August 2005

Introduction

This knowledge path about postpartum depression has been compiled by the Maternal and Child Health Library at Georgetown University. It offers a selection of current, high-quality resources about the prevalence and incidence of postpartum depression; identification and treatment; impact on the health and well-being of a new mother and her infant; and implications for service delivery. The knowledge path is aimed at health professionals, policymakers, program administrators, researchers, and women experiencing postpartum depression and their families. This path will be updated periodically.

Please note: While this knowledge path focuses on postpartum depression (i.e., depression that occurs within the first 12 months following childbirth), several resources below more broadly address perinatal depression (i.e., depression that occurs during and after pregnancy).

Related topics: Please see our knowledge paths about preconception and pregnancy and locating community-based services to support children and families.

Hotline

• MCH Hotline. Offers a hotline number to help pregnant women and mothers with newborns identify free or low-cost services for themselves and their infants in their communities. The MCH Hotline is a service of the Maternal and Child Health Bureau (MCHB).

  The hotline phone number is (800) 311-2229 (BABY); (800) 504-7081 (Spanish).

  
  

Overview

• See the American Academy of Family Physicians' Postpartum depression and the "baby blues," rev. ed. (2004), which describes the symptoms of postpartum depression and treatment options. This patient education brochure is also available in Spanish.
  

  
  

Web Sites: A-Z

• Depression After Delivery (D.A.D.). Contains resources for families coping with mental health issues associated with childbearing, including information about the symptoms of postpartum depression, selecting a therapist, and volunteer contacts. Also offers a list of postpartum support groups in several states, most of which are facilitated by health professionals.
  
  
• March of Dimes (MOD). Offers consumer information in English and Spanish about perinatal depression via MOD's Pregnancy and Newborn Health Education Center.
  
  
• Massachusetts General Hospital (MGH): Center for Women's Mental Health. Contains resources for health professionals and consumers about the evaluation and treatment of perinatal psychiatric disorders, including postpartum depression.
  
  
• Maternal and Child Health Bureau (MCHB). Describes MCHB's initiatives on behalf of America's women, infants, children, adolescents, and their families. MCHB is part of the Health Resources and Services Administration (HRSA). In addition to the MCH Hotline, resources and initiatives related to perinatal depression include

  Depression during and after pregnancy: A resource for women, their families, and friends. (2006).

  MCH Research Program. Offers information about funding opportunities and currently funded research projects that have the potential to improve health services and delivery of care for maternal and child health (MCH) populations. Several projects focus on perinatal depression.

  Perinatal Depression: Emerging Perspectives and Practices. Includes an agenda, speakers' materials, and links to additional resources related to an MCH DataSpeak audioconference about perinatal depression.

  Also see the Maternal and Child Health Library for additional information about the initiatives and programs supported by MCHB that pertain to perinatal depression.

• MedlinePlus: Postpartum depression. Contains a list in English and Spanish of authoritative health information sources about postpartum depression for consumers and health professionals. Includes links to overview articles and information about clinical trials, coping, research, treatment, and organizations that focus on the topic. Also links to local service providers for postpartum depression in several states. MedlinePlus is a health information service of the National Library of Medicine.
  
  
• National Institute of Mental Health (NIMH). Contains research information and publications for health professionals and consumers about research, clinical trials, funding opportunities, and training on women and mental health, including conditions such as postpartum depression.
  
  
• National Mental Health Association (NMHA). Contains fact sheets, position statements, and other education, advocacy, research, and treatment information for a wide range of mental health conditions including postpartum depression.
  
  
• National Women's Health Information Center (NWHIC). Contains a fact sheet about depression during and after pregnancy and links to resources on the topic. NWHIC is a service of the Department of Health and Human Services (DHHS).
  
  
• Perinatal Depression. Offers a Web-based curriculum to help health professionals learn how to identify, treat, or refer women with perinatal depression. Health professionals can earn continuing education credit for completing the free curriculum. The curriculum was produced by the Virginia Department of Health in collaboration with the University of Virginia Office of Continuing Medical Education, with support from the Health Resources and Services Administration (HRSA).
  
  
• Perinatal Foundation. Contains information about the Perinatal Mood Disorders Initiative designed to advance understanding about prenatal and postpartum depression and improve the care available for women and families. Resources about perinatal depression include fact sheets, a poster, a collection of culturally specific narratives, a position statement, screening tools, and treatment references. The Perinatal Foundation works in partnership with the Wisconsin Association for Perinatal Care (WAPC) to improve the health of infants, mothers, and families from preconception to early childhood. A recent publication is

  Perinatal mood disorders: You can't tell by looking. A blueprint for action. (2004).

• Postpartum Support International (PSI). Contains articles, bibliographies, and other resources about postpartum mental health for women and their families. Also offers online discussion groups and contact information for state and local support groups. PSI is an international network of women, their families, and professionals that focuses on postpartum mental health and social support.
  

  
  

Additional Electronic Publications

• Blass D. 2005. Riding the emotional roller coaster. Washington, DC: American College of Obstetricians and Gynecologists (ACOG). This article for women and their families addresses the many physiological issues related to pregnancy and the postpartum period. It describes the role of hormones, the safety of antidepressants during pregnancy, and symptoms of depression.
  
  
• Cheng D. 2005. About postpartum depression. Baltimore, MD: Maryland Department of Health and Mental Hygiene. This brochure for new mothers provides an overview of postpartum depression. It is available in Chinese, English, French, Korean, Russian, Spanish, and Vietnamese.
  
  
• Gaynes BN, Gavin N, Meltzer-Brody S, Lohr KN, Swinson T, Gartlehner G, Brody S, Miller WC. 2005. Perinatal depression: Prevalence, screening accuracy, and screening outcomes. Rockville, MD: Agency for Healthcare Research and Quality (AHRQ). This report presents the results of a systematic review of the evidence on the prevalence and incidence of perinatal depression, the accuracy of screening instruments for perinatal depression, and the effectiveness of interventions for women at high risk for developing perinatal depression.
  
  
• Grantmakers in Health. 2004. Addressing maternal depression. Washington, DC: Grantmakers in Health. The fact sheet describes the prevalence of maternal depression, its impact, and treatment. Opportunities for grantmakers in the following areas are also discussed: educating women about maternal depression, promoting screening and treatment, integrating mental health services into programs serving pregnant and parenting women, increasing the availability of peer support for mothers who are experiencing depression, and supporting research on maternal depression.
  
  
• Jellinek M, Patel BP, Froehle MC, eds. 2002. Bright Futures in practice: Mental health. (2 v.). Arlington, VA: National Center for Education in Maternal and Child Health. This guide contains information on mental health promotion and substance use prevention for infants, children, and adolescents from birth through age 21. It is designed to inform primary care pediatric health professionals about the essentials of mental health promotion; to identify the support that infants, children, and adolescents need for good mental health; and to assist in the development and implementation of mental-health-promotion programs and policies. A section is devoted to postpartum mood disorders and their effects on individual and family functioning.
  
  
• National Depression Initiative. 2003. Depression during pregnancy and early parenthood. Sydney NSW, Australia: Multicultural Health Communication Service. This brochure covers the signs and symptoms of depression during pregnancy and early parenthood and outlines treatment options and coping strategies. It is available in 18 languages.
  
  
• Onunaku N. 2005. Improving maternal and infant mental health: Focus on maternal depression. Los Angeles, CA: National Center for Infant and Early Childhood Health Policy. This report examines the impact of maternal depression on the social and emotional health of young children and recommends specific steps that early childhood programs and public health administrators can take to address the unmet mental health needs of mothers.
  
  
• Singhal M. 2005. Role of state public health in perinatal depression. Washington, DC: Association of State and Territorial Health Officials (ASTHO). This fact sheet discusses the role of state public health agencies in partnering with national and statewide programs to ensure access to mental health information and services for pregnant women and new mothers.
  

  
  

Print Publications

• Beck CT, Driscoll JW. 2006. Postpartum mood and anxiety disorders: A clinician's guide. Sudbury, MA: Jones and Bartlett Publishers. This book for health professionals describes the six mood and anxiety disorders that may present during a woman's postpartum year and focuses on assessment, screening tools, diagnosis, treatment, and implications for practice
  
  
• Bennett SS, Indman P. 2002. Beyond the blues: A guide to understanding and treating prenatal and postpartum depression. San Jose, CA: Moodswings Press. This book offers information for women and their families needing help with prenatal and postpartum depression and anxiety.
  
  
• Burt VK, Hendrick VC. 2005. Clinical manual of women's mental health, 2nd ed., rev. Arlington, VA: American Psychiatric Publishing, Inc. This book for health professionals provides evidence-based medical and psychiatric facts related to the assessment and treatment of women with psychiatric conditions. Chapters are devoted to pregnancy and the postpartum period.
  
  
• Cohen LS, Nonacs RM, eds. 2005. Mood and anxiety disorders during pregnancy and postpartum. Arlington, VA: American Psychiatric Publishing, Inc. This book examines the nature, diagnosis, and treatment of psychiatric illness during pregnancy and postpartum, including treatment options for women who are breastfeeding.
  
  
• Cox J, Holden J. 2003. Perinatal mental health: A guide to the Edinburgh Postnatal Depression Scale (EPDS). London, UK: Gaskell Publications. This book provides an overview of postnatal depression and discusses the origins and development of the Edinburgh Postnatal Depression Scale (EPDS); international and cultural issues concerning postnatal depression; use of the EPDS in research, counseling and other interventions; EPDS screening and intervention services; and how to use the EPDS. Two appendices include the original EPDS and 20 translations in Arabic, Chinese (Mandarin), Czech, Dutch, French, German, Greek, Hebrew, Hindi, Icelandic, Japanese, Maltese, Norwegian, Portuguese, Punjabi, Slovenian, Spanish, Swedish, Urdu, and Vietnamese.
  
  
• Henshaw C, Elliott S, eds. 2005. Screening for perinatal depression. London, UK: Jessica Kingsley Publishers. This book for health professionals describes available methods for perinatal depression screening, their advantages, and their drawbacks.
  
  
• Kendall-Tackett KA. 2005. Depression in new mothers: Causes, consequences, and treatment alternatives. Binghamton, NY: Haworth Press. This book for health professionals describes the impact of maternal depression on the health of a new mother and her infant; conditions that may co-occur with postpartum depression; treatments, including diet, exercise, herbs, and psychotropic medications; the role of psychotherapy and community-based programs; and the impact of various treatments on breastfeeding
  
  
• Sichel D, Driscoll JW. 1999. Women's moods: What every woman should know about hormones, the brain, and emotional health. New York, NY: HarperCollins Publishers. This book examines depression and anxiety in women and presents a self-care program.
  
  
• Stoppard JM, McMullen LM. 2003. Situating sadness: Women and depression in social context. New York, NY: New York University Press. This collection of qualitative research articles examines the influence of sociocultural factors, such as economic distress, childbearing or child care difficulties, or feelings of powerlessness that may play a significant role in women's depression.
  

  
  

Databases

The databases listed below are excellent tools for identifying data, additional literature and research, and programs about postpartum depression. Many of the entries below contain tips on how to use the databases efficiently. Please note that databases vary in how terms should be entered; for example, some require quotation marks and others don't. Enter search phrases as shown in bold below.

Data

• Pregnancy Risk Assessment Monitoring System (PRAMS). Presents state-specific, population-based data on maternal experiences and behaviors before, during, and immediately following pregnancy. PRAMS is a surveillance project of the Centers for Disease Control and Prevention (CDC) and state health departments. A recent report is

  Pregnancy Risk Assessment Monitoring System (PRAMS): PRAMS and postpartum depression. (2004).

Literature and Research

• Clinical Evidence. Describes the best available evidence from systematic reviews of the literature about the prevention and treatment of clinical conditions. Select postnatal depression in the box, Conditions in depth, and click on Go. Clinical Evidence is available by subscription only from the BMJ Publishing Group Limited, located in the United Kingdom.
  
  
• ClinicalTrials.gov. Provides access to information about clinical research studies for a wide range of diseases and conditions. Included are a summary of the purpose of the study, recruiting status, criteria for patient participation, location of the trial, and contact information. Enter postpartum depression in the box under Search Clinical Trials to identify studies on the topic. ClinicalTrials.gov is a service of the National Institutes of Health (NIH) and is developed by the National Library of Medicine (NLM).
  
  
• Cochrane Database of Systematic Reviews. Presents systematic reviews of health care interventions internationally. Provides access to article abstracts. Enter postpartum depression under Search Abstracts and click on Search. Access to the full-text article requires a subscription. The database is published by the Cochrane Collaboration, an international nonprofit organization based in the United Kingdom.
  
  
• Computer Retrieval of Information on Scientific Projects (CRISP). Contains information about federally funded biomedical research projects conducted at universities, hospitals, and other research institutions. Search CRISP to identify scientific concepts, emerging trends and techniques, or specific projects and/or investigators. Type postpartum depression in the search term box of the Query Form and click on Phrase in the Global Logic field. Click on Submit Query to get your results. The database is maintained by the Office of Extramural Research at the National Institutes of Health.
  
  
• Database of Abstracts of Reviews of Effects (DARE). Contains summaries of systematic reviews that have met strict quality criteria. Included reviews have to be about the effects of interventions. Each summary also provides a critical commentary on the quality of the review. To identify reviews about postpartum depression, select Search DARE. Under databases, select DARE and enter the search phrase, postpartum depression OR postnatal depression. Click on Search to get your results. DARE is produced and maintained by the Centre for Reviews and Dissemination at the University of York.
  
  
• Maternal and Child Health Library at the National Center for Education in Maternal and Child Health (NCEMCH), Georgetown University. Maintains several databases to collect, manage, and disseminate knowledge about MCH, with special emphasis on knowledge gained from initiatives and programs supported by the Maternal and Child Health Bureau (MCHB). The library's bibliographic database is

  MCHLine®. Comprises an online catalog of materials in the Maternal and Child Health Library. To identify items on the topic, type "postpartum depression" in the simple search field of the database search form.

  The Maternal and Child Health Library also offers an organizations database.

• National Guideline Clearinghouse (NGC). Contains evidence-based clinical practice guidelines and related materials for health professionals. Enter "postpartum depression" in the search box to identify guidelines on the topic. The database is an initiative of the Agency for Healthcare Research and Quality (AHRQ).
  
  
• PubMed. Contains over 15 million citations for biomedical articles that date back to the 1950s. These citations are from MEDLINE and additional life science journals. PubMed includes links to many sites providing full-text articles and other related resources. To identify articles on the topic, enter the search phrase depression, postpartum. Then, click on Limits and make the following selections on the page: select a date (e.g. Published in the last 2 years); click on Languages: English; and select Tag Terms: MeSH Major Topic. PubMed is a service of the National Library of Medicine (NLM).
  

Programs

• MCH Organizations Database. Lists over 2,000 government, professional, and voluntary organizations involved in MCH activities, primarily at a national level. Type "postpartum depression" in the simple search field of the database search form to identify organizations that focus on the topic. This database is a product of the Maternal and Child Health Library at the National Center for Education in Maternal and Child Health (NCEMCH), Georgetown University.
  
  
• National Mental Health Information Center: Mental Health Services Locator. Telephone: (800) 789-2647 (voice) or (866) 889-2647 (TDD). Identify mental health services in your community by selecting your state and choosing from one of several directories.
  

  
  

Online Discussion Groups

• Postpartum Communication Forums. Offers discussion boards, chat rooms, e-mail groups, and other forums for new mothers, spouses, and families to communicate. The forums are a service of Postpartum Support International (PSI).
  
  
• Postpartum Stress Center Message Boards. Contains a collection of online discussion groups for women experiencing postpartum mood disorders and their family members.
  

  
  

Author: Susan Brune Lorenzo, M.L.S., Maternal and Child Health Library.
Reviewers: Diana Cheng, M.D., Maryland Department of Health and Mental Hygiene; Justine M. Desmarais, M.P.H., Association of Maternal and Child Health Programs; Deborah F. Perry, Ph.D., Georgetown University Center for Child and Human Development; Olivia K. Pickett, M.A., M.L.S., Maternal and Child Health Library; Teresa Twomey, Postpartum Support International and Postpartum Virginia.