A new Health of America study from the Blue Cross Blue Shield Association finds that postpartum depression has climbed 30% in the past few years. That’s a huge leap in a short time. Experts have some hypotheses about why. But what’s clear is that more can be done to identify women at risk, diagnose them earlier and connect them to treatment. One group in a unique position to help is pediatricians. Blue Cross & Blue Shield of Rhode Island (BCBSRI), the state’s largest health plan, has empowered them to make a difference.
Pediatricians screen moms for postpartum depression
Waterman Pediatrics is a large pediatric practice in East Providence, where Elizabeth Lange, MD is likely to see new mothers more often than they see their OBGYNs or primary care providers after giving birth.
“Given that babies have at least eight visits to the pediatric office in the first year of life, pediatricians are really well positioned to screen mothers for postpartum depression,” says Lange. “In fact, according to the American Academy of Pediatrics, this screening is the standard of care,” says Lange. “The frequency of check-ups coupled with the emerging doctor-family relationship makes talking about postpartum depression a logical part of well-baby care.”
Like many pediatricians, Lange is trained to ask new mothers a set of questions designed to screen for postpartum depression. While Rhode Island has treatment resources, it often takes some coordination to connect a mother with the postpartum depression treatment that’s best for her. Thanks to dedicated per patient funding support from BCBSRI, pediatric offices are able to hire the clinical staff necessary to provide this care coordination service. Across the state, pediatric practices have hired social workers, pediatric nurse care managers, or parent consultants.
“When a mother screens positive for postpartum depression I invite our office’s nurse care manager to meet the mother right in the exam room,” says Lange. “That’s critical because offering help on the spot is not only more convenient for busy new mothers, but also ensures they are connected to the care they need in real time.”
Since a mother’s (or primary care giver’s) mental health can directly impact an infant’s development, Lange says screening and making a treatment plan can make a huge difference.
Postpartum depression can affect the mother-baby relationship
While 80% of mothers experience periods of the “baby blues” (crying, feeling overwhelmed, sadness), 20% of mothers have more intense feelings of anxiety, hopelessness, sadness – postpartum depression. “Over the years, I have seen babies who were underfed because the mother’s postpartum depression prevented her from reading the baby’s hunger cues,” says Lange. “I have also seen mothers whose depression prevented them from enjoying their baby, engaging and talking to their baby.”
Babies raised by mothers with untreated postpartum depression can have delayed language and physical skills as well as an insecure attachment to their mother. With the proper diagnosis and treatment, all of this is reversible.
Several pediatric practices in Rhode Island, representing more than 35,000 patients, are now participating in regular training on postpartum depression screening, supported in part by BCBSRI. The Rhode Island Medical Journal analyzed the results:
“This collaborative effected a statewide culture shift to the importance of screening for postpartum depression and referring for treatment...Screening and referral rates improved from 28% to 77% among the participating practices.”
Treatment can save lives
Lange says her aim is to make sure moms feel it’s safe to have a conversation about their own well-being, and that they won’t be judged or punished if they’re having trouble connecting with or taking care of their babies—a symptom of postpartum depression. The condition is treatable, she says, and it can save lives. And because BCBSRI recognizes the value in connecting new mothers with treatment as early as possible, Lange and Rhode Island pediatricians have new skills and resources to do that.
Blue Cross & Blue Shield of Rhode Island is a licensee of the Blue Cross Blue Shield Association, an association of independent, locally operated Blue Cross and Blue Shield companies.