Blog Action Day 2008

I just found out about the Blog Action Day 2008. On October 15th registered bloggers are supposed to blog about poverty to "bring awareness and incite action." So with this post I will discuss poverty and postpartum depression.

Postpartum depression can affect anyone, regardless of income level, race, nationality, or religion. However according to the University of Wisconsin School of Medicine and Public Health, depression in the postpartum period occurs in 10-15% of all new mothers (about 1 out of 8), with rates up to twice as high for women living in poverty. Additionally their website states, "Recognition and treatment are important components of improving both the mother's quality of life and that of her baby and family. With treatment, it is shown that the impact of PPD on babies may be minimal. But, if the depression remains untreated and becomes a chronic, recurrent condition, it can impact the mother-infant attachment relationship and can contribute to delays in the child's cognitive and language development, behavioral problems or other psychological issues."

So why are the rates higher for women living in poverty? First let's take a look at some of the factors that go into causing PPD.

• hormone changes - after delivery estrogen and progesterone levels in the body drop. Hormones can greatly affect mood, causing irritability, anxiety, depression and affecting reaction to stress (as in PMS, teenage females, and menopause.)
• stress - being on duty 24 hrs a day, baby waking up every couple of hours, an unpredictable schedule, and an increased workload. Also consider worrying. Worrying about all the new stuff the baby needs, like a car seat, crib, stroller, clothes, diapers, etc. What if there's no money to pay for these things? What if you can't pay your utility bill? What if you don't even have a place to live?
• Feeling overwhelmed - feeling like you have to be superwoman; doing chores, laundry, dishes, calming a screaming baby, maybe balancing employment outside the home, etc.
• unrealistic expectations - trying to live up to society's standards when it's not possible
• lack of support from family and friends
• marital problems - which can be a vicious circle because the stress of new parenthood combined with any of the other stressors on this list, and financial strain can cause marital problems
• financial strain - This can be especially hard when you are responsible for another little life. You have to keep a roof over your head, keep food on the table, keep the electricity on. Maybe you have hospital bills to pay for the birth. If your baby has special needs then add on more costs. If a new mother is under pressure to go to work, rather that take maternity leave that just compounds the problem. Many employers don't have paid leave, so any time off that is taken means no money. Also keep in mind that she's probably making a minimal amount of money that will have to go to pay for child care and transportation.
• sleep deprivation - being deprived of sleep wreaks havoc on the human body. It lowers your resistance to fight sickness, affects your thinking ability and memory, affects your motor function, and affects your mood. Just think it has been used as an interrogation tool on prisoners of war.
• birth of multiples - more work, more crying, and often they are born premature and via c-section
• grief over an unexpectedly difficult delivery or c-section. labor is quite tiring, leaving you emotionally drained, and c-sections require longer recovery times. There is also a feeling of lost control when things don't turn out the way you planned.
• pre-term birth or delivery of a child with birth defects - this may catch you off guard and involve emotional ups & downs, and worrying.
• family history of depression, bipolar disorder, OCD, or anxiety/panic disorder
• traumatic family history
• women who experience severe PMS are more likely to suffer from PPD, according to the American Psychological Association
• difficulties at job
• history of abuse
• poor nutrition - This could be from an eating disorder, severe morning sickness that increased malnutrition, or not having the money to buy appropriate food. People affected by poverty don't have the option of fruits, vegetables, meat, and prenatal vitamins.
• pregnancy being unwanted or unplanned

So for people living in poverty, postpartum depression can be a big problem. They don't have access to nutritional foods and are under more stress due to financial concerns. Women that live in poverty don't have access to proper health care either. If they can visit a doctor, they may walk a way with prescriptions that they don't have money to fill. My prescription for Lexapro was over $100, thankfully my insurance covered half of it. For a lot of people taking medication that costs money is not an option.

Then there is the question of, what happens when the postpartum depression goes untreated? The mother/child bond will be affected. There can be learning disabilities, behavior problems, and other psychological problems for the child. The National Center for Children in Poverty at Columbia University came out with a study in Jan 2008 about Reducing Maternal Depression and It's Impact on Young Children (http://www.nccp.org/publications/pub_791.html) They advise that depressed mothers affect the readiness of young children entering school. In areas where there is a school system that these children, these children will enter school with these problems which will take a toll on their education (as well as the teachers and school system.) In some countries, however, children living in poverty may not ever attend school. These children will grow up with the effects of the learning disabilities, behavior problems, and possibly psychological problems. They in turn will likely pass these traits on to their own children.

If you have any thoughts about poverty and postpartum depression or ideas feel free to comment.