Healthy Mom, Happy Families: Understanding Pregnancy and Postpartum Mood and Anxiety Disorders

 

In the DVD Healthy Mom, Happy Family: Understanding Pregnancy and Postpartum Mood and Anxiety Disorders you meet four women – Nicole, Kim, Nina, Denise and husband David. All of the women have suffered and recovered from perinatal mood disorders.  In sharing their experiences, these women will help reassure and educate new mothers, their family members and friends, and health care professionals. Their poignant stories are complemented by up-to-date information from three experts in the field: PSI President Birdie Meyer RN, MA; Pec Indman EdD, MFT; and Caroline Little Cribari MD, PhD.
Movie length: 13 minutes.

Healthy Mom, Happy Families: Understanding Pregnancy and Postpartum Mood and Anxiety Disorders

What Is Postpartum Depression? - Katie Monarch, L.C.S.W. (VIDEO) | EmpowHER - Women's Health Online

 

Katie L. Monarch:
My name is Katie Monarch and I am the Project Director for the Post Partum Depression program at St. Joseph Hospital, and we applied for a grant, which we received through UniHealth Foundation for three years to start a formalized postpartum depression program. And so what we did with that is, we designed an educational component as well as a screening, and what we are currently doing is we screen 100% of our moms here at St. Joseph Hospital through our Bridges program using the Edinburgh Depression Scale.

When a mom scores moderate to high off of that Edinburgh Depression Scale then the program follows that mom either from the time that she goes home or at four to six weeks she will receive a follow-up call from us doing the Edinburgh Scale again, and then she also receives another screening at three to six months.

Moms are able to enter the program at any time, and once they enter the program they receive treatment through individual counseling with a licensed clinician once a week, as well as a support group with other moms on a weekly basis.

The Post Partum Depression program is a little bit different than say a Mommy and Me group in the sense that it allows the moms to talk about how they are feeling, are they enjoying this, how are they bonding with the baby, how are they getting along in their relationships, how is their anxiety, sadness, any type of feelings that they may have.

We also work with our OBs, pediatricians, and family practice doctors, and we actually notify the OBs if a mom scores at bedside moderate to high, sending them a letter that lets them know that when their patient comes in, please let her know that she did score moderate to high on the scale and to give the Post Partum Depression program a phone call.

OBs’ offices as well as pediatricians make referrals. If they see more that they think may need a little bit of help, if she is tearful, if she is just not coping well, if she is overwhelmed, exhausted, they call as well, and the program will make a referral.

Postpartum blues begin at anywhere from three days and last up to ten days. And those are days that you may experience feeling down, tired, a little bit overwhelmed, but you do see some light. You can see that there is some blue in the sky. You can find some joy in life and the things that you like to do. You can find some joy in the baby or with your significant other, but you have some periods where you are depressed and down, but you have periods where you are feeling good.

Postpartum depression can last anywhere from right after birth up to a year. That’s where you have more bad days than you have good. So if I wake up on a continuous basis and I am just extremely overwhelmed, I am anxious, I am not able to sleep, I am having some thoughts of “What have I done? Oh my gosh! I don’t know what to do with the baby. I am frightened.” I start having perhaps some panic attacks, I am breathing, I think I am going to be fainting, than you are probably going into a postpartum depression. And the depression is basically lack of sleep, like I said, feeling overwhelmed, feeling anxious, sometimes having some obsessive thoughts about something, perhaps maybe the cleanliness of the baby. I have to change the baby every hour on the hour, or thoughts such as, ”I am afraid to carry the baby because what if I drop her or what if she rolls off the bed,” even though she may be one or two days old.

So that’s the difference. The difference between postpartum blues is, it’s kind of a depression that all of us experience in our lives, where postpartum depression continues and it just doesn’t seem to get any better.

About Katie L. Monarch, L.C.S.W.:
Katie Monarch is the Project Director for the Post Partum Depression program at St. Joseph Hospital in Orange, California, where she helped design an education-focused facility. At this hospital all new mothers are screened for postpartum depression through the Bridges for Newborns program using the Edinburgh Postnatal Depression Scale (EPDS).

What Is Postpartum Depression? - Katie Monarch, L.C.S.W. (VIDEO) | EmpowHER - Women's Health Online

My EmpowerHER Conditions Digest

Postpartum Depression

herarticle:
Postpartum Depression Therapy: Who Can Help Me and How?

Posted Susan Dowd Stone Jan 14, 2010 - 4:34am
0 comments 13 reads

herarticle:
Postpartum Depression: Questions to Ask Yourself Before Meeting with Your Provider

Posted Susan Dowd Stone Jan 14, 2010 - 5:12am
0 comments 10 reads

27% of low-risk births in Ohio done by C-section | chillicothegazette.com | Chillicothe Gazette

BY JESSICA ALAIMO • CentralOhio.com • January 11, 2010

More than a quarter of the low-risk babies born in Ohio to first-time mothers are born by a Caesarean section.
There is also a wide disparity in these numbers within state hospitals, according to 2008 data just released by the Ohio Department of Health. The rates range from 6.6 percent to 60 percent.
Women who undergo C-sections face the normal risks of surgery -- infection, blood loss and an extended recovery time. Babies have a greater chance of respiratory problems or injury from the incision, medical professionals say.
Genesis Bethesda Hospital in Zanesville is near the state average. Dr. Bijan Goodarzi, an obstetrician at Bethesda, said the hospital also handles riskier pregnancies referred from elsewhere.
The hospital does not perform vaginal births with a previous Caesarian.
C-sections are frequently justified in low-risk situations, Goodarzi said. Women or unborn children might have physical reasons why surgery is needed, such as a contracted pelvis or fetal hemorrhaging.
Others are determined on a case-by-case basis. Once, Goodarzi said, a woman's husband was ready to be deployed to Afghanistan. While she wasn't ready to go into labor, doctors determined a C-section could be performed safely, so she could give birth before her husband left.
Licking Memorial Hospital in Newark has one of the lowest rates in the state --16 percent.
Dr. Elizabeth Koffler, an obstetrician at LMH, said the rise in the national rate, which is at 32 percent, has to do with more women having twins or triplets and also maternal obesity.
Women who request a C-section tend to have a fear of labor and also a fear of future complications, Koffler said.
Unlike some hospitals, Licking Memorial does do vaginal births after Caesarians, she said.
At Coshocton Hospital, nurse Amanda Poorman said C-sections are performed when they are medically necessary or directed by the obstetrician.
"For most of our primary (Caesarian sections), moms have at least had a trial of labor," Poorman said.
Twenty-nine percent of births were done by C-section there, but only 20 percent are primary operations -- meaning 9 percent had previously given birth by surgery, Poorman said.
At Berger Hospital in Circleville, the number of C-sections has remained constant at about 17 percent, said Barb Poole, director of maternity services.
Miami Valley Hospital in Dayton has the state's lowest C-section rate among first-time, low-risk births. Of these 1,315 births, 88 were Caesarians, a rate of 6.6 percent.
The hospital specializes in high-risk births, so there are a number of specialists on staff, said Dave McKenna, a maternal fetal medicine specialist at Miami Valley.
"Some hospitals are too quick to do C-sections," McKenna said. "Babies do better after vaginal delivery. There is a lower rate of admission to the neonatology critical care unit due to low rates of respiratory problems ... they're more likely to successfully breast-feed."
Jessica Alaimo can be reached at (740) 328-8576 or jalaimo@nncogannett.com.

27% of low-risk births in Ohio done by C-section | chillicothegazette.com | Chillicothe Gazette

Percentage of C-sections varies greatly in different parts of Ohio | bucyrustelegraphforum.com | Bucyrus Telegraph Forum

By Jessica Alaimo • CentralOhio.com • January 9, 2010

More than a quarter of the low-risk babies born in Ohio to first-time mothers are born by a Caesarian section.

There is a wide disparity in these numbers within state hospitals, according to 2008 data just released by the Ohio Department of Health. The rates range from 6.6 to 60 percent.

Women who undergo C-sections face the normal risks of surgery -- infection, blood loss and an extended recovery time. Babies have a greater chance of respiratory problems or injury from the incision, medical professionals say.

Janet Runner, vice president of patient care services at Bellevue Hospital in Sandusky County, said even though the hospital's C-section rate is higher than the state average, the mothers and babies have good outcomes.

"We have a system in place where we check all C-sections for appropriateness," she said.

Many women request scheduled Caesarian sections. When that happens, doctors have a frank conversation with the mom-to-be about the risks involved.

Total C-sections in Sandusky County stayed level, around 22 percent, between 1990 and 1995. They dropped off between 1996 and 2000, and have increased since then, according to state data.

In the late 1990s, the hospital had midwives on staff. Since midwives spend more time with their patients, the mom is more likely to give birth vaginally.

But more recent research showed having a traditional birth after a previous Caesarian is harmful to the mother. So more women who had a C-section had the procedure for subsequent babies, said Dr. Elizabeth Koffler of Licking Memorial Hospital in Newark.

Now, only a limited number of hospitals allow vaginal birth after Caesarians, which has become a special procedure.

Dr. Cynthia Flynn at Memorial Hospital in Fremont said repeat procedures are driving the hospital's increase in C-sections.

Generally, the decision to have a primary C-section is made by the doctor, but the American Congress of Obstetricians and Gynecologists supports a woman's right to choose a C-section for any reason, Flynn said.

Dr . Guy Capaldo, an obstetrician and gynecologist at Women's Care in Mansfield, said the C-section rate in his area is on par with the national average.

Common reasons for low-risk pregnancies to end in C-sections are because the baby is too big, or because it is not coming out head first. The baby also may have fetal hemorrhaging or some other symptom that requires a quick delivery.

Capaldo said he tries to avoid C-sections simply by request.

"They come in, they want to pick the day, want to pick the time that they'll have their baby," Capaldo said.

When that happens, he discusses the risks of both birthing methods. Going into labor has far fewer risks, he said.

Dr. Bijan Goodarzi, an obstetrician at Genesis Bethesda Hospital in Zanesville, said C-section requests don't happen often, but when they do they're handled on a case-by-case basis.

Once, Goodarzi said, a woman's husband was ready to be deployed to Afghan-istan. While she wasn't ready to go into labor, doctors determined a C-section could safely be performed, so she could give birth before her husband left.

There is some evidence C-sections are better for the woman's long-term health. Brazil, Goodarzi said, has the highest level of C-sections. Those women also have lower instances of urinary incontinence and pelvic organ prolapse.

Miami Valley Hospital in Dayton has the state's lowest C-section rate among first-time, low-risk births in the state. Of these 1,315 births, 88 were Caesarians, a rate of 6.6 percent.

The hospital specializes in high-risk births, so there are a number of specialists on staff, said Dave McKenna, a maternal fetal medicine specialist at Miami Valley.

"Some hospitals are too quick to do C-sections," McKenna said. "Babies do better after vaginal delivery. There is a lower rate of admission to the neonatology critical care unit due to low rates of respiratory problems. They're more likely to successfully breast-feed."

jalaimo@nncogannett.com 740-328-8576

Percentage of C-sections varies greatly in different parts of Ohio | bucyrustelegraphforum.com | Bucyrus Telegraph Forum

Cincinnati Doula Training May 21-23, 2010

Posted by: "Pamela Bell"

Fri Jan 8, 2010 7:32 am (PST)

toLabor (formerly ALACE) Birth Doula Training May 21-23

Learn more about pregnancy and how to support birthing women and their
families at this 3-day hands-on training with experienced instructor, birth
advocate and doula Therese Hak-Kuhn. The training will be held at
Grailville in Loveland, just north of Cincinnati, Ohio on May 21-23. You
will receive resources and information about birth options and choices, all
necessary information to complete your full toLabor certification and begin
your career as a doula. Attached is a detailed brochure outlining the
organization and the training. A registration form is included in the
brochure and discounts are available for early registration and for doulas
previously trained with other organizations.
Please feel free to forward this information to lists or individuals you
think may be interested and help spread the word!
For further information or questions or if you are not able to view the
attachment, please contact Pam Bell at 513-313-2068 or
womenswisdom@gmail.com.

Pregnant women at risk for depression if stressed, lack social support | University of Michigan Health System

 Educating clinicians about how to identify and treat serious illness in expectant mothers is crucial to minimizing complications, researchers say

Meet the expert:
Christie A. Lancaster, M.D., M.S.

ANN ARBOR, Mich. - Some pregnant women are more likely to be depressed than others.

A new U-M study published in this month’s American Journal of Obstetrics and Gynecology, finds that factors such as stress, mental health history, social support, and whether a pregnancy was intended, contribute to a woman being more at risk of experiencing depression than others.

“Depression has been associated with adverse outcomes for both mom and baby, including pre-term delivery, pre-eclampsia, sleep disturbances for both mom and baby, and maternal-infant attachment effects, in addition to its impact on the mother's daily quality of life,” says Christie A. Lancaster, M.D., M.S., a U-M clinical lecturer in the department of Obstetrics and Gynecology and lead author in the study.

Depression, experienced by as many as 12.7 percent of pregnant women, is a serious complication that, if identified, can be treated during pregnancy.

Lancaster and a team of researchers set out to study risk factors that could help doctors evaluate a patient’s risk for depression while pregnant.

The study consisted of a literature review that evaluated 159 English-language articles published between 1980 and 2008 conducted in the U.S., Europe, Canada, New Zealand and Australia.

Those studies looked at risk factors such as maternal anxiety, life stress, history of depression, a lack of social support, unintended pregnancy, type of medical insurance, domestic violence, lower income, lower education, smoking, relationship status and poor relationship quality.

Numerous studies have been conducted regarding postpartum depression, but few have looked at risk factors for depression while a woman is pregnant.

U-M researchers felt that studies that concentrate on post-partum depression are not adequate in evaluating depression risks in pregnant women because factors such as pregnancy intention and social support may vary before and after the arrival of the baby. Therefore, those factors could potentially be related to depression at one time point but not another.

Because more organizations are now promoting screening women for depression during each trimester of pregnancy, researchers deemed it important to identify the risk factors.

Study results showed that maternal anxiety, life stress, prior depression, lack of social support, domestic violence, unintended pregnancy, relationship factors and public insurance have a high correlation with depressive symptoms in pregnant women.

Authors of this study say it’s imperative for practicing clinicians to be educated in identifying depression in pregnant women.

At the University of Michigan Health System, all pregnant patients are screened for depression during pregnancy even though not all women with a positive screening test will have or develop clinical depression.

“We are hoping that providers can use the presence or absence of risk factors such as those identified in our study to enhance their assessments for depression in addition to the information that they obtain from the screening test,” Lancaster says.

Additional authors: Christie A. Lancaster, MD, MS; Katherine J. Gold, MD, MSW, MS; Heather A. Flynn, PhD; Harim Yoo; Sheila M. Marcus, MD; Matthew M. Davis, MD, MAPP; all of the University of Michigan Health System

Funding: This study was supported by Robert Wood Johnson Clinical Scholars Program

Journal reference: doi: 10.1016/j.ajog.2009.09.007

Pregnant women at risk for depression if stressed, lack social support | University of Michigan Health System