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Moms Help Moms Duck Postpartum Depression

Peer Phone Calls Prevent Postpartum Depression in at-Risk Mothers
By
WebMD Health News
Reviewed by Louise Chang, MD

Jan. 15, 2009 -- Phone calls from volunteer mothers who overcame postpartum depression prevent depressive symptoms in at-risk mothers, a Canadian study shows.

"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 Toronto.

It's the first big study to show that postpartum depression can be prevented without intensive home care, Dennis says.

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.

Postpartum Depression: More Than Baby Blues

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 for help.

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