Nurture the Mother

POSTPARTUM PLAN:  Doulas of North America has a comprehensive postpartum plan.

EDINBURGH POSTNATAL DEPRESSION SCALE: Self-administered questionnaire with scoring.

SELF DISCOVERY IN THE POSTPARTUM PHASE, is an excellent read for people working with women in the postpartum time. This article, written by one of our workshop panelists, Binda Colebrook, is based on her Master's in social work thesis exploring new mother's experience of the postpartum phase and the role played by their postpartum doulas.   She reports her findings, garnered from a series of interviews, in this concise, and well-written article with practical applications for all of us.

PERINATAL DEPRESSION: TREATMENT OPTIONS AND DILEMMAS by Teri Pearlstein.  J Psychiatry Neurosci 2008;33(4):302-18

The treatment of depression during pregnancy and the postpartum period raises unique concerns about safety for the developing fetusand the infant. An increasing number of studies suggest adverse effects from untreated stress, anxiety and depression as well as adverse effects from antidepressant and other psychotropic medications. Even when studies suggest a lack of short-term adverse effects with some medications, the paucity of systematic longitudinal follow-up studies investigating the development of children exposed to medications during pregnancy and breastfeeding causes apprehension. This review’s objective is to highlight what is currently known about the negative effects of untreated disease and exposure to psychotropic medication, the treatment dilemmas confronting women with perinatal depression and issues that future studies should address so that a woman with perinatal depression can make an optimally informed decision.

COMPLEMENTARY AND ALTERNATIVE MEDICINE FOR PERINATAL DEPRESSION by Marlene P. Freeman. Journal of Affective Disorders 112 (2009) 1-10. 

Abstract
Introduction: Perinatal Major Depressive Disorder (MDD) is common and poses particular treatment dilemmas. Complementaryand Alternative Medicine (CAM) treatments are widely used, accessible, and understudied for well-defined psychiatric indications. Women are more likely than men to both suffer from MDD and use CAM.

Methods: A PubMed/Medline search was conducted to assess the evidence base for commonlyutilized CAM treatments, MDD,and perinatal depression.

Results: Among CAM treatments, omega-3 fatty acids have received the most specific study in terms of epidemiological,preclinical, and clinical research for perinatal depression. Three randomized placebo-controlled trials have been conducted in which investigators assessed omega-3 fatty acids vs. placebo for perinatal depression, with conflicting results. CAM interventions that can be easily added to a treatment plan with little risk and general health benefits for most women include omega-3 fatty acids, exercise, and folate, although data are insufficient at this time to recommend any of these as monotherapy for perinatal depression. S-adenosyl-methionine (SAMe) and bright light therapy may be reasonable to consider based on the evidence in MDD. St. John's Wort requires further study with regard to safety in pregnancy, and drug interactions can be a potential problem.
Discussion: Further study is required to elucidate the role of CAM treatments for perinatal depression, and the clinical context of perinatal depression requires safe, effective, and accessible treatment options.

TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER website has several sections on alternative therapies for perinatal depression by Kathleen Kendall Tackett.  A wide variety of options are discussed including psychotherapy, exercise, omega 3 fatty acids, St. John's Wort, and light therapy. Kathleen is the author of many books including, Depression in New Mothers: Causes, Consequences and Treatment Alternatives (2009).

POSTPARTUM SUPPORT INTERNATIONAL:  PSI organized in 1987 to "increase awareness among public and professional communities about the emotional changes that women experience during pregnancy and postpartum.  Focused on having people get the facts and get help, this website is an excellent resource. 

New Light Solutions, Reed Schimmelfing's website, provides information on the use of bright light therapy as an alternative to medication for postpartum depression.  The website also provides links to compelling articles, including Dr. Teri Perlstein's Perinatal depression: treatment options and dilemmas.

The Green River Doula Network is a local, nonprofit organization that provides a wealth of current information about local, independent birth professionals including birth and postpartum doulas, acupuncturists, lactation consultants, nanny care, and therapists who specialize in the postpartum time.  A great place to find local postpartum support.

MotherWoman, Inc.:  MotherWoman is a locally based organization with a national reputation for excellence in facilitator training and their postpartum support group model.