The Postnatal Blues

Midwives may help combat postpartum blues. Women who received enhanced care from midwives were 40 percent less likely to report depression.

By Mechelle De Craene, published on May 01, 2003 - last reviewed on April 24, 2007

Personalized attention from a trained professional helps combat postpartum depression. British women who received enhanced care from midwives were 40 percent less likely to report depression.

University of Birmingham researchers surveyed more than 2,000 new mothers who received multiple visits from a midwife in the two weeks following delivery. Enhanced care included a standardized checklist for postpartum depression and visits up to two months postpartum.

"Rather than just suggesting that midwives visit women according to their need, midwives were given the tools to facilitate this," says Christine MacArthur, Ph.D., a professor of maternal and child epidemiology at the University of Birmingham in England.

Postpartum mood disturbances range from the so-called baby blues—half of new mothers experience moodiness—to postpartum psychosis. Though rare, postpartum psychosis has gained widespread attention due to Andrea Yates, the Texas mother sentenced to life in prison for drowning her five young children. Postpartum depression strikes between 10 and 20 percent of new mothers within six months of childbirth. There is no direct link between hormonal imbalances and severe postpartum depression, according to Laura Miller, M.D., an associate professor of psychiatry at the University of Illinois in Chicago, who has reviewed the disorder in the Journal of the American Medical Association.

But there is a cross-cultural correlation between postpartum depression and social support: Societies in which new mothers are routinely aided by the community or by relatives exhibit lower rates of postpartum depression.

Midwifery offers such support, but it is far from a hallmark of postnatal care in the United States, where women usually visit a health-care professional just once in the four to six weeks following delivery. "That women should receive multiple home visits during the postpartum period is not even a topic of discussion," says Deanne Williams, executive director of the American College of Nurse-Midwives. This makes it all the more important to monitor American women for depression, because, says Williams, "All new mothers should be considered at risk."