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Prevention of Postnatal Depression

Ten to 15 percent of women who have given birth experience postpartum or postnatal depression (PND). It is the most common complication related to childbirth, but is often unrecognized because patients either don't recognize symptoms or because they fear stigma and aren't aware that there are treatment options. For women who have experienced postnatal depression with previous pregnancies or who are experiencing depression symptoms prior to childbirth, treatment for PND should be started in the weeks prior to the birth of the child.

  1. Risk Factors

    • Risk factors for PND include depression and anxiety during the pregnancy. Other risk factors include stressful events that occur during or immediately after the birth of the child. Poor social support, marital problems or a history of depression can also predispose women toward postpartum depression. If a new mom begins to show symptoms of depression, she should notify her doctor immediately. Postnatal depression can last for months--or even years--if left untreated, and can lead to other illnesses, isolation and suicide. If you experience depression after pregnancy, do not be afraid to seek help immediately-- especially if you feel overwhelmed and are afraid that you may hurt your baby.

    Psychopharmacology

    • Antidepressants are more likely to succeed at preventing postnatal depression if the antidepressant is one that has been used successfully with the patient previously. If the patient has never used antidepressants, it can take some time to find one that works successfully, and this might make it harder to prevent postnatal depression from developing. Antidepressants are effective, but breastfeeding mothers frequently fear passing along the drug to their babies through breast milk. Nortriptyline, paroxetine and sertraline are antidepressants commonly prescribed for breastfeeding mothers because of their limited effect on the baby. Two trials in 2005 showed no evidence that antidepressants consistently prevent postpartum depression.

    Psychological Treatments

    • Psychological therapies like cognitive behavioral therapy have been tried with mixed results and might provide an alternative to antidepressants; however; the effectiveness of talking therapies and behavioral interventions is unclear. Dr. Jane Morrell's groundbreaking study of recent mothers in England divided patients between those who received either a cognitive behavioral therapy or individual person-centered therapy with health care workers. The study found that supportive therapies were most effective at reducing long-term effects of postpartum depression.

    Psychosocial Support

    • Other studies indicate that group therapies can help provide educational and emotional support that helps new moms endure the stress of a new baby. Support by family, friends and colleagues; emotional health education; depression screening and follow-up telephone support services in the immediate months after the birth of the child have also been shown to have some effectiveness at helping prevent postnatal depression. Support groups can be valuable, but the patient should consult a physician as well and consider both medication and formal psychotherapy.

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