A third of first-time mothers suffer depressive symptoms, research finds

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baby, Children, Depression, depressive symptoms, diagnosis, early years, first-time mothers, four years postpartum, GPs, health professionals, health visitors, irritable, low mood, maternal health, mental health issues, midwives, mothers, new mothers, parents, Postnatal Depression, postpartum, pregnancy, risk, signs, tearful, training, worrying

A third of first-time mothers suffer depressive symptoms, research finds

One in three first-time mothers suffers symptoms of depression linked to their baby’s birth while pregnant and/or during the first four years of the child’s life, according to research.

And more women are depressed when their child turns four than at any time before that, according to the study, which challenges the notion that mothers’ birth-related mental struggles usually happen at or after the baby’s arrival.

The findings have led to calls for all women giving birth in the UK to have their mental health monitored until their child turns five to ensure that more of those experiencing difficulties are identified.

The results are based on research in Australia, but experts believe that about the same number of women in the UK experience bouts of mental ill-health associated with becoming a mother.

In all 1,507 women from six hospitals in Melbourne, Australia, told researchers from the Murdoch children’s research institute and royal children’s hospital in Parkville, Victoria, about their experience of episodes of poor mental health at regular intervals until their child turned four.

The authors found that almost one in three first-time mothers reported “depressive symptoms on at least one occasion from early pregnancy to four years postpartum [and that] the prevalence of depressive symptoms was highest at four years postpartum”. The women’s depressive symptoms are often short-lived episodes and do not mean that the women were diagnosed with postnatal depression. Studies in both the UK and internationally have estimated that between 10% and 15% of new mothers suffer from that clinical condition.

The researchers also found that four years after the child’s birth 14.5% display depressive symptoms, of whom 40% had not previously reported feeling very low. At that time, women with only one child were much more likely (22.9%) than those with two or more offspring (11.3%) to be depressed.

Dr Jim Bolton, a member of the Royal College of Psychiatrists and a consultant psychiatrist at a London hospital, said that one in three women giving birth in the UK were likely to become depressed at some point during those first four years. “If a similar study was done here, I wouldn’t be surprised if the results were similar. Usually the sorts of mothers who are at greater risk of depression are younger mothers who feel they can’t cope and mothers living in situations of adversity or deprivation or partner violence,” he said.

“These findings are about depressive symptoms, which can be very short-lived, not a formal diagnosis of illness or postnatal depression. This study isn’t saying that one in three women gets that,” stressed Bolton, who treats mental health problems in pregnancy and after birth among new mothers in his hospital’s women’s health unit.

The authors recommend that the UK overhauls its monitoring of maternal mental health, which focuses on pregnancy and the early years after birth, because more than half the women who experience depression after becoming a parent are not identified by GPs, midwives or health visitors.

More women could have postnatal depression than the usual estimate of 10%-15% partly because women may mistake the signs of it – which include being more irritable than usual or unusually tearful, inability to enjoy being a parent or worrying unduly about the baby’s health – as being things undergone by all new mothers.

Health professionals do not always spot it or ask the right questions to identify it, though are far more aware of it than ever, Bolton added.

One leading psychiatrist said that the one in three women who had depressive symptoms was between two and five times higher than the estimated number of people in the general population who would experience serious low mood in their lifetime, but was higher than the number of women who experienced the most severe forms of depression. Between 5%-10% of people generally suffer major/serious depression during their lifetime.The study, published in BJOG: An international journal of obstetrics and gynaecology, is the first to follow a sizeable number of new mothers for as long as four years after birth. Elizabeth Duff, senior policy adviser at the parenting charity the NCT, said: “This study has included mothers for four years after birth, so suggests that perinatal mental health needs to be monitored for a longer period. Given the devastating effects of postnatal depression, health professionals should give equal consideration to the mental and physical health of parents with young children.”

A Department of Health spokeswoman said it welcomed any new research that would lead to women receiving better help with maternal depression.

“We want to do everything we can to make sure women and families get as much support as possible throughout pregnancy and beyond. That’s why, earlier this month, we announced that expert training in mental health will be rolled out for doctors and midwives to identify and help women who are at risk of depression or other mental health issues,” she said.

Numbers of midwives and health visitors have been growing under the coalition, while specialist mental health doctors and midwives will help improve earlier diagnosis of such problems, she added. However, the Royal College of Midwives said that even more midwives were needed to ensure mothers received the best possible care of their psychological welfare.

Suffering in Silence

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Children, Depression, isolation, mental health issues, Postnatal Depression, pregnancy

Suffering in Silence

Health Secretary Andrew Lansley said that no woman should have to cope with postnatal depression without help. As part of the recently announced pledges announced by the government to provide joined up care and focus on the emotional well-being of new parents is a promised £400 million investment in psychological and talking therapies to support women who suffer as a result of postnatal depression.

An estimated one in four of us may suffer from some form of mental illness during our lives and , 1 in 10 – over 70,000 women in England and Wales will suffer from postnatal depression (PND) following the birth of a child. It is not known if this figure includes women who report an inability to cope or general unhappiness after birth.

Over the last year, 4Children, the family outreach charity, launched its Give me Strength campaign, which looked at three causes of family instability and vulnerability, which they believe if addressed, can lead to improved family stability and a good start for children. One area targeted by the campaign was postnatal depression. 4Children carried out a survey via the Bounty parenting club into postnatal depression. The shocking results paint a picture of women and their families suffering in silence, a lack of awareness of the symptoms of PND and fear of being stigmatised as ‘being crazy’.

This survey, like others before, again suggests that women are very unhappy about revealing their concerns to health professionals when having to respond to formalised questioning on the subject. This can prevent many mothers who may benefit from early therapy coming forward – it was also reported that 49% of women did not seek help and of those women in the survey who sought help 30% said that they had to wait for nearly six months for that help. A supportive relationship with a midwife she knows could solicit this information in a sensitive way.

Similarly, a YouGov survey on behalf of the NSPCC of 516 women with children under one, reported that almost three quarters of all new mothers would have liked more professional advice before their baby was born. They wanted more information on how to deal with sleep deprivation and coping with their baby’s crying as well as anxiety, fear and depression. The survey also showed that at some point during the first eight weeks following birth, over half (57%) of mothers felt isolated with no-one to turn to. A significant number of new mothers, more than 1:3 (39%) admitted ‘getting angry’ with their baby, and 1:5 (20%) of mothers in that survey said that they were frequently “very upset” by their baby’s crying.

We should not underestimate the devastating impact of perinatal mental health on the child and should be aware that the woman’s partner could suffer as well. It is acknowledged that some partners can suffer from depression due to the sheer impact of trying to cope with a partner’s illness and or a new baby.

It is important to contextualise the degrees of mental health problems from pregnancy right through to birth and post birth. This would enable us develop an understanding and awareness that mental health problems in the perinatal period can range from unhappiness during the pregnancy or after birth to full-blown mental health disorder. That way, we we could develop more effective care with appropriate strategies in response to women’s specific symptoms – these may include a variety of supportive measures, talking therapies or other more significant therapies such as psychological or medications if appropriate. There are criticisms that some women who come forward to report symptoms for PND are too easily prescribed anti depressants instead of undertaking a broader holistic assessment to identify any underlying problems.

Two key recommendations from the Report are that GPs commit to offering psychological therapies and ‘social prescribing’ – befriending schemes and support groups if a diagnosis of PND is made. The second really relates mainly to midwives although the report implies that increasing the number of health visitors and reintroducing a new ante-natal role for health visitors would identify and support more women.

My view is that the health visitor has a role; however, midwives spend more time with the women during the perinatal period and have the unique opportunity to educate the woman about emotional well-being during pregnancy, post birth and being a parent. Midwives can, and should, discuss and enable the woman to understand that at times she may feel unable to cope, be unfamiliar and not confident with her new role as a parent or not liking the baby very much and feel vulnerable. We midwives should be able to spend a little more time with women in the perinatal period and ask them on every occasion how they are feeling and coping and offer specific help – which we ourselves do not necessarily have to provide, but can signpost or refer women on to.

As a society, we probably do not understand the extent to which perinatal mental health problems can impact adversely on families and in particular children. There is a paradox of society’s expectation of the happy mother, perfect parents with a much loved baby. This is in contrast compared to the hidden realities of becoming and being parents, and at times the emotional anguish of women and their partners behind closed doors, trying to fit into this neat societal construct.

Mothers to get ‘named midwife’ under plan to combat postnatal depression

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miscarriage, Postnatal Depression, pregnancy, stillbirth

Mothers to get ‘named midwife’ under plan to combat postnatal depression

Mothers will receive one-to-one care from a named midwife during labour and birth as part of government plans to combat postnatal depression.

Women who have a miscarriage or stillbirth and parents who are forced to cope with the death of a baby will also be offered increased support from theNHS.

Under the plans, health workers will be given enhanced training so they can spot the early signs of postnatal depression.

The move was welcomed by the Royal College of Midwives (RCM) and parenting forums. Cathy Warwick, chief executive of the RCM, said the pledges were “very good news” for women and midwives.

“These are positive plans from the government targeting areas of maternity care that are under-prioritised and under-resourced,” she said.

“The impact of a miscarriage or a stillbirth can be devastating for the woman and her family and postnatal depression can be a crippling and sometimes fatal illness. Early detection and treatment is crucial.

“It is also excellent to see an intention to ensure that long-standing NHS commitments, such as one-to-one care in labour and choice about where and how women give birth, become a reality for all women.”

According to the RCM, 5,000 more midwives would be needed to deliver the care proposed.

Justine Roberts, co-founder of Mumsnet, welcomed the renewed support but said a sustained effort was needed to ensure mothers benefited from the changes.

“Sadly there are many experiences shared on Mumsnet of women not getting the best care when they need it,” she said.

“The announcement that services provided during miscarriage are to be monitored is a real advance towards identifying best and worst practice and therefore towards improving the care received.”

Sally Russell, co-founder of Netmums, also welcomed plans to address postnatal depression – a common condition that is often kept hidden.

“Most mums and dads find it difficult to admit they are suffering and yet it can be a blight on their lives,” she said. “Having better support from local services could make a big difference and we’re delighted that the government has identified this as a priority.”

Alongside beefed-up training for health visitors – who provide services for expectant and new parents after birth – the government has pledged to improve maternity care by ensuring women have one named midwife to oversee their care during pregnancy and after they have their baby, making sure every women has one-to-one midwife care and giving parents-to-be the choice over where and how they give birth.

The NHS will also be judged on how well it looks after parents who have miscarried, suffered a stillbirth or cot death, with patients asked to rate their care.

According to the Royal College of Psychiatrists, 10-15% of women who have a baby suffer from postnatal depression.

Several celebrities, including actor Gwyneth Paltrow, have spoken of their experience of the condition, which usually starts within a few months of birth. Around one in three women experience symptoms in pregnancy, which then continue. Treatment options depend on the severity of the depression, but include medication and counselling.

The health secretary, Andrew Lansley, said: “We have listened to the concerns of women about their experiences of maternity care, which is why we are putting in place a ‘named midwife’ policy to ensure consistency of care.

“Not least, we will focus on the quality of care given to mothers-to-be and measure women’s experience of their maternity care for the first time.”

Why can’t we stay married?

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age, Children, Divorce, Marriage, Postnatal Depression

http://www.independent.co.uk/news/uk/home-news/why-cant-we-stay-married-7657610.html

It could be described as a depressing portrait of a modern relationship: a career-driven couple meet later in life, have a whirlwind romance and settle down quickly to have children. Then things start to go wrong.

This is the picture painted by research carried out by the parenting website Netmums, which found that modern relationships are most likely to break down after just three years due to the stresses of late parenthood.

Relationship specialists immediately pointed to a growing trend for “fast forward” partnerships as couples leave it later in life to get together – but spend less time getting to know each other before moving in together and having children. One in 20 couples polled admitted they were expecting a baby within three months of getting together and 15 per cent within a year.

Consequently, the study of 1,500 people found that couples are now four and a half times more likely to split up after three years – earlier than the “seven year itch” traditionally cited as the danger point in a relationship. More than 20 per cent of couples who split saw their relationship fall apart between two and four years, while only 3 per cent broke up seven years in.

The latest figures from the Office of National Statistics show that women now delay having children until they are nearly 30. The average age of women giving birth in England and Wales is now a year older than it was a decade ago (29.5 in 2010 compared with 28.5 in 2000).

The figures also suggest an increase in the number of parents who are living together, as the number of those who are married or in civil partnerships continues to fall. The proportion of births to couples who are married or in civil partnerships was 53 per cent in 2010, compared with 61 per cent in 2000, and 88 per cent in 1980.

But births registered by parents who appeared to be cohabiting – by jointly registering the baby and giving the same address – has risen, reaching 31 per cent of all births in 2010, compared with 25 per cent in 2000.

Penny Mansfield, director of One Plus One, the relationships charity, said: “This poll supports what we know of the changing social patterns that we see all around us. People are not marrying in the numbers that they did but they are forming partnerships and having children.

“People may have a series of relationships and then get to a certain age and then think: ‘Oh we should have children’ without necessarily having made more of a commitment. When you get this more informal approach to relationships – particularly when you have children – relationships are much more unstable.

“People also now have much higher expectations of relationships. So when people hit difficulties, often when they become parents, they think: “Things aren’t what they were’.”

Two out of five parents responding to the poll reported that they were so short of time and money that they could only go out as a couple “two or three” times a year. Fifteen per cent said they “never” went out as a couple anymore, while 14 per cent only had a single night a year together. Only one in 100 parents now spends quality time together a few nights a week.

Leila Collins, a counselling psychologist and lecturer at Middesex University, said: “There’s a great deal of pressure on women to educate themselves and prepare themselves for careers. Consequently the age at which they are prepared to settle down is a bit older and they may feel the clock is ticking. Even though they are a bit older and more experienced, when it comes to choosing a partner to start a family with, they may make mistakes.

“If you are going to have children with someone you need to be absolutely sure, no matter how much the clock is ticking. It is absolutely ludicrous and childish for people to think that they can have a child with someone and move on. You cannot take these risks with other people’s lives on a whim.”

The study also found that two thirds of couples believe it is harder to maintain a relationship nowadays compare to a generation ago. Almost two in five couples said it was more difficult to maintain a relationship because women were forced to work and had less time for their partners, while 22 per cent thought couples were less committed and too quick to split. One in 10 believe couples take having children “too lightly”.

Netmums founder Siobhan Freegard said: “Relationships are tough at the best of times, but add in young children, lack of time, work and money worries and it’s little surprise couples are splitting up earlier than ever before. There is unprecedented pressure on women to be the perfect wife, mother and career woman while men are feeling more and more unsure of their role.”

Having children was shown to be the biggest problem area. Almost half (42 per cent) of people who took part in the research claimed having children made them less close – with only a third saying they became closer after kids.

Four in five people polled said their relationship suffered when they were exhausted after the birth of a new baby or looking after young children. Almost half (46 per cent) went off sex, while two in five felt less attractive after putting on weight.

More than half blamed money worries and debts for problems in their relationship, while a third suffered postnatal depression. One in 14 admitted to starting an affair, while 9 per cent said their partner wanted to become more sexually adventurous when they didn’t.