Objective-To examine socioeconomic status (SES) as a risk factor for depressive symptoms in late pregnancy and the early postpartum period. A secondary objective was to determine whether SES was a specific risk factor for elevated postpartum depressive symptoms beyond its contribution to prenatal depressive symptoms.Design-Quantitative, secondary analysis, repeated measures, descriptive design.Setting-Participants were recruited from paid childbirth classes serving upper middle class women and Medicaid-funded hospitals serving low-income clients in Northern California.Participants-A sample of 198 first time mothers was assessed for depressive symptoms in their third trimester of pregnancy and at one, two, and three months postpartum. Callouts: New mothers with low SES are twice as likely as higher SES mothers to develop new onset depressive symptoms at three months postpartum. Women with four SES risk factors (low monthly income, less than a college education, unmarried, unemployed) were 11 times more likely than women with no risk factors to have clinically elevated depression scores at three months postpartum. Health care professionals must assess for depressive symptoms during pregnancy and continue to assess for symptoms throughout the first year postpartum regardless of socioeconomic status. Main OutcomePublisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptWomens Health Issues. Author manuscript; available in PMC 2011 March 1. Published in final edited form as:Womens Health Issues. 2010 ; 20(2): 96-104. doi:10.1016/j.whi.2009. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptResults-Low SES was associated with increased depressive symptoms in late pregnancy and at 2 and 3 months, but not at 1 month postpartum. Women with four SES risk factors (low monthly income, less than a college education, unmarried, unemployed) were 11 times more likely than women with no SES risk factors to have clinically elevated depression scores at 3 months postpartum, even after controlling for the level of prenatal depressive symptoms.Conclusion-Although new mothers from all SES strata are at risk for postpartum depression, SES factors including low education, low income, being unmarried, and being unemployed increased the risk of developing postpartum depressive symptoms in this sample. KeywordsPostpartum Depression; Prenatal Depression; Socioeconomic StatusResearch suggests that women are more likely than men to develop a major affective mood disorder in their lifetime (Burt & Stein, 2002). Moreover, the risk of developing a d...

Sleep disturbance and depressive symptoms were associated at Time 1 and Time 4. For new mothers, a complaint of trouble falling asleep (delayed sleep onset latency) may be the most relevant screening question in relation to their risk for postpartum depression.

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To determine the contribution of infant temperament to the relationship between maternal sleep disturbance and depressive symptoms. Utilizing a prospective design, 112 couples recruited from childbirth education classes were assessed in third trimester and postpartum. Instruments included Center for Epidemiologic Studies Depression Scale, General Sleep Disturbance Scale, wrist actigraphy, and an investigator-developed tool to assess infant temperament completed by mothers and fathers. Regardless of infant temperament, mothers who slept < 4 h between midnight and 6 am and mothers who napped < 60 min during the day were at increased risk for depression at three months postpartum. Infant temperament was associated with maternal sleep but was not a significant predictor of depressive symptoms after controlling for other contextual factors. Postpartum clinical visits should include questions about maternal sleep so interventions can be directed toward sufficient sleep to minimize risk of postpartum depression.

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The purpose of this study was to explore Vietnamese American mothers' perceptions and experiences with postpartum traditions, postpartum depression (PPD), and mental health help-seeking behavior. Participants were 15 Vietnamese mothers who had given birth to at least one live infant within the previous year. A screening tool revealed that a third of the mothers had probable PPD. More than half reported having recent/current postpartum "sadness" during the interviews. Postpartum traditions played important roles in their well-being and maintaining strong cultural values. However, some reported feelings of isolation and the desire to be able to carry out postpartum traditions more frequently. Many who had reported sadness said that they would not seek professional help; all had felt that their condition was not "severe" enough to warrant help-seeking. Future PPD interventions should consider the importance of postpartum cultural traditions and address help-seeking barriers as ways to prevent the adverse effects of untreated PPD.

Callouts: 1) Chinese American women may first disclose depressive symptoms to their spouses and that they could rely on them for emotional and instrumental support. 2) Practicing postpartum traditions out of respect for older family members is common among Chinese American women, even if they do not necessarily believe in them. 3) For Chinese American women, barriers to help-seeking include mental health care costs, lack of services or not knowing where the services are, stigma, and language/cultural barriers. 4) Chinese American women may report sadness or PPD with clinicians, but may not meet the diagnostic criteria for PPD of standard screening tests. 5) Outreach and educational programs are necessary to increase the Chinese American community's awareness about PPD and help-seeking benefits, and reduce PPD associated stigma.

Background: Nurses working in the high-stress environment of the neonatal intensive care unit (NICU) are at high risk of experiencing grief after death of a baby. Design: Using a quantitative cross-sectional design, a convenience sample of nurses working in a Level IV NICU in Northern California, United States completed online surveys. Level of grief among NICU nurses, perceptions of grief support available at their institution, and past and future grief coping methods were assessed. Participants: A diverse sample of 55 NICU nurses, mean age 45.5 (SD = 11.7) years. Setting: A high-acuity NICU in one large Northern California hospital. Methods: Participant demographic data and the Revised Grief Experience Inventory were completed online. Results: Total grief scores ranged between 22 and 82 with a mean of 46.9 (SD = 17.4). Sixty percent (n = 33) moderately/strongly disagreed on adequacy of current grief support services at their institution and 81% (n = 45) reported hospital staff could benefit from additional grief support. Nurses' past grief support included family, friends, and church. Future grief resources would include family, friends, and co-workers. Participants indicated need for debriefing and additional nurse staffing resources at the time of a patient death. Conclusions: Neonatal intensive care unit nurses in our study reported experiencing grief. Debriefing and bereavement support may be helpful for nurses working in high-stress environments where there is a higher likelihood of patient death.