By LISA CAPOBIANCO
Extensive crying, feelings of hopelessness, and feeling anxious for no apparent reason are just a few symptoms of maternal depression that many women may not expect after giving birth. Left untreated, health experts say these symptoms could interfere with a new mother’s ability to bond with her baby, which is crucial in a child’s first year of life.
But the United Way of West Central Connecticut has teamed up with local health and educational groups in Bristol to form a program that helps women detect these symptoms from the start.
The Maternal Depression Screening Initiative is a collaborative project of United Way’s Bristol Early Childhood Alliance and its Infant and Toddler Committee to identify expectant and new mothers suffering from potential perinatal mood disorders with the goal of connecting them to resources for treatment. The committee consists of a number of local organizations, including Bristol Community Organization, Wheeler Clinic, Bristol-Burlington Health District, and Bristol Family Resource Center among others.
The program, which began in January, is one program under United Way’s grant-funded community plan for Bristol called the Bristol Early Childhood Blueprint—a lengthy document that is consistently updated with plans to ensure children enter school healthy and ready to learn.
The initiative aims to improve outcomes for the most vulnerable mothers and infants by offering perinatal depression screens into women’s regular visits to the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). These screens will start prenatally or when a pregnant woman enrolls in WIC, and will continue at every visit up until the baby turns a year old. During their WIC visit, women are screened by the Edinburgh Postnatal Depression Scale, which serves as an accurate way to determine maternal depression.
Women who score a 10 or greater on the scale will receive detailed information after the screening, but women who score less than that and still feel depressed also will receive help.
“They’re offered resources in the community where they can go for help, and also encouraged to go to their OBGYN for help too,” said Kim Carmelich, director of the Parent and Child Center at Bristol Hospital, which is in charge of the program’s data reporting.
Since the program began, Carmelich said some screens have been both positive and negative. To date, more than 500 families have undergone screenings, which exceeded the committee’s estimate of 348 families. Carmelich said about 22 percent of those screenings came in positive, and 89 percent of women with positive screens were able to accept information about where they could seek help. About 22 percent of women (who had follow-up appointments) with a positive screen utilized information referrals.
Carmelich said warning signs of maternal depression include not feeling like yourself for an extended period of time, not feeling interested in engaging with your newborn child, and losing interest in normal activities, as well as extensive crying and feelings of hopelessness.
“It’s normal to feel overwhelmed when you have a new baby, but when it goes beyond that, and you’re not able to cope with that…you might need to ask for help,” said Carmelich.
“Some new moms don’t recognize those signs themselves, so other family members or friends…can also be on the look out,” added Donna Osuch, president and CPO of United Way of West Central Connecticut.
Research shows that maternal depression can have negative effects on a child. Children with depressed mothers have a higher risk of having an attachment disorder, which could affect their ability to develop secure relationships and to achieve developmental milestones. They also will have an increased chance of having a behavioral or mental health disorder.
“The first years of a baby’s life are so important for brain development and bonding, and their ability to attach,” said Carmelich, adding maternal depression is most likely to occur in the first year of motherhood. “We’re screening in that whole period because [maternal depression] may not happen right away.”
Carmelich said maternal depression can interfere with the relationship between a mother and child, resulting in a lack of nurturing attention. This lack of appropriate interaction such as talking, singing or cuddling can interfere with a child’s ability to learn and grow, said Carmelich.
“If the mother is not bonding with that baby and stimulating the baby and meeting that baby’s needs, it can affect the attachment between not only a parent and child…but it can affect [the child’s] ability to attach to other people in the future,” said Carmelich, adding that those attachments also play a role in language development. “They lose some of those abilities.”
Osuch added if those attachments do not form, physiological changes may occur.
“Part of the bonding also increases…a person’s ability to withstand stress later in life,” said Osuch. “If you’ve had a secure, strong attachment in those first years….you will be stressed out by that situation, but you’ll move beyond it.”
Carmelich and Osuch said research shows that the preparation gap for children entering school begins to show at nine months old. When new mothers talk to their babies or engage with them in play, children are already forming those pathways to learn and grow.
“If it could be recognized, and some support services can be put in place…it makes a bigger difference and less likely for that baby to get behind,” added Osuch.
Carmelich said the project aims to help open the conversation among new mothers about postpartum depression, and to help connect the resources they need to treat those symptoms early on. According to Bristol Hospital 2012 births data, 14.6 percent of new mothers have had a past history with mood disorders or a mental health issue. Data also shows that at least 36 percent of all deliveries were to low income mothers, as indicated by enrollment in Medicaid or Husky Insurance plans. Carmelich said both groups face a higher risk of developing a mood disorder during pregnancy or within the first year of a baby’s life.
Carmelich said new mothers who know they have a mental health history should speak with their doctors beforehand, especially if they currently take medication. Carmelich said expectant mothers should share this information with their medical providers to make sure the kind of medicine they are taking is safe while pregnant or breastfeeding.
As more awareness on the project has spread, Carmelich said more people have been open to talking about postpartum depression. Osuch and Carmelich said they hope to continue the program in the future. Recently, the committee submitted a grant application to the Women & Girls Fund of the Main Street Community Foundation.
“They didn’t talk about it [in previous generations], and the best way to get help…is to talk about it and to have people feel safe disclosing the way they’re feeling,” said Carmelich.