Postpartum Depression

 

            Pregnancy and birth are two of the key milestone changes in a
woman’s life. It is a time for a celebration of the birth of their loved one, a
new beginning. While physical changes are obvious changes and can easily be
fixed, mental changes happen as well. These mental changes can be challenging
to treat and they may stem from withdrawal from family and friends, insomnia,
loss of energy and may even be as critical as difficulty bonding with their
newborn. These mental changes and challenges are called postpartum depression
and they affect teen and adolescent mothers. Postpartum depression is a
“serious illness that can occur in the first few months after child birth. It
can also happen after miscarriage or birth” (HealthLink BC, 2017, para. 1). In
Canada alone, during the postpartum period, 7.5 percent of women are reportedly
to have depressive symptoms. Therefore, due to an increase in postpartum
depression in adolescent mothers, health promotional strategies should be
considered to improve the physical and mental well-being of pregnant mothers.

            There is a huge
health disparity with regards to postpartum depression in terms of women living
in urban areas compared to women living in rural areas. Women in urban areas
reported of less social support than women living in rural areas, for the
reason that in the rural area is more family oriented. According to Simone Vigod
(2013), who is a study author and psychiatrist at Women’s College Hospital states
that, smaller areas have more support and it is more of a family oriented
culture, whereas in larger cities there are more loved ones moving away and
relocating, working long hours and most of the time would not be present. This
is very alarming considering the geographical location because, most would
think that pregnant women living in urban areas would have more social support
and healthcare support due to easy hospital accessibilities but that is not the
case. In addition, Canadian born women have a lower risk of having postpartum depression
due to their lack of engagement in the healthcare system. This is supported by
Simone Vigod (2013), as she states that “They may not be as engaged with the
healthcare system in terms of getting care prior to delivery, so they may be
less well-treated in terms of their depression prior which can increase their
risk of postpartum depression” (as cited in Tucker, para. 16). Non-Canadian
born women are not as knowledgeable when it comes to acquiring help when they
start suffering from mild postpartum depression, instead they resort to assistance
from their loved ones which has a small success rate given that they are living
in an urban area. Lastly, with such health disparities that is occurring
between rural-urban pregnant women, an effective promotion strategy must be in
place to bridge the gap of disparities.

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            Eliminating
health disparities in Canada is very crucial in order to eliminate postpartum
depression in adolescent mothers. Canada should implement the United Kingdom’s
National Institute for Health and Care Excellence (NICE) antenatal and
postnatal framework. This guideline will recognize, assess, and treat mental
health problems in women who have plans of pregnancy, is pregnant or pregnant
in the past (National Institute for Health and Care Excellence, 2017, para. 1).
In addition, NICE will also promote early detection and management of mental
health problems to improve the quality of life for pregnant women. NICE is
supported by Dr. Simone Vigod (2017) in which she states, “This way each
jurisdiction would have a better map of the evidenced-based services that
should be provided and might be provided, by different arms of the health and
social service system” (as cited in Tomasi, para. 8). Streamlining this health
strategy will allow more women suffering from postpartum depression to be
assured that there are ways to cope with their mental challenges in less
complicated ways. Line ups for therapy and counselling will take a vast amount of
time and waitlists are very long, by having strategies such as NICE there will
be an impact in the health care industry. Similarly, due to line ups and long
waiting list for counselling and physical therapy, online therapy for mothers
suffering from postpartum depression is very useful as it can be easily accessed
by pregnant mothers without leaving their homes, and it is also cheaper than
attending physical therapy. Online therapy is called Therapy Assisted Online Cognitive
Behavioral Therapy Program (TAICBT). TAICBT according to Patricia Tomasi
(2017), has been making a good reputation in Canadian workplaces, for the
reason that it is less expensive than in person therapy. It also suggests that
TAICBT and in person therapy is as equally effective in treating mild to
moderate depression and anxiety. By having both NICE and TAICBT as the two rubrics
for eliminating health disparity such as postpartum depression in pregnancy, it
will be easier for healthcare professionals to treat, diagnose, and cure such
mental challenges.

            The effectiveness
of both TAICBT and NICE is very effective. Patricia Tomasi (2017) states that
50 new mothers from Saskatchewan were randomly assigned to receive TAICBT, and
the women that received the online therapy group experienced a decrease in postpartum
depression symptoms versus mothers who did not receive the treatment. It is
also said that 20 percent of women who tried the online therapy have shown improvement,
while 62 percent is considered to be recovered. In addition, 60 percent of
mothers completed the whole therapy. Considering the statistics of the study,
it is very clear that Therapy Assisted Online Cognitive Behavioral Therapy Program
has a significant effect in treating mild to moderate depression in pregnant
mothers. Connie Chow from Edmonton, Alberta, states “It really helped me
when I couldn’t leave the house and was a good bridge to my mommy program. I
wish I had known about it earlier. It would have helped me realize that my
thoughts weren’t healthy and maybe I would have been able to enjoy the newborn
experience more” (as cited in Tomasi, 2017, para. 21). Similarly, NICE
postnatal and antenatal framework has a positive effect on pregnant mothers, a
questionnaire was sent to all the mothers who received the treatment and it
showed a high level of satisfaction with the service. Also, on the ten year
outcomes of the service there are no maternal deaths, no infanticides, and
patients feedback stating that they are fulfilled with the service.
Furthermore, NICE postnatal and antenatal framework serves no waiting lists,
flexible appointments with different days, times and place which includes home
visits as well. By taking into consideration these two health promotions, it is
seen that both are very effective and with more funding and research that will
be put onto it, postpartum depression will be a problem of the past.

            To conclude,
health disparities such as an increase postpartum depression in adolescent
mothers occur due to language barriers, ethnic traditions, geographical
location, financial, and social status. However, with these in mind there are
health promotion strategies that can be used to combat such issues. Canadian
government should follow United Kingdom’s NICE postnatal and antenatal
framework which is very effective in making sure pregnant mothers get the care
they need. It also acknowledges the care and treatment of the mother and
educates them on the step by step procedure on how to provide care for their
infants. In addition, it will also inform the mother the consequences of having
no treatment post pregnancy and the pros and cons of getting treatment.
Furthermore, health care professionals will be able to monitor and assess those
mothers who currently have mental issues and those mothers at risk of
developing mental issues. In contrast, Therapy Assisted Cognitive Behavioral Therapy
(TAICBT) have also been deemed to be successful and thus require more health
promotion strategies. With studies shown, TAICBT can follow up on pregnant
mothers and gain contact with them in the comfort of their own homes. Longer
lineups, child care responsibilities, and other health care appointments to
receive therapy are also one of the main issues posed for pregnancy mothers and
suffering from postpartum depression. TAICBT offers in home visits as well making
sure that pregnant mothers can be assessed in a timely manner. However, to
improve these strategies more media exposure on these health promotions should
be in place to educate mothers and future mothers that are in need of help. Also,
to further assist and cover Non-Canadian born mothers, financial assistance
should be provided regardless of their financial situation. Lastly, NICE
antenatal and postnatal framework and Therapy Assisted Cognitive Behavioral Therapy
is not perfect at its state, but more research and funding should be provided
to make sure it lasts in a desired amount of time for its longevity in the healthcare
industry.

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