CLINICAL ISSUES
The Impact of Postpartum Depression on Mothering

https://doi.org/10.1111/j.1552-6909.2006.00087.xGet rights and content

As a rule, mothers are the primary caregivers of infants regardless of employment or marital status. Thus, any factors that impact mothering affect the infant and have public health significance. National attention is now focused on postpartum depression, a major variable affecting mothering. The impact of postpartum depression on the various components of the maternal role is described. Recommendations for health care practice include screening for depression across the first postpartum year and developing a strong network for mental health referrals. JOGNN, 35,652‐658; 2006. DOI: 10.1111/J.1552‐6909.2006.00087.x

Section snippets

The role of mother

The maternal role is vitally important to ensure the infant’s safety, survival, and well‐being, but it does not come without costs. In describing the tremendous adaptation required of a new mother, Maushart (1999)wrote, “once a woman becomes a mother, her life will never again be quite her own, or in quite the same way” (p. 123). New motherhood is characterized by profound change, a strong sense of loss, isolation, and fatigue (Rogan, Barclay, Everitt, & Wyllie, 1997). Yet, for most mothers,

Threats to maternal role functioning

Several key infant and health variables may affect maternal role functioning. Positively perceived social support has been identified as essential for maternal role functioning and confidence (Cutrona & Troutman, 1986). Stress, such as marital problems, has a detrimental effect on maternal‐infant interactions and overall maternal role functioning (Mercer, 1986), but positive support appears to counterbalance the effect of stress. The time required to achieve optimal maternal role functioning

Definition of PPD

Depression is defined by the presence of five of the following symptoms, one of which must be either one or two according to the Diagnostic and Statistical Manual of Mental Disorders (DSM‐IV)(American Psychiatric Association, 1994). Additional features that are common in major depression with postpartum onset are italicized. The term “with postpartum onset,” from the DSM‐IV (American Psychiatric Association) is used to describe an episode that begins within 4 weeks of birth. Symptoms include

Postpartum depression screening

New mothers are unlikely to seek treatment for depression (Flynn, Davis, Marcus, Cunningham, & Blow, 2004), so many cases remain undiagnosed and untreated despite effective available treatment options. Since maternal depression negatively influences child mental health and well‐being, it is our obligation to women, children, and the community to screen and educate women and families about PPD. Postpartum depression can occur up to a year after giving birth (American College of Obstetricians and

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