Applying Research for Healthier Pregnancies

Do you have a loved one that’s currently expecting or are you pregnant yourself? 

Many pregnant women, new mothers and those that care for them fear postpartum depression. They’ve heard stories of women with postpartum psychosis who harm themselves and their babies. They worry that it could happen to them, too.

Depression and anxiety can happen to anyone and is not uncommon in pregnancy. Although mental health issues are more common than diabetes and high blood pressure, most physicians don’t ask pregnant women about their mood as mental health assessment is often not a part of routine prenatal care. 

As a result, most pregnant women who need help for anxiety or depression don’t have the chance to get it.

Here are two reasons why ALL pregnant women should have access to mental health screening:

• Prenatal depression and anxiety are as common as postpartum depression. They are also the biggest risk factors for postpartum depression.1
   

• One in three women who struggle with prenatal depression still have symptoms when their children go to Kindergarten if they don’t get help. 2,3 If they don’t get screened, chances are they won’t get help.

You might not think that it really matters whether a doctor checks pregnant women for mental health problems. After all, the last time you had your yearly physical your doctor didn’t screen you for a cold or the flu. She knows that if you come down with symptoms and you need help, you’ll contact her.

Until recently, we thought that if women needed help they’d tell their doctor:

This is not the case.

New research by our team at the University of Alberta and the University of Calgary tells us this simply isn’t true. There is a third reason why we need to screen pregnant women for mental health problems.

We asked pregnant women whether they would raise concerns about their mental health with their doctor.4 This is what we found in our study of 460 women:

• 53% of women would not raise concerns about their mental health with their physician because they do not know what emotions are “normal” and “not normal” during pregnancy.
   

• 67% would not initiate a conversation about mental health with their prenatal provider because they preferred to talk about their concerns with their partner, friend, or family.
   

• 44% said they would not want to be seen as “depressed” or “anxious” by their provider and therefore wouldn’t feel comfortable raising mental health issues on their own.
  
  

Why this is important:

Most pregnant women won’t tell their doctor that they are struggling with anxiety or depression.

Women who had experienced depression or anxiety before they became pregnant. In other words, those who have the greatest risk for prenatal depression and anxiety.

What surprised us, though, was that 99.8% of women said that if their doctor asked about their mental health, they would be honest! They’d feel comfortable responding to their doctor’s questions.

This is why we believe it is so vital for us to as healthcare professionals to screen for prenatal depression and anxiety. If you yourself are pregnant and have been feeling down, we encourage you to reach out to a loved one or your own family doctor for help. Friends and family can also offer support by checking in. It all starts with a simple question of concern.

Further Information

References:
 

• Milgrom J, Gemmill AW, Bilszta JL, et al. Antenatal risk factors for postnatal depression: a large prospective study. Journal of affective disorders 2008;108:147-57.
   

• Giallo R, Woolhouse H, Gartland D, Hiscock H, Brown S. The emotional-behavioural functioning of children exposed to maternal depressive symptoms across pregnancy and early childhood: a prospective Australian pregnancy cohort study. European child & adolescent psychiatry 2015.
   

• van der Waerden J, Galera C, Saurel-Cubizolles MJ, Sutter-Dallay AL, Melchior M, the EM-CCSG. Predictors of persistent maternal depression trajectories in early childhood: results from the EDEN mother-child cohort study in France. Psychological medicine 2015:1-14.
   

• Kingston D, Austin, M-P., Heaman, M., McDonald, S., Lasiuk, G., Sword, W., Giallo, R., Hegadoren, K., Vermeyden, L., Veldhuyzen van Zanten, S., Kingston, J., Jarema, K, Biringer, A. Barriers and facilitators of mental health screening in pregnancy. Journal of Affective Disorders 2015;accepted manuscript.