And because at least half of women with PPD experience a recurrence
of the illness after having another child, responsible parenting
necessitates careful thought and medical planning before deciding to get
pregnant again. Once PPD is present, "all resources must go toward
treating the mother," advises Raskin. "Stress of any sort, including the
stress of caring for children, will prevent the mother from
healing."
Preventing PPD
Effective prevention would help render treatment less necessary,
avert emotional damage to children and potentially save lives. Shoshana
Bennett is one mother who might have benefited from preventive measures.
Instead, her childbirth classes concentrated on breathing techniques and
what to pack for the hospital. And during her first postpartum checkup,
Bennett's obstetrician glossed over her weight gain of 40 pounds and
uncontrollable weepiness.
When Bennett mentioned to her family that she was having a
difficult time, her mother-in-law—a postpartum nurse for 20 years—told Bennett's husband, "Shoshana is a mother now. She needs to stop complaining and just do it." Bennett's own mother was supportive but,
despite her background in therapy, failed to recognize the signs of
serious emotional illness. Bennett also began seeing a psychologist, who
only probed for issues in her past. Eventually, about two years after the
birth of each of her two children, Bennett's obsessive concerns finally
faded on their own.
Several years later, Bennett happened to see a television program
on postpartum depression. "I cried for an hour, looked at my husband and
said, 'That's me!'" she says. Afterward, she earned her Ph.D. in clinical
psychology and founded a self-help group for postpartum disorder
sufferers. Then in 1992, she was named president of the Post-partum
Health Alliance, a California state organization.
Today, the discussion of postpartum mood disorders is often
inadequate in reference manuals. General physicians can find the terms
postnatal depression, postpartum depression and puerperal psychosis in
the
International Classification of Diseases manual, says
Cheryl Meyer, Ph.D., J.D., an associate psychology professor at Wright
State University in Dayton, Ohio. "However, they may only use these
diagnoses for patients whose symptoms do not meet criteria for other
disorders, such as depression," she explains.
Jennifer Moyer, now a coordinator for PSI and a postpartum support
consultant, understands firsthand why medical professionals need to pay
more attention to postpartum mood disorders. For her, recovery came after
two years of medication, therapy and family support, and she believes
that talking to someone who has experienced a severe postpartum mood
disorder firsthand is essential for recovery. She now combines her own
experience with her background in health care marketing to advocate for
education and prenatal and postnatal screening.
Until the health insurance industry and government agencies are
willing to allocate sufficient resources to guarantee the presence of
skilled psychiatrists and psychologists on pre- and postnatal-care teams,
assessing and treating postpartum mood disorders will continue to fall
through the cracks. Both Moyer and Bennett join other health care
professionals in the hope that efforts to focus on women's emotional
needs before and after pregnancy will gain momentum. This effort will
help other women and their families avoid disabling yet treatable
illnesses or, tragically, from having to endure another preventable
murder of an innocent infant.
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