How does postpartum depression impact my patients, including parents and infants?
Parents with postpartum depression may experience the following:
- Less responsive to infant’s needs
- Less likely to use best practices with infant (attend well-child visits, use home safety devices, breastfeed, etc.)
- Mothers in recovery are 6 times more likely to experience PPD
- Interpersonal violence is more common with PPD. Women and birthing people with partners with controlling or threatening behavior are 5 times more likely to experience PPD.
- Reduced attachment between mother and child
In addition, a significant amount of research suggests that PPD is associated with adverse effects on the infant’s development including behavioral, cognitive, and health-related outcomes.
What do I say to a parent who may be experiencing PPD?
It’s important to normalize PPD and use nonjudgemental and supportive language when screening patients for PPD. Below includes examples of phrases as well as recommendations for talking to your patients about PPD:
- “Being a new parent can be an incredibly wonderful and overwhelming experience and it is normal to feel both.”
- “We know that PPD is common in many women after giving birth so I talk to all the families I work with about this.”
- Provide comfort by lessening the parent’s feelings of isolation and shame, and encourage them to believe that a better future is possible
- Assure the parent that concerns about PPD do not make them an unhappy or bad parent
- Avoid assumptions
- Avoid judgmental tones or assuming the parent has PPD before screening and assessment is complete
- Ask the parent if they have been screened for PPD by another healthcare professional
What treatment options can I refer to my patients?
Counseling and Therapy
Both counseling and therapy can be effective ways to help parents address their feelings, thoughts, and actions. Parents struggling with postpartum depression can benefit from therapy by learning new ways to cope with stress and manage their feelings. Including significant others such as spouses and other family members in treatment can also help improve communication and gain their support during difficult times. Counseling can be tailored to meet individual needs, either through one-on-one sessions or a formal group therapy program, depending on what works best for the individual.
Medication
Antidepressants may be effective in treating postpartum depression. It’s important for new parents to contact their health care provider to discuss any medications and treatments for postpartum depression.
Support groups & additional strategies
Support groups can be helpful in a variety of ways, including:
- Helping parents make connections with other parents struggling with postpartum depression
- Learning helpful and practical coping skills from other parents
- Reduces a sense of isolation
In addition to therapy and medication, many parents benefit from supplemental supports such as yoga, exercise, or meditation. Providers can refer patients to these resources for postpartum depression including support for mental health and parenthood.
How can I find a clinician for my patient?
- Massachusetts Child Psychiatry Access Project (MCPAP) for Moms
Phone Number: (855) 666-6272, or 855-MOM-MCPAP
A free referral resource available from Monday to Friday, 9:00am–5:00pm, for front-line providers serving pregnant and postpartum people. A Care Coordinator will work with the provider to determine the patients’ needs such as consultation regarding psychiatric care, community care coordination, or both. If you are an obstetric provider, you can enroll directly in MCPAP for Moms. - The Day Hospital
Short term, intensive mental health treatment in a day treatment facility for both mom and infant located in Providence, Rhode Island.
Assessment & treatment tools
PPD screenings provide a standardized method for providers to gain insights about a family’s situation and their current stressors. Screenings can help reduce stigma, create trust between the patient and provider, and identify barriers that may interfere with a family reaching their goals.
MassHealth is reimbursing providers for PPD Screening using a DPH approved Validated Screening Tool
- Transmittal Letter
PHY-148: Payment for Postpartum Depression Screening (May 2016) - MCPAP for Moms
Resources for adult and pediatric providers including recent literature, provider toolkit, and assessment and screening tools - Postpartum Support International
Trainings, screening tools, treatment guidelines, and resourcesfor clinicians - More Screening Tools, Trainings, & Continuing Education
Prevention & early identification resources for PPD
There are various steps to take in order to reduce stress after delivery and to identify the early signs of PPD. If you are working with pregnant and postpartum individuals and families, especially those who may be at risk for depression, some of the following resources may be helpful for your clients or patients.
- Welcome Family
A free, universal one-time nurse visit for all mothers with newborns. Currently available in Fall River, Boston, Lowell, Holyoke, and Springfield. - Early Intervention Partnerships Program
A home visiting program that provides services in communities with some of the state's highest rates of infant mortality and morbidity. EIPP aims to identify maternal and infant risks as early as possible and connects families to services to prevent or reduce poor health and/or developmental outcomes. - Text4Baby
Text4baby sends free text messages to pregnant women and new moms with useful tips about having a healthy pregnancy and a healthy baby. - U.S. Food and Drug Administration
The FDA provides resources to help parents make good choices about medicines, foods, and other products for mom and baby during and after pregnancy. - Baby Friendly Hospital Initiative
The Baby-Friendly Hospital Initiative (BFHI) is a global program that was launched by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) in 1991 to encourage and recognize hospitals and birthing centers that offer an optimal level of care for infant feeding and mother/baby bonding.
PPD regulations on screening reporting requirements
- Postpartum Depression Screening and Reporting Regulations (DOC)
- PPD Sub Regulatory Guidance (DOC)
- All Provider Bulletin 254: Voluntary Reporting on Perinatal Depression Screening (DOC)
- PPD Regulations Information (DOC)
- PPD Annual Data Reporting Form (Carrier) (DOC)
- PPD Annual Data Reporting Form (Provider) (DOC)
National Clinical Guidelines for Health Care Providers
- ACOG Statement on Depression Screening (2015)
Recommends that clinicians screen patients at least once during the perinatal period for depression and anxiety symptoms using a standardized, validated tool. - AAP Incorporating Recognition and Management of Perinatal and Postpartum Depression Into Pediatric Practice (2010)
Pediatric practices, as medical homes, can establish a system to implement postpartum depression screening and to identify and use community resources for the treatment and referral of the depressed mother and support for the mother-child (dyad) relationship. - Screening for Depression in Adults: US Preventive Services Task Force Recommendation Statement(2016)
Recommends screening for depression in the general adult population, including pregnant and postpartum women.
Additional Resources
- Massachusetts Perinatal Mental Health Data Analysis Plan 2021
- Mom's Mental Health Matters: Healthcare Providers
- ACOG Postpartum Depression Publications
- AdCare Educational Institute Mailing List
- Postpartum Support International Training Certification
- MCPAP for Moms
- JFCS Center for Early Relationship Support
- Massachusetts Health Promotion Clearinghouse
- Massachusetts Home Visiting Initiative (MHVI)