Rates of postnatal depression may be higher than previously estimated, a children’s charity has claimed today. Various medical sources estimate that around 10-15% of new mothers are affected, but according to the charity 4Children around 3 in 10 new mothers may experience the condition.
The figure is based on a new survey and report conducted by the charity in a bid to look at how postnatal depression (PND) is perceived and treated in the UK. According to the figures gathered by the charity:
Based on its findings, the charity has called for changes in the way that postnatal depression is handled, including campaigns to raise awareness and improve diagnosis of the condition.
It is important that pregnant women or new mothers who are feeling low discuss the problem with a health professional, as these symptoms may be due to PND rather than normal hormonal changes and tiredness. While the new survey suggests that mothers with the condition avoid seeking help, it is definitely worth doing so as there are a number of effective treatments available.
The charity 4Children conducted a survey of 2,318 new mothers to collect information about their awareness and experiences of postnatal depression, and to estimate how many mothers suffer from the condition. The charity says it worked with the Bounty parenting club to carry out the survey, although it is not clear how the participants were identified or if they were part of the parenting club.
The survey addressed a number of aspects of PND, including perceptions of the condition among new mothers, the attention the NHS gives to the condition and access to services to treat PND. The report goes on to make recommendations on how to improve awareness and treatment of the condition in order to minimise the negative impact on new mothers, families and children.
A proportion of mothers will experience depression around four to six weeks after giving birth. There is a broad range of symptoms that women with PND may experience, and as well as the obvious symptom of feeling low, those affected may also have feelings such as loneliness and guilt, or experience tiredness and sleep problems.
The condition is distinct from ‘baby blues’, a short-term drop in mood reportedly experienced by approximately 80% of new mothers. The baby blues disappear within a week or so, whereas postnatal depression symptoms are longer lasting and can sometimes interfere with day-to-day life. Symptoms can include feeling an inability to connect with or look at the new baby, and feeling too anxious to interact with friends and family.
In its report, 4Children say that it considers new mothers to have PND if they experience three or more of the following symptoms:
Those who experience three symptoms are considered to have mild PND, five-to-six symptoms to have moderate PND, and those experiencing more than six to have severe PND.
There are still questions as to why mothers develop PND, but current theories tend to focus on it being caused by changes in hormone levels, or the idea that genetic predisposition interacts with environmental and social factors to bring about symptoms.
Current NICE guidance on antenatal and postnatal care recommends that healthcare professionals routinely ask pregnant women three questions regarding experiencing symptoms of depression. This is intended to identify antenatal depression, raise the mother’s awareness of baby blues and postnatal depression, and identify risk factors for postnatal depression.
Around two weeks following birth women should be assessed for resolution of baby blues and assessed for depression if symptoms are persisting. Guidelines emphasise the need for early identification and treatment of depression during pregnancy or after birth, and the importance of ensuring that mothers are aware of all available treatment options.
Psychological ‘talking’ therapies are recommended as first-line treatment of mild and moderate cases of antenatal or postnatal depression. However, antidepressant treatment may be considered, with the risk-benefits associated with such treatment in pregnant or breastfeeding women taken into account.
Guidance also emphasises the need to address the impact of postnatal depression across the whole family, with services tailored to meet the needs of not only mothers but also fathers, partners and children.
The report looked at several different aspects of women’s experiences with PND. Below is a selection of some of its key findings.
When looking at the prevalence of the condition, the survey found that:
In terms of awareness of the condition and available treatments, the survey found that among new mothers who were experiencing PND, reasons for not seeking treatment were reported as:
Across all the women surveyed, 43% said they thought that partners needed more information about the symptoms of PND.
Of those mothers who did seek professional treatment:
Among women that sought professional help, 22% said they were unsatisfied with the treatment they received.
Of those who received treatment:
Those who sought help often reported feeling that their treatment was overly reliant on the use of antidepressant medication, and that they did not have easy access to psychological therapies - the preferred treatment option for mild postnatal depression, according to NICE guidelines.
The report contains a variety of recommendations to improve the treatment of PND in the UK. The recommendations focus on improving awareness, social support and appropriate and timely treatment. The charity calls for:
The NHS recommends that new mothers who suspect they are suffering from PND see a healthcare professional such as their GP, midwife or health visitor as soon as they can. Talking treatments such as cognitive therapy, cognitive behavioural therapy (CBT) or interpersonal therapy have been shown to have the same success rate (50-70%) as antidepressant medication in the treatment of moderate PND. Our section on postnatal depression has further information on the symptoms of PND and treatments for PND.
It is also important that pregnant women speak to their GP, midwife or health visitor if they have any concerns about developing PND, and mention any previous experience with depression or anxiety. This will ensure that appropriate care is received and may help to prevent PND.