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Postpartum Depression

When motherhood is sweet and scary

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Most new mothers experience childbirth as a lovable time with their new baby. However, an estimated 25 percent of new moms experience an emotional distress known as postpartum depression (PPD),1which can be a frightening experience for any new mother.

According to the Mayo Clinic, symptoms of PPD include loss of appetite, insomnia, irritability, fatigue, loss of interest in sex, lack of joy, shame, guilt or inadequacy, severe mood swings, difficulty bonding with the baby, withdrawal from family and friends, and thoughts of harming self or the baby.2

Although depression is one of the most common complications women experience during and after pregnancy, it often goes undiagnosed, according to WomensHealth.gov.

Increasing Awareness & Treatment

Postpartum psychosis (PPP), an extreme form of PPD, typically develops within the first 2 weeks after delivery. The symptoms may include confusion and disorientation, hallucinations and delusions, paranoia, and attempts to harm self or the baby.2"Texas is all too familiar with the horrific headlines that can result when new mothers suffering from severe mental illness go undiagnosed," said Ramona Osburn, MBA, director of behavioral health, Harris Methodist Springwood Hospital in Bedford, TX. "We hope to increase awareness of the mental health issues women face and increase the number of women who are receiving treatment."

Houston resident Andrea Yates is known for killing her five young children in 2001 by drowning them in the bathtub in her house. She had been suffering for years with severe PPP.1PPP affects 1-2 new mothers in 1,000; it results in a suicide rate of 5 percent and an infanticide rate of 4 percent.3

Follow Up 48 Hours After

Laura Burnett, BSN, RN, IBCLS, knows the fear of a new mother suffering from PPD. Burnett is the nursing supervisor for the Harris Methodist HEB Hospital Breastfeeding Support Center in Bedford, TX, which opened in 1997. The center has 77 RNs in women's services, which includes labor and delivery, postpartum, nursery, gynecology and NICU, and six lactation consultants supervised by Burnett. Since its opening, the center has served about 45,000 new mothers with a staff of six RNs who have more than 160 years total nursing experience.

"It's pretty scary from a nursing perspective," Burnett said. "We used to refer these patients to their ob/gyn. We now have a rule that all moms must be seen at the support center within the first 48 hours after giving birth."

Burnett, whose predecessor initiated the launch of the center, said about five new mothers a year out of about 3,000 experience severe PPD requiring admittance to the emergency department.

"Two patients have been admitted within the past week for PPP," said Linda Woodson, BSN, RN. "I just want them to get the care they need to feel good."

Woodson is the nurse manager for the mother/baby and women's services unit at Arlington Memorial Hospital in Arlington, TX, where women suffering from depression, notably new mothers suffering from PPD, find comfort in a new program.

First Program for Women in Texas

In August, Harris Methodist Springwood Hospital opened Texas' first hospital-based intensive outpatient program - the Springwood Program for Women - designed to treat depression in women during childbearing and postchildbearing years.

The initiative is a comprehensive program for women at various ages and stages of life who are struggling with pregnancy complications, PPD, loss of a child, infertility and hormone-related conditions, such as menopause.

According to Osburn, the new center received 10 patients during the first week of its opening.

"Throughout the entire country, hospitals are closing their psychiatric units," Osburn said. "THR [Texas Health Resources], however, believes in treating the whole person."

The program includes cognitive behavioral group therapy, patient and family education, educational groups on women's issues, and treatment and discharge plans coordinated with referring clinicians and physicians. The program offers morning and evening programs on Monday, Wednesday and Friday from 9 a.m. to noon or 6-9 p.m.

One Size Does Not Fit All

Osburn emphasized depression is not "one size fits all" when it comes to gender.

"Many of the struggles women face, such as miscarriage and PPD, can only be understood by other women with the same experiences," she said. Our program is specific to women grieving a loss and the hormonal issues associated with that loss."

Program counselors work with the patient, the family and the physician, therapist and/or referral source to reach individualized treatment goals. Patients can be referred to the center by a physician, therapist, employee assistance program counselor or self-referral.

According to Osburn, the intensive program is designed to help women balance their treatment requirements with work, education and home/life schedules.


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Kudos to Harris Methodist Springwood Hospital for their innovative program. NIMH has more information on the topic at: http://www.nimh.nih.gov/topics/womens-mental-health.shtml

therapist October 31, 2008
TX




     

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