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Post by Denise Ellis on Jan 28, 2016 21:48:40 GMT -4
As a mother of three children, I applaud the United States Preventative Service Task Force for recommending screening pregnant women for depression. The anticipation of a newborn creates multiple stressors for mothers such as childcare needs, fear of employment scrutiny, demands for access to health care, financial constraints to provide for a child, insufficient support systems,dead beat fathes, coping with hormonal changes and changes in body image. Pregnancy is a time when women need a lot of emotional support both during pregnancy and especially postpartum. The added stress of a crying child postpartum is enough to cause some mothers to feel like having crying spells too. Screening for depression during pregnancy should be performed by Obstetricians. Counseling should be provided first before the institution of medication unless the depression is severe. SSRI's should be used with caution since several studies have associated the use of drugs such as Paxil and Fluoxetine with increased risks for heart, and vascular defects (Furu, et al, 2015). The risks factors for birth defects with anti-depressant medications, although present are rare. Discounting antidepressants in pregnant mothers pose the risk of depression relapse, fatigue, chills, anxiety, and irratibily. I believe it would be safer to explain the risks and benefits to expectant mothers and allow them to decide the best treatment option. Mothers should optimally be prescribed medications that have no teratogenic risk. Treatment options for using ECT should also be considered for mothers with newly diagnosed major depressive disorder. Screening and treating mothers for depression will have a positive impact on providing adequate prenatal and post partum care for both Mom and baby.
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Post by Daniel Asher on Jan 29, 2016 11:35:27 GMT -4
I think the problem with screening for depression in pregnant women or those planning to get pregnant is the severe limitation of therapy once a diagnosis is made. Majority of psych meds are contraindicated in pregnant women. It would be more beneficial if a pt's pcp screened for any prepartum psychosocial abnormalities and followed up after the baby is born. Once a baby is delivered, an obgyn is only liable for care of the mother and child for only a couple of months. I think the societal shift can be attributed to the increase in depression found in mothers. Women are much more independent and are choosing work over kids.
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Post by Ezekiel udoh on Feb 1, 2016 15:33:21 GMT -4
postpartum depression, feelings of sadness and anxiety can be extreme and might interfere with a woman’s ability to care for herself or her family. Because of the severity of the symptoms, postpartum depression usually requires treatment. The condition, which occurs in nearly 15 percent of births, may begin shortly before or any time after childbirth, but commonly begins between a week and a month after delivery.Unfortunately as highlighted in some replies, medications and pregnant women don't always turn out to be a perfect fit coupled with the fact that awareness is moderately low.That being said a shift to a more after birth oriented care not only for the babies but for the mother's too should go a long way to curtail this problem.
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Post by Audu Abdulmalik on Feb 2, 2016 12:15:33 GMT -4
The period of childbirth and after childbirth can be very critical to women mental health status,of all the mental health illnesses they are more prone to depression during pregnancy and postpartum depression.But unfortunately for them they are mostly often not screened,diagnosed or treated this being that medicine in this age has become highly specialized.They make more contact primarily with their obstetrics/gynecology doctors who often times do not indeptly focus on this part of the patient.Understandably drug based treatment during pregnancy should not be encouraged because this drugs can become teratogenic to the child health.Ultimately screening of pregnant and recent mothers should be introduced.
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Post by Pooja Bendala on Feb 3, 2016 18:53:47 GMT -4
A previous article on Healthline.com stated that 1 in 10 Americans have experienced depression at one point or another, 80% of people who have clinical symptoms of depression and are not receiving any treatment for their depression. It is sad to think those are the numbers. Depression is a real thing and if in the general population it is as high as the statistics show, it is probably much more prevalent in pregnant women. The guidelines that the Task force has set out to screen pre, peri -partum is important. While there have been numerous instances in the past of mothers suffering from postpartum depression, the same can be said for those who are pregnant. During those times the body is under a lot of stress, the idea of new changes coming, financial restraints, etc. can be overwhelming. It is important that screening is done for these individuals. Depression even nowadays is considered to be taboo in some cultures, and these barriers need to be broken down. There was a patient diagnosed with depression in the office secondary to adjustment disorder. She had recently gotten married, had a baby, and was working full time as a teacher. Overwhelmed was an understatement. She was not getting sleep, and she was having suicidal ideation. During the interview she admitted at times during the pregnancy she felt this way as well but was scared to tell anybody, “Because it was supposed to be a happy time.” Hearing her story I fully support the task force and think more open discussions need to occur between providers and pregnant women as well as the general population, to prevent any consequences from occurring.
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Post by Randy Lindgren on Feb 4, 2016 10:40:32 GMT -4
I agree with the task force screenings before pregnancy and during. Pregnancy seems to be a very traumatic experience as far as lifestyle adjustments that have to be made and pressures of near future parenthood. I think it is very important to assess patients for possible depression during pregnancy because it is much more than just physical changes that happen, and drastic hormone changes put these patients at risk of many emotional/psychological imbalances. I think it is important for pregnant women to have support, such as other friends with children or who are pregnant to help guide them into motherhood. Through observing another parent or pregnant individual I think many women would feel a sense of relief in being better prepared for their future.
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Post by Joel Romance on Feb 8, 2016 15:27:58 GMT -4
This article is not only informative, but in many cases it could be life saving. The amount of women developing depression after birth is quite substantial and I believe there are several ways to counteract this problem. First off, from the article, there needs to be a more intuitive form of screening in order to catch all cases of depression that have no already been identified. Secondly, I believe that some form of training or classes after or even before birth would be very beneficial. Any woman having a child with no sense of guidance from a family member or close friend may be in for a rude awakening. With certain training or simple teaching, women can learn small things about their newborn that may have otherwise taken weeks and an increased amount of frustration and anguish. By having certain protocols in place after a birth for any mother, depression and other closely related problems can be proactively handled and treated.
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Post by brandonkrout on Feb 11, 2016 19:17:33 GMT -4
It's interesting that this article points out how many women are affected by depression coinciding with their pregnancies. Looking back on my Ob/Gyn rotation, we would routinely ask women how they were doing as it pertains to depression and depressive symptoms. I can't think of a single woman answering positively about depression like symptoms, either during her pregnancy or in the few weeks after. So this article is something that is different from my experience during my rotation.
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Post by camilo on Feb 17, 2016 20:39:55 GMT -4
Reading this article reminds me of one ER "code blue" we Pediatrics duty clerks had to rush down to administer CPR. I saw the mother sitting stoically in one corner while we did what we're supposed to do for her baby. We looked at each other, I asked more details because it looked to me the baby is not at all responding to all we did. So I found out the baby was DOA,dilated pupils,no pulse, extremities all showing zero circulation. My attention was at the mother and I was already suspecting child abuse. This was right after New Year's Eve which is always a joyful time in the firecracker mecca of the Philippines -all of Manila lights up for 2 to 3 hours non-stop, and people are as noisy as can be. But for this Mother and child -Tragedy of the highest caliber - though I cannot seem to see that in the pale stoicism of the mother who couldn't even pretend to cry for her long dead child. So here we see a real problem before us among mothers with post-partum depression and mothers who experience "temporary insanity" in pregnancy. None of these are simple cases, and all of these need the much needed attention we can give, and given time and the commitment of many doctors who see the Light - we will be able to make a difference in the lives of these future patients who will one day be right in front of us yearning for an answer to their real problems.
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