Maternal depression and its consequences for women, children and families is a devastating and an important public health issue. Each year nearly 800,000 women in the Untied States suffer from a major depression before or after giving birth. Postpartum depression (PPD) is a serious condition that affects not only a woman herself, but also her new baby, spouse, other children, family, friends and coworkers. Of particular concern is maternal depression's links to problems in children's health, mental health and development. The child of an untreated mother with PPD has three times the chance of suffering from major depression later in life. Unfortunately, women are frequently left feeling alone and confused when sadness, anxiety or other negative emotions emerge before or after childbirth.

          The prevalence of chronic depression among women is higher during the childbearing years than it is at other stages of life. Women have twice the rate of depression as men. Among mothers of young children, estimates of the prevalence of depression range from 12 percent to 50 percent. The peak age of occurrence for depression among women is between 18 and 29 years - the prime childbearing years - and rates remain high through the age of 44. Only 15 percent of these patients receive any care at all. This is due to a combination of the lack of training of the physicians who care for them but of even more importance is the reluctance of these women to reveal the problems they are having because they fear being sent to mental hospital, jail or having their baby taken away. There is really no pure entity involved, and most of the patients have severe anxiety disorders and many disabling physical symptoms as well.

Fortunately these patients can be identified with a depression screening tool called the Edinburgh Postpartum Depression Scale. It is well over 90 percent accurate. Even if patients don't go any farther at the time of testing due to their reluctance to expose themselves, the reading of the questions and the implications are the basis can be the basis for their coming to treatment on their own and having a much better idea that their struggle is not unique. Fortunately, chronic depression in mothers and postpartum depression can be effectively treated. Patients who receive the correct treatment have over a 90 percent recovery rate. Yet conventional efforts at diagnosis and treatment often fail because primary caregivers, including OB/GYN's, pediatricians, family practitioners and others do not have the time or training to address this issue. Additionally, women suffering PPD fear that if what they are experiencing is known, they may be sent to a psychiatric hospital or jail, or they may have their babies removed from their custody. Their mistrust isolates them because they believe they are the only mother who is "so bad."  

Role of Family Mental Health Institute (FMHI)

Despite the prevalence of PPD and its dangerous consequences, the public is generally unaware of its severity and those women with PPD often suffer in isolation. In 2002 The Family Mental Health Foundation (new successor Institute 2005) was launched in an effort to increase public awareness of postpartum depression, help the affected women receive peer support and professional care, implement depression-screening programs and conduct professional education and research. FMHI's vision is to make universal depression screening for all new mothers and mothers-to-be a standard of care in the United States.  Presently, there is no national campaign on PPD -- no unified message, call to action, or national strategy to convey the seriousness of this issue nor is there any comprehensive plan to eradicate the problem. Treatment for PPD often entails a combination of medication with psychotherapy and counseling. This combination therapy has proven to be effective in 90 percent of the cases studied. Women are able to reclaim their lives and begin enjoying their families and friends again. It has been shown that the children of women who have been successfully treated show definite improvement.

We helped the National Naval Medical Center design and implement a program of universal screening of all prenatal and postpartum women.  This involved four departments of the hospital; OB, Pediatrics, Psychology and Social Work. It was so successful it has become the standard of care throughout the United States Navy. The state of New Jersey just passed a law mandating depression screening and counseling for new mothers. Our Second Annual PPD Screening and Awareness Campaign will include a Capitol Hill Briefing for Hill staff, with honored guest speaker and patient advocate, Edrienne Carpenter. We will follow the briefing with a Tea, "Get Screened, Get Treated, Get Well," at the APHA, under the aegis of Dr. Barbara Hatcher, APHA's director of global education.