Jan. 15, 2009 -- Phone calls from volunteer mothers who overcame postpartum
depression prevent depressive symptoms in at-risk mothers, a Canadian study
"Mothers who received this support were at half the risk of depressive
symptoms 12 weeks after delivery," says study leader Cindy-Lee Dennis, PhD,
Canada research chair in perinatal community health at the University of
It's the first big study to show that postpartum depression can be prevented without intensive home care,
The study included 701 women at risk of postpartum depression. Half got
standard postnatal care and half got peer support. With standard care, 25% of
the mothers had significant depressive symptoms 12 weeks after delivery. About
half as many women who got peer support -- 14% -- had such symptoms.
After an extensive review of existing research, Dennis saw that efforts to
prevent postpartum depression were most effective if begun soon after a woman
gives birth -- and if they were home based.
But that's a problem: In Canada, as in the U.S., it's uncommon for health
care workers to routinely visit families at home once they and their babies
leave the hospital.
Dennis' solution: Recruit women who overcame postpartum depression, give
them very brief training, and have them make regular telephone calls to at-risk
women from two to 12 weeks after they gave birth.
"So we recruited mothers from the community who felt they had themselves
experienced postpartum depression, so they know what it is like," Dennis tells
WebMD. "Mothers are more willing to disclose their feelings to another mother
who knows what it is like than to a doctor or nurse."
Training of the peers was intentionally brief.
"You don't want to overtrain them and make them paraprofessionals -- that
would change the dynamics of the relationship," Dennis says. "We mostly talked
with them about how to establish a relationship over the telephone and how to
provide support. And we taught them how to identify depression so they could
refer depressed women to professional care."
The peer support was intended not to replace professional help, but to serve
as a link between communities and the health system.
It's very common for women to have the baby
blues in the first days after giving
birth, says Diane Wulfsohn, PhD, a clinical psychologist at Atlanta's
Northside Hospital. But those with significant depressive symptoms two weeks
after delivery are at risk of postpartum depression.
"Depression in the past, prior postpartum depression, complicated pregnancy, and life difficulties or stress are red flags for
postpartum depression," Wulfsohn says. "And postpartum depression is an
umbrella term. It describes several mood reactions women can experience at this
critical time of huge hormonal shifts."
Wulfsohn agrees with Dennis that in the U.S., there's no formal outreach
system for identifying women who suffer postpartum depression. The stress is on
making families aware of the symptoms and of making sure they know whom to call