Postpartum depression: the (in) experience of Brazilian primary healthcare professionals

Abstract

Without consistent screening and diagnostic techniques, Brazilian health professionals are insecure about identifying and treating cases of postpartum depression. Referring women to psychiatric units entail more time for women to be diagnosed and treated and increased costs for health services. Primary healthcare professionals require training to screen, identify, and treat postpartum depression in primary healthcare settings.

Cross-Cultural Approach of Postpartum Depression: Manifestation, Practices Applied, Risk Factors and Therapeutic Interventions

“…The low prevalence in certain countries such as Singapore, Malaysia and Japan probably can be attributed to the adoption of more ''Western'' lifestyle of these civilizations. Unlike, the low prevalence in certain countries, like Nepal, and the large variation within the same countries, can be attributed, as also demonstrated by previous studies, on (1) cultural aspects, related to the specific perception of these civilizations, for mental health as well as the social exclusion of those who are diagnosed as mentally ill [2,131], (2) differences in estimation methodology, the time of the evaluation and the specific characteristics of the culture under study in each case [2,21,34,116,153], (3) the lack of medical information and medical intervention in some cultural groups under study [107,124], (4) the way in which women in nW-cultures express their symptoms, mainly through physical reactions, in contrast to women from Western cultures [2,21,28,34,35,154]. A significant fact, which could also affect the recognition of the disease, could be the absence of reference to the disease in some cultures.…”

“…Postnatal checkups on women are carried out in their homes 1 week and 40 days after labor, from the Family Health Strategy (FHS). FHS is a group of health professionals, but with inadequate education and limited clinical knowledge about the recognition, diagnosis and treatment of PPD, and as a result the only help they can provide to women with depressive symptomatology is recommending them to a psychiatrist, risking the status of women to be deteriorated in case of delay referral [124].…”

“…The majority of women who experience depressive symptoms in Brazil are identified by their family environment, which observes extraordinary changes in their behavior. Most women feel regret without specific reason and refuse to take care of the baby [124].…”

“…Despite the high prevalence of the disease in Brazil, the Brazilian Ministry of Health has not adopted specific protocols and guidelines for diagnosis and treatment of the disease [127]. Postnatal medical care has as focus the physical health of women and so the disease is a neglected topic in primary healthcare [124]. Postnatal checkups on women are carried out in their homes 1 week and 40 days after labor, from the Family Health Strategy (FHS).…”

Rastreio de sintomas depressivos e ansiosos em mulheres no pós-parto: estudo descritivo

“…Um transtorno de humor característico do puerpério e considerado um quadro intermediário entre a disforia puerperal e a psicose puerperal é a depressão pós-parto (DPP). Acomete cerca de 10 a 20% das puérperas e tem início, geralmente, nas primeiras quatro semanas do pós-parto estendendo-se até um ano, no entanto alcança sua intensidade máxima nos seis primeiros meses (4,5) .…”