Postpartum Depression and the Affordable Care Act: Recommendations for Social Work Educators

Abstract

The Patient Protection and Affordable Care Act (ACA) mandates ongoing research on postpartum depression; however, very little research has been published in social work journals and in advanced-level textbooks on this topic. This article describes the problem of postpartum depression and argues that social work educators and researchers must pay greater attention to this issue in light of the ACA mandates, so that social workers can provide effective services to postpartum mothers and their children. The Council on Social Work Education's recently published Educational Policy and Accreditation Standards are considered while making curriculum recommendations on postpartum depression for social work educators. Keywords: Patient Protection and Affordable Care Act, maternal and child health, postpartum depression, perinatal mood disorders, social work educationApproximately six million pregnancies occur in the United States each year, and up to 25% of the mothers develop postpartum depression (Gaynes et al., 2005;Schaar, 2012). Mothers with postpartum depression typically experience sadness; loss of interest in activities; noticeable changes in eating and sleeping patterns; problems in thinking, concentrating, and making decisions; feelings of worthlessness, shame, or guilt; thoughts of harming themselves (Centers for Disease Control [CDC], 2013); and increased need for psychiatric hospitalizations for depression and suicidality (Georgiopoulos, Bryan, Wollan, & Yawn, 2001;Kennedy, Beck, & Driscoll, 2002;Lucero, Beckstrand, Callister, & Sanchez Birkhead, 2012). The symptoms are persistent, eventually affecting not only the mother but her infant, spouse/partner, and extended family as well (Letoruneau, Tramonte, & Willms, 2013;Ngai & Ngu, 2015).Babies born to mothers with postpartum depression often develop numerous longstanding problems including decreased cognitive skills (McGarry, Kim, Sheng, Egger, & Baksh, 2009), poor attention (Ramchandani, Stein, Evans, O'Connor, & the ALSPAC Study Team, 2005, and social withdrawal (Boyd, Zayas, & McKee, 2006). The fathers complain of feeling left out and less satisfied in their relationship with the mother (Mitnick, Heyman, & Slep, 2009). Keefe et al./POSTPATUM DEPRESSION 203 Unlike symptoms of major depressive disorder, which manifest within two weeks of the precipitating stressors (American Psychiatric Association, 2013), symptoms of postpartum depression may not become evident until several months after the mother has given birth (Chaudron et al., 2010;Parade, Blankson, Leerkes, Crockenberg, & Faldowski, 2014). Consequently, practitioners may avoid giving a diagnosis of postpartum depression due to what they perceive as the late onset of symptoms.Moreover, social work journals provide practitioners with limited guidance on postpartum depression. We searched various social work databases for articles published in social work journals focusing on perinatal mood disorders published between the years 1980 to 2015. The search resulted in 101 published articles of...

Having our say: African-American and Latina mothers provide recommendations to health and mental health providers working with new mothers living with postpartum depression

“…These stressful and overwhelming issues may lead many mothers of color to believe their depression is a normal part of motherhood and inhibit them from reaching out for help. Moreover, social workers in all settings have few research studies authored by social workers that are published in social work journals to guide them in their practice (Keefe, Brownstein-Evans, Lane, Carter, & Polmanteer, 2015).…”

Social Workers’ Screening Practices for Postpartum Depression

“…Despite the fact that social workers have a long-standing history of providing services to mothers and children, there has been little research published in social work journals to guide them in their work with mothers with PPD (Keefe, Brownstein-Evans, Lane, Carter, & Rouland Polmanteer, 2015). Although relevant to the population of mothers living with PPD, research from other professional fields such as nursing and psychiatry is more likely to address individual/biomedical factors such as hormonal fluctuations than to consider issues known to affect maternal and child well-being such as neighborhood safety and domestic violence (Lane et al, 2008).…”

“…Some of the respondents also reported learning about PPD through empirical literature, including social work journals. We were somewhat stymied by this outcome given the dearth of research reported in social work journals on PPD (Keefe et al, 2015). Although we were pleased to find that some of the responding social workers screen mothers from birth to one year, results from other studies conclude that PPD may not manifest until after one-year post-childbirth (O'Hara & McCabe, 2013;O'Hara & Wisner, 2014).…”

“…Because mothers living with PPD are more likely to seek services from social workers than from professionals from other disciplines (Zittel-Palamara, Rockmaker, Schwabel, Weinstein, & Thompson, 2008), social workers are in an excellent position to screen new mothers for PPD (Abrams & Curran, 2007). To date, however, there has been limited research that has investigated whether or not social workers screen new mothers at risk for PPD.Despite the fact that social workers have a long-standing history of providing services to mothers and children, there has been little research published in social work journals to guide them in their work with mothers with PPD (Keefe, Brownstein-Evans, Lane, Carter, & Rouland Polmanteer, 2015). Although relevant to the population of mothers living with PPD, research from other professional fields such as nursing and psychiatry is more likely to address individual/biomedical factors such as hormonal fluctuations than to consider issues known to affect maternal and child well-being such as neighborhood safety and domestic violence (Lane et al, 2008).…”

“…Research has begun to address the problem of too few knowledgeable social workers screening new mothers for PPD. For example, recently published research concludes that BSW and MSW programs can incorporate content on PPD seamlessly into their curricula (Keefe, et al, 2015), and specific recommendations have been made for developing social work continuing education workshops to train social workers on how to work with mothers who have PPD (Keefe, Rouland Polmanteer, & Brownstein-Evans, in press). …”