Many Women Do Not Disclose Postpartum Mood Symptoms, Survey Finds

About 20% of women failed to disclose symptoms of postpartum mood disorder (PPMD) to their health care providers, while 46% said that barriers such as stigma and negative perception of therapy made it difficult or impossible to report such symptoms, according to the results of a survey published in this month’s Maternal and Child Health Journal.

Betty-Shannon Prevatt, M.A., L.P.A., and Sarah Desmarais, Ph.D. of North Carolina State University conducted an online survey of 211 predominantly white, middle-class women who had given birth within the past three years on their perceived barriers to psychological treatment (PBPT). The PBPT questionnaire included items in eight broad categories: stigma, lack of motivation, emotional concerns, negative evaluation of therapy, misfit of therapy to needs, time constraints, participation restrictions, and availability of services.

The participants also filled out self-reports on their socioeconomic status, depression and anxiety symptoms, stress levels, support network, and to whom they had disclosed possible PPMD symptoms.

Over half (107) of the respondents reported experiencing disrupted mood during the postpartum period, but only 52 received a mental health diagnosis from a physician. Stigma, time constraints, and lack of motivation were the most frequently reported barriers. Unemployment, history of mental illness, current depression/anxiety/stress symptoms, and self-identification of postpartum symptoms were associated with reporting more barriers.

“These findings suggest that those women most in need of treatment are also the ones who perceive the most barriers to receiving care,” the authors wrote. “Because the current sample was fairly well educated and affluent, we would expect even greater endorsement of barriers among women of more modest education and means, who are at heightened risk of PPMD.”

In contrast, higher levels of social support were associated with greater odds of symptom disclosure. “The social support networks of expectant women are underutilized resources for improving maternal mental health,” the authors wrote. “To that end, interventions should encourage women to fortify their social support network while pregnant and provide strategies for mobilizing this support during the postpartum period.”

For related information, see the Psychiatric News article “Early Postpartum Depression Screenings Not Enough to Identify High-Risk Women.”

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