After I gave birth in England 23 years ago, the doctor -- or someone at the hospital -- told me that a midwife was going to check on me at home for a few days. I cringed. For whatever reason (maybe my own distorted perception of British midwives), I imagined a snippy old lady in a white-starched uniform barging into my living room, barking orders about how I should nurse my baby and set sleep schedules with military precision.
Boy was I wrong. The day after I got home, a young woman showed up who looked like a Birkenstock-clad meditation instructor (I think she really did wear Birkenstocks). She weighed the baby, examined me to make sure my uterus was shrinking back to normal size, and that breastfeeding was going well. No rules, just comforting words.
After 10 days, she stopped coming because my baby and I were both doing well. Then six weeks later, another health visitor showed up (also funded by Britain's National Health Service). Despite the delightful service first time around, my initial reaction was curmudgeonly yet again. Wasn't this an invasion on my privacy? And once again, I was taken back by the niceness of it all.
The health visitor and I sat on the floor and talked about me, that is my feelings about motherhood and how I was coping. I didn't realize at the time but her seemingly random questions were really a checklist to spot signs of postpartum depression.
I thought about that experience when I opened the New York Times this morning to a front-page story about a government panel advising screening for postpartum depression. And then, no surprise, it was picked up all over, NPR, LA Times, CBS, and so on. The advice, according to one story was prompted by a new study that found depression after birth is more common than previously thought, and that it often starts during pregnancy not afterwards
Ten years ago, Emory University researchers published a study in the American Journal of Obstetrics and Gynecology that tallied the amount of postpartum depression and concluded that the exact same thing. We need to screen women during their prenatal visits. That study was followed by another larger one (also about 10 years ago) that amassed all the data and concluded, again, that we need to screen women.
The latest advice is one part of a bigger report by the U.S. Preventive Services Task Force. As NPR's Joanne Silberner noted, the new part is that after similar depression-prevention reports (one in 2002 and another in 2009), this one gives a "special shout out for pregnant women and new moms."
We know that during pregnancy, you're slammed with a tsunami of hormones: HCG (human chorionic gonadotropin), estrogen, progesterone among others skyrocket.
And then just when you think you're getting used to your new chemical state, the baby is born and your hormones plummet. So far we don't know the exact chemical basis triggering postpartum depression.
Regardless of the science -- or lack of it -- I hope that at least the new report, from an influential group of experts, will finally give birth to a strategy that will offer support to women, for their own sake and the sake of their children. We aren't talking investing in expensive equipment or new drugs or even funding house-calling health workers (though that would be nice), but simply making sure that screening for depression is part of routine prenatal visits.
If you think you might have postpartum depression, contact your health care provider. For more information, visit http://www.postpartum.net/.