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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

August 2013

Recognizing Postpartum Depression in the Primary Care Setting 

While many new moms experience the “baby blues” for a few weeks after childbirth, nearly 13% of pregnant women and new mothers grapple with the more severe, long-lasting form of depression known as postpartum depression.

Postpartum depression can occur a few days after childbirth or several months later, sometimes beginning only after a woman weans her baby from breastfeeding.

Untreated depression can contribute to a variety of health problems for mother and baby, including having a premature birth, not gaining a healthy amount of weight during pregnancy, and giving birth to a low-weight baby. After birth, undiagnosed and untreated postpartum depression can interfere with mother-child bonding and contribute to a mother feeling overwhelmed and losing confidence in her ability to meet her child’s needs. According to researchers, the children of mothers with untreated postpartum depression can develop a variety of behavioral issues, including sleeping and eating difficulties and temper tantrums, and may also experience delays in language development.

Although all women are at risk of postpartum depression, the following factors can heighten risk:

  • A personal history of depression, postpartum depression, or other mental health disorders
  • A lack of support from family and friends
  • Anxiety or negative feelings about the pregnancy; an unplanned or unwanted pregnancy
  • Stressful life events in the last year, including marriage or money problems
  • Young age
  • Substance abuse

Symptoms of postpartum depression include:

  • Crying
  • Feeling sad, hopeless, and overwhelmed
  • Loss of interest in activities the patient once enjoyed
  • Trouble sleeping, even when the baby is sleeping, or sleeping more than usual
  • Having little energy
  • Difficulty concentrating and making decisions
  • Feeling restless, irritable, or anxious
  • Withdrawal from family and friends
  • Feeling overly worried about the baby or feeling distant and detached from the baby

The baby blues should not be confused with postpartum depression. Up to half of all new mothers will experience the baby blues during the first few days after delivery. The probable cause of the baby blues is the dramatic drop in progesterone and estrogen after delivery. Symptoms of the baby blues include tearfulness, mood swings, irritability and anxiety. However, these symptoms typically are milder than with postpartum depression and disappear within a two week period. If these feelings do not go away or worsen a new mother may be experiencing postpartum depression.

Early detection and treatment of postpartum depression is vital in preserving the health of mother and child. In many cases, therapy is effective in treating depression and anxiety during and after pregnancy.  Encouraging the patient to seek out a support system—a new mother’s group or a group for women dealing with postpartum depression—can also be helpful. However, antidepressant medications may also be needed.

How Optum/United Behavioral Health (Optum/UBH) can help your patients—For complex clinical situations, Optum/UBH is available to provide consultative assistance. Practitioners can call the Optum/UBH Physicians Consultation Service at (800) 292-2922. To refer a patient for behavioral health services and to facilitate the coordination of care, call Optum/UBH at (888) 777-4742.

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Eric H. Schultz,
President and Chief Executive Officer

Richard Weisblatt PhD,
Senior Vice President, Provider Network

Annmarie Dadoly,

Kristin Edmonston,
Production Coordinator