Governor Recognizes May as Maternal Mental Health Month

[dropcap]Depression during pregnancy and the postpartum period is increasingly recognized as an important maternal and child health concern. Prevalence estimates have been reported to range from 10-20%, with a higher prevalence among adolescents and low-income populations. Data from the Virginia Pregnancy Risk Assessment Monitoring System (PRAMS) shows that 26% of women who gave birth during 2007-2008 reported symptoms of postpartum depression, while 30% of Hispanic and 28% of African American women reported depressive symptoms. Intimate partner violence, smoking, substance abuse, and stressful life events have been shown to be risk factors for perinatal mood and anxiety disorders (PMAD). According to Virginia PRAMS, 6.2% of women who gave birth (2007-2008) reported physical abuse by an intimate partner during pregnancy, 22.3% reporting smoking, 8.6% reported alcohol, and 25.6% reported 3-5 stressful events during pregnancy.[/dropcap]

Untreated PMAD has serious consequences for the mother and child.  Depression during pregnancy has been associated with adverse fetal and neonatal outcomes including low birth weight, preterm delivery, and fetal growth restriction. According to the American Academy of Pediatrics (AAP), each year more than 400,000 infants are born to mothers whoare depressed which makes depression the most under-diagnosedobstetric complication in the United States.  Postpartum depression can cause family dysfunction, prevent effective mother-baby bonding, cause early cessation of breastfeeding, and adversely affect infant growth, behavior and brain development. Infants of depressed mothers show less engagement and eye contact with their mother and are at risk for failure to thrive, attachment disorder, and developmental delay.  Depression can cause mothers and/or parents to neglect health care advice, including safety and preventive measures such as car seat, home safety measures, and health feeding practices.  Mothers who are depressed are less likely to read to, cuddle with, and interact with their child, leading to deficits in language acquisition.

There are many opportunities to identify women with PMAD in our healthcare system: prenatal and postpartum appointments, and pediatric well-child visits. However, inadequate referral and treatment options coupled with barriers to access and use of available mental health services (e.g., stigma, poor help-seeking behaviors) prohibit proper diagnosis, treatment, and support for affected women and their families.  Systematic screening is not yet widespread. The Edinburgh Postnatal Depression Scale (EPDS) is a brief, reliable and validated screening tool that can be used during pregnancy and the postpartum period.

Out of concern for the women, children, and families affected by PMAD in the Hampton Roads area, local psychiatrists, pediatricians, clinical psychologists, nurses, and other public health professionals have begun collaborating, along with Postpartum Support Virginia (PSVa), to address this important public health issue. The Tidewater Perinatal Mental Health Consortium has initiated efforts to raise awareness, educate, and train healthcare professionals while improving access to quality multidisciplinary mental health services.  Currently, the availability of adequate treatment, including social support, needs to be PSVa in Hampton Roads: Williamsburg, Newport News, and the Kempsville area of Virginia Beach. 

Governor McDonnell’s proclamation recognizing May 2013 as Maternal Depression Month serves to highlight the seriousness of this public health issue and brings much needed attention to the need for better programs and improved access to mental health services for women and families in our region and throughout Virginia.

Please visit www.mhpregnancy.org or www.postpartumsupportVA.org for more information. 

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