Postpartum Progress

Postpartum Mood Disorder Event June 12th in Spokane

Postpartum Support International of Washington and the Council for Children & Families will host "Postpartum Mood Disorders: A Community Discussion of PPMDs" on June 12th from 10:30am to 5pm at the Downtown Spokane Public Library.  Presentations will include information on the cultural implications of PPMDs, the importance of early assessment and diagnosis, and the wellness model of treating PPMDs.  All are welcome.  The event is free and lunch will be provided.  To RSVP, email wcpcan@wcpcan.wa.gov.

Two PPD Advocates Win Eli Lilly Welcome Back Award

Eli Lilly and Company is honoring six inspiring winners at the 10th annual Welcome Back Awards ceremony in Washington, D.C. on Saturday, May 3.  For the past decade, the Welcome Back Awards has recognized individuals for their outstanding commitments to mental health, donating nearly half a million dollars to not- for-profit organizations on behalf of program honorees.

Lilly established the Welcome Back Awards in 1998 to fight the stigma associated with depression and to promote the understanding that depression is treatable.  Each year, an independent panel of national mental health leaders recognizes five individuals for their outstanding achievements, and Lilly awards donations ranging between $10,000 and $15,000 to the not-for-profit organization of each winner's choice.  Two of the 2008 winners are major advocates in the field of postpartum mood disorders:

Lifetime Achievement:  Mary Jo Codey, West Orange, N.J.
Mary Jo Codey's personal experiences with postpartum depression during both her pregnancies opened her eyes to the impact that limited knowledge and understanding of postpartum depression had in her community and throughout her state.  As the first lady of New Jersey, Codey seized the opportunity presented by her husband's 14 months as governor from 2004 to 2006 to bring attention to the condition through public appearances and interviews.  She courageously detailed her experiences with an illness that many find difficult to understand.  In addition, Codey played a key role in developing, and served as spokesperson for, a widely successful statewide postpartum depression education campaign, "Recognizing Postpartum Depression: Speak Up When You are  Down."  She also inspired New Jersey's groundbreaking Postpartum Depression Screening and Education law.  On the national level, Codey has lobbied on Capitol Hill in support of legislation designed to support research and education relating to postpartum depression and psychosis and provide support services for sufferers.

Psychiatry:  Margaret Spinelli, M.D., New York, N.Y.
Margaret Spinelli has been passionate about solving the problems of those around her since she was young.  An inherent desire to help others led her to a career in nursing.  While working with impoverished women at a Brooklyn clinic, Spinelli became interested in learning more about the mental health of expectant mothers.  Now considered a leading expert in the field of perinatal psychiatry, Spinelli has been touring the world, lecturing and teaching on the subject for the past 20 years.  Her groundbreaking work has focused on researching and evaluating women who have committed infanticide due to postpartum mental disorders, and she has performed a significant amount of pro bono work for women with psychiatric illnesses.  Spinelli continues to find her work not only rewarding, but also therapeutic as she recognizes that for every mother she treats, there is a child (or children) who benefits.

"For the past decade, the Welcome Back Awards has been honoring individuals in the depression community who have challenged the status quo by designing, developing and facilitating programs that bring awareness to the condition and relief to those who suffer from it," said John Hayes, M.D., vice president of Lilly Research Laboratories and global brand development team leader of neuroscience, Eli Lilly and Company.  "It is important for Lilly to recognize these unique voices in the depression community as a way to inspire them to continue their good work and promote recovery.  I am honored to present Welcome Back Awards, now in its tenth year, to these admirable individuals."

Nominations for the 2009 WBA may be submitted by anyone wishing to be recognized for his or her outstanding achievements in the depression community or wishing to recognize someone else.  For more information, call 800-463-6440 or visit http://www.welcomebackawards.com/.

PPD Warrior Chicks Rock!

Postpartum Depression Warrior Chicks (and the supportive "roosters" out there), you rock!  The Depression & Bipolar Support Alliance's online petition to support the Melanie Blocker Stokes MOTHERS Act has now reached nearly 12,000 signatures in a week and a half.  I'm so excited for you and all of the other concerned people around the country who are taking action to show they care for new mothers.

Do we need more signatures?  ABSOLUTELY!!  Those U.S. Senators need to hear completely loud and clear that we believe the women of America deserve more research into the cause of postpartum mood disorders, better trained healthcare providers and greater awareness to reduce the stigma.  Keep pressing on your friends, and loved ones, and church members, and neighbors, and pets with opposable thumbs to sign, sign, SIGN!  Let's get 100,000 signatures -- don't forget, 800,000 women in America suffer from postpartum mood disorders each year. 

Here is the link again to the DBSA online petition, which is supported fully by Postpartum Support International (and Postpartum Progress, of course!): http://www.capwiz.com/ndmda/issues/alert/?alertid=11246546

We especially need to hear from people in the following states:  Massachusetts, North Carolina, Maine, Minnesota, Tennessee, Colorado, Mississippi, Utah, Connecticut, Alaska, Iowa, Nebraska, Arkansas, West Virginia, Kansas, Delaware, Hawaii, New Mexico, New Hampshire, Idaho, DC, Alabama, South Dakota, Montana, Louisiana, Oklahoma and Wyoming.  If you know people who live there, give them a shout out and see how they feel about the MOTHERS Act.  Bloggers in those areas, please help us out.  I hope more people from those states will be able to join us in supporting this bill, which is about taking positive action against a devastating illness.  I've got a Mississippi family contingent that I'm going to start calling as soon as I'm done with this post!! 

MOTHERS Act Losing Momentum -- Online Petition Needs Your Signature

It's time to talk about the Melanie Blocker Stokes (MBS) MOTHERS Act again.  I know, I know.  We've heard this all before, you're thinking.  I already called my Senator, you're thinking.  I already wrote about this on my blog, you're thinking.  Sheesh!, you may even be thinking.  Well, apparently everything you and I have done so far in support of this bill hasn't been enough. 

As you may know, there are some people who are completely convinced that the MBS MOTHERS Act is a conspiratorial plot by the government to drug pregnant and postpartum women, and it must be STOPPED AT ALL COSTS!!!!!!!!!!!!!!!!  You and I know that's not true.  So we've kind of ignored the negative campaign -- been slightly pissed and sometimes even truly annoyed but gone on with our day because it's silly and we have lots of more important things to worry about than some misguided folks.  But the U.S. Senate can't ignore it when lots and lots and lots of people speak out.  That's how they work, right?  Polls.  When they hear from lots of people on a certain issue, they tend to go in that direction.  Right now our Senators are hearing from a whole host of people who think it's a really bad idea to pass this bill -- a bill that provides funding for increased research into the cause and treatments of postpartum mood disorders, provides better training for healthcare providers and provides for an awareness campaign so that more women will know about these illnesses and realize that they can get help. Those people, bless their hearts, are very vocal and have every right to say what they think. (Tom Cruise must be very pleased.) 

Conversely, those who believe in the MBS MOTHERS Act are not being anywhere near vocal enough. Our Senators are NOT HEARING from enough of those of us who support it.  If this trend continues, this bill will not pass.  What happened to us, and to hundreds of thousands like us, and to our friends and sisters and mothers and girlfriends will keep happening.  Women will continue to think they've gone crazy, never to return to their old selves.  They will continue to live in fear of speaking up and telling someone about it.  They will continue to be afraid to lose their children.  They will continue to suffer, hurting both their health and the health of their children, because they won't get treatment.  Some might even kill themselves, or become so ill they harm their children.  That is unacceptable to me.  Is it acceptable to you?  I started this blog because I was damn well not going to let anybody go through the isolation and terror and ineffective treatment from an untrained doctor that I received.  Don't you feel the same? 

Postpartum Progress readers, and anyone who cares about postpartum mood disorders, I very humbly beg you to complete two very easy assignments:

1.  Click this link and sign this petition to support passage of the MBS MOTHERS Act.  It is as easy as pie.  Thanks to the Depression and Bipolar Support Alliance for getting the petition going.  All you have to do is fill out your name and address and click send, and it will be sent all the proper places.   The petition is also supported by Postpartum Support International.

2.  Forward the petition link to everyone you know and tell them to sign their name to it as well.

We need thousands of people to do this.  Not just a few hundred.  Seriously, thousands.  Please get clicking. And if you have a website, or an organization of proactive women and moms, or a blog, please get your readers/members involved ASAP.

P.S.  In case you're wondering, here is a list of the respected organizations that endorse the Melanie Blocker Stokes MOTHERS Act:

• Postpartum Support International
• Association of Women's Health, Obstetric and Neonatal Nurses
• American College of Obstetricians and Gynecologists
• Children's Defense Fund
• March of Dimes
• American College of Nurse Midwives
• Suicide Prevention Action Network USA
• Mental Health America
• Depression and Bipolar Support Alliance
• National Alliance on Mental Illness
• National Women's Law Center
• National Partnership for Women & Families
• National Council for Community Behavioral Healthcare
• Association of Maternal and Child Health Programs
• American Psychological Association
• American Psychiatric Association
• Postpartum Resource Center of New York

If you would like to add your organization to this illustrious list, please let me know at stonecallis@msn.com.  (They can't all be part of the conspiracy to drug America's moms, can they???)
 

CDC Releases Latest Statistics on PPD Today

Per Miranda Hitti at WebMD, the CDC today issued its latest statistics on postpartum depression, and the figures show that certain groups of women may be at higher risk.  The CDC's report included more than 52,000 new moms in 17 states. The prevalence of self-reported postpartum depression ranged from 11.7% in Maine to 20.4% in New Mexico.  Postpartum depression was more often reported by teenage moms, mothers with less than 12 years of education, Medicaid patients, smokers, victims of physical abuse before or during pregnancy, and women under traumatic or financial stress during pregnancy.  Having a low-birth-weight baby or a baby admitted to a neonatal intensive care unit was also tied to self-reported postpartum depression in most of the 17 states.

The postpartum depression statistics, published in the April 11 edition of the CDC's Morbidity and Mortality Weekly Report, don't separate women who became depressed after giving birth from women who were already depressed before pregnancy.

The CDC urges women to get treatment for postpartum depression for the sake of mother and baby alike.

The CDC also notes that the American College of Obstetricians and Gynecologists recommends that doctors screen all new moms for postpartum depression four to six weeks after birth.

P.S.  Here's a link to the Wall Street Journal's health blog's coverage of the CDC report on postpartum depression.

Straight Talk About Hospitalization & Postpartum Depression

One area I don't like to talk about is hospitalization.  I don't know why.  It's like the ultimate embarrassment for me or something that at one point I had to be hospitalized in a mental hospital (UGH!) for depression.  It was only for a few days, but it's one thing of which I have to say I still feel slightly ashamed.  If our society considered mental illness a physical illness, then of course I wouldn't be ashamed, because there is nothing at all wrong with being sick and having to go to the hospital.  But you and I both know that's not the way people think when it comes to "mental institutions."  Nonetheless, I can't let that stop me from talking openly to you about a type of treatment that some women with postpartum mood disorders must experience, so here goes ...

The truth is, if we are a danger to ourselves or others we need to be hospitalized.  Period.  I wish there were another way, a better solution, but as far as I know there isn't.   I got to a point where I thought I might kill myself.  And so, that's where I was sent.  The minute I got there and saw what was coming I completely changed my mind about killing myself, of course.  I told them very articulately that I was all better and there was no need to move forward.  (Stop the train, I want to get off!)  But once the proverbial cat is out of the bag you can't put it back in. 

Here's what you should know:  Mental hospitals aren't a treat.  It can feel like being in jail.  Once you are in you can't just get out any old time you want.  At least not for 48 hours or so.  You don't have access to all of your things because they take them away from you to make sure there's nothing dangerous or illegal in them. You don't have free access to the people you love, except during limited visiting hours.  The decor is sorely lacking.  The food stinks.  The beds are lumpy.  You don't even have the right to go to the bathroom at any time without permission.  I remember at one point being in the cafeteria trying to eat the awful food and I needed to pay a visit to the facilities.  They wouldn't let me, because they couldn't leave my group and couldn't let me leave the cafeteria alone.  I was humiliated and infuriated.  "I'm a competent grownup!  How dare you tell me I can't go to the bathroom!  What happened to basic human dignity??!!"  They were unimpressed by my reaction, and I had to wait.  Also, I was in the general adult ward, with men and women in all sorts of mental states -- addicts, schizophrenics, people suffering from depression or bipolar disorder -- and I was scared.  The truth is no one would choose to hang out with a group of people she doesn't trust to make safe choices.  But be all of that as it may, it was the exact right place for me. 

I truly benefited from being in that hospital at that moment.  Once we get over the thinking that we are somehow better, special and different from the rest of the people in the "asylum", it can be a profound experience.  First, they took care of me and helped me become stable.  I was in a crisis and they helped me out of it.  Second, I was humbled and made to understand via circumstance that we are all one step away from losing our minds no matter where we come from or how much money we make or what we look like or what job we have or how competent we've been up 'til now.  Third, I learned that severely mentally ill people are still people, and I became very empathetic to their plight.  I remember watching a man who stood in the corner all day brushing himself off and found out it was because he thought there were snakes on him.  Another young man curiously kept cutting the eyes out of pictures of people in magazines.  Only later did I notice he had been taping them up surreptitiously in strategic places throughout the ward -- in the leaves of the ficus tree, on the wall clock, in the plastic floral wreath covered in a layer of dust.  The eyes watched me wherever I went.  I imagined what those two men, and some of the others, might have been like as innocent, happy children with no inkling of what was to come in their lives.   Could they help the situation they were in now?  Maybe, maybe not.  I went from a state of fear to one of wonder and to one of caring about these people and hoping for their well-being.   

I have family members of women with postpartum depression or psychosis reach out to me to tell me their sister or daughter has been hospitalized and that it's absolutely the WRONG place for her.  "She doesn't belong with those other people.  She's not crazy.  She's just not doing well."  I completely understand what they mean.  It's the wrong place for everyone.  Wouldn't we all like to go recuperate from wanting to kill ourselves in Tahiti?  Don't they have a "Mental Health Weekend" 3-day package at the Ritz?  That would be lovely but that's not how it works.  So I tell them I know it seems like a mistake, but it's actually the exact right place for her at that moment.  I tell you that if it's what you have to do to restore your sanity and return home a more healthy mother to your baby, just do it.  Suck it up and do it.  No matter how yucky it is, you will live.  And you might be a better person for it.

   

Meet Me in Houston for the Annual PSI Conference

Registration is now open for the Postpartum Support International annual conference to be held in Houston at the Hilton Americas June 4-7.  I am including a PDF of the conference brochure below so that you can learn all about the various speakers and sessions.  I love this conference, not only for the updated information I am able to get but also because I get to spend time with my fellow warrior chicks and some amazing healthcare professionals who are dedicated to helping women with perinatal mood disorders.  I hope you'll be able to attend and I'll get to see you all in person!

Download psi_conference_brochure_08.pdf

USA Today's Health Blog "Better Life" & Postpartum Progress

ARE YOU KIDDING ME????!!!!!!! 

Forgive me for yelling, but I can't contain my excitement.  I found out this week that USA Today's Health blog, called Better Life and written by Rita Rubin, inludes Postpartum Progress in its list of blogs worth reading.   Rita was a medical reporter for USA Today for 10 years before taking on the newspaper's health blog.  Prior to joining USA Today she was a medical reporter for U.S. News & World Report and the Dallas Morning News.  One of her top news interests is women's health, and we are so lucky that she thinks the topic of perinatal mood disorders is important enough to include on Better Life.  Her list of blogs worth reading also includes those of the American Cancer Society, American Diabetes Association, American Heart Association, Mayo Clinic, Revolution Health and Organized Wisdom (where, by the way, I put together the wisdom card on postpartum depression). 

Please go check out the Better Life blog and support it as much as you can!

House Passes Paul Wellstone Mental Health and Addiction Parity Act

Last week, the U.S. House of Representatives passed the Paul Wellstone Mental Health and Addiction Parity Act.  This bill, which has now moved on to the Senate, requires insurers and health plans to end the imposition of treatment limitations or financial limitations when they offer mental health benefits that are more restrictive than those applied to medical and surgical services.  (It does not require insurers to offer mental health coverage, but first things first I guess.)  Following is an overview of some of the bill's key provisions, as taken from Speaker Nancy Pelosi's website:

Requires equity in financial requirements. Under the bill, an insurer or group health plan must ensure that any financial requirements – such as deductibles, copayments, coinsurance, and out-of-pocket expenses – applied to mental health and addiction benefits are no more restrictive or costly than the financial requirements applied to comparable medical and surgical benefits that the plan covers.

Requires equity in treatment limits. Under the bill, a group health plan must ensure that the treatment limitations – such as frequency of treatment, number of visits, and days of coverage – applied to mental health and addiction benefits are no more restrictive than the treatment limitations applied to comparable medical and surgical benefits that the plan covers.

Does not mandate mental health benefits. The bill does not mandate insurers or group health plans to provide any mental health coverage. The bill’s provisions only apply to plans that choose to offer mental health coverage. 

Exempts certain businesses. The bill exempts small businesses with 50 or fewer employees. It also exempts those businesses that experience an overall premium increase of 2 percent or more in the first year and 1 percent in subsequent years.

Covers same mental illnesses and addiction disorders as FEHBP. The bill ensures that group health plans cover the same range of mental illnesses and addiction disorders covered by the Federal Employees Health Benefits Program – i.e., the mental illnesses and addiction disorders included in the mental health practitioner’s guide, the Diagnostic and Statistical Manual of Mental Disorders (DSM).

Does not mandate out-of-network benefits. The bill simply states that if a plan already offers out-ofnetwork benefits, it must offer out-of-network benefits on the same terms for mental health services as it does for medical and surgical services.

Does not pre-empt stronger state parity laws. The bill establishes a federal standard, a floor of protections that would apply to job-based health coverage, but allows states to be more protective of their residents with stronger parity laws.

Explicitly permits medical management of health benefits. The bill allows the use of medical management tools that are based on valid medical evidence and pertinent to the patient’s medical condition so that specific coverage is not arbitrary in its application and more transparent to the patient.

Provides for enforcement. The bill provides remedies to protect beneficiaries’ rights and permits enforcement of the bill’s equity requirements by the Internal Revenue Service, the Department of Health and Human Services, and the Department of Labor.

Postpartum Perspective & Unexpected Blessing Blog On MOTHERS Act

Here's a great post on the new blog Postpartum Perspective about the MOTHERS Act opposition.  Check it out! One highlight:

"We have ended up debating whether or not postpartum mental health problems should be treated with medication, whether breastfeeding while taking meds is good or bad, whether health care providers should be more or less intrusive in mother's women's lives. Why aren't we debating about whether or not the fact that women are dying due to lack of support is a problem?"

And another great piece on Unexpected Blessing from Lauren Hale, as she openly shares what she went through and why the MOTHERS Act is so crucial.  A highlight:

"I believe in this bill because I have lived through the very depths of the condition it is fighting to uncover and remove the stigma of so that the next mother who suffers will not have to suffer in silence, will not have to go to her doctor and be rejected and told to “suck it up” and that this is a normal part of motherhood, something that she should get over, something that shouldn’t be happening because she is more than 6wks postpartum and therefore all her hormones should be back to normal by now."

Postpartum Progress Speaks Out in Full Support of MOTHERS Act

I said I would speak out on the ridiculous campaign being waged through petitions and blogs right now to block passage of the Melanie Blocker Stokes MOTHERS Act ... so here goes (hold on to your hats, folks):

I am truly peeved and disappointed at the breathless, hysterical ranting going on about the MOTHERS Act.  Many of those who oppose it seem to have done LITTLE to NOTHING to inform themselves about the actual bill and the organizations that support it.  Falsehoods are being spread.  Here are some examples:

"A federal bill that is dangerous to mothers and their newborns but being promoted under the guise of ensuring that 'new mothers and their families are educated about postpartum depression, screened for symptoms, and provided with essential services ...'  This is quite simply false ... it will push more mothers onto dangerous antidepressant drugs ..."

"If this bill is passed, any money spent on screening will be a complete waste of tax dollars.  The results will be an INCREASE in the severity and frequency of postpartum depression and an increase in violence and suicide."

"This legislation will ensure that new mothers and their families are also subjected to such treatment as they are screened for symptoms and provided so called 'help' that pushes these new mothers over the edge."

"The bill was originally proposed in response to the death by suicide of Melanie Stokes, a pharmaceutical rep. who took her own life by leaping from a balcony several stories off of the ground. Contrary to popular understanding it was not post-partum depression that killed Melanie, but the numerous antidepressant drugs she was taking ..." 

I'm not sure what algorithm they're using that would indicate that doing more to identify and treat these illnesses would lead to more PPD -- is this the new math they're teaching in schools?  And I have no idea how in good conscience they could spread lies about Melanie Blocker Stokes when her fearless and amazing mother Carol has worked so hard to get legislation like this passed so that other mothers can avoid the pain she has had to endure in losing her daughter. 

Now I know standards dictate that I don't share with you what these people are saying because it somehow gives them a voice.  But I'm blowing up the standards today, because I think my readers need to know exactly what is being said, so that you can be moved to speak up about it and defend the importance of the MOTHERS Act.  (One of the organizations behind this push is CCHR.  CCHR is the Church of Scientology.  Need I say more?)

The Melanie Blocker Stokes MOTHERS Act does NOT recommend drugs or require drugs or endorse drugs.  What is does is the following:

• Encourage the Department of Health and Human Services to coordinate and continue research to expand the understanding of the causes of, and find treatments for, postpartum conditions. 
• Encourage a national public awareness campaign to be administered by HHS to increase awareness and knowledge of postpartum depression and psychosis.
• Encourage HHS to make grants available for projects for the establishment, operation and coordination of systems for the delivery of essential services to individuals with postpartum depression.

There is no nefarious undercurrent, no plot by "the man."  The simple point is to continue to look into the causes of postpartum mood disorders, to let people know they exist and to provide better support services for the women who have them and their families.   Period, the end.  Every woman has the choice to decline participation in a screening, and every woman has the choice to look at all of the various treatment options available to her and choose the best one for her, whether it includes medication, therapy, alternative treatments, support groups or some combination thereof. 

Do I agree that we must be careful to only treat those who are ill?  Of course.  Do I agree that we must be careful in the types of treatments that are used, and must recognize the risks of taking certain treatments as well as the risks of not taking them?  Of course.  But I will not allow fearful conspiracy theorists to derail what is most important, which is getting our country's healthcare system to eliminate the stigma of mental illness, recognize the prevalence of postpartum mood disorders, learn more about their cause, allow new mothers who are suffering to feel safe in getting professional help and identify the best and safest treatments possible.

Please add your thoughts.  Scroll to the bottom of this post and look for the comments link to speak out.  C'mon girls - USE YOUR VOICE.

Here are links to other great comments about the opposition and the importance of supporting the MOTHERS Act.  If I've missed your response, let me know and I'll add it to this list.

• Susan Stone, President of PSI - this is so beautifully written - you MUST read it
• Spin Me I Pulsate
• Buoy for Perinatal Blues & Beyond
• Postpartum Perspective
• Unexpected Blessing/Sharing the Journey
• Depression Introspection

Why Universal Screening for PPD is Necessary

I found an excellent article on Health Commentary calling for universal screening for PPD written by Amy Gagliardi, a writer and research based at Yale University.  Check out the whole piece, but here is a highlight:

Wilen and Mounts in their article, Women with Depression – “You Can’t Tell by Looking” suggest that when screening for depression in the health care setting is based on clinical observation alone, 50% of women suffering from depression are missed.  In a study of 888 pediatricians, Olson et al conclude that even during the postpartum period when pediatricians have frequent contact with mothers and babies, pediatricians rarely identify maternal depression through a routine inquiry about symptoms or through family history.  In fact, the most common identification method reported was the physician’s overall impression or the impression in combination with 1 or 2 questions about the mother’s symptoms. Only 4% of the physicians in this study reported using formal diagnostic criteria to identify maternal depression while none reported using a validated screening tool to identify maternal depression. 

Universal screening is a necessary prerequisite towards the identification and treatment of maternal depression and this is not a responsibility specific to any one discipline.  Whether we are discussing perinatal depression, which is depression during pregnancy and the postpartum period, or depression at any time throughout the life course, systematic and universal screening is the most effective way to identify depression.  Of interest is a study which utilized a 2 question screen of mothers during well child visits. One group of mothers received the screen on paper while the other group was screened by means of a scripted interview.  Although both methods were proven to require very little time, the paper screen was verified to be a more effective model.

Study Shows Immigrants Face Higher Risk of PPD in Canada

Immigrants, refugees and women seeking asylum in Canada are four to five times more likely to suffer from postpartum depression than women born there, according to a study published this month in the Canadian Journal of Psychiatry.

"Postpartum depression is more likely to be recognized in Canadian-born moms, but our study shows its much more common in immigrant women and they don't seek help as much as the Canadian women do," said Dr. Donna Stewart, the principle author of the study.

She said the results of the study surprised her, considering a well-documented phenomenon known as the "healthy immigrant effect."

"Immigrants to Canada are much healthier than Canadian-born women, and there have been lots and lots of studies showing that, so from that perspective it did surprise me. From the perspective that it didn't surprise me, as a clinician, I see a lot of foreign-born women who get depression after they have a baby. I also know from the public health nurses that they see them in the community and they're not willing to come and seek services" ...

"We find from the women that there's the stigma of depression, that they're frightened word will get around that they're not good mothers, that their babies might be taken into care. We hear from the health care providers that they're not quite sure what the customs are for these groups, sometimes the language is an impediment, and sometimes they feel that the families don't want these women to seek care."

Stewart said the high incidence of postpartum is largely due to the lack of social support for newly arrived women.

"Their parents are often in their country of origin, their families are back in their country of origin and they may not have had time to make friends here yet. So I think they're very isolated. And I think they often don't know about social services that might be out there, how to meet other moms with young babies, and they also don't know how to access health services very well" ...

She said immigrant social services also need to become better educated, and more aware that when they see new, immigrant moms, that there is a greater risk of postpartum depression and to know some of the services they can be referred to.

"In many countries, depression isn't talked about. So if you have someone coming from one of the far eastern countries, for example, where depression isn't talked about very much and where it's highly stigmatized, the service providers from that background may also not think to ask about it," Stewart said.

UCSF Hosting PPD Lecture & Training March 26-27

The University of California San Francisco, Community Medical Centers and the March of Dimes will be hosting "Shouldn't I Be Happy? What Everyone Needs to Know About Depression and Anxiety During Pregnancy and the Early Mothering Years" on March 26th at the UCSF Fresno Center.  The event will feature Dr.Shaila Misri, one of the leading reproductive psychiatrists in North America and founder and director of Reproductive Mental Health at St. Paul's Hospital and BC Women's Hospital in Vancouver, Canada. A training session will be held the following day from 8am to 2pm.  CME and CEUs are available.  Registration for the lecture is $20, and $30 for the training.  For more information, call 559-499-6532 or email shissong@fresno.ucsf.edu.

Study Says Poorer Moms & African-American Moms More Likely to Suffer PPD

A study of new mothers in Iowa found that poorer mothers were more likely to suffer postpartum depression, as were African-American women.

Forty percent of Iowa mothers with a household income of less than $20,000 suffered from clinically-significant postpartum depression, compared to only 13 percent of new mothers whose household income was $80,000 or more, according to a study of 4,332 women from four Iowa counties.

The study, conducted by U of I psychologist Lisa Segre, was published last April in the journal Social Psychiatry and Psychiatric Epidemiology, the U of I reported Tuesday. Women were surveyed in the late 1990s about 4.6 months after they had given birth.

"Women who are poor already have a lot of stress, ranging from poor living conditions to concerns about paying the bills," Segre said in a news release. "The birth of an infant can represent additional financial and emotional stress, and depression negatively impacts the woman's ability to cope with these already difficult circumstances."

In a second study on race and postpartum emotions in Iowa, Segre found that African-American mothers are more likely than white mothers to experience depressed moods immediately after giving birth, but Latina mothers are less likely to experience depressed moods.

This survey was given to 26,877 English-speaking mothers in maternity wards of Iowa hospitals in 2001 and 2002. The results were published in March 2006 in the Journal of Reproductive and Infant Psychology. Segre said the results may indicate women with strong social support are more resistant to postpartum depression.

Segre and psychology professor Michael O'Hara have worked with Healthy Start in Des Moines to teach caseworkers and nurses to screen new mothers for depression. They are also developing a program of "listening visits," in which a caseworker or nurse listens to mildly- or moderately-depressed mothers talk through their problems.

Segre recently received a five-year grant from the National Institutes of Health to evaluate the effectiveness and acceptability of listening visits in the United States. She will travel to Des Moines to interview participating mothers from Healthy Start before and after their listening visits.

French Study Shows Link to PPD & Having Boys, While China Study Links PPD to Girls

A new research study has been released in France showing that giving birth to boys may raise the risk of severe postpartum depression. (For the full WebMD story, click here.)

From WebMD: " ... the study author himself warns that the results may not apply to U.S. women. 'I believe that it would be dangerous to alarm all U.S. women about [the potential mental health hazards associated with] boys' delivery,' writes Claude de Tychey, PhD, professor of clinical psychology at the Universite Nancy 2 in Nancy Cedex, France ..."

This is interesting, but I wouldn't give it too much thought at this point.  Although I did suffer PPOCD after giving birth to a boy ... Hmmmmm.  Interestingly enough, a different piece of research from China shows that women there are more likely to suffer PPD if they have a girl.   

Brazen Careerist Writes About PPD & Working Women

This is a great post from Penelope Trunk of the Brazen Careerist blog.  She writes about experiencing PPD while working, and makes suggestions on what women should know about PPD if they're the breadwinner in the family.  She bravely shares what she went through, including the following:

"Then, one night, the baby was screaming and our three-year-old wouldn’t go to bed and my husband was telling me that I needed to get the three-year-old some milk and I was saying that he should and I’ll get the baby and he rolled his eyes, and then I took a knife out of the dirty dishes and stabbed my head.

I don’t actually remember doing it. I remember my husband saying, 'Oh my god. There’s blood everywhere.'

Here’s how crazy I was: I just put the knife back in the sink and went to get the baby.

Go check out the rest of Penelope's story.

Mother Reach Receives Grant to Help Mothers with Postpartum Depression

The Mother Reach London and Middlesex Coalition in Ontario, Canada, received a provincial grant this week that will help it continue to educate, support and care for those experiencing, or at risk for developing, postpartum depression.

With new mothers and young families on hand, Denis Gadwa from the Ontario Trillium Foundation announced a $55,000 grant that will allow the coalition to carry on its weekly drop-in services for the next two years.

The local coalition was formed in an effort to create a caring community where women at risk for, or dealing with, postpartum depression could access resources and treatment to help them manage the illness effectively.

"Because of the generous financial support from the Ontario Trillium Foundation, the drop-in centre will be able to continue its vital services in our community," said Laura Dueck, public health nurse and co-chair of the Mother Reach London and Middlesex coalition. "Women receive the support they need to achieve optimal health for themselves, their children and their family. Ultimately, this benefits our whole community."

The Mother Reach London and Middlesex Coalition is made up of representatives from more than 20 local health and social service agencies and organizations, as well as members from the community.

The coalition operates free, two-hour drop-in sessions each week, where knowledgeable staff and volunteers provide helpful information and access to resources for mothers who are currently experiencing symptoms or those who may be at risk.

Drop-in sessions take place at the MAC Youth Centre, 366 Oxford St. E., Suite 201 London, Thursdays between 1 and 3 p.m. Free childcare is also provided on-site during the drop-in sessions.

AMA Newspaper Focuses on Barriers to Caring for PPD Moms

American Medical News, the newspaper of the American Medical Association has just published a great story on postpartum mood disorders called "Beyond the Baby Blues: A Spectrum of Postdelivery Conditions."  It features myself and a host of fabulous doctors, including Dr. Marlene Freeman, Dr. Shoshanna Bennett and Dr. Katherine Wisner among others.  It covers barriers to care by physicians, which is extremely important given that we're trying to get a bill passed in the Senate asking for more education and training of doctors, among other things.  Here is my favorite quote from the article:

"This is a disease that lives between specialties [obstetrics/gynecology, psychiatry, pediatrics]," Dr. Wisner added. "Patients are running around in circles."

Exactly.

National Center for Children in Poverty Releases New Policy Brief on Maternal Depression

Project THRIVE a the National Center for Children in Poverty at Columbia University has just released a new policy brief on maternal depression: Reducing Maternal Depression and Its Impact on Young Children: Toward a Responsive Early Childhood Policy Framework.  The policy brief provides an overview of why it is so important to address maternal depression as a central part of the effort to ensure that all young children enter school ready to succeed. It highlights:

• what research says about the impact of maternal depression on young children, particularly infants and toddlers, and how prevalent maternal depression is;
• examples of community and programmatic strategies to reduce maternal depression and prevent negative cognitive, social emotional and behavioral impacts on young children;
• key barriers to focusing more attention to maternal depression in policies to promote healthy early child development and school readiness;
• state efforts to address policy barriers and craft more appropriate policy responses; and
• recommendations

You can download the PDF and read the executive summary here.

Project THRIVE is a public policy analysis and education initiative at the National Center for Children in Poverty to promote healthy child development and to provide policy support to the State Early Childhood Comprehensive Systems (ECCS) initiatives funded by the Maternal and Child Health Bureau.

Part of NCCP’s longstanding commitment to promote improved state early childhood policies and practices, the goal of Project THRIVE is to help states strengthen and expand their early childhood systems, paying particular attention to strategies that improve services for those at highest risk and that help reduce disparities in access and quality of care to early childhood health and mental health.

PSI Annual Conference To Be Held in Houston June 4-7

Save the Date!  This year's Postpartum Support International conference will be held in Houston, June 4-7 at the Hilton Americas-Houston.  The event is co-sponsored by the Women's Mental Health Initiative of the Mental Health Association of Greater Houston.  Some of the main speakers include Dr. Margaret Spinelli, Dr. Lucy Puryear, Valerie Plame Wilson and George Parnham.  Registation will begin in March.  I'll be there, and I hope to see you there as well!  For more information, visit www.postpartum.net.

Codey and Spinelli Win Eli Lilly Welcome Back Awards for Work on Perinatal Mood Disorders

Mary Jo Codey has won the 2008 Eli Lilly Welcome Back Lifetime Achievement Award.  For years, Mary Jo has been a national spokesperson and crusader for maternal mental health, sharing her story to help other women reach out for help. The campaign she inspired in New Jersey, "Speak Up When You're Down," has become a model for states across the country to offer programs, services and resources for women suffering from perinatal mood disorders.

Also, Dr. Meg Spinelli of Columbia University has won a 2008 Eli Lilly Welcome Back Award in the category of psychiatry. Dr. Spinelli was selected based on the depth of her experience, knowledge and commitment to the issue of perinatal mental health. The award carries at $10,000 prize to be donated at her discretion.

Eli Lilly launched the Welcome Back Awards program 10 years ago to fight the stigma associated with depression and promote the understanding that depression is treatable.  Many congrats to both Dr. Spinelli and Mary Jo Codey!!!!!  And thanks to Susan Stone, president of Postpartum Support International, for letting me know about this great news.

Guest Author: Sarah Pond of mama2mama

Sarah Pond, co-founder of mama2mama in Canada, was kind enough to share with us her story of postpartum depression.  This is a beautifully written story, and a very comprehensive one in which she lists all of her various symptoms.  I don't normally post something this lengthy on Postpartum Progress because I like everything to be easily digestible, but this is worth it.

"The third day after my daughter's birth, a vortex of dark, deafening, and terminally sinister energy swallowed me whole. It sounds dramatic and it was. It overcame me in the car on the way home from the hospital. My baby slept soundly in her carseat, blissfully unaware that her primary caregiver was beginning a freefall into a churning turmoil. I remember commenting to my husband that I was suddenly not feeling too well. An understatement, to be sure.

Every moment after that, I struggled in the teeth of a malevolent beast, while desperately attempting to keep up the appearance of a happy, serene mommy. It felt like a struggle of life and death proportions. I suppose it was.

At the 5 month mark, when sleep deprivation was becoming debilitating, I made an appointment with my (former) family doctor. She gave me the following advice: Get some rest, eat more fatty foods and don't spoil the baby. She neither mentioned PPD nor asked me any relevant questions, nor suggested any resources. The appointment lasted all of six minutes. I timed it.

I kept on going, not following the doctor's advice. At last, on a Saturday afternoon, when my daughter was 7 months old, I crashed hard and ended up a