Skip to main content

Advertisement

SpringerLink
Log in

Desired assistance versus care received for postpartum depression: access to care differences by race

  • Original Contribution
  • Published:
Archives of Women's Mental Health Aims and scope Submit manuscript

Abstract

One in seven women who have a baby will experience postpartum depression. Although there are many treatments for postpartum depression, many women do not receive assistance. When left untreated, this condition can have a deleterious affect on the woman’s health/mental health, the child’s cognitive, psychological, emotional and social development, the marital relationship and ability to contribute to society. This study examined 45 women’s self-reported desire for PPD care and ability to obtain to these services in Erie County, New York. Results showed differences in desired care by race, differences in access to care by race and revealed the lack of PPD care in general.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Ahn YM, Kim MR (2004) The effects of a home-visiting discharge education, on maternal self-esteem, maternal attachment, postpartum depression and family, function in the mothers of NICU infants. Daehan Ganho Haghoeji 34(8):1468–1476

    Google Scholar 

  • Appleby L, Hirst E, Marshall S, Keeling F, Brind J, Butterworth T, Lole J (2003) The treatment of postnatal depression by health visitors: impact of brief training on skills and clinical practice. J Affect Disord 77(3):261–266

    Article  PubMed  Google Scholar 

  • Armstrong KL, Fraser JA, Dadds MR, Morris J (1999) A randomized, controlled trial of nurse home visiting to vulnerable families with newborns. J Paediatr Child Health 35(3):237–244

    Article  PubMed  CAS  Google Scholar 

  • Bates C, Paeglis C (2004) Motherhood and mental illness. RCM Midwives 7(7):286–287

    PubMed  Google Scholar 

  • Boath E, Cox J, Lewis M, Jones P, Pryce A (1999) When the cradle falls: the, treatment of postnatal depression in a psychiatric day hospital compared with routine primary care. J Affect Disord 53(2):143–151

    Article  PubMed  CAS  Google Scholar 

  • Boulvain M, Perneger TV, Othenin-Girard V, Petrou S, Berner M, Irion O (2004) Home-based versus hospital-based postnatal care: a randomized trial. BJOG: International Journal of Obstetrics and Gynaecology 111(8):807–813

    Article  Google Scholar 

  • Brown S, Lumley J (2000) Physical health problems after childbirth and maternal depression at six to seven months postpartum. International Journal of Obstetrics and Gynaecology 107(10):1194–1201

    CAS  Google Scholar 

  • Campbell SB, Cohn JF, Meyers T (1995) Depression in first-time mothers: Mother-infant interaction and depression chronicity. Dev Psychol 31:340–357

    Article  Google Scholar 

  • Carter AS, Garritty-Roukas FE, Chazan-Cohen R, Little C, Briggs-Gowan M (2001) Maternal depression and co-morbidity: predicting early parenting, attachment security and toddler social–emotional problems and competencies. J Am Acad Child Adolesc Psych 40:18–26

    Article  CAS  Google Scholar 

  • Cattel DL, King EA (1996) Estrogen for postnatal depression. J Fam Pract 43(1):22–23

    Google Scholar 

  • Centers for Disease Control and Prevention (CDC) Pregnancy Risk Assessment Monitoring System (PRAMS): PRAMS and postpartum depression. Department of Health and Human Services. http://www.cdc.gov/prams/References/PPD.htm. Cited September 10, 2007

  • Chaudron LH, Szilagyi PG, Kitzman HJ, Wadkins HI, Conwell Y (2004) Detection of postpartum depressive symptoms by screening at well-child visits. Pediatrics 113(3 Pt 1):551–558

    Article  PubMed  Google Scholar 

  • Chaudron LH, Kitzman HJ, Peifer KL, Morrow S, Perez LM, Newman MC (2005) Self-recognition of and provider response to maternal depressive symptoms in low-income Hispanic women. J Women’s Health 14(4):331–338

    Article  Google Scholar 

  • Chen CH, Tseng YF, Chou FH, Wang SY (2000) Effects of support group intervention in postnatally distressed women: a controlled study in Taiwan. J Psychosom Res 49(6):395–399

    Article  PubMed  CAS  Google Scholar 

  • Civic D, Holt VL (2000) Maternal depressive symptoms and child behavior problems in a nationally representative normal birthweight sample. Matern Child Health J 4:215–221

    Article  PubMed  CAS  Google Scholar 

  • Clark R, Tluczek A, Wenzel A (2003) Psychotherapy for postpartum depression: a preliminary report. Am J Orthopsychiatr 73(4):441–454

    Article  Google Scholar 

  • Cooper PJ, Murray L, Wilson A, Romaniuk H (2003) Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression: IImpact on maternal mood. Br J Psychiatry 182:412–419

    Article  PubMed  Google Scholar 

  • Craig E, Judd F, Hodgins G (2005) Therapeutic group programme for women with postnatal depression in rural Victoria: a pilot study. Australas Psychiatry 13(3):291–295

    Article  PubMed  Google Scholar 

  • Currie ML, Rademacher R (2004) The pediatrician’s role in recognizing and intervening in postpartum depression. Pediatr Clin North Am 51(3):785–801

    Article  PubMed  Google Scholar 

  • Davey SJ, Dziurawiec SS, O’Brien-Malone A (2006) Men’s voices: postnatal depression from the perspective of male partners. Qual Health Res 16(2):206–220

    Article  PubMed  Google Scholar 

  • Dennis CL (2004) Treatment of postpartum depression, Part 2: a critical review of non-biological interventions. J Clin Psychiatry 65(9):1252–1265

    Article  PubMed  Google Scholar 

  • Edge D, Rogers A (2005) Dealing with it: black Caribbean women’s response to adversity and psychological distress associated with pregnancy, childbirth, and early motherhood. Soc Sci Med 61:15–25

    Article  PubMed  Google Scholar 

  • Garg A, Morton S, Heneghan A (2005) A hospital survey of postpartum depression education at the time of delivery. J Obstet Gynecol Neonatal Nurs 34(5):587–594

    Article  PubMed  Google Scholar 

  • Gjerdingen D (2003) The effectiveness of various postpartum depression treatments and the impact of antidepressant drugs on nursing infants. J Am Board Fam Pract 16(5):372–382

    PubMed  Google Scholar 

  • Gregoire AJ, Kumar R, Everitt B et al (1996) Transdermal oestrogen for treatment of severe postnatal depression. Lancet 347:930–933

    Article  PubMed  CAS  Google Scholar 

  • Grigoriadis S, Kennedy SH (2002) Role of estrogen in the treatment of depression. J Therapeutics 9(6):503–509

    Article  Google Scholar 

  • Hamilton JA, Sichel DA (1992) Postpartum measures. In: Hamilton JA, Harberger PN (eds) Postpartum psychiatric illness: a picture puzzle. University of Pennsylvania Press, Philadelphia, PA, pp 219–254

    Google Scholar 

  • Hearn G, Iliff A, Jones I, Kirby A, Ormiston P, Parr P, Rout J, Wardman L (1998) Postnatal depression in the community. Br J Gen Pract J R Coll Gen Pract 48(428):1064–1066

    CAS  Google Scholar 

  • Hickman SA, LeVine DL (1992) Postpartum disorders and the law. In: Hamilton JA, Harberger PN (eds) Postpartum psychiatric illness: a picture puzzle. University of Pennsylvania Press, Philadelphia, PA, pp 283–295

    Google Scholar 

  • Holopainen D (2002) The experience of seeking help for postnatal depression. Aust J Adv Nurs 19(3):39–44

    PubMed  Google Scholar 

  • Honey KL, Bennett P, Morgan M (2002) A brief psycho-educational group intervention for postnatal depression. Br J Clin Psychol 41(Pt 4):405–409

    Article  PubMed  Google Scholar 

  • Howell EA, Mora PA, Horowitz CR, Leventhal H (2005) Racial and ethnic differences in factors associated with early postpartum depressive symptoms. Obstet Gynecol 105(6):1442–1450

    PubMed  Google Scholar 

  • Johnson J, Cohen P, Kasen S, Smailes E, Brook J (2001) Association of maladaptive parental behaviour with psychiatric disorder among parents and their offspring. Am J Psychiatr 58:453–460

    CAS  Google Scholar 

  • Kendell RE, Chalmers JC, Platz C (1987) Epidemiology of puerperal psychoses. Br J Psychiatry 150:662–673

    Article  PubMed  CAS  Google Scholar 

  • Kersting A, Kuschel S, Reutemann M, Ohrmann P, Arolt V (2003) Outpatient psychotherapy for mothers: First empirical results. Psychiatry 66(4):335–345

    PubMed  Google Scholar 

  • Klier CM, Muzik M, Rosenblum KL, Lenz G (2001) Interpersonal psychotherapy adapted for the group setting in the treatment of postpartum depression. J Psychother Pract Res 10(2):124–131

    PubMed  CAS  Google Scholar 

  • Kostaras X, Fox D, Kostaras D, Misri S (2000) The impact of partner support in the treatment of postpartum depression. Can J Psychiatry 45(6):554–558

    PubMed  Google Scholar 

  • Lindahl V, Pearson JL, Colpe L (2005) Prevalence of suicidality during pregnancy and the postpartum. Archives of Women’s Mental Health 8(2):77–87

    Article  PubMed  CAS  Google Scholar 

  • Lumley J, Small R, Brown S, Watson L, Gunn J, Mitchell C, Dawson W (2003) PRISM (Program of Resources, Information, and Support for Mothers): protocol for a community-randomised trial. BMC Public Health 3:36–50

    Article  PubMed  Google Scholar 

  • Maley B (2002) Creating a postpartum depression support group: out of the blue. AWHONN Lifelines 6(1):62–65

    PubMed  Google Scholar 

  • Marcus SM, Barry KL, Flynn HA, Tandon R, Greden JF (2001) Treatment guidelines for depression in pregnancy. Int J Gynecol Obstet 72:61–70

    Article  CAS  Google Scholar 

  • Martinez-Schallmoser L, Telleen S, MacMullen NJ (2003) The effect of social support and acculturation on postpartum depression in Mexican American women. J Transcult Nurs 14(4):329–338

    Article  PubMed  Google Scholar 

  • Mathers DC, Loncar D (2006) Projections of global morality and burden of disease from 2002 to 2030. PLoS Medicine, 3(11), e442 DOI 10. 137/journal.pmed.0030442. http://medicine.plosjournals.org/archive/1549–1676/3/11/pdf/10.1371_journal.pmed.0030442-L.pdf

  • Mauthner NS (1997) Postnatal depression: how can midwives help? Midwifery 13(4):163–171

    Article  PubMed  CAS  Google Scholar 

  • Milgrom J, Negri LM, Gemmill AW, McNeil M, Martin PR (2005) A randomized controlled trial of psychological interventions for postnatal depression. Br J Clin Psychol 44(Pt 4):529–542

    Article  PubMed  Google Scholar 

  • Moses-Kolko EL, Roth EK (2004) Antepartum and postpartum depression: healthy mom, healthy baby. J Am Med Women’s Assoc 59(3):181–191

    Google Scholar 

  • Murray L, Cooper PJ (1997) Postpartum depression and child development. Psychology Medicine 27:253–260

    Article  CAS  Google Scholar 

  • Murray L, Sinclair D, Cooper P et al (1999) The socio-emotional development of 5-year old children of postnatally depressed mothers. J Child Psychol Psychiatry 40:1259–1271

    Article  PubMed  CAS  Google Scholar 

  • Murray L, Cooper PJ, Wilson A, Romaniuk H (2003) Controlled trail of the short- and long-term effect of psychological treatment of post-partum depression: IIImpact on the mother–child relationship and child outcome. Br J Psychiatry 182:420–427

    Article  PubMed  Google Scholar 

  • NICHD Early Child Care Research Network (NICHD) (1999) Chronicity of maternal depressive symptoms, maternal sensitivity, and child functioning at 36 months. Dev Psychol 35:1297–1310

    Article  Google Scholar 

  • Nonacs RM, Soares CN, Viguera N, Pearson K, Poitras JR, Cohen LS (2005) Bupropion SR for the treatment of postpartum depression: a pilot study. Int J Neuropsychopharmacol 8(3):445–449

    Article  PubMed  CAS  Google Scholar 

  • Oates M (2000) Perinatal maternal mental health services. Royal College of Psychiatrists, London, England

    Google Scholar 

  • O’Hara MW, Swain AM (1996) Rates and risks of postpartum depression: a meta-analysis. Int Rev Psychiatry 8:37–54

    Article  Google Scholar 

  • O’Hara MW, Stuart S, Gorman LL, Wenzel A (2000) Efficacy of interpersonal psychotherapy for postpartum depression. Arch Gen Psychiatry 57(11):1039–1045

    Article  PubMed  CAS  Google Scholar 

  • Olson MR, Cutler LA, Legault F (1991) Bittersweet: a postpartum depression support group. Can J Public Health 82(2):135–136

    PubMed  CAS  Google Scholar 

  • Parke S, Hardy B (1997) Postnatal depression: making better use of health visitors and community psychiatric nurses. Prof Care Mother Child 7(6):151–152

    PubMed  CAS  Google Scholar 

  • Peel D (2001) Infanticide happens when no real mental health care exists. Tex Med 97(9):15–17

    PubMed  CAS  Google Scholar 

  • Scott D (1992) Early identification of maternal depression as a strategy in the prevention of child abuse. Child Abuse Negl 16:345–358

    Article  PubMed  CAS  Google Scholar 

  • Scrandis DA (2005) Normalizing postpartum depressive symptoms with social support. J Am Psychiatr Nurses Assoc 11(4):223–230

    Article  Google Scholar 

  • Seidman D (1998) Postpartum psychiatric illness: the role of the pediatrician. Pediatr Rev 19(4):128–131

    Article  PubMed  CAS  Google Scholar 

  • Simons J, Reynolds J, Mannion J, Morison L (2003) How the health visitor can help when problems between parents add to postnatal stress. J Adv Nurs 44(4):400–411

    Article  PubMed  Google Scholar 

  • Small R, Brown S, Lumley J, Astbury J (1994) Missing voices: what women say and do about depression after childbirth. J Reprod Infant Psychol 12:19–22

    Article  Google Scholar 

  • Stuart S, Couser G, Schilder K et al (1998) Postpartum anxiety and depression: onset and co-morbidity in a community sample. Journal of Nervous and Mental Disorders 186:420–424

    Article  CAS  Google Scholar 

  • Ugarriza DN (2004) Group therapy and its barriers for women suffering from postpartum depression. Arch Psychiatr Nurs 18(2):39–48

    Article  PubMed  Google Scholar 

  • United States Department of Health & Human Services (2005) Depression during and after pregnancy. http://www.womenshealth.gov/faq/postpartum.htm. Cited September 12, 2007

  • Wiley CC, Burke GS, Gill PA, Law NE (2004) Pediatricians’ views of postpartum depression: a self-administered survey. Archives of Women’s Mental Health 7(4):231–236

    Article  PubMed  CAS  Google Scholar 

  • Wood AF, Meigan M (1997) The downward spiral of postpartum depression. Am J Matern Child Nursing 22(6):308–316

    Article  CAS  Google Scholar 

Download references

Acknowledgment

Special appreciation is given to Fantastic Sam’s for donating gift certificates to study participants. This project was support by the Buffalo State College Research Foundation.

Author information

Authors and Affiliations

  1. Social Work Department, Buffalo State College, 1300 Elmwood Avenue, Buffalo, NY, 14222, USA

    Kimberley Zittel-Palamara

  2. AmeriCorp, Buffalo, NY, USA

    Julie R. Rockmaker

  3. Creativision, Buffalo, NY, USA

    Kara M. Schwabel

  4. Psychiatry Department, Buffalo Medical Group, Buffalo, NY, USA

    Wendy L. Weinstein

  5. School of Social Work, University of Texas at Austin, Austin, TX, USA

    Sanna J. Thompson

Authors
  1. Kimberley Zittel-Palamara
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Julie R. Rockmaker
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kara M. Schwabel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Wendy L. Weinstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sanna J. Thompson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kimberley Zittel-Palamara.

Appendix

Appendix

General information

  • Age ___________ Number of people in household ________

  • Race/Ethnicity: ______Prefer not to answer

    • _____African-American/Black _____Native American/Indigenous

    • _____Latino/Hispanic _____Caucasian/White

    • _____Asian American _____Other__________________________

  • Please check all insurances that you presently have ____Prefer not to answer

    • _____Private health insurance _____Medicare _____Medicaid _____Other

  • Annual Salary _____Prefer not to answer

    • ______Below $12,000

    • ______$12,000–$30,000

    • ______$30,000–$50,000

    • ______$50,000–$70,000

    • ______$70,000–$100,000

    • ______Over $100,000

  • Residential Area: ___ Urban ___Suburban ___Rural

  • Religion: ________________________________

    • o Do you find strength in your religion?

      • _____No _____Yes _____Not sure ______Prefer not to answer

    • o Have you felt depression symptoms after previous pregnancies? _______Yes _______No

      • ▪ If yes, how many pregnancies have you had? ________

      • ▪ If yes, how many times have you experienced depressed symptoms after delivery? _______

      • ▪ What length of time did your longest episode last? __________

  • Number of Children: _____________

  • How many child(ren) did you have when you were first diagnosed with PPD depression? ______________

  • Did you have children after you first experienced depression symptoms after delivery?

    • _____No ______Yes ______Currently pregnant

  • Had you been diagnosed with any of the following prior to experiencing PPD?

    • _____Depression _____Obsessive Compulsive Disorder

    • _____Anxiety _____Manic Depression/Bipolar

    • _____PTSD _____Other:___________________________

  • Were you taking an antidepressant or other mental health mediation prior to becoming pregnant?

    • _____No ______Yes ______Not sure

    • o If yes, what medications? __________________________________________

    • _______________________________________________________________

    • o If yes, was the antidepressant or other mental health medication discontinued when you became pregnant?

      • _____No ______Yes ______Not sure

      • ▪ If yes, did your symptoms return during your pregnancy?

        • _____No ______Yes ______Not sure

      • ▪ If yes, how many months pregnant were you when your symptoms returned? ____

      • ▪ If yes, did you start to take the medication again during pregnancy?

        • _____No ______Yes ______Not sure

        • • If yes, at what month did you restart the medication? _______

    • o If yes, how long after you gave birth was your medication started again? ____

      • ▪ Was it the same medication you were taking prior to pregnancy?

        • _____No ______Yes _______Not sure

      • ▪ If not, why? _________________________________________________

      • _____________________________________________________________

      • _____________________________________________________________

      • ▪ What medications were you prescribed instead? ____________________

      • _____________________________________________________________

To the best of your knowledge have any of the following blood relatives ever discussed symptoms of depression after delivering a child?

  • _____Mother

  • _____Sister

  • _____Aunt

  • _____Female cousin

  • _____Grandmother

  • _____Great grandmother

  • _____Other blood relative_____________________________________________________

  • _____None that I am aware of

ID: ____________page 3

Access to postpartum depression care

  • What areas of PPD care do you believe to be important for you to feel better? (Please check all that apply)

    • _____Psychiatric care _____Pediatrician

    • _____Primary care physician _____Spiritual assistance/direction

    • _____OB/GYN care _____Support group (online)

    • _____Hospital inpatient _____Support group (in person)

    • _____Midwife care _____Individual counseling

    • _____Social Worker _____Medication

    • _____Psychologist _____Other:_________________________

  • What areas of PPD care do you/did you receive? (Please check all that apply)

    • _____Psychiatric care _____Pediatrician

    • _____Primary care physician _____Spiritual assistance/direction

    • _____OB/GYN care _____Support group (online)

    • _____Hospital inpatient _____Support group (in person)

    • _____Midwife care _____Individual counseling

    • _____Social Worker _____Medication

    • _____Psychologist _____Other:_________________________

  • How would you describe your ability to get PPD care? (Only check one)

    • _____ Excellent _____ Fair

    • _____ Good _____ Poor

  • Do you need PPD assistance now?

    • _____No ______Yes ______Not sure

  • Do you/did you have difficulty getting PPD care?

    • _____No ______Yes ______Not sure

    • o If yes, please identify what made/makes it difficult: (Check all that apply)

      • _____ Not sure who to speak to about how I was/am feeling

      • _____ Education about postpartum depression

      • _____ Tried to find resources but could not

      • _____ Lack of referral to appropriate resources

      • _____ Postpartum depression symptoms made/makes it difficult to take action

      • _____ Comments from health care professionals that “this is normal”

      • _____ Pressure from family and friends saying things like “Just get over the baby blues”, “it is normal, you are fine”

      • _____ Cost of care

      • _____ Insurance limitations

      • _____ Transportation difficulties

      • _____ Health limitations

      • _____ Child care difficulties

      • _____ Fear that child/ren would be removed from the home

      • _____ Other (describe) ______________________________________

  • How did you get linked to the postpartum depression that you receive now?

    • __________________________________________________________________________________

    • __________________________________________________________________________________

  • Do you wish to have/you had spiritual or religious guidance as you are/were going through postpartum depression?

    • _____No _____Yes _____Not sure _____prefer not to answer

    • o If yes, what kind of spiritual or religious guidance would (have) you like(d)?

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zittel-Palamara, K., Rockmaker, J.R., Schwabel, K.M. et al. Desired assistance versus care received for postpartum depression: access to care differences by race. Arch Womens Ment Health 11, 81–92 (2008). https://doi.org/10.1007/s00737-008-0001-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00737-008-0001-1

Keywords

Search

Navigation