| The Childbirth Professional’s Role in Combating Postpartum Depression by Laura Nance |
“What? You are going on vacation with six children? Are you crazy? That doesn’t sound like much of a
vacation to me!” Such were the comments I heard when I recently went on a week-long trip with two of my
friends and our six children, ages one to eight. It turned out to be the most relaxed trip I have taken since I
had children, a true vacation. We took turns cooking and two mothers and three older children could go snow
tubing. This experience provided me a feel for how other cultures live, surrounded by family and friends,
everyone sharing the load. No wonder postpartum depression is almost unheard of in developing lands.
Americans could learn a lot about preventing postpartum depression by imitating the way these extended
family cultures live.
With several families living in the same house, responsibilities are shared, reducing the load of each individual
person. This is especially seen in the birth period. Grandmothers, aunts and cousins rally around the
mother. In the comfort of her own home, she follows the natural course of labor that her body was made for. It
is a quiet, peaceful experience without the hustle and bustle of noise and bright light of a hospital. She is
encouraged and supported through her labor by women who have traveled this same path, women who view
birth as a normal but sacred event. The women stay with her afterward and care for household chores such
as cooking, cleaning, and caring for other children. This allows her the opportunity to focus all her energy on
resting and breastfeeding and getting to know her new baby. She has security in the knowledge that she is
surrounded by her loved ones who will continue to support and help her.
By contrast, the American high tech birth is filled with inductions, monitors, epidurals and cesarean sections.
When these interventions are used routinely, they take the birth away from the mother so that it is no longer
her experience. She does not participate fully in the amazing miracle of birthing her baby. She is then sent
home where her husband will be away at work all day, as will most of her friends and neighbors. The average
American family is spread all over the country, leaving new mothers without the help and experience of her
mother and sisters. She is expected by American culture to be up immediately; cooking, cleaning and doing
laundry, in addition to caring for her newborn and any other children she may have. In many cases she will
return to work herself in as few as six weeks. Take the feelings of loneliness and inadequacies as a new
mother, combine with plunging hormone levels, add to the nagging emptiness acquired from her birth
procedure and you have the perfect concoction for postpartum depression.
According to Robin Lim in After the Baby’s Birth, approximately 3-20% of women experience PPD and 4% of
these experience symptoms for as long as one year. The truly sad part of the statistics however, is that while
over 90% of post-natally depressed women sense a problem, only 20% report their symptoms to a medical
professional. While most women with PPD do not outwardly harm themselves or their baby, the effects can still
be debilitating and long lasting. During this special time of bonding if a mother with a newborn baby has
feelings of despair, inadequacy, helplessness and hopelessness, along with panic attacks, impaired
concentration and hostile behavior, the ability to mother and the relationship between the two is impaired.
Since birth and the early months together as a family are some of the most joyous times a woman will
experience and some of the most important developmentally for the baby, the cloud of postpartum depression
should not overshadow this period.
Can we change the way America lives? Can we encourage extended families to live together and push for
more home births? Probably not. However, as childbirth professionals, we are in a unique position as change
agents in the prevention and treatment of postpartum depression. How can we use this position to the fullest
extent possible to positively affect families?
Our part in the battle against postpartum depression begins in the prenatal education period by teaching
families the value of positive birth consumerism and informed consent. Most women do not even realize they
have a voice when it comes to their birth. The concept that “the doctor knows best” and “the doctor is in
charge” rums rampant. Women need to have the confidence that in most instances their bodies function
correctly to produce a baby, and usually function even better without medical intervention. They need to know
they have the right to say what they do and don’t want when it comes to their body and the birth of their child.
If this right is taken away from women it can be a contributing factor in the development of PPD.
As an advocate for the laboring mother, a doula helps to ensure that the mother’s voice is heard. This leads to
a reduced instance of unwanted medical procedures, such as pitocin augmentation, epidural and cesarean
section, which could contribute to developing PPD. A labor doula also helps keep the energy positive during
the birth and later helps the mother remember her birth as a joyous experience.
Any new mother can feel overwhelmed by the task of caring for a new baby while functioning on less than
optimal sleep. When women are without the support of their own mother or other female family members or
friends this feeling can go from overwhelming to despair. A postpartum doula can alleviate the pressure by
helping out around the house or with other children and encouraging rest and breastfeeding. She also helps
by helping the mother to gain confidence in her own ability as a mother.
The final way we can make a huge difference is by educating the families we work with (along with ourselves)
in the recognition of the symptoms of PPD along with the knowledge that developing a depressive condition is
not a defect on their part and that treatment options do exist. Short-term antidepressant use is many times
used in the treatment of PPD. Many antidepressants are compatible with breastfeeding therefore there is no
reason to quit breastfeeding because of medication. In fact, continued breastfeeding should be encouraged,
as it can be an important tool in the treatment of PPD due in part to the release of the hormones oxytocin and
prolactin. If a woman had a less than optimal birth experience she can gain great confidence in the fact that
she can still give her infant the perfect food and the special relationship that the nursing mother/baby dyad
experiences. This education should take place during the prenatal period before it could be an issue. As
professionals we need to be aware of situations that may make a family more at risk for postpartum
depression. We also need to be observant in all situations for possible signs of PPD.
Many times we have a more intimate relationship than other professionals have with the families we serve.
This puts us in a special position to arm women in prevention, recognition and treatment of postpartum
depression, because it is a potentially preventable and very treatable condition.
vacation to me!” Such were the comments I heard when I recently went on a week-long trip with two of my
friends and our six children, ages one to eight. It turned out to be the most relaxed trip I have taken since I
had children, a true vacation. We took turns cooking and two mothers and three older children could go snow
tubing. This experience provided me a feel for how other cultures live, surrounded by family and friends,
everyone sharing the load. No wonder postpartum depression is almost unheard of in developing lands.
Americans could learn a lot about preventing postpartum depression by imitating the way these extended
family cultures live.
With several families living in the same house, responsibilities are shared, reducing the load of each individual
person. This is especially seen in the birth period. Grandmothers, aunts and cousins rally around the
mother. In the comfort of her own home, she follows the natural course of labor that her body was made for. It
is a quiet, peaceful experience without the hustle and bustle of noise and bright light of a hospital. She is
encouraged and supported through her labor by women who have traveled this same path, women who view
birth as a normal but sacred event. The women stay with her afterward and care for household chores such
as cooking, cleaning, and caring for other children. This allows her the opportunity to focus all her energy on
resting and breastfeeding and getting to know her new baby. She has security in the knowledge that she is
surrounded by her loved ones who will continue to support and help her.
By contrast, the American high tech birth is filled with inductions, monitors, epidurals and cesarean sections.
When these interventions are used routinely, they take the birth away from the mother so that it is no longer
her experience. She does not participate fully in the amazing miracle of birthing her baby. She is then sent
home where her husband will be away at work all day, as will most of her friends and neighbors. The average
American family is spread all over the country, leaving new mothers without the help and experience of her
mother and sisters. She is expected by American culture to be up immediately; cooking, cleaning and doing
laundry, in addition to caring for her newborn and any other children she may have. In many cases she will
return to work herself in as few as six weeks. Take the feelings of loneliness and inadequacies as a new
mother, combine with plunging hormone levels, add to the nagging emptiness acquired from her birth
procedure and you have the perfect concoction for postpartum depression.
According to Robin Lim in After the Baby’s Birth, approximately 3-20% of women experience PPD and 4% of
these experience symptoms for as long as one year. The truly sad part of the statistics however, is that while
over 90% of post-natally depressed women sense a problem, only 20% report their symptoms to a medical
professional. While most women with PPD do not outwardly harm themselves or their baby, the effects can still
be debilitating and long lasting. During this special time of bonding if a mother with a newborn baby has
feelings of despair, inadequacy, helplessness and hopelessness, along with panic attacks, impaired
concentration and hostile behavior, the ability to mother and the relationship between the two is impaired.
Since birth and the early months together as a family are some of the most joyous times a woman will
experience and some of the most important developmentally for the baby, the cloud of postpartum depression
should not overshadow this period.
Can we change the way America lives? Can we encourage extended families to live together and push for
more home births? Probably not. However, as childbirth professionals, we are in a unique position as change
agents in the prevention and treatment of postpartum depression. How can we use this position to the fullest
extent possible to positively affect families?
Our part in the battle against postpartum depression begins in the prenatal education period by teaching
families the value of positive birth consumerism and informed consent. Most women do not even realize they
have a voice when it comes to their birth. The concept that “the doctor knows best” and “the doctor is in
charge” rums rampant. Women need to have the confidence that in most instances their bodies function
correctly to produce a baby, and usually function even better without medical intervention. They need to know
they have the right to say what they do and don’t want when it comes to their body and the birth of their child.
If this right is taken away from women it can be a contributing factor in the development of PPD.
As an advocate for the laboring mother, a doula helps to ensure that the mother’s voice is heard. This leads to
a reduced instance of unwanted medical procedures, such as pitocin augmentation, epidural and cesarean
section, which could contribute to developing PPD. A labor doula also helps keep the energy positive during
the birth and later helps the mother remember her birth as a joyous experience.
Any new mother can feel overwhelmed by the task of caring for a new baby while functioning on less than
optimal sleep. When women are without the support of their own mother or other female family members or
friends this feeling can go from overwhelming to despair. A postpartum doula can alleviate the pressure by
helping out around the house or with other children and encouraging rest and breastfeeding. She also helps
by helping the mother to gain confidence in her own ability as a mother.
The final way we can make a huge difference is by educating the families we work with (along with ourselves)
in the recognition of the symptoms of PPD along with the knowledge that developing a depressive condition is
not a defect on their part and that treatment options do exist. Short-term antidepressant use is many times
used in the treatment of PPD. Many antidepressants are compatible with breastfeeding therefore there is no
reason to quit breastfeeding because of medication. In fact, continued breastfeeding should be encouraged,
as it can be an important tool in the treatment of PPD due in part to the release of the hormones oxytocin and
prolactin. If a woman had a less than optimal birth experience she can gain great confidence in the fact that
she can still give her infant the perfect food and the special relationship that the nursing mother/baby dyad
experiences. This education should take place during the prenatal period before it could be an issue. As
professionals we need to be aware of situations that may make a family more at risk for postpartum
depression. We also need to be observant in all situations for possible signs of PPD.
Many times we have a more intimate relationship than other professionals have with the families we serve.
This puts us in a special position to arm women in prevention, recognition and treatment of postpartum
depression, because it is a potentially preventable and very treatable condition.
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| CHARLOTTE, NC * HUNTERSVILLE, NC * CONCORD, NC * GASTONIA, NC * SHELBY, NC * HICKORY, NC * STATESVILLE, NC * ROCK HILL, SC * FT. MILL, SC |
| PROFESSIONAL PRE- AND POST-BIRTH ASSISTANTS OF CHARLOTTE, NC & SURROUNDING AREAS |
Labor Doula and a CAPPA trained Lactation Educator. She is also a Labor
Doula Trainer for CAPPA. Laura has an interest in the cultural differences of
birth in other countries, especially traditional societies.
Doula Trainer for CAPPA. Laura has an interest in the cultural differences of
birth in other countries, especially traditional societies.
