way at the joy and happiness of new mothers”(p. 2).
What Postpartum Depression Feels Like...
National Coalition for Maternal Mental Health (2016)
Understanding Postpartum Depression...
The Mayo Clinic Minute (2018)
The American Psychiatric Association (2019) clearly emphasizes that “baby blues” and postpartum depression (PPD) are not the same, and the latter has serious implications for the health and wellbeing of both the mother and the child. The American College of Obstetricians and Gynecologists (2018) has acknowledged that the postpartum period as a critical timeframe for both a woman and her infant, and has made continuous recommendations for the optimization of establishing and providing ongoing care as needed to ensure best outcomes in identifying and addressing PPD. However, despite the increased awareness being drawn upon the issue, and the continued efforts being made by leading healthcare professionals to proactively identify and address symptoms that may present as indicators, underutilization of postpartum care and noncompliance with mental health recommendations play a role in undermining effective impact upon the prevalence of this condition.
Feeley and colleagues (2016) articulate that despite valid and reliable screening tools being available to detect the symptoms of PPD, there is a lack of evidence to indicate that the screening process yields effective uptake of the mental health services recommended. They further indicate in their research that few of the women (18-36%) positively identified as depressed accepted and utilized the prescribed mental health services to address their healthcare needs (Feeley, Bell, Hayton, Zelkowitz, & Carrier, 2016). Moreover, of those few who accept a referral for mental health services, less than half followed through with contacting the mental health provider (Feeley et al., 2016). Screening is not enough. Identifying the women who are in need of care is only a first step. Women who do not receive proper postpartum care for their mental health needs will not benefit from the efforts made to screen and identify their circumstances.
PSYCHOSOCIAL AND SOCIOCULTURAL IMPACT
What is keeping women from seeking out care to address their postpartum healthcare needs?
Despite the many efforts to reduce the shame and isolation associated with the diagnosis of various mental health conditions within the United States, the stigma continues to pervade within American culture. Baines and colleagues (2013) indicate that some mothers who have been positively identified as experiencing PPD “are reluctant to seek professional help for fear they will be admitted to a psychiatric unit, get ‘locked up’ or have their baby taken from them.” (p. 780). Women have also reported that they are ashamed to admit to partners and family the feelings they are experiencing, and as a result suffer with their emotions silently – or may be completely unaware that their emotional response to the postpartum experience is beyond the scope of ‘typical’ baby blues (Kim & Dee, 2017).
Other research indicates that there is a general distrust of healthcare providers and the greater healthcare establishment, with women regarding each as threatening or as an inappropriate solution to their needs (Baines, Wittkowski, & Wieck, 2013). Fear and distrust of the medical establishment is particularly prevalent among low socioeconomic demographics and minority populations, who represent an increasingly vulnerable population for the prevalence of PPD. While the American Psychiatric Association has rounded their estimate to one in seven women to experience the condition of PPD, research suggests that women of color may develop an increased rate of PPD at upwards of 38% (Keefe, Brownstein-Evans, & Polomanteer, 2016).
While PPD poses a serious mental health concern for the mother as an individual, there exists an additional critical concern for the developmental and emotional health of the infant. The impact upon infant health is particularly important within the first year postpartum (Barkin & Wisner, 2013). Untreated postpar