Rethinking maternal depression

When you talk about maternal or postpartum depression with Dr. Darius Tandon, he’ll tell you that it’s more prevalent than you think, and that it goes beyond the mom. Tandon is an associate professor at the Northwestern University Feinberg School of Medicine where he is also the Associate Director of the Center for Community Health. He and his colleagues have developed the intervention program Mothers and Babies. The program is designed to help prevent and treat symptoms of maternal depression in expectant and new mothers. (Read a story about the Mothers and Babies program coming to Florida.)

 Dr. Darius Tandon

Dr. Darius Tandon

What are some common misconceptions about maternal depression?

One misconception is that it is always extreme. [...] What we often see is that women who are struggling with postpartum depression have some symptoms but they oftentimes are not as noticeable. If you look at the statistics there are roughly 10 to 15 percent of women who will experience depression right after delivering a child. One misconception is that only those women who are in that 10 to 15 percent range might have negative outcomes, but even for mothers who have mild to moderate symptoms and who might not meet the criteria for full blown depression – we know that that affects their relationship with their child. Mom might have mild to moderate symptoms, but often she’s not going to receive the services and supports she needs because a lot of those services are relegated to more severe cases.

What impact can maternal mental health have on a baby's development?

 Download a printable pdf of this maternal depression fact sheet in  english  or in  spanish .

Download a printable pdf of this maternal depression fact sheet in english or in spanish.

There’s research to show that mothers who are depressed might be less likely to have timely well-child visits and immunizations. There’s a whole host of outcomes that relate to what happens when mom is trying to engage in parent behaviors when she’s depressed. Mom might be less spontaneous, engaging and attentive which can lead to negative socio developmental outcomes for the child. Attachment insecurity and difficulties with social interaction are some of the things we see in babies whose mothers are struggling with depression.

Is it common practice for pediatricians and OB/GYNs to screen for maternal depression?

I think that there is growing sentiment that it is important for pediatricians and OB/GYNS to screen and I think we’re also seeing an increase nationally in the percent of practices who are screening. I think the issue then is, if somebody screens positive, then what happens? I think that's the real challenge now. We’re moving away from “Is it important to screen?” and toward “What do we do?” That’s when we run into issues because there aren’t enough mental health providers and we’re not sure that mothers are receiving the services they need. We know that, for various reasons, women who are referred for mental health services are not always going to engage with those services. With Mothers and Babies, the idea is that if the mother is already engaged in a home visiting program and has developed a relationship with the home visitor, why not train that home visitor to help mom with her symptoms rather than relying on mom having to engage with another service provider. Because we know so few women are actually going to engage with those outside services, our philosophy is to find ways to bring those services to them.