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Pregnancy and Postpartum

Women With Unintended Pregnancy Are More Likely to Suffer from Postpartum Depression

by Dr. Sarah Allen
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A new study published on May 8 in BJOG: An International Journal of Obstetrics and Gynaecology, shows that women who became pregnant unintentionally are four times more likely to suffer from postpartum depression at twelve months postpartum.

Unintended pregnancy was defined in the study as both mistimed and unwanted pregnancies. Data was analysed for 688 women at three months and 550 women at twelve months and the results showed that postpartum depression was more likely in women with unintended pregnancies at both three months (11% vs. 5%) and twelve months (12% vs. 3%). The increased risk was highest at 12 months which indicates that this group of women have a long term risk of depression. When age, education level and poverty status were factored into the results, women with unintended pregnancy were still twice as likely to have postpartum depression at twelve months.
The authors conclude that unintended pregnancy may have a long term effect on maternal wellbeing and clinicians could consider pregnancy intention at antenatal visits and offer appropriate support both during and following the pregnancy.

Dr Rebecca Mercier, from the Department of Obstetrics and Gynaecology, University of North Carolina and co-author of the research said: “While many elements may contribute to postpartum depression, the results of this study show that unintended pregnancy resulting in live birth could also be a contributing factor. Simple, low-cost screening interventions to identify women at risk could allow targeted intervention when appropriate”.

I find that when women at risk for PPD come in for therapy during their pregnancy they have less symptoms and a shorter duration of symptoms than if they prolong getting help. The sooner they resolve their feeling about the unplanned pregnancy, the less likely they will experience depression postpartum.

Therapy is useful for resolving issues both during pregnancy and postpartum.

John Hopkins Researchers Uncover Genetic Predictors of Postpartum Depression

by Dr. Sarah Allen
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John Hopkins researchers have uncovered specific chemical alterations in two genes that, when present during pregnancy, reliably predict whether a woman will develop postpartum depression. This is a small study but if it can be replicated on a larger scale that would mean great news for pregnant moms. We already ask that doctors screen pregnant women by asking about risk factors such as prior or family history of mood disorders, current stressful situations or relationships but it is much easier (and therefore more likely that doctors have time to do it) if it is added to the standard battery of blood tests doctors already give pregnant women.

If we can more easily identify women who have a high risk for PPD, then we provide the new mom with support and education about effective treatments while she is still pregnant and hopefully get help started immediately following birth to reduce the depression’s severity or length. This will also help normalize the experience (research has shown that 10 – 20% of new moms experience PPD) and women won’t feel that it something that they are doing wrong or feel guilt about not enjoying new motherhood. We mustn’t start viewing PPD as only due to genetics though. We must also recognize the impact stressors i.e. lack of support, loneliness, financial and environmental stress or trauma have on PPD. This is a very small study but the researchers say they hope to move to the next step to collect blood samples from a larger group of pregnant women and follow them for a longer period of time.

Exciting News!

by Dr. Sarah Allen

When I set up my new website at the end of 2012 I also set up this blog but I have never got around to writing on it. It has been such a difficult thing to start – what to say? Today though I have had a two pieces of really, really good news so […]

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Your ‘Not To Do List’ For Happy Holidays!

by Dr. Sarah Allen

  It is very easy to forget that holidays are the time to have fun. I think this is especially true for women as they are frequently the ones trying to make everything work out. We have super long To Do Lists and although it feels good to check items off it can also mean […]

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Pregnancy & Postpartum Disorder

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  • Testimonials

    When I had my first baby I had what I now know was postpartum depression but I didn’t get any help. It did go away after about 18mths but it was a miserable way to begin motherhood.  When I was pregnant with my second child I started to become depressed again and this time told my OB/GYN how I was feeling and she referred me to Sarah. By starting to deal with how I felt and change the way I was handling the stresses in my life, I was in a much better place when my baby was born. The second time round my PPD was much less severe and didn’t last as long. Sarah was also really helpful in teaching me ways to make the transition of becoming a big sister easier for my oldest one too.   My husband came with me for some sessions and that really helped our relationship and we started working on parenting issues together.  Sarah’s counsel and support really helped our family transition to the good place we are all in today.
    Sara D.
    I began seeing Dr. Allen when my first child was around a year old. I had experienced a very traumatic birth, after a difficult pregnancy where I was on bed rest for a good portion of the time. The first year of my son’s life was spent worrying constantly. I also experienced flashbacks to the birth, which was an emergency C-section under general anesthesia. My son was in the NICU for several days following his birth, and I was not given very much information as to why. I remember thinking that he would die, or that something awful was going to happen. I experienced a great deal of anxiety that first year, and I thought that it was due to being a new mom. I wasn’t sleeping, I wasn’t eating as normal, and I remember being worried about leaving the house or taking my baby with me anywhere. I worried constantly about illness, germs, etc. The first day that I saw Dr. Allen, she gave me some questionnaires to fill out before we started talking. Then we sat down and talked about my experiences with my son’s birth and the early days of his life, and the year or so since then. I remember to this day the relief that I felt when she looked at me and said that I had PPD and PTSD, which was a result of the trauma I experienced during and immediately after the birth of my son. She explained how my brain had reacted to the stress of these events, and related it to why I was feeling the way that I felt. It made so much sense. Then, she described ways that I could get over the trauma, work through the feelings, and recover from PTSD and PPD. I felt so empowered, and so happy that the way I felt had a name, and that it was treatable. It also made me feel so validated in the ways that I had felt and reacted following my son’s birth. I wasn’t going crazy. My reaction was normal and natural. And with the help of Dr. Allen, and the type of therapy that she uses, I knew I could recover. It is over five years since that first visit with Dr. Allen, and I still use the tools that she taught me today to deal with stress. I credit her with helping me to become a more empowered, happier person.
    Elizabeth
    I refer as many patients as I can to Dr. Allen. She is an expert in treating perinatal mood disorders, and a well-trained and experienced therapist who is committed to working with her clients to develop a treatment plan designed for each individual. She exhibits genuine warmth, kindness and compassion for each of her clients. Dr. Allen has been a colleague of mine for more than 20 years, and I have great confidence when I refer patients to her.
    Leslie Lowell StoutenburgRNC, MS, FACCE Director, Pregnancy & Postpartum Mood & Anxiety Disorder Program and President of Postpartum Support International
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    • Redbook Article : Men Get Postpartum Depression Too
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