Attempts to prevent postnatal depression

Background: Post-partum depression (PPD) is an underdiagnosed condition, affecting 1 in 8 women worldwide. This study aimed to investigate the knowledge, attitudes, beliefs, and practices in relation to PPD among health practitioners at Levy Mwanawasa University Teaching Hospital Obstetrics and Gynaecology (OBS/GYN) departments. The study further sought to gain insight from mental health practitioners at Chainama Hills College Hospital (CHCH) on the reasons for the underdiagnoses of PPD. Methods: This cross-sectional study collected data from 20 OBS/GYN health practioners at LMUTH through questionnaires and CHCH mental health practioners through a focus group discussion. Quantitative data was analyzed using descriptive statistics in SPSS Version 27, while qualitative data was analyzed thematically in Nvivo software. Results: 85% (17) of the respondents could define PPD, 50% (10) were able to identify risk factors, only 40% (8) had attended to patients with PPD, with 60% (12) reporting not having provided care to patients with PPD. Additionally, 80% (16) of the respondents had negative attitudes towards early assessment and diagnostic interventions for PPD, citing its perceived rarity and the time required for screening as reasons. Themes underlying underdiagnosis of PPD include prioritization of child care over maternal well-being and time constraints within postnatal clinics. Conclusion: This study identified critical gaps in healthcare practitioners' knowledge and attitudes toward postpartum depression (PPD), particularly regarding early assessment and diagnosis. Factors contributing to PPD underdiagnosis include community-related issues such as cultural misconceptions, practitioner-related limitations including insufficient knowledge and skills, and facility-related challenges like prioritizing child care over maternal care. These findings highlight the need to incorporate comprehensive PPD education into healthcare training programs, implement routine screening protocols, foster supportive patient-care environments, address cultural misconceptions at the community level, enhance healthcare practitioners' competencies through ongoing training, and promote interdisciplinary collaboration.

This article is based on a major empirical study of the state of adoption of Computerised Medical Records (CMRs) among General Practitioners (GPs) in Australia and Sweden. Responses were gained from a mail out questionnaire to random samples of GPs in both countries (n=600/country). This paper will report on the main findings gained emphasising some of the various similarities and differences between the two sample groups. This comparative study adds to the existing body of CMR literature by way of providing a cross cultural perspective on GP adoption states. As a result, some concluding comments are offered for understanding high and low diffusion rates of CMRs among GPs and the implications for health policy and technology adoption strategies.

To describe the geographical mobility of general practitioners in Australia, both within rural areas and between rural and metropolitan areas. Annual panel survey of GPs between 2008 and 2012. Work location, categorised by a typology based on geographical location and community size; frequency of mobility (change of location category); and characteristics of those who moved. There were 3906 participants in 2008 (representative cohort, 19% of Australia's GP workforce) and 3502, 3514, 3287 and 3361 in subsequent years. 1810 GPs participated in all 5 years, and 10900 origin-destination pairs were observed after removing GP registrars from the dataset. A total of 133 GPs moved from rural to metropolitan locations, 103 moved from metropolitan to rural locations, and 271 observed location changes were within rural areas. Annual location retention rates were 95% in regional centres, 90% in small rural towns and 82% in very remote areas. GPs in small towns of <5000 residents had the highest risk of leaving rural practice. Mobility rates were significantly higher for GPs who had worked in a location for under 3 years and those working as either contracted or salaried employees, and somewhat higher for international medical graduates. Younger age was a small predictor of increased mobility, while sex and family status had no association with mobility. GPs working in small communities and those in a rural location for less than 3 years are most at risk of leaving rural practice.

Objective: Covid-19 infection was first diagnosed in Wuhan, China, and became a pandemic. Afterward, it had a devastating effect on mental and physical health. Postpartum depression (PPD) is a common health problem that needs attention to improve women’s healthcare. Herein, we aim to search for the PPD incidence in the pandemic period.&#x0D; Methods: A prospective cross-sectional study was conducted. A total of 126 pregnant women were included for the study. None of the patients had Covid-19 infection. Inclusion criteria included; women were aged 18 or over and ability to communicate fluently provided informed consent to participate. Women who had late fetal loss and stillbirth or neonatal death were excluded. Patients age, gravida, medical history, previous or ongoing psychological disease, and drug use, alcohol use and smoking, obstetric follow-up regarding any complication for the fetus or mother, socio-economic status, spouse support, sleep disorder, hyperemesis gravidarum, type of delivery, fetal birth weight, height, AGGAR scores 1-5th min, neonatal intensive care unit (NICU) admissions were recorded. Postpartum depression diagnosis was evaluated via Edinburgh Postpartum Depression Scale (EPDS). Patients were grouped into two, group 1 consisted of patients who are at low risk for postpartum depression and group 2 was at high risk for depression according to their EPDS scores.&#x0D; Results: The mean age of the patients was 28.90±5.26 (18-41). 68 (54%) of the patients had vaginal deliveries and 58 (46%) of them had cesarean section. The average weight of newborn babies was 3324±586.11 grams (2750-4950), 1st minute APGAR score was 7.75±0.9 (4-8), 5th minute APGAR score was 8.88±0.45 (7-9). 23 (18.3%) of the newborns were admitted to neonatal intensive care (Table 1). According to the EDPS scores, only 12% of the patients were classified as having high risk group for depression. Lower income, previous psychiatric illness, higher education levels and having newborn needs NICU were found to significantly related to PPD (p = 0.029, p = 0.034, p=0.046 and p = 0.001 respectively) (Table 2). The other parameters were not found to be significantly related to PPD scores.&#x0D; Conclusion: Covid-19 was not found to increase the rate of PPD in short term notice in our center, which was affected seriously. Studies with a higher number of patients and in different regions are necessary to state a precise conclusion.

Postpartum depression has been shown to affect women's health in the long term but no studies have assessed this in the Islamic Republic of Iran. This study determined the prevalence of current depression and illness in women who had experienced postpartum depression four years after childbirth, and evaluated the factors associated with current depression. In a cohort study in 2009, 1801 pregnant women without depression at 32-42 weeks of pregnancy attending Mazandaran primary healthcare centres were examined for postpartum depression using the Edinburgh Postnatal Depression Scale (EPDS). After four years, 204 women of the original cohort with postpartum depression and 467 without postpartum depression were again evaluated using the EPDS, and other questionnaires to determine the prevalence of current depression and other health problems. Multivariable logistic regression analysis was used to evaluate the factors associated with current depression and other health problems. The mean age of the women was 30.13 (SD 5.21) years. Women with postpartum depression were two times more likely to experience depression four years after childbirth (OR = 2.16, 95% CI: 1.38-3.36). They were also significantly more likely to experience chronic diseases (OR = 2.49, 95% CI: 1.38-4.50) and score higher on the General Health Questionnaire (OR = 2.50, 95% CI: 1.38-4.50). Postpartum depression predisposes women to later depression and other mental and physical health problems. Women with postpartum depression need to be identified and provided with support and appropriate interventions to avoid later health problems.

Background: Postpartum depression (PPD) is a serious mental health condition that affects women after childbirth. Early recognition of PPD is crucial for preventing worsening of maternal mental health. Objectives: This study aimed to investigate the knowledge and attitudes about PPD among women in Pakistan. Methodology: A descriptive, multicenter, cross-sectional study was conducted for 3 months in 3 public and 3 private sector hospitals in Lahore to collect data from 330 pregnant females at any gestational age, those with routine checkups 40 days after delivery, or those who came for treatment of PPD. Data were entered and analyzed using SPSS. Descriptive statistics were used to compute frequencies, and regression analysis was applied to determine factors influencing knowledge about PPD. Results: Knowledge about PPD was low, with a common misconception that it only exists with suicidal thoughts (57.3%) and occurs in females with previous psychological issues (64.3%). The majority of females (90%) had poor attitudes, believing that PPD would resolve on its own. Statistical analysis revealed a significant association between age and knowledge about PPD. Univariate analysis revealed that participants aged 31–35 (OR 2.09; p = 0.05) and &gt;35 years (OR 2.26; p = 0.04) were more likely to have good knowledge than those aged &lt;25 years. Educational level, family income, and area of residence did not significantly influence knowledge of PPD. Conclusion: The study revealed low levels of knowledge regarding PPD. Increasing educational awareness is crucial for improving PPD recognition and management.

After perinatal or postpartum depression, the decision to have another baby can be fraught with emotion. Rebecca Fox Starr movingly shares her story and those of others who have decided to carry, adopt, or not have another child and helps readers explore their own feelings about their own baby ever after. In her last bookBeyond the Baby Blues: Anxiety and Depression During and After PregnancyRebecca Fox Starr gave a candid account of her battle with prenatal and postpartum anxiety and depression. Rebecca’s story has touched readers deeply and, as her own journey has continued, so has her story, having veered in an unexpected direction: the decision about a future baby. What many people do not realize is that the idea of another pregnancy post-postpartum can be cripplingly frightening to a womanandher loved ones. Rebecca addresses this woefully in her first book, opening up about her sadness that her “shop is closed.” Having a baby was an option taken off the table, for a reason completely out of her control. Until it wasn’t. In 2017 Rebecca and her husband began exploring the idea of expanding their family, and, therefore consulted experts in the fields of obstetrics and gynecology, psychiatry, perinatal mental health, fertility, adoption, surrogacy, and grief (in coping with the idea that, despite all of the options, the most sound of all could be tonothave another child). Books on the topic of pregnancy after postpartum depression are scarce, making it difficult to find support or advice. This book, anchored in Rebecca’s story, offers an informative guide to the expert advice and insight, alongside current research, for women who want to explore pregnancy and other family expansion options after postpartum depression. With heartfelt stories, clinical data, and a consideration of the range of options and the emotions that along with them, Rebecca’s book fills a gaping hole in an area that leaves too many women feeling abjectly alone.

Background: The prevalence of Postpartum Depression in India varies from 6.8-21.5%. About 5% women reported persistent PPD symptoms even three years after childbirth. PPD increases the suicide risk among mothers. It not only affects the psychological health but also physical health &amp; quality of life of mother. Maternal PPD affects the mother child bonding and also the child growth &amp; development. Objective: To assess the long-term effects of post-partum depression on the mothers and the children at 1 year-5 years. Methodology: We have done a Cohort study with 290 mother-child dyads in both rural and urban area of Khordha, Odisha. Mothers were screened using EPDS for PPD at 6wk to 6 months after delivery. The outcome for mothers and children were assessed at one year to five years after delivery. Chronic depression was assessed with EPDS, confirmed by psychiatric evaluation and suicidality of the mother with SBQ-R; child anthropometric outcomes with WHO growth charts and development with Bayley Scale of Infant and Toddler Neurodevelopment. Results: Among the 62 mothers screened positive for post-partum depression, 18 (29%) were found to have Chronic depression and a significant association was found between post-partum and chronic depression (OR=11.25, CI- 4.60- 27.69, p-value &lt;0.001]. Conclusion: Maternal post-partum depression had significant impact on the maternal and child child-health in the long term.

Postpartum depression (PPD) poses a significant mental health concern for mothers globally. Despite a substantial prevalence, PPD often goes undetected and untreated, particularly in low- and middle-income countries (LMICs) like Pakistan. This study assesses the knowledge and attitudes toward postpartum depression among the social support system of pregnant women in Pakistan. A cross-sectional study was conducted at three healthcare institutions in Pakistan, investigating the knowledge and attitudes surrounding PPD among the support system of gravidarum women. Participants included a diverse sample of 363 individuals, above 18 years forming the social support system for pregnant women. Data were collected through interviews using validated questionnaires, providing insights into their demographic profiles, knowledge, and attitudes toward PPD. IBM-SPSS version 26.0 was used for data analysis, employing statistical tests like Kruskal-Wallis, Mann-Whitney U, Spearman correlation to examine associations. The sample (N = 363) was demographically diverse, with participants aged 18-60 years, predominantly urban-dwelling (83.5%), educational levels ranged from uneducated (19.6%) to higher education (38%). Findings reveal a moderate level of awareness (44.6%) but a negative attitude (47.5%) toward PPD among participants. Stigmatizing concerns regarding disclosure highlights the need for non- judgmental support, while positive attitudes toward non-mystical explanations (Black Magic and Jinns) of PPD suggest progress in mental health understanding. This study highlights the need for targeted interventions to address the stigma surrounding PPD and promote supportive environments for pregnant women in Pakistan. Enhancing awareness and fostering open dialog about PPD within social support networks can play a crucial role in mitigating its impact on maternal mental health.

Objective: This study examines the impact of age, race/ethnicity, and depression history on the development of postpartum depression (PPD) among substance-using pregnant individuals. Design: This retrospective electronic medical record review examined maternal-child dyads from one university-affiliated pediatric clinic in Michigan to assess factors associated with PPD. Materials and Methods: A retrospective chart review was conducted at one university-affiliated pediatric practices in the Midwestern U.S., focusing on maternal-child dyads with children born since July 2016. Eligible participants had linked maternal prenatal/delivery records and pediatric medical records through age 3 and had self-report of or biochemically confirmed pregnancy substance use. The primary outcome was PPD, assessed using the Edinburgh Postnatal Depression Scale (EPDS) and maternal self-report of an external diagnosis. Results: Among 173 participants, 25.2% experienced PPD. Private insurance holders were over four times as likely to develop PPD (OR = 4.30, 95% CI: 1.36–13.58), and marijuana use increased risk nearly fivefold (OR = 4.91, 95% CI: 1.41–17.12). A history of mental health conditions was associated with a nearly fourfold increase in PPD risk but was not statistically significant after adjustment. Age and minority race/ethnicity were not significant predictors. Conclusions: Marijuana use and private insurance status were the strongest predictors of PPD in this substance-exposed population. While prior mental health history, age, and minority race/ethnicity were associated with increased PPD risk, these factors were not statistically significant. These findings highlight the need for targeted maternal mental health interventions and further research on socioeconomic and substance use-related risks. Support: This project is affiliated with Central Michigan University and was funded by NIH/NICHD grant: 1 R03 HD109588-01.

To evaluate the predictors of postpartum depression and to examine the effects of maternal racial identity on postpartum depression among women with low incomes in the United States. We conducted a secondary data analysis using baseline data from the Baby's First Years study, including postpartum women living below the federal poverty line who were recruited from four diverse communities in the United States. Postpartum depression symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Logistic regressions were performed to identify associations between pre-identified postpartum depression risk factors and postpartum depression among participants, followed by predictive margins analyses to elaborate on probability of postpartum depression across different racial identity groups in the sample. The sample included 1,051 postpartum women. Almost one-half of participants identified as Black (45.9%), followed by White (20.7%), American Indian (1.8%), and Asian (1.3%). Prevalence of postpartum depression in the sample was 24%. Financial insecurity and alcohol use were positively associated with postpartum depression, whereas level of education and reported physical health were negatively associated with postpartum depression. Mothers who identified as Black had an 8.3% higher probability of postpartum depression than that of White mothers in the sample. Nurses working with populations with low income should assess social determinants of health to provide holistic mental health care. Women with low incomes should be referred to resources which account for their financial burden. Racial disparities exist in perinatal care, and birth and postpartum mental health outcomes. It is crucial to address the systemic racism faced by Black mothers experiencing postpartum depression.

Postnatal mental health problems affect 10-15% of women and can adversely impact on mother-infant interactions and bonding, the mother's mood, and feelings of competence. There is evidence that attending performing arts activities, such as singing, dancing, and listening to music, may improve maternal mental health with potential for an effect on postnatal depression. A systematic review will be conducted to assess the effect of mother-infant group music classes on postnatal depression compared to standard care, no control or wait list control. Studies will be included that report on postnatal depression. Further outcomes of interest include anxiety, stress, parenting competence, confidence and self-efficacy, perceived social support and mother-infant bonding. Infant and child outcomes measuring cognitive development, behaviour and social and emotional development will be included. Search databases to be used will be Medline, EMBASE, CINAHL, PsycINFO, Scopus, CENTRAL, Web of Science, Maternity and Infant Care and discipline-specific journals for music. The Cochrane's Template for Intervention description and replication (TIDieR) checklist and guide will be utilised to aid a detailed description, standardised assessment and quality assurance. Risk of bias will be assessed by the authors using the Cochrane Handbook for Systematic Reviews of Interventions risk of bias tool. If sufficient studies are available, meta-analyses will be conducted to combine, compare and summarise the results of the studies for more precise estimates of effects. Where meta-analysis is not possible, results for each individual study will be reported through qualitative narrative data synthesis. This systematic review will identify and synthesise evidence of the measured effect of postnatal mother-infant interventions involving music on maternal psychological and psychosocial outcomes and infant/child outcomes. This protocol was registered with Prospero on 18 October 2021 (registration number CRD42021283691). https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021283691.

Postpartum depression (PPD) is a common and debilitating mental health condition affecting many mothers worldwide. This review article aims to explore the complex effects of PPD on mothers and infants, focusing on maternal care. The transition to motherhood is a critical period characterized by numerous physical, psychological, and social changes, making women vulnerable to the onset of PPD. Consequently, PPD can significantly impact a mother's ability to provide optimal care for her infant, leading to potential adverse consequences for both parties. The article synthesizes existing research literature on the topic, encompassing studies from various disciplines, including psychology, psychiatry, obstetrics, and pediatrics. It begins by providing an overview of the prevalence and risk factors associated with PPD, emphasizing the importance of early detection and intervention. The impact of PPD on maternal caregiving behaviors, such as bonding, sensitivity, and responsiveness, is then examined, highlighting the potential disruptions in the mother-infant relationship. Furthermore, the article delves into the potential consequences of impaired maternal care on infant development, including emotional, cognitive, and social domains. Several factors contributing to the complex interplay between PPD and maternal care are discussed, including hormonal changes, psychosocial stressors, and the influence of social support networks. The review also addresses the bidirectional nature of the mother-infant relationship, whereby infant characteristics and behaviors can exacerbate or mitigate the effects of PPD on maternal care. Moreover, the article explores the role of healthcare providers and the importance of implementing effective screening, assessment, and treatment strategies for PPD to promote optimal maternal-infant outcomes. By consolidating current knowledge on the topic, this review article provides valuable insights into the multifaceted effects of PPD on both mothers and infants. Recognizing the significance of maternal care and understanding the mechanisms through which PPD disrupts it can inform the development of targeted interventions to promote early detection, effective treatment, and supportive interventions for mothers experiencing PPD. Ultimately, improving maternal mental health and enhancing maternal-infant relationships can yield long-term positive effects on mothers' and infants' well-being and development.

Association between adverse perinatal events and postpartum depressive symptoms in a North American prospective preconception cohort study.

Background: Postpartum depression (PPD) is certainly called a mental health disorder that occurs after the birthing process, and is a disorder that hands down one of the most harmful factors relating to the childbirth process, infant health, and mortality. Disregarding the psychological aspects of the mothers, PPD has the potential to damage the bonding process between the mother and infant, and create an unhealthy mother–infant relationship. PPD also affects the initial breastfeeding of the infant, and breastfeeding is one of the most important aspects of the baby's health. PPD also influences the psychological and emotional development of the infant. Objectives: Determining the rate of postpartum depression in postnatal women and its relationship with the mother–infant bond and the initiation and exclusivity of early breastfeeding. Methodology: This cross-sectional study targeted women who postnatal attend a follow-up clinical appointment within the first six weeks after delivery. Depression during the postpartum period was measured utilizing the Edinburgh Postnatal Depression Scale. Maternal infant bonding was measured through a tested bonding questionnaire. Breastfeeding practices were also measured through interviews regarding the time of initiation and exclusivity. The SPSS software version 24.0 was used to analyze the data, and a p-value of less than 0.05 was deemed to be statistically significant. Results: A total of 150 postnatal women were included, with a mean age of 27.6 ± 4.8 years. Postpartum depression was identified in 46 participants (30.7%). Mothers with PPD demonstrated significantly lower maternal–infant bonding scores compared to non-depressed mothers (42.3 ± 6.1 vs. 51.7 ± 5.4; p &lt; 0.001). Early initiation of breastfeeding within one hour of birth was significantly lower among depressed mothers (54.3% vs. 78.1%; p = 0.002). Exclusive breastfeeding rates were also significantly reduced in women with postpartum depression (p = 0.004). Conclusion: Postpartum depression is quite common, which is correlated with difficulties with bonds between the sufferers and their children and problems with breastfeeding. Psychosocial interventions adapted to the digital format could help improve the mental health and outcomes for the children of affected mothers. Keywords: Postpartum depression; Breastfeeding; Maternal bonding; Mental health