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Prenatal reality check may cut risk of postpartum depression. (Inquire about Hopes, Expectations).
NEW YORK -- A little prenatal candor can go a long way in preventing or minimizing the impact of postpartum depression, Dr. Diana Dell said at a press briefing sponsored by the American College of Obstetricians and Gynecologists.
"Women are under tremendous pressure to make perfect babies and to be perfect mothers and perfect wives. Having a baby is supposed to be the most beautiful, fulfilling experience in a woman's life ... and she's got huge expectations about what it will be like. And then reality hits," said Dr. Dell, who is with the departments of psychiatry and ob.gyn. at Duke University Medical Center, Durham, N.C.
That reality is a lot less like a Gerber baby food commercial and a lot more like Marine boot camp than most new mothers expect. "It is incessant demand, and the woman must obey every order. There's no rest, no mercy and no concern for your feelings," Dr. Dell said.
This is not to say that false expectations cause postpartum depression. But in a woman with a history of depression or other risk factors, the discord between longstanding expectations and the realities of early parenthood can trigger episodes of depression, which can sometimes tailspin very quickly.
Dr. Dell believes it is essential during prenatal visits to brief women--especially first-time mothers--about postpartum realities and to take time to explore their emotions and their hopes and expectations. Ideally this should continue throughout the postpartum period as well.
"We've had a conspiracy of silence about all of this. Doctors don't ask, and women don't tell," she said.
She estimated that up to 70% of all pregnant women experience some symptoms of depression during their pregnancy or in the postpartum period. But only between 10% and 16% of them meet the criteria for major depression. Up to 20% will have an episode of major depression before the child's first birthday The numbers are even higher--in the range of 25%--for first-time adolescent mothers.
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Source: HighBeam Research, Prenatal reality check may cut risk of postpartum depression....