As today marks the beginning of National Postnatal Depression week, it is timely to reflect upon the issue of emotional and mental health conditions that occur during pregnancy and in the year following the birth of a baby.
This period is known as the ‘perinatal period’, which marks a time of great change in a woman’s life placing her at significantly greater risk of developing emotional and mental health disorders.
The most common mental health disorders are depression and anxiety. Australian research indicates that up to 10 per cent (one in 10) of women will experience depression during pregnancy, and this increases to almost 16 per cent (one in seven) in the months following the birth of a baby[i].
Less common severe mental health disorders such as puerperal (postpartum) psychosis and bipolar disorder arise or recur and can place both the mother and baby at significant risk.
The impact of mental health disorders during pregnancy and in the year following
Whether mild, moderate, or severe, maternal mental health problems are known to have a significant impact – on all members of the family and the community.
When considering the financial cost to the community, the immediate cost of not treating depression and anxiety for births in one year is well in excess of $500M3.
Our research to date highlights the devastating impact of these conditions on mothers, fathers, and the whole family.
For mothers, depression and anxiety is difficult to manage at any time of life – but when considering the impact of pregnancy or the need to also look after a baby – the effects of these conditions is compounded even further and can make it very difficult for a mother to cope from day to day4.
“All I wanted to do was to just crawl into bed and stay there, on my own, and everyone to go away – including my baby and my mum.”
There are also flow on effects for the relationship and the father. We know that men whose wives/partners are suffering are 50% more likely to also experience postnatal depression themselves5.
“The person I had known for years was just gone…she didn’t respond to me or anyone.”
Perinatal mental Health in Australia
Australia has become a world leader in the area of perinatal mental healthcare. This has stemmed from significant investment in research1, planning5, and implementation of the National Perinatal Depression Initiative (NPDI).
Despite these great advances, however – many challenges remain, these include:
Low awareness and High Stigma:
still exists in Australia today and is often leading to conditions becoming more severe. Many women and men do not seek help until they reach crisis point – by which time the condition has become more sever and the impacts more widespread.
Lack of Universal Screening:
routine screening of mental health conditions and risk factors remains inconsistent – delaying timely identification and effective treatment.
Non- systematic data collection:
currently data is not collected in a consistent way – making it impossible to track or monitor if women are receiving effective care.
Lack of Research:
there is insufficient research to inform the most clinically and cost effective approaches to detecting, managing and treating perinatal mental health disorders in Australia and Internationally.
Introducing COPE: Centre of Perinatal Excellence
In response to this, COPE has been established as a new, not for profit organisation, that will provide the much needed, dedicated focus on perinatal emotional and metal health conditions6.
COPE works in collaboration with others to achieve our six COPE Objectives as there is a clear need for a dedicated focus on perinatal mental health.
COPE’s six Objectives:
1) Provide leadership, support and advice to the National Initiative
COPE works closely with all governments and beyondblue to continue the successful national implementation of Australia’s National Perinatal Depression Initiative (NPDI) through ongoing consultation with our stakeholders, experts in the perinatal field, women and their families.
2) Support health professionals to deliver best practice
COPE works to embed Australia’s Clinical Guidelines19 through the development of innovative practical tools, training and educational resources. Guided by the latest research evidence, these tools will support health professionals to deliver effective screening and management practices.
3) National Data Collection and Analytics
4) Raise awareness, understanding and reduce the stigma
Using innovative approaches COPE works with others to educate, inform and empower women and family members to access safe and effective support and treatment.
5) Integration with Support Services
COPE will work with the range of local and state-based treatment and support services nationally to further promote pathways to care and support in the community and ensure cohesive integration of these services.
6) Research and Advocacy
All work undertaken by COPE is underpinned by high-quality, evidence-based research. Through our ongoing work with leading experts and stakeholders, COPE will undertake the much-needed research to inform future directions of the NPDI. Further, by working alongside women and their families, we will continue to advocate for the needs of those at risk of, or experiencing mental health disorders in the perinatal period.
Join us in our mission to raise awareness, reduce stigma and improve outcomes for women, infants and their families.
Get involved by joining us on twitter or facebook, donating and becoming part of our growing momentum.
We also want to know more about your experience! If you are a woman who has had depression or anxiety whilst pregnant or any time in the year following birth – tell us about your experience and inform our work. Simply complete our COPE Survey.
“Unfortunately, there is still a stigma around depression generally, but I think particularly amongst women. We can be our own worst enemies – especially when it comes to motherhood. We need to stop giving each other a hard time and come together with love and support”.
Together we can work to reduce the debilitating and often devastating impact of perinatal mental health disorders for women, infants, their families and the community.
Dr Nicole Highet is Founder and Executive Director of COPE: Centre of Perinatal Excellence, a clinical psychologist and former Deputy CEO of beyondblue.
1Buist A and Bilszta J (2006) the beyondblue National Postnatal Screening Program, Prevention and Early intervention 2001-2005, Final Report. Vol 1: National Screening Program. Melbourne: beyondblue; the national depression initiative.
2Austin M-P and Priest SR (2005) Clinical issues in perinatal mental health: New developments in the detection and treatment of perinatal mood and anxiety disorders. Acta Psychiatr Scand 112:97-104.
3Valuing perinatal mental health. The consequences of not treating perinatal depression and anxiety. Price Waterhouse Coopers. November 2012.
4Highet NJ, Stevenson A (2011) Consumer experiences of living with perinatal depression and anxiety – a qualitative analysis. Melbourne: beyondblue; the national depression initiative.
5Paulson, J.F, Bazemore, S.D (2010) Prenatal and postpartum depression in fathers and its association with maternal depression: a meta-analysis. Journal of the American Medical Association. 303 (19) 1961-1969.
5beyondblue National Action Plan for Perinatal Mental Health 2008-2010: Full Report
6Highet NJ and Purtell CA (2012) The National Perinatal Depression Initiative. A synopsis of progress to date and recommendations for beyond 2013.