Postpartum Depression: Do Intrapartum Events Matter?

Abstract

Approximately 500,000 women in the US suffer from postpartum depression (PPD) every year. Yet only half of women affected seek treatment. PPD affects the entire family unit, altering parenting behaviors and increasing prevalence of depression among male partners of women suffering from PPD. In addition, infants whose mothers suffer from PPD have a higher risk of Sudden Infant Death Syndrome (SIDS) and more frequent hospitalization as well as cognitive and behavioral delays. Despite the significance of PPD to the health of women and families, most research has focused on the identification and treatment of PPD. Research pertaining to intrapartum events as possible risk factors for PPD has been contradictory and variable in quality. The purpose of this study is to examine possible relationships between intrapartum events and subsequent incidence of postpartum depression.The Diathesis-Stress Model provides the foundation for this proposed research, in which a combination of vulnerability factors (diatheses) in the context of life events (stress) results in psychopathology (PPD). Vulnerability factors such as previous history of depression, prenatal anxiety, or low self esteem may interact with intrapartum stressors such as cesarean section, induction of labor, or use of pain medication to increase PPD symptomatology. This study will examine the stress component of the Diathesis-Stress Model.The study design was a retrospective descriptive design aimed at identifying relationships between intrapartum events and PPD. A chart review was performed to identify intrapartum events and scores on the Edinburgh Postnatal Depression Scale (EPDS) at two- and six- weeks postpartum. The sample consisted of 102 women who delivered at a specified rural New England birthing center during 2007.Nurses commonly interface with women in health care settings and are uniquely poised to educate them about PPD. Nurses have the unique opportunity to alert women to the potential risk for PPD and encourage them to report signs and symptoms early. Increased reporting of symptoms can reduce the number of unidentified cases and promote interventions that avert some of the devastating emotional, physical, and economic consequences.