At least one in ten pregnant women suffers from bouts of depression. In addition to the hormonal changes associated with pregnancy, depression can result from the stress of adjusting to the many changes associated with pregnancy and subsequent motherhood.
For women with an easily available support system to help them through these changes – family, sympathetic friends, prenatal classes, public health nurses – stress can be managed and may even be energizing in meeting the challenges ahead. But, for many other women, especially those living in isolated situations, depression can escalate to levels that may be harmful to both the woman and the infant. Research shows that depressed moms can have difficulty caring for their children, depriving the infant of the nurturing that lays the foundation for healthy brain development. Plus, family relationships can suffer from the stress that depression on top of adjustment to a new baby can cause.

The following resources compiled by the UW Center on Infant Mental Health and Development (www.son.washington.edu/centers/cimhd/) can help First Steps providers and other health care professionals caring for pregnant and parenting women at risk for depression.

• Keys to Postpartum Depression, created by nurse scientists at the University of Washington and members of the Washington State First Steps Team, offers a series of multi-media training modules on Understanding and Treating Women with Perinatal Depression & Mood Disorders; Relationship Focused Practice; and Screening for Perinatal Depression. Approximately 50% of women with perinatal depression are never identified.

• Postpartum Support International of Washington. Local providers, support groups, programming and educational materials for mothers, partners and practitioners. Go to ppmdsupport.com, or call 1-888-404-PPMD (7763) for most current resources.

• Postpartum Support International. Information, resources, support groups. (www.postpartum.net).

• Nursing Best Practice Guidelines for Postpartum Depression. A new report from the Registered Nurses Association of Ontario (RNAO) promotes self-care activities performed either individually or with health professionals as an effective antidote for depression. These activities include exercise, sleep and nutrition, adhering to treatment, and engaging in supportive relationships that promote feelings of well-being. Health professionals can support self-care in their patients by addressing factors such as self-concept, self-efficacy and motivation. To access RNAO’s complete report, including specific guidelines for clinical practice, education and policy work, go to http://www.rnao.org/.

• Speak Up When You’re Down, a website launched by the New Jersey as part of a statewide educational campaign, is designed to help both consumers and health care professionals with a wide range of information and resources about postpartum depression, including an on-line PPD support group and personal testimonials (http://www.rnao.org/).

• Speak Up When You’re Down! Washington State Postpartum Depression Public Awareness Campaign, is a new educational campaign in Washington state based on the New Jersey model. For more information about the campaign, including helpful resources and brochures available for distribution, contact wcpcan@dshs.wa.gov or call 206-464-6151.

• The NURSE program is an effective strategy for caring for the brain and promoting healing through Nourishment and Needs, Understanding, Rest and Relaxation, Spirituality, and Exercise. For more details and a care plan, go to the “Journal of Obstetric, Gynecologic, and Neonatal Nursing,” March/April 2005 (http://jognn.awhonn.org/). The program was developed by Sichel and Driscoll (1999) and is also described in Women’s Moods: What Every Woman Must Know About Hormones, the Brain, and Emotional Health, 1999, HarperCollins Publishers.

• The LEVITY Program, developed by UW Professor of Nursing Marie-Annette Brown, offers a drug-free approach to mild depression using increased exposure to sunlight, regular exercise, and vitamin therapy. For a detailed description and treatment plan using Brown’s clinically-proven program, see When Your Body Gets the Blues, by Marie-Annette Brown, Ph.D., RN and Jo Robinson, 2002, St. Martin’s Press, or go to www.thebodyblues.com .