Violence during pregnancy by intimate partner increases risk of Postnatal Depression

A study included in an early online publication of The Lancet examines the correlation of partner violence against women during pregnancy and the effect this may have on postpartum mental health.

The study took place in Brazil and included women from ages 18-49 years old. 1133 pregnant women were eligible for the study with 1045 included in the analysis. Of those 1045, 270 had postnatal depression. The most common form of partner violence? Psychological. “Women reporting the highest frequency of psychological violence were more likely to have postnatal depression even after adjustment.” while “Women who reported physical or sexual violence in pregnancy were more likely to develop postnatal depression but this association was substantially reduced after adjustment for psychological violence and confounding factors.”

The importance of this study may shift attention to psychological violence and abuse during pregnancy as an increased risk factor for postnatal depression. Physical and sexual violence still warrants attention.

Growing up, we all heard the phrase “Sticks and stones will break my bones but words will never hurt me.” According to this study, words may be even more harmful. The true danger here is that Psychological abuse is often a precursor to physical or sexual violence.

Another recent study also found that “Even After Leaving Abuser, Moms Mental Health Declines.” A mother’s level of depression and anxiety were still high at least two years after escaping an abusive relationship. This research study comes from Ohio State University and included data from 2400 women who were married to, or living with the father of their child at the end of the first year of a three year period. They were broken down into three groups. The women participating were all nearly low income, minority, first time moms and likely experiencing additional stresses. Women who stayed or left a relationship showed higher levels of anxiety and depression, meaning (psychologically) they were no better off than women who stayed. That said, the researchers DID find that “abused mothers who had more social support did better after the end of their relationship than those with less help from family and friend.”

Lesson learned here? Reach out for support. Don’t settle for abuse. You are better than that. You deserve better. Your child deserves better.

If you are an abused mom/woman, you can start by calling a Domestic Violence Hotline. Start here. Start now. Call 1-800-799-SAFE (7233) or visit the National Domestic Violence Hotline’s website for help. You are not alone.


Health care practitioners discourage disclosure of Postnatal Depression

Picture by Flickr

Picture by Flickr

In a study published yesterday, UK researchers reviewed the disclosure of Postnatal Depression from three different vantage points – the mother, the GP, and home health visitors.

The results are chilling.

The mothers reported making a conscious decision regarding their decision to disclose symptoms of Postpartum Depression which is not terribly shocking because I went through the same thing. It is most definitely a conscious decision and a difficult one at that.

The chilling result lies within the response of the Health Practioners  “described strategies used to hinder disclosure and described a reluctance to make a diagnosis of postnatal depression, as they had few personal resources to manage women with postnatal depression themselves, and no services to which to refer women for further treatment.”

I feel as if I’ve been punched in the gut. I want to cry, scream, yell, stomp my feet. But I know that won’t change what’s going on over there and even over here because I’m sure this attitude is very pervasive in the medical community here in America as well.

Where’s the responsibility of the medical professional who turns a blind eye to the struggling new mother and actually uses strategies to prevent her from admitting she’s having a hard time? How does that serve anyone but the selfish nature of that physician? What happened to the Hippocratic Oath and “Do no Harm?”

If we pretend a problem doesn’t exist, it doesn’t go away. What if we pretended cancer was all in our heads and didn’t offer chemo, radiation, or other therapies? Would it go away or would it sit and fester, eventually killing us and hurting those around us? I think we all know that answer. It is no different with Postpartum Mood Disorders. Left untreated a new mother may even slip into Psychosis as she tries to rationalize intrusive thoughts or fall even deeper into depression and attempt to take her own life or even worse, that of her infant’s.

With all the online resources, training, and knowledge at the fingertips of even lay-people such as myself, there is no excuse for medical professionals to ignore this condition anymore. Any medical professional in my opinion who would implement strategies to hinder disclosure of symptoms should be stripped of the right to practice medicine. It’s wrong and it should NOT be acceptable. Mothers deserve to be treated honestly and with respect. They need to be given a safe place in which they are able to admit any emotional trauma or difficulty they are having. Giving them this space will foster the growth of trust and compassion rather than continue to grow the cold shoulder on which they have apparently been leaning upon.

So what can we do about this? Write about it like Katherine Stone, myself, Cheryl Jazzar, and others. SPEAK like Natalie Dombrowski, become active in online peer support like Tonya Rosenberg, talk to another mom and let her lean on you. Let her know you too have been there. Talk with doctors or their nursing staff about your experience and how important their role in discover and recovery can be. Write your Senator in support of The MOTHER’S Act as this wil laid in the growth of knowledge and support among the medical professional as well as research regarding how to bring the new mother and medical professional together. Sharing your story is the best thing a survivor can do. Our voices woven together can be the strongest advocate for increased treatment and acceptance. Won’t you lend us yours?

On experiencing Postnatal Depression with a second child

British novelist Sarah May has a new novel coming out: The Rise and Fall of the Domestic Diva. She also recently opened up about experiencing Postnatal Depression after the birth of her second child. Sarah didn’t experience PND after the birth of her first son, even though she had additional risk factors of being young, still in college, and not having planned the pregnancy. The second pregnancy was planned, her older son was 11 and in school. Yet she found herself in the throes of PND. You can read more about her experience here.

The Guest Spot: Jess Banas

Military Moms Face Higher PPD Risk: The story behind the Report

written by Jess Banas, Online PSI Coordinator

This past year, Jess Banas composed a report regarding the increased risk faced by Military moms who experience a deployment either during their pregnancy or within the first year following the pregnancy. What she discovered is astounding and the following article details her experience of uncovering the story.

I always feel odd when my kids go back to school after a long hot summer…..don’t get me wrong, it is nice to have the free time, but it feels like a bit too much free time to me.  There is so much frenetic activity around the house in the summer and then all of a sudden, it comes to an abrupt halt!!  The house gets so quiet and calm, yet I still feel like there are kids to entertain and things I have to get done!

Last year was no exception, so when September rolled around and I found myself with an empty quiet house and a bunch of extra energy, I decided to pray that my free time could go to good use.  I asked God to make me an instrument for change… show me the direction you want me to go now……not the first time I have asked God to do that, but one of many times.

He always answers me when I pray for this.  This time was no different.  In fact, the next day, I received the September MedEdPPD Newsletter.  I decided since I had the time, to sit and give it a read.  I had not had a chance to read any article from MedEdPPD before and wondered if there was anything worthwhile inside of it.

Turns out, MedEdPPD said there was a very interesting article about military moms getting PPD that was recently published in the International Herald Tribune.

I looked up the article and read it.  There was one statement that really caught my attention:

Repeated, Extended Deployments Stressing US Military Families

The Associated Press
Published: August 11, 2007

‘Pregnant women with deployed husbands have 2.8 times as much risk of developing postpartum depression as other pregnant women, say researchers at San Diego’s Naval Medical Center.’

Perhaps that statement caught my attention because I did too many word problems with my son’s math class the previous year.  Perhaps because I am a bit of a statistics nerd and am far too curious for my own good.  Perhaps that statement caught my attention because I had said that prayer the day before.  For whatever reason and because of that statement, I started to wonder….

Could pregnant women with deployed husbands get PPD 56% of the time?!  The statisical risk for PPD in the general population is 15-20%, so if you multiply 2.8 by 20% you get 56%.

How many people in a certain/specific population has to become ill with something before that illness is considered to be of epidemic proportions?

Would those statistics also pertain to the number of women who are so severely depressed that they
attempt suicide?!  That percentage could be as high as 35%!!

Exactly how many women are we talking about here?!

And most important of all:

Did these women know how great their risk for PPD was?!?

My stomach was starting to churn.  I had to figure this out.  I just HAD to.  There was no question except how.  How was I going to figure this all out.

I was intimidated by the task ahead of me.  I worried that some of the people I had worked with over the past seven years would think I was nuts, but I also knew that these were the same people who had the answers.  All I had to do was just be brave enough to ask the questions.  So I thought about all the families who were represented by the numbers and I wrote some emails to my peers at PSI.

To my great delight, no one thought I was nutty at all.  In fact, I received an outpouring of information, medical reports relating to PPD, direction, and support.  Wendy Davis of PSI sent me the summary of the abstract that the article in the Herald was written about and suggested I contact the main author (Dr. Jeffrey Millegan), directly.

I was very nervous and my hands were shaking when I dialed Dr. Millegan’s number.  I was sure that it would take months before I got to speak with him, but to my surprise, his office connected me directly to him.  I told him who I was and asked him about his abstract’s percentages.  He said the risk was 2.31 (not 2.8 ) times greater for women who had deployed spouses and told me he’d be happy to send me a copy of the abstract via email.  He was more than kind and extremely forthcoming with his information.  He even directed me to the Pentagon for more information.  I was so relieved to find him such a considerate, open minded man and thanked him profusely for his time.

I had lots of reports and studies from my peers, so my next step was to contact the Pentagon and try to get as close to an accurate number of women at risk.  I found the Pentagon’s website and was connected to Public Affairs Officer, Janice Ramseur at the Office of the Assistant Secretary of Defense – American Forces Information Services (What a mouthful!!).  I asked her for the the approximate number of military wives who became pregnant last year prior to their husbands deployment.  On September 28th, I received a (5) Microsoft Office Excel document that stated approximately 357,000 women became pregnant last year before their husbands were deployed.

I had everything I needed to figure out all the answers to my questions.  Now I needed to put everything together and get the information to as many people as possible.  I decided to ask Susan Stone, the President of PSI, to publish my findings.  She not only agreed, she thanked me for doing it and helped me with editing my work, so it would be met with respect and considered by medical professionals.  I was so excited!

Once my ‘report’ was finished, I sent it to the PSI Research Chairperson, Dr. Merrill Sparago for verification.  It has now been posted on PSI’s website for medical professionals to read.  The part of the report that is most important to me is this statement:

‘After reading all of these statistics, one might consider that at 15-20% and at 2.3 times greater risk (35-46%), the number of military spouses expected to get postpartum depression might jump to numbers approximating 145,000. One might further hypothesize that approximately 51,000 (15% also at 2.3 times greater risk, or 35%) of those women could become so severely depressed that, without treatment, they attempt suicide. Even if we keep the suicide statistic at 15%, the number remains significant at approximately 22,000 military women attempting suicide.’

I hope the work I did inspires additional research and programs to support expectant military families.  More importantly, I hope women affected by the statistics get the information they need to appropriately plan for the possibility of PPD.  As the Herald Tribune article stated, ‘Families are the backbone of our soldiers. That’s what holds you together,’

Personally, I want those families to be as strong as possible.  They are the backbone and that backbone should not be weakened if our soldiers are going to be laying their lives on the line for us.  Strengthening that backbone is the very least that we can do for them, isn’t it?

If you are a military family and need support for PPD, please consider these important resources:

Sharing the Journey with Michael Lurie

I first saw Michael Lurie on a Fox Morning program and immediately thought how wonderful it was for him to be sharing his story as it is very rare indeed to get a glimpse into the postpartum experience from a father’s perspective. In his book, My Journey to Her World: How I Coped with My Wife’s Postnatal Depression, Michael is transparently open and honest with the events as they unfolded. Familiar with his wife’s previous depressive episodes, her postnatal experience and his subsequent depression went well beyond anything either of them could have ever fathomed. I am honored to share his words with you here and sincerely hope that you will share them with the men in your lives. Michael has been extremely gracious and kind (we’ve had technical difficulties in pulling this together – our emails weren’t the greatest of playmates!) in completing this and I thank him for his patience. I also thank him for his bravery in forging such a valuable addition to resources available for fathers with partners suffering from postpartum depression.

Click here to purchase your own copy of
My Journey to Her World

My Journey to Her World by Michael Lurie (cover)

How hard was it for you to witness your wife’s struggle with Postpartum Depression? What were some of the emotions you went through?

Very difficult to heartbreaking. Some emotions I went through were:

Helplessness- not being able to make things better quickly

Disbelief- I couldn’t believe things hag gotten so bad

Anger- Angry with G-d for Kate’s illness. Anger at family and friends who I felt did not fully understand the severity of the situation

Fear- that Kate may harm herself and the baby

At what point did you decide to write your book, My Journey to Her World?

Following several months of watching Kate deteriorate, I started brainstorming my thoughts on a piece of paper t try and get some cathartic release. A I wrote down my thoughts, I realized that this was a story that needed to be told to others in order to help others and avoid the frustration I felt at not having a resource spec ifically aimed for men.

Has becoming a Father changed you?

It has given me a sense of unconditional responsibility and love to my children which will last the rest of my life.

What aspect of being a Father is the most challenging? The Least?

Most challenging- the constant feeling of responsibility for another human being who is totally dependent on you.

Least challenging- the ability to unconditionally love your child.

How difficult was it to accept your own experience with depression during this time? Do you feel it brought you closer to your wife and allowed you to better understand her?

It was very difficult to accept my position and I need it confirmed by a third party (doctor) before acknowledging it. It did bring me closer to my wife as I got a small ‘taste’ of what a sufferer of depression goes through.

What are some things you did to actively support your wife during her episode of Postpartum Depression?

I ensured that she was functional even at her worst point and asked her to do even the smallest of chores- e.g. help m e fold the laundry.

I acknowledged her feelings and let her release emotions without questioning whether they were rational or not.

I ensured that on a practical level, there was nothing to worry about

I respected her need at times to be alone

I made her feel 100% comfortable to tell me how she was feeling at any time of day or night

Just as women with PPD learn that taking care of themselves is important, this is a lesson that Fathers should heed as well. What do you do on a regular basis to feed your soul and ensure that you stay in a good place?

Nurture and develop your hobbies and interests. Remember that you are first and foremost an individual who needs to look after them self in order to look after others.

Did PPD strengthen or weaken your marriage? Do you feel that you both are in a better place now than prior to PPD?

It strengthened it as it made us more committed to one another.

It made me appreciate my wife more for overcoming it and being such a fantastic mother

I would not say we are in a better place now as we were in a good place beforehand. I would say we are in a different place now as we have the realization and experience of PPD and its devastating effects.

What do you find to be the best part of being a Father?

The privilege of providing love and care for a child and seeing them develop into fulfilled and content people

If there was one piece of advice you could give to an expectant father (new or experienced), what would it be and why would this be important for him to hear?

Talk to people and if there is a problem – seek help. Don’t suffer alone.