Postpartum Mood and Anxiety Disorder Prevention: What does that mean?

It is estimated that one in five women will struggle through a Postpartum Mood and Anxiety Disorder like postpartum Depression (PPD).  That’s an enormous amount of women who suffer every year.  PMADS have been considered to be the most common complication of childbirth, and yet many women continue to suffer in silence and not receive the help they deserve.  And that is just not okay.

What if, just for a moment, we were to consider a new way of thinking about this.  What if we were to assume that if you are giving birth to a baby that you simply WILL develop a postpartum mood and anxiety disorder IF you do not have adequate biological, psychological, and social support?  In other words, if you have a baby and do so without sufficient planning/care/support with a focus around sleep, nutrition, exercise, nervous system and stress management, identity shifting, role changing, and community, you will, all of you, become depressed and/or anxious.

Does that change things for you?

See, at this point, most of the attention and care around PMADS still exist at the treatment level.  When a mom becomes depressed or anxious we call in the forces in order to get her well.  We assume, in most instances, that she will be okay until she is not, and often women have to suffer first before feeling better. 

But what if we could change that?

Imagine for a moment, this: because it is understood that women who give birth will develop a PMAD (given the complex interplay between shifting hormones that affect brain chemistry and external stress), prenatal and postpartum birth care and cultural understanding simply include support around physical (sleep, nutrition, physical exercise, breath, hydration, brain chemistry), psychological (counseling, expectation management, role changes -work, mothering, relationships-, and social (community) health?  What if, in an ideal world, insured health care included prenatal and postpartum contact with a nutritionist, sleep consultant, and personal trainer skilled at helping you understand how to keep your brain resilient through the shift to parenthood?  What if Midwifery and Obstetric care included time with a mental health specialist who could help you to understand your strengths and challenges and help you to work through the complicated psychological shifts that occur in motherhood?  What if each postpartum woman had several in home visits from a mental health professional who could asses her level of support and also screen for early symptoms of depression and anxiety?  What if simply by signing up to be a mother you were also signing up for well-rounded early family mental health support?

What if the culture of your community was that women who give birth also get holistic mental health support as a part of the endeavor—that, because we understand that maternal and infant mental health is connected, you simply can’t expect one without the other?

If postpartum mental health challenges were expected, would the support also be expected?

Would it be easier for you to engage in this kind of preventative care?

We are, of course, a way off from this.  But prevention is still possible if we see it as imperative.  If we stop assuming that maternal depression and anxiety is a sign of weakness and that strong women don’t need help, we can help all women who give birth understand that mental health is at risk in early motherhood, no matter who you are.  With this new paradigm, it is suddenly unethical to refrain from support planning.  And, suddenly, it is everybody’s job to set women and families up for success.