MHM Magazine

Issue 4 | 2021 | MENTALHEALTHMATTERS | 15 MHM Postpartum depression (PPD), a mood disorder commonly impacting women within the first 12 months after giving birth, often falls between the cracks of two medical specialties: OB-GYN and psychiatry. Symptoms of this debilitating disorder may include persistent and extreme sadness, anxiety, indifference, and changes in sleep, energy, and appetite. If left untreated, it can put both infant and mother in harm’s way. AN OBSTETRICIAN’S ROLE IN RECOGNISING PPD Obstetricians usually don’t see a woman for a postpartum checkup until six weeks after delivery. At this visit, if a woman says anything about not feeling like herself, she will likely be told by her doctor that it will pass. On the other hand, if obstetricians are concerned about signs of PPD and seek a referral to counselling, the patient usually has to wait an additional six weeks for an appointment. With PPD, this is a serious problem. The sooner PPD is addressed, the sooner the mother, baby and her family will be safe. A caring obstetrician, knowing that six weeks is too long to wait, may try to prescribe anxiety medications to tide the patient over until the counsellor can be seen. This opens obstetricians up to complaints by psychiatrists that they are providing care outside their scope of practice. It’s a Catch-22 with potentially devastating results. A PATH TO TREATMENT It’s no wonder that authors Karen Kleiman and Valerie Davis Raskin report that: “Even though PPD is very common, only a small fraction of women who experience it ever get the help they need.” The medical community, including obstetricians and psychiatrists, don’t often talk about finding pregnancy- related depression early, but it can be done. It can be done with less expense, less morbidity, and a better outcome. I’ve been thinking outside the box for many years and understand By Dr. Alan Lindemann Obstetrician and maternal mortality expert Elgin, North Dakota, USA WAYS TO COMBAT POSTPARTUM DEPRESSION