Postpartum Depression
After ten months of being pregnant, our bodies have gone through immense change. We’ve increased our blood supply by two fold, stretched our ligaments, and rearranged our organs to accommodate our growing child. Maybe we lost sleep, maybe we developed stretch marks, maybe our lips got plumper; despite all the variability, what is certain is that our bodies are incredible and through the help of hormones, we have grown a human.
These hormones are powerful communicators, and they start working as soon as the egg is fertilized. First, progesterone levels rise to thicken the lining of the uterus and help ensure healthy implantation (Hormones during pregnancy, 2020). Then, it continues with rapidly rising levels of human chorionic gonadotropin hormone, commonly known as hcg; this is the same hormone that is being tested for with a pregnancy test. Additionally, women experience rising estrogen levels to help maintain the health of the placenta (Hormones During Pregnancy, 2020). In fact, estrogen levels rise rapidly in the first trimester before peaking in the third trimester (Lay, 2017). Other hormones, such as human placental lactogen, are produced by the placenta to give nutrition to the fetus as well as trigger milk glands for breastfeeding (Hormones During Pregnancy, 2020). All of these hormones are circulating and performing their respective roles throughout pregnancy, and once the baby is born they do not immediately decrease.
While all of these hormones are necessary for establishing and maintaining a healthy pregnancy, the shifts in levels, especially in the postpartum period, can cause postpartum depression. According to the Center for Disease and Control (CDC), as many as one in eight women experience postpartum depression, which, depending on the state, can actually become as prevalent as one in five. During prenatal care, women are often screened for depression by their obstetrician. This occurs again at the postpartum check-up to see if women are feeling any of the symptoms. These symptoms can range from lack of interest in usual activities to sleeplessness, hopelessness, and feelings of extreme guilt or anxiety (Depression among women, 2020). Many women experience a term defined as baby blues; which is less intense and usually includes worrying, sadness and feeling extremely tired (Depression among women, 2020). This differs from postpartum depression because it is usually more mild and resolves on its own after a couple of weeks. For those women who experience these symptoms more intensely, it is important to identify them and utilize resources to manage them. This includes speaking with your doctor, who can then offer therapeutic interventions with medication or counseling. However, it is also important to confide in your partner or a close friend or family member. Having support, especially during the immediate postpartum period, is important for a woman’s mental health; these people can offer emotional support or encouragement to take walks, or provide reminders to take medication (Depression Basics, 2020). Partners are important in helping identify changes in mood or behavior, and offering support and encouragement for a new mom to take time for herself.
It is important to identify any symptoms of depression, whether they seem mild or severe. If these emotions are not identified and supported, they can lead to thoughts of harming oneself or one’s child. Having a support system through this transitional period is important for the health of both mother and child. In a study conducted by Corrigan, Kwasky and Groh (2015), they found simply screening for mental health symptoms was not always enough to detect and treat postpartum depression and a mother’s perception of her support, as well as actual support available, is a better predictor of postpartum depression than the screening tools. What is even more shocking, is the United States spends more than one hundred billion dollars annually on childbirth, yet the infant mortality rate is higher than twenty-eight other developed countries with increasing health disparities between races (Corrigan, Kwasky and Groh, 2015). These statistics are disappointing for a developed country and emphasizes the importance in identifying symptoms early; however, this cannot occur without proper education of patients and providers. The healthcare community needs to work together to educate, identify, and treat postpartum depression to improve the health outcomes of women and their children.
References
Corrigan, C. P., Kwasky, A. N., & Groh, C. J. (2015). Social Support, Postpartum Depression, and Professional Assistance: A Survey of Mothers in the Midwestern United States. The Journal of perinatal education, 24(1), 48–60. https://doi.org/10.1891/1058-1243.24.1.48
Depression Basics. (2020). National Institute of Health. Retrieved from https://www.nimh.nih.gov/health/publications/depression/index.shtml#pub8
Hormones During Pregnancy. Johns Hopkins University. Retrieved from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/staying-healthy-during-pregnancy/hormones-during-pregnancy
Lay, J. (2017). What bodily changes can you expect during pregnancy? Healthline. Retrieved from: www.healthline.com/health/pregnancy/bodiky-changes-during


