Perinatal Depression

     Perinatal mortality is the number of stillbirths or deaths during the first week of life.  In 2009, worldwide stillbirths were 2.6 million.  There is, without question, a link between maternal and perinatal health.  Medical disturbances which women may acquire include obstructed labor, high blood pressure, unsafe abortion, infection, and hemorrhage.  In other words, these are all examples of maternal morbidity (1, 2, 3, 4, 5, 6).  In poor countries, maternal death rates are especially high.  The occurrence of maternal or death rates will improve whenever there is suitable medical care (2).  It is true that in sub-Saharan Africa and Southern Asia, these rates are higher than in some other regions of the globe (2).  These situations in health care may suffer because of long-distance to health care facilities.  Also, there are cultural practices, beliefs, and inadequate information which hamper medical care.  Other examples of these poor outcomes include serious illnesses such as malaria, diabetes mellitus, and heart disease (2).

     One must understand that both parents may experience emotional instability when they have a child.  The term “baby blues” is well-known to clinicians that four-fifths of mothers may have it after this major event in their lives.  Psychological depression will likely resolve within 10 days.  However, some mothers will show symptoms of perinatal depression, and psychiatric signs may suggest that there is a mental disturbance.  Its term is perinatal depressive disorder, and many Americans are surprised when they learn that this is common in the United States.  In fact, 11.5 percent is the mean in that region of the globe (1, 2, 3, 4, 5, 6).   

     These mental health disorders include depressed mood and energy, anxiety, sadness, hopelessness, and panic attacks.  Some of these mothers may experience resentment of the baby, irritability, or fear of leaving the house.  In fact, more than a half million women suffer from this illness yearly.  Women of all racial/ethnic groups can be susceptible to it.  At the same time, there are predispositions which some women have.  These tendencies have to do with substance use disorders, teenage pregnancy, physical or sexual abuse, and multiple births.  Multiple birth refers to twins, triplets, or the occurrence of more than one baby during the pregnancy.  Whereas they are more common today than singleton pregnancies, they also present significant challenge with child rearing (1, 2, 3, 4, 5, 6, 7). 

     Additional observations of perinatal depressive disorder include inadequate social support, previous history of depression, anxiety, and bipolar disorder.  Moreover, difficult pregnancy can pose a problem for these women.  Less common cases may include postpartum psychosis.  However, such instances are a medical emergency because the women have psychotic signs and symptoms.  This is a complex situation for mother and child.  One must also keep in mind that “Suicide is the second-leading cause of death for women in the post-partum period” (1, 2, 5, 6).

     The occurrence of post-partum depression has long been present in hospitals and clinics across the globe.  Modern technology has, in some ways, made its management better than it was in previous decades or even centuries.  Integration of medical and psychiatric care will further enhance the outcomes for these patients and families.

1.  Van Niel, M. and Payne, J.  (2020).  Perinatal depression:  A review.  Cleveland Clinic Journal of Medicine, 87, 273-277.

2.  World Health Organization.  (2020).  Perinatal health.

3.  U.S. Centers for Disease Control and Prevention.  (2020).  Reproductive health.

4.  Muzik, M. and Borovska, S.  (2010).  Perinatal depression:  Implications for child mental health.  Mental Health in Family Medicine, 7, 239-247.

5.  U.S.  Department of Health and Human Services.  Office on Women's Health.  Postpartum depression. 

6.  Mayo Clinic.  (2020).  Postpartum depression.

7.  U.S. National Library of Medicine.  Medline Plus.  Twins, triplets, multiple births.

8.  Copyright 2020.  Michael Koger, Sr., M.D.  All rights reserved.

     The information contained in this article is for educational purposes only, and one should not use it for diagnosis or treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.