P, Howard LM (November 2014). "Bipolar disorder, affective psychosis, and schizophrenia in pregnancy and the post-partum period". Lancet. 384 (9956): 1789–1799. doi:10.1016/s0140-6736(14)61278-2. PMID 25455249. S2CID 44481055.
  80. ^ "Postpartum Psychosis". Royal College of Psychiatrists. 2014. Archived from the original on 24 October 2016. Retrieved 27 October 2016.
  81. ^ Wesseloo R, Kamperman AM, Munk-Olsen T, Pop VJ, Kushner SA, Bergink V (February 2016). "Risk of Postpartum Relapse in Bipolar Disorder and Postpartum Psychosis: A Systematic Review and Meta-Analysis". The American Journal of Psychiatry. 173 (2): 117–127. doi:10.1176/appi.ajp.2015.15010124. PMID 26514657.
  82. ^ Orsolini L, Valchera A, Vecchiotti R, Tomasetti C, Iasevoli F, Fornaro M, et al. (12 August 2016). "Suicide during Perinatal Period: Epidemiology, Risk Factors, and Clinical Correlates". Frontiers in Psychiatry. 7: 138. doi:10.3389/fpsyt.2016.00138. PMC 4981602. PMID 27570512.
  83. ^ a b c d e Yildiz PD, Ayers S, Phillips L (January 2017). "The prevalence of posttraumatic stress disorder in pregnancy and after birth: A systematic review and meta-analysis" (PDF). Journal of Affective Disorders. 208: 634–645. doi:10.1016/j.jad.2016.10.009. PMID 27865585.
  84. ^ a b c Heyne CS, Kazmierczak M, Souday R, Horesh D, Lambregtse-van den Berg M, Weigl T, et al. (June 2022). "Prevalence and risk factors of birth-related posttraumatic stress among parents: A comparative systematic review and meta-analysis". Clinical Psychology Review. 94: 102157. doi:10.1016/j.cpr.2022.102157. hdl:1871.1/4788a1a5-deff-427f-bd77-a33ebdaf22fc. PMID 35584590. S2CID 248337797.
  85. ^ a b Dekel S, Stuebe C, Dishy G (2017). "Childbirth Induced Posttraumatic Stress Syndrome: A Systematic Review of Prevalence and Risk Factors". Frontiers in Psychology. 8: 560. doi:10.3389/fpsyg.2017.00560. PMC 5387093. PMID 28443054.
  86. ^ a b Ayers S, Wright DB, Thornton A (18 September 2018). "Development of a Measure of Postpartum PTSD: The City Birth Trauma Scale". Frontiers in Psychiatry. 9: 409. doi:10.3389/fpsyt.2018.00409. PMC 6153962. PMID 30279664.
  87. ^ Grekin R, O'Hara MW (July 2014). "Prevalence and risk factors of postpartum posttraumatic stress disorder: a meta-analysis". Clinical Psychology Review. 34 (5): 389–401. doi:10.1016/j.cpr.2014.05.003. PMID 24952134.
  88. ^ a b c d Van Sieleghem S, Danckaerts M, Rieken R, Okkerse JM, de Jonge E, Bramer WM, et al. (November 2022). "Childbirth related PTSD and its association with infant outcome: A systematic review". Early Human Development. 174: 105667. doi:10.1016/j.earlhumdev.2022.105667. PMID 36152399. S2CID 252342586.
  89. ^ a b c Cook N, Ayers S, Horsch A (January 2018). "Maternal posttraumatic stress disorder during the perinatal period and child outcomes: A systematic review". Journal of Affective Disorders. 225: 18–31. doi:10.1016/j.jad.2017.07.045. PMID 28777972. S2CID 5007700.
  90. ^ Lai X, Chen J, Li H, Zhou L, Huang Q, Liao Y, et al. (July 2023). "The incidence of post-traumatic stress disorder following traumatic childbirth: A systematic review and meta-analysis". International Journal of Gynaecology and Obstetrics. 162 (1): 211–221. doi:10.1002/ijgo.14643. PMID 36571476. S2CID 255181351.
  91. ^ a b c Ukatu N, Clare CA, Brulja M (1 May 2018). "Postpartum Depression Screening Tools: A Review". Psychosomatics. 59 (3): 211–219. doi:10.1016/j.psym.2017.11.005. PMID 29396166.
  92. ^ a b "Screening for Depression During and After Pregnancy". American College of Obstetricians and Gynecologists, Committee Opinion. February 2010. Archived from the original on 2 November 2014.
  93. ^ Earls MF (November 2010). "Incorporating recognition and management of perinatal and postpartum depression into pediatric practice". Pediatrics. 126 (5): 1032–1039. doi:10.1542/peds.2010-2348. PMID 20974776.
  94. ^ Stowe ZN, Hostetter AL, Newport DJ (February 2005). "The onset of postpartum depression: Implications for clinical screening in obstetrical and primary care". American Journal of Obstetrics and Gynecology. 192 (2): 522–526. doi:10.1016/j.ajog.2004.07.054. PMID 15695997.
  95. ^ Bränn E, Fransson E, Wikman A, Kollia N, Nguyen D, Lilliecreutz C, et al. (May 2021). "Who do we miss when screening for postpartum depression? A population-based study in a Swedish region". Journal of Affective Disorders. 287: 165–173. doi:10.1016/j.jad.2021.03.013. PMID 33799034. S2CID 232773376.
  96. ^ a b Cox JL, Holden JM, Sagovsky R (June 1987). "Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale". The British Journal of Psychiatry. 150 (6): 782–786. doi:10.1192/bjp.150.6.782. PMID 3651732. S2CID 13841634.
  97. ^ "Postpartum Depression Screening: MedlinePlus Lab Test Information". medlineplus.gov. Retrieved 20 November 2019.
  98. ^ a b Davila RC, Segre LS (January 2018). "A Nurse-Based Model of Psychosocial Support for Emotionally Distressed Mothers of Infants in the NICU". Journal of Obstetric, Gynecologic, and Neonatal Nursing. 47 (1): 114–121. doi:10.1016/j.jogn.2016.12.007. PMID 28482172. S2CID 39562650.
  99. ^ Tahirkheli NN, Cherry AS, Tackett AP, McCaffree MA, Gillaspy SR (24 November 2014). "Postpartum depression on the neonatal intensive care unit: current perspectives". International Journal of Women's Health. 6: 975–987. doi:10.2147/IJWH.S54666. PMC 4247145. PMID 25473317.
  100. ^ a b Dennis CL, Dowswell T (February 2013). Dennis CL (ed.). "Psychosocial and psychological interventions for preventing postpartum depression". The Cochrane Database of Systematic Reviews. 2 (2): CD001134. doi:10.1002/14651858.CD001134.pub3. PMID 23450532. S2CID 4812056.
  101. ^ Dennis CL, Dowswell T (February 2013). "Psychosocial and psychological interventions for preventing postpartum depression". The Cochrane Database of Systematic Reviews (2): CD001134. doi:10.1002/14651858.CD001134.pub3. PMID 23450532. S2CID 4812056.
  102. ^ Dennis CL, Hodnett E, Kenton L, Weston J, Zupancic J, Stewart DE, et al. (January 2009). "Effect of peer support on prevention of postnatal depression among high risk women: multisite randomised controlled trial". BMJ. 338: a3064. doi:10.1136/bmj.a3064. PMC 2628301. PMID 19147637.
  103. ^ a b Grigoriadis S, Erlick Robinson G, Fung K, Ross LE, Chee CY, Dennis CL, et al. (December 2009). "Traditional postpartum practices and rituals: clinical implications". Canadian Journal of Psychiatry. 54 (12): 834–840. doi:10.1177/070674370905401206. PMID 20047722.
  104. ^ Alasoom LI, Koura MR (April 2014). "Predictors of postpartum depression in the eastern province capital of saudi arabia". Journal of Family Medicine and Primary Care. 3 (2): 146–150. doi:10.4103/2249-4863.137654. PMC 4139996. PMID 25161973.
  105. ^ Pilkington PD, Milne LC, Cairns KE, Lewis J, Whelan TA (June 2015). "Modifiable partner factors associated with perinatal depression and anxiety: a systematic review and meta-analysis". Journal of Affective Disorders (Systematic review and meta-analysis). 178: 165–180. doi:10.1016/j.jad.2015.02.023. PMID 25837550.
  106. ^ Curry SJ, Krist AH, Owens DK, Barry MJ, Caughey AB, Davidson KW, et al. (February 2019). "Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement". JAMA. 321 (6): 580–587. doi:10.1001/jama.2019.0007. PMID 30747971.
  107. ^ US Preventive Services Task Force, Curry SJ, Krist AH, Owens DK, Barry MJ, Caughey AB, et al. (12 February 2019). "Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement". JAMA. 321 (6): 580–587. doi:10.1001/jama.2019.0007. ISSN 0098-7484. PMID 30747971.
  108. ^ Thomson M, Sharma V (May 2017). "Therapeutics of postpartum depression". Expert Review of Neurotherapeutics. 17 (5): 495–507. doi:10.1080/14737175.2017.1265888. PMID 27892736. S2CID 20919770.
  109. ^ Molyneaux E, Telesia LA, Henshaw C, Boath E, Bradley E, Howard LM (April 2018). "Antidepressants for preventing postnatal depression". The Cochrane Database of Systematic Reviews. 2018 (4): CD004363. doi:10.1002/14651858.CD004363.pub3. PMC 6494522. PMID 29669175.
  110. ^ Gurol-Urganci I, Langham J, Tassie E, Heslin M, Byford S, Davey A, et al. (1 March 2024). "Community perinatal mental health teams and associations with perinatal mental health and obstetric and neonatal outcomes in pregnant women with a history of secondary mental health care in England: a national population-based cohort study". The Lancet Psychiatry. 11 (3): 174–182. doi:10.1016/S2215-0366(23)00409-1. ISSN 2215-0366. PMID 38278162.
  111. ^ "Community perinatal mental health teams reduced women's risk of mental illness relapse". NIHR Evidence. 26 November 2024.
  112. ^ a b Langan R, Goodbred AJ (May 2016). "Identification and Management of Peripartum Depression". American Family Physician. 93 (10): 852–858. PMID 27175720. Archived from the original on 25 October 2017.
  113. ^ McCurdy AP, Boulé NG, Sivak A, Davenport MH (June 2017). "Effects of Exercise on Mild-to-Moderate Depressive Symptoms in the Postpartum Period: A Meta-analysis". Obstetrics and Gynecology. 129 (6): 1087–1097. doi:10.1097/AOG.0000000000002053. PMID 28486363. S2CID 43035658.
  114. ^ Pritchett RV, Daley AJ, Jolly K (October 2017). "Does aerobic exercise reduce postpartum depressive symptoms? a systematic review and meta-analysis". The British Journal of General Practice. 67 (663): e684–e691. doi:10.3399/bjgp17X692525. PMC 5604832. PMID 28855163.
  115. ^ Dennis CL, Hodnett E (October 2007). "Psychosocial and psychological interventions for treating postpartum depression". The Cochrane Database of Systematic Reviews (4): CD006116. doi:10.1002/14651858.CD006116.pub2. PMID 17943888.
  116. ^ Pearlstein, T., Howard, M., Salisbury, A., & Zlotnick, C. (2009). Postpartum depression. American journal of obstetrics and gynecology, 200(4), 357-364.
  117. ^ a b c d e Fitelson E, Kim S, Baker AS, Leight K (December 2010). "Treatment of postpartum depression: clinical, psychological and pharmacological options". International Journal of Women's Health. 3: 1–14. doi:10.2147/IJWH.S6938. PMC 3039003. PMID 21339932.
  118. ^ Smith, E. K., Gopalan, P., Glance, J. B., & Azzam, P. N. (2016). Postpartum depression screening: a review for psychiatrists. Harvard Review of Psychiatry, 24(3), 173-187.
  119. ^ Anderson LN (2013). "Functions of Support Group Communication for Women with Postpartum Depression: How Support Groups Silence and Encourage Voices of Motherhood". Journal of Community Psychology. 41 (6): 709–724. doi:10.1002/jcop.21566. ISSN 1520-6629.
  120. ^ Beck, C. T. (2008). State of the science on postpartum depression: What nurse researchers have contributed—Part 2. MCN: The American Journal of Maternal/Child Nursing, 33(3), 151-156.
  121. ^ Singla DR, Lawson A, Kohrt BA, Jung JW, Meng Z, Ratjen C, et al. (May 2021). "Implementation and Effectiveness of Nonspecialist-Delivered Interventions for Perinatal Mental Health in High-Income Countries: A Systematic Review and Meta-analysis". JAMA Psychiatry. 78 (5): 498–509. doi:10.1001/jamapsychiatry.2020.4556. PMC 7859878. PMID 33533904.
  122. ^ Stuart S (2012). "Interpersonal psychotherapy for postpartum depression". Clinical Psychology & Psychotherapy. 19 (2): 134–140. doi:10.1002/cpp.1778. PMC 4141636. PMID 22473762.
  123. ^ a b Brown JV, Wilson CA, Ayre K, Robertson L, South E, Molyneaux E, et al. (February 2021). "Antidepressant treatment for postnatal depression". The Cochrane Database of Systematic Reviews. 2021 (2): CD013560. doi:10.1002/14651858.cd013560.pub2. PMC 8094614. PMID 33580709.
  124. ^ McDonagh MS, Matthews A, Phillipi C, Romm J, Peterson K, Thakurta S, et al. (September 2014). "Depression drug treatment outcomes in pregnancy and the postpartum period: a systematic review and meta-analysis". Obstetrics and Gynecology. 124 (3): 526–534. doi:10.1097/aog.0000000000000410. PMID 25004304. S2CID 1508392.
  125. ^ MacReady N (7 April 2014). "Postpartum VTE Risk Highest Soon After Birth". Medscape. Archived from the original on 6 February 2017. Retrieved 31 October 2017.
  126. ^ a b Frieder A, Fersh M, Hainline R, Deligiannidis KM (March 2019). "Pharmacotherapy of Postpartum Depression: Current Approaches and Novel Drug Development". CNS Drugs. 33 (3): 265–282. doi:10.1007/s40263-019-00605-7. PMC 6424603. PMID 30790145.
  127. ^ "Bench-to-bedside: NIMH research leads to brexanolone, first-ever drug specifically for postpartum depression". National Institutes of Health (NIH). 20 March 2019. Retrieved 2 August 2019.
  128. ^ "Press Announcements - FDA approves first treatment for post-partum depression". www.fda.gov. Retrieved 23 March 2019.
  129. ^ a b Office of the Commissioner (17 April 2019). "FDA approves first treatment for post-partum depression". FDA. Retrieved 2 August 2019.
  130. ^ Walker J (4 August 2023). "First Pill for Postpartum Depression Is Approved by FDA". Wall Street Journal. ISSN 0099-9660. Retrieved 16 November 2023.
  131. ^ a b Oystein Berle J, Spigset O (1 February 2011). "Antidepressant Use During Breastfeeding". Current Women's Health Reviews. 7 (1): 28–34. doi:10.2174/157340411794474784. ISSN 1573-4048. PMC 3267169. PMID 22299006.
  132. ^ a b Weisskopf E, Fischer CJ, Bickle Graz M, Morisod Harari M, Tolsa JF, Claris O, et al. (4 March 2015). "Risk-benefit balance assessment of SSRI antidepressant use during pregnancy and lactation based on best available evidence". Expert Opinion on Drug Safety. 14 (3): 413–427. doi:10.1517/14740338.2015.997708. ISSN 1474-0338. PMID 25554364.
  133. ^ Hallberg P, Sjöblom V (February 2005). "The Use of Selective Serotonin Reuptake Inhibitors During Pregnancy and Breast-feeding: A Review and Clinical Aspects". Journal of Clinical Psychopharmacology. 25 (1): 59–73. doi:10.1097/01.jcp.0000150228.61501.e4. ISSN 0271-0749.
  134. ^ "FDA Prescribing Information for Brexanolone" (PDF). Retrieved 23 March 2019.
  135. ^ Cole J, Bright K, Gagnon L, McGirr A (August 2019). "A systematic review of the safety and effectiveness of repetitive transcranial magnetic stimulation in the treatment of peripartum depression". Journal of Psychiatric Research. 115: 142–150. doi:10.1016/j.jpsychires.2019.05.015. PMID 31129438. S2CID 167209199.
  136. ^ Dennis CL, Dowswell T (July 2013). "Interventions (other than pharmacological, psychosocial or psychological) for treating antenatal depression". The Cochrane Database of Systematic Reviews. 2013 (7): CD006795. doi:10.1002/14651858.CD006795.pub3. PMC 11536339. PMID 23904069.
  137. ^ "Postpartum Support International - PSI". Postpartum Support International (PSI). Retrieved 9 April 2022.
  138. ^ a b Honikman JI (1 September 2006). "The role of Postpartum Support International in helping perinatal families". Journal of Obstetric, Gynecologic, and Neonatal Nursing. 35 (5): 659–661. doi:10.1111/j.1552-6909.2006.00088.x. PMID 16958724.
  139. ^ Davis WN, Raines C, Indman P, Meyer BG, Smith A (January 2018). "History and Purpose of Postpartum Support International". Journal of Obstetric, Gynecologic, and Neonatal Nursing. 47 (1): 75–83. doi:10.1016/j.jogn.2017.10.004. PMID 29156212. S2CID 206337303.
  140. ^ Held, L., & Rutherford, A. (2012). Can't a mother sing the blues? Postpartum depression and the construction of motherhood in late 20th-century America. History of psychology, 15(2), 107.
  141. ^ a b Maloni, J. A., Przeworski, A., & Damato, E. G. (2013). Web recruitment and internet use and preferences reported by women with postpartum depression after pregnancy complications. Archives of psychiatric nursing, 27(2), 90-95.
  142. ^ Baker, C. D., Kamke, H., O'Hara, M. W., & Stuart, S. (2009). Web-based training for implementing evidence-based management of postpartum depression. The Journal of the American Board of Family Medicine, 22(5), 588-589.
  143. ^ World Health Organization. (1985). WHO/NICHD Planning Meeting on the Use of Longitudinal Data Banks for Research on Child Growth and Psychosocial Development, AMRO, Washington, DC, 1–2 October 1984: report of the meeting (No. MNH/MCH/85.1. Unpublished). World Health Organization.
  144. ^ "Friends of National Institute of Child Health and Human Development". www.apa.org. Archived from the original on 15 March 2022. Retrieved 16 April 2022.
  145. ^ a b McCance-Katz, E. F. (2018). The substance abuse and mental health services administration (SAMHSA): new directions. Psychiatric services, 69(10), 1046-1048.
  146. ^ National Center for Children in Poverty. Infant and Early Childhood Mental Health in Home Visiting. NCCP; Bank Street Graduate School of Education. https://www.nccp.org/mental-health-in-home-visiting/
  147. ^ Miller, L. J. (2002). Postpartum depression. Jama, 287(6), 762-765.
  148. ^ a b Thomas LJ, Scharp KM, Paxman CG (19 May 2014). "Stories of postpartum depression: exploring health constructs and help-seeking in mothers' talk". Women & Health. 54 (4): 373–387. doi:10.1080/03630242.2014.896442. PMID 24617862. S2CID 39250196.
  149. ^ a b c Prevatt BS, Lowder EM, Desmarais SL (September 2018). "Peer-support intervention for postpartum depression: Participant satisfaction and program effectiveness". Midwifery. 64: 38–47. doi:10.1016/j.midw.2018.05.009. PMID 29908406. S2CID 49304436.
  150. ^ "Postpartum Depression Support Groups in the U.S. & Canada". POSTPARTUM PROGRESS. Retrieved 9 April 2022.
  151. ^ "HOME". Shades of Blue. Retrieved 9 April 2022.
  152. ^ a b "National Association of Professional and Peer Lactation Supporters of Color - Provider Directory". napplsc.org. Retrieved 9 April 2022.
  153. ^ "POSTPARTUM PROGRESS | postpartum depression and postpartum anxiety help for moms". POSTPARTUM PROGRESS. Retrieved 9 April 2022.
  154. ^ a b Khúc, Mimi. The Asian American Literary Review. Volume 10, Issue 2, Fall/winter 2019, "Open in Emergency : a Special Issue on Asian American Mental Health." Edited by Mimi Khúc, 2nd edition., The Asian American Literary Review, Inc., 2019.
  155. ^ a b Dennis CL, Chung-Lee L (December 2006). "Postpartum depression help-seeking barriers and maternal treatment preferences: a qualitative systematic review". Birth. 33 (4): 323–331. doi:10.1111/j.1523-536X.2006.00130.x. PMID 17150072.
  156. ^ "NAMI HelpLine | NAMI: National Alliance on Mental Illness". www.nami.org. Retrieved 28 April 2022.
  157. ^ "Home". suicidepreventionlifeline.org. Retrieved 28 April 2022.
  158. ^ "PSI HelpLine (English & Spanish)". Postpartum Support International (PSI). Retrieved 28 April 2022.
  159. ^ "SAMHSA's National Helpline | SAMHSA - Substance Abuse and Mental Health Services Administration". www.samhsa.gov. Retrieved 28 April 2022.
  160. ^ "Postpartum Health Alliance | You are not alone". postpartumhealthalliance.org. Retrieved 28 April 2022.
  161. ^ a b c Ramphos ES, Kelman AR, Stanley ML, Barrera AZ (December 2019). "Responding to women's needs and preferences in an online program to prevent postpartum depression". Internet Interventions. 18: 100275. doi:10.1016/j.invent.2019.100275. PMC 6926164. PMID 31890624.
  162. ^ a b Abrams LS, Dornig K, Curran L (April 2009). "Barriers to service use for postpartum depression symptoms among low-income ethnic minority mothers in the United States". Qualitative Health Research. 19 (4): 535–551. doi:10.1177/1049732309332794. PMID 19299758. S2CID 26227040.
  163. ^ "Addressing the Increased Risk of Postpartum Depression for Black Women | NAMI: National Alliance on Mental Illness". www.nami.org. 26 July 2021. Retrieved 1 May 2022.
  164. ^ a b c d Ko JY, Rockhill KM, Tong VT, Morrow B, Farr SL (February 2017). "Trends in Postpartum Depressive Symptoms - 27 States, 2004, 2008, and 2012". MMWR. Morbidity and Mortality Weekly Report. 66 (6): 153–158. doi:10.15585/mmwr.mm6606a1. PMC 5657855. PMID 28207685.
  165. ^ Schumacher M, Zubaran C, White G (June 2008). "Bringing birth-related paternal depression to the fore". Women and Birth. 21 (2): 65–70. doi:10.1016/j.wombi.2008.03.008. PMID 18479990.
  166. ^ Brown-Bowers A, McShane K, Wilson-Mitchell K, Gurevich M (May 2015). "Postpartum depression in refugee and asylum-seeking women in Canada: A critical health psychology perspective". Health. 19 (3): 318–335. doi:10.1177/1363459314554315. PMID 25389234. S2CID 206717561.
  167. ^ Bowen A, Muhajarine N (2006). "Prevalence of antenatal depression in women enrolled in an outreach program in Canada". Journal of Obstetric, Gynecologic, and Neonatal Nursing. 35 (4): 491–498. doi:10.1111/j.1552-6909.2006.00064.x. PMID 16881993.
  168. ^ a b c Lanes A, Kuk JL, Tamim H (May 2011). "Prevalence and characteristics of postpartum depression symptomatology among Canadian women: a cross-sectional study". BMC Public Health. 11 (1): 302. doi:10.1186/1471-2458-11-302. PMC 3118237. PMID 21569372.
  169. ^ Daoud N, O'Brien K, O'Campo P, Harney S, Harney E, Bebee K, et al. (August 2019). "Postpartum depression prevalence and risk factors among Indigenous, non-Indigenous and immigrant women in Canada". Canadian Journal of Public Health. 110 (4): 440–452. doi:10.17269/s41997-019-00182-8. PMC 6964473. PMID 30767191.
  170. ^ a b c d e Halbreich U, Karkun S (April 2006). "Cross-cultural and social diversity of prevalence of postpartum depression and depressive symptoms". Journal of Affective Disorders. 91 (2–3): 97–111. doi:10.1016/j.jad.2005.12.051. PMID 16466664.
  171. ^ a b c d Evagorou O, Arvaniti A, Samakouri M (March 2016). "Cross-Cultural Approach of Postpartum Depression: Manifestation, Practices Applied, Risk Factors and Therapeutic Interventions". The Psychiatric Quarterly. 87 (1): 129–154. doi:10.1007/s11126-015-9367-1. PMID 25986531. S2CID 1285417.
  172. ^ a b c d e f g h Mehta S, Mehta N (March 2014). "An Overview of Risk Factors Associated to Post-partum Depression in Asia". Mental Illness. 6 (1): 14–17. doi:10.1108/mi.2014.5370. PMC 4253395. PMID 25478140.
  173. ^ Ahmed SR, Watt F, Mahfoud ZR, Korayem M, Buhmaid S, Alberry M, et al. (August 2023). "Examining Feasibility, Acceptability, and Preliminary Outcomes of a Culturally Adapted Evidence-Based Postpartum Depression Preventive Intervention for Women in Doha, Qatar: Protocol for a Randomized Controlled Trial". JMIR Research Protocols. 12 (1): e11623. doi:10.2196/11623. PMC 10457694. PMID 37566449.
  174. ^ a b c d Haque A, Namavar A, Breene KA (2015). "Prevalence and Risk Factors of Postpartum Depression in Middle Eastern/Arab Women". Journal of Muslim Mental Health. 9 (1). doi:10.3998/jmmh.10381607.0009.104. hdl:2027/spo.10381607.0009.104. ISSN 1556-5009.
  175. ^ a b c d Di Florio A, Putnam K, Altemus M, Apter G, Bergink V, Bilszta J, et al. (April 2017). "The impact of education, country, race and ethnicity on the self-report of postpartum depression using the Edinburgh Postnatal Depression Scale". Psychological Medicine. 47 (5): 787–799. doi:10.1017/S0033291716002087. PMC 5369767. PMID 27866476.
  176. ^ Bashiri N, Spielvogel AM (1 May 1999). "Postpartum depression: a cross-cultural perspective". Primary Care Update for OB/GYNS. 6 (3): 82–87. doi:10.1016/S1068-607X(99)00003-7.
  177. ^ a b c Atuhaire C, Brennaman L, Cumber SN, Rukundo GZ, Nambozi G (2020). "The magnitude of postpartum depression among mothers in Africa: a literature review". The Pan African Medical Journal. 37: 89. doi:10.11604/pamj.2020.37.89.23572. PMC 7680231. PMID 33244352.
  178. ^ Hahn-Holbrook J, Cornwell-Hinrichs T, Anaya I (2018). "Economic and Health Predictors of National Postpartum Depression Prevalence: A Systematic Review, Meta-analysis, and Meta-Regression of 291 Studies from 56 Countries". Frontiers in Psychiatry. 8: 248. doi:10.3389/fpsyt.2017.00248. PMC 5799244. PMID 29449816.
  179. ^ a b "Women and hysteria in the history of mental health". Clinical Practice and Epidemiology in Mental Health. 19 October 2012.
  180. ^ "Shedding More Light on Postpartum Depression – PR News". www.pennmedicine.org. Retrieved 25 March 2020.
  181. ^ a b c Brockington I (2005). "A Historical Perspective on the Psychiatry of Motherhood". Perinatal Stress, Mood and Anxiety Disorders. Bibliotheca Psychiatrica. KARGER. pp. 1–5. doi:10.1159/000087441. ISBN 3-8055-7865-2.
  182. ^ a b c Kempe M (2015). The Book of Margery Kempe. Oxford University Press. ISBN 978-0-19-968664-3. OCLC 931662216.
  183. ^ Jefferies D, Horsfall D (2014). "Forged by fire: Margery Kempe's account of postnatal psychosis". Literature and Medicine. 32 (2): 348–364. doi:10.1353/lm.2014.0017. PMID 25693316. S2CID 45847065.
  184. ^ Jefferies D, Horsfall D, Schmied V (February 2017). "Blurring reality with fiction: Exploring the stories of women, madness, and infanticide". Women and Birth. 30 (1): e24–e31. doi:10.1016/j.wombi.2016.07.001. PMID 27444643.
  185. ^ Carlson ET (1967). "Franz G. Alexander and Sheldon T. Selesnick. The History of Psychiatry: An Evaluation of Psychiatric Thought and Practice from Prehistoric Times to the Present, New York: Harper & Row, 1966, p. xvi + 471. $11.95". Journal of the History of the Behavioral Sciences. 3 (1): 99–100. doi:10.1002/1520-6696(196701)3:1<99::AID-JHBS2300030129>3.0.CO;2-2. ISSN 1520-6696.
  186. ^ "The Project Gutenberg eBook of The Yellow Wallpaper, by Charlotte Perkins Gilman". www.gutenberg.org. Retrieved 27 April 2020.
  187. ^ Quawas R (May 2006). "A New Woman's Journey into Insanity: Descent and Return in The Yellow Wallpaper". Journal of the Australasian Universities Language and Literature Association. 2006 (105): 35–53. doi:10.1179/000127906805260310. ISSN 0001-2793. S2CID 191660461.
  188. ^ a b Taylor V (1996). Rock-a-by baby: Feminism, Self-help, and Postpartum Depression. New York, NY: Routledge. pp. 2–6. ISBN 978-0-415-91292-1.
  189. ^ Rehman AU, St Clair D, Platz C (June 1990). "Puerperal insanity in the 19th and 20th centuries". The British Journal of Psychiatry. 156 (6): 861–865. doi:10.1192/bjp.156.6.861. PMID 2207517. S2CID 33439247.
  190. ^ Rhodes AM, Segre LS (August 2013). "Perinatal depression: a review of US legislation and law". Archives of Women's Mental Health. 16 (4): 259–270. doi:10.1007/s00737-013-0359-6. PMC 3725295. PMID 23740222.
  191. ^ Cheng CY, Fowles ER, Walker LO (2006). "Continuing education module: postpartum maternal health care in the United States: a critical review". The Journal of Perinatal Education. 15 (3): 34–42. doi:10.1624/105812406X119002. PMC 1595301. PMID 17541458.
  192. ^ a b c d e f Thorsteinsson EB, Loi NM, Farr K (8 November 2018). "Changes in stigma and help-seeking in relation to postpartum depression: non-clinical parenting intervention sample". PeerJ. 6: e5893. doi:10.7717/peerj.5893. PMC 6230434. PMID 30425892.
  193. ^ Laderman C (1987). Wives and midwives: childbirth and nutrition in rural Malaysia (1st pbk. ed.). Berkeley: University of California Press. p. 202. ISBN 978-0-520-06036-4.
  194. ^ McElroy A, Townsend PK, eds. (2009). "Culture, Ecology, and Reproduction". Medical Anthropology in Ecological Perspective. pp. 217–66. ISBN 978-0-7867-2740-7.
  195. ^ Klainin P, Arthur DG (October 2009). "Postpartum depression in Asian cultures: a literature review". International Journal of Nursing Studies. 46 (10): 1355–1373. doi:10.1016/j.ijnurstu.2009.02.012. PMID 19327773. S2CID 19493163.
  196. ^ a b Coodley L (2002). "Postpartum depression: voice from a historian". Pediatric Nursing. 28 (3): 300. PMID 12087655.
  197. ^ a b Fisher K (2003). "To Save Her Children's Souls: Theoretical Perspectives on Andrea Yates and Postpartum-Related Infanticide". Thomas Jefferson Law Review. 25: 599.
  198. ^ West SG (February 2007). "An overview of filicide". Psychiatry. 4 (2): 48–57. PMC 2922347. PMID 20805899.

193. "Maternal Depression and Child Development." Paediatrics & Child Health, U.S. National Library of Medicine, October 2004

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