Photo: CC St. Peter's Health Regional Medical Center
St. Peter's Health in Helena, Montana, received a prestigious award from Agency for Healthcare Research and Quality's (AHRQ) for their efforts to improve postpartum mental health in rural communities.
AHRQ, a branch of the U.S. Department of Health and Human Services, issued a challenge during the summer of 2020 for hospitals to present evidence-based plans to address the needs of women and families after having a baby. Helena's St. Peter's Health and Birmingham, Alabama's Pack Health were the winners of a $50,000 award for their innovations.
St. Peter's team implemented universal screening programs to identify at-risk mothers. The hospital screened patients for risk factors such as alcohol, substance use, depression, and anxiety. The health team connected patients and families with community resources.
Birmingham's Pack Health's program leveraged a digital health platform to connect new mothers to coaches and health advisors.
Photo: kieferpix Istock/Getty Images
Postpartum depression is an inaccurate term. Perinatal mood and anxiety disorders can occur anytime after conception up to one year after delivering a baby. One in seven women suffers from a mood disorder related to pregnancy and childbirth.
Risk Factors for Perinatal Mood Disorders include:
- Stressful live events.
- Low social support.
- Previous history of depression.
- Family history of depression.
- Difficulty getting pregnant.
- Being a mom to multiples, like twins, or triplets.
- Being a teen mom.
- Preterm (before 37 weeks) labor and delivery.
- Pregnancy and birth complications.
- Having a baby who has been hospitalized.
Perinatal depression can be dark and debilitating, leaving mothers unable to function or adequately care for themself or their baby. Symptoms vary from person to person but include crying spells, sadness, hopelessness, and guilty. Some may express a lack of happiness or feel the absence of bonding with the baby. Some may have thoughts of self-harm or of hurting the baby.
Shame, guilt, and feelings of inadequacy prevent moms from reaching out for help. Moms fear judgment. They wonder "what is wrong with me" for not feeling blissful over the birth of their child. They fear their family will judge them. Others fear they may lose their baby if they express their true feelings out loud.
Some moms have intrusive thoughts causing fear and anxiety. Negative thoughts do not necessarily equal behavior. Help is available to manage these thoughts.
These symptoms indicate a new mom requires medical attention. The first step in treating perinatal mood disorders is recognizing the problem. Patients are often relunctant to share these feelings. Health providers may not be comfortable in screening for peripartum mood disorders.
Treatment options vary from person to person. Some women may only need to expand their social support network. Others benefit from group or individualized therapy. Pharmaceutical interventions may be neeed for others.
Chart: CDC.gov
The Agency for Healthcare Research and Quality recognized the increased challenges facing postpartum mental health care in the rural setting. Access to care, cost, transportation, and internet access all create barriers to identifying and treating those at risk for perinatal mood disorders.
The federal agency's mission is "to make health care safer, higher quality, more accessible, equitable, and affordable," The stated goals are to "keep patients safe, help doctors and nurses improve quality, and to develop data to track changes in the health care system."
The AHRQ competition brought together digital health and other nontraditional health partners to find unique and innovative solutions to help rural families receive the help they need. Perinatal depression and anxiety universal screening programs for perinatal depression and anxiety along with patient and provider education programs help these women come out of the shadows.
Women need to know they should never feel ashamed to speak up about postpartum depression. These award-winning programs help patients and doctors learn to ask the right questions to get the help they deserve. .