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Postpartum Depression: The Romans Had A Word (or Two) For It

Postnatal Depression

We derive the adjective postpartum from the Latin ‘post partum’ where ‘post’ means after and ‘partum’ means birth. Postnatal means the same thing, also from the Latin with ‘natalis’ also meaning birth.

Postpartum Depression: Men too

Postpartum Depression is a form of clinical depression affecting women after childbirth. Men are not immune. Postpartum Depression (PPD), may occur in up to 25% of women. It is neither the same as Post Partum Exhaustion which is generally caused by lack of sleep. Nor is Postpartum Depression the same as the baby blues or maternity blues experienced by up to 80% of postnatal women, (and some men). Baby blues are not an antecedent or condition precedent of Postpartum Depression.

Symptoms of Postpartum Depression

PPD may present a number of symptoms at any time in the 12 months after birth. There may be poor self regard, guilt, melancholy, despair, inconsolabilty, inability to enjoy small, or great, pleasures, anger, panic, extreme tiredness, sleeplessness, eating disorders, inadequacy, and more.

Predicting Postpartum Depression

There are a number of known predictors of Postpartum Depression. These include bottle rather than breast feeding; smoking; prior history of depression; prenatal depression; prenatal anxiety; poor relationship with father of child; baby blues; low socio-economic status; lack of partner; race; and an unplanned or unwanted pregnancy.

Postpartum Depression and Afro-Americans, the poor, and the homosexual

In the US, a 2006 study showed about 16% of new mothers were depressed. Of these, Asians and Pacific Islanders stood at about 11%, Whites and Hispanics around 15% each, while Native Americans and Afro-Americans made up 22 and 25% each. Even when these results were adjusted for other social factors, Afro-Americans were still at significantly greater risk of developing Postpartum Depression. The same study also showed that lower incomes correlated to higher rates of Postpartum Depression and vice versa. A 2007 study showed lesbian and bisexual mothers had notably higher EPDS scores than heterosexual women. No relationship has been established between Postpartum Depression and pregnancy hormone levels.

Postpartum Depression: Scottish Detective work

Health professionals may use the Edinburgh Postnatal Depression Scale (EPDS), as a screening method for Postpartum Depression. An easy-to-complete questionnaire is completed 6-8 weeks after birth by the mother.  The questionnaire asks the new mother to self-rate against the following propositions on a scale of 0, 1, 2 or 3 points.

1. I have been able to laugh and see the funny side of things
2. I have looked forward with enjoyment to things
3. I have blamed myself unnecessarily when things went wrong
4. I have been anxious or worried for no good reason
5. I have felt scared or panicky for no very good reason
6. Things have been getting on top of me
7. I have been so unhappy, I have had difficulty sleeping
8. I have felt sad and miserable
9. I have been so unhappy that I have been crying
10. The thought of harming myself has occurred to me

A number of research studies have shown the tool to be reliable and sensitive in detecting Postpartum Depression. A score of 10 or less is normal. A score of 13/30 or more indicates that the new mother is likely to develop significant Postpartum Depression. Interview and mental status assessment are employed to confirm the EPDS.

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