NM leads in postpartum depression
By The Associated Press
Posted: 02/17/2009 12:00:00 AM MST
http://www.lcsun-news.com/ci_11719502?source=most_emailed
ALBUQUERQUE — A higher percentage of New Mexico mothers are suffering from symptoms of postpartum depression
compared to new mothers in 16 other states, a survey shows.
One-fifth of new mothers surveyed in New Mexico reported having symptoms of postpartum depression. Maine had the
lowest rate at 11 percent and South Carolina came in second worst at 19.5 percent in the Pregnancy Risk Assessment
Monitoring System survey released this month. This marked the first time the question was asked in New Mexico.
Women living in poverty and those who suffer from domestic abuse, use tobacco, are younger or unmarried are at a
higher risk for postpartum depression, said Eirian Coronado, the state Health Department's director for the PRAMS
survey.
"We're looking at people who are struggling more financially, people who are struggling more socially, they experience
more of those symptoms," Coronado said.
The study, done with the U.S. Centers for Disease Control and Prevention, surveyed new mothers who had live births in
2004 and 2005, the latest years for which data is available.
Coronado said what's difficult to tell from the results was how many mothers experienced the more common baby blues
caused by hormonal fluctuations after pregnancy versus how many women were clinically depressed.
A mother was counted as having postpartum depressive symptoms, if she said she was often or always feeling down,
depressed or hopeless; or she often or always had little interest or little pleasure in doing things since the time her baby
was born.
Twenty-seven percent of American Indian mothers and 22 percent of Hispanic mothers reported postpartum symptoms,
compared with 15 percent of non-Hispanic white women.
A statewide steering committee is looking into postpartum depression as a result of the PRAM survey, the Health
Department said.
Coronado said New Mexico lacks a standardized screening method to check for postpartum depression in new mothers
and there's ambiguity about what various government agencies or health professionals are doing when it comes to
treating women with the disease.
Felicia Mancini, a certified nurse midwife at University Midwifery Associates, said her research — which used a 70-
question survey to screen for postpartum depression among 750 Albuquerque mothers — found that such a tool was a
feasible way to identify mothers suffering from the disease.
"Women really liked the idea that we were asking the question," Mancini said. "They felt like it was a more holistic
approach to their experience as mothers."
And, she said, the providers were happy to have a framework of questions to ask.
"To me there's nothing more important than the health of the mother in terms of raising a child," Mancini said. "Being
around somebody who's depressed and untreated, that has health risks (for the child). We know that."
Depressed mothers fail to connect with their baby, which leads to developmental delays in infants and children, Mancini
said.
The 77-question PRAMS survey covered a wide range of issues from conception to prenatal care and breast-feeding. The
department surveyed about one in 12 New Mexico women giving live birth every month.
A bright spot in the findings was that 68 percent of mothers are putting their babies to sleep on their backs, compared with
45 percent in 1998, the first year the survey was conducted in New Mexico. The American Academy of Pediatrics
recommends the practice to reduce the risk of Sudden Infant Death Syndrome.
Though SIDS deaths in New Mexico have decreased, there's a national debate on whether that is because of the "Back to
Sleep" campaign or due to a different classification system of infant deaths being used, Coronado said.
Another concern raised by the survey was the number of women who stopped breast-feeding after nine weeks. The
American Academy of Pediatrics recommends exclusive breast-feeding for the first six months of a baby's life.
The survey showed 84 percent of women breast-fed or pumped breast milk for their new infant after they were born, but
only 57 percent did so for more than two months.
Sixty-two percent of mothers who stayed at home breast-fed their infants for more than nine weeks, compared with only
51 percent of working mothers or those in school.
Sharon Giles-Pullen of the state Health Department's Women Infant Children program says breast-feeding advocates
around the state are working with hospitals and doctors to discourage the distribution of free formula.
Having the formula, especially when it comes from a doctor, undermines a mother's confidence that they can breast-fed
exclusively, Giles-Pullen said.
Twila Randolph, nursing manager of the mother-baby care unit at Presbyterian Hospital in Albuquerque, said the hospital
stopped automatically giving free formula to new mothers about three years ago, though it still provides some formula, for
example, to mothers who have been ordered by physicians to give supplemental formula.
As a result of earlier PRAMS surveys, the Legislature passed a law in 2007 that requires workplaces to provide a place for
women to pump or breast-feed.
Still, most women cannot bring their infants to work with them, so Coronado, who said she is pregnant, supports extended
maternity leave for new mothers.
"If six months of exclusive breast-feeding is the goal, then maternity leave should be six months," she said.
Health survey
Here are some findings from the statewide Pregnancy Risk Assessment Monitoring System, which surveyed about one in
12 New Mexico women giving live birth every month for 2004 and 2005, the latest years available:
• 43 percent of women surveyed had an unintended pregnancy. Among mothers not trying to get pregnant, 48 percent
were not using contraception.
• 18 percent of mothers were binge drinkers — having five or more alcoholic drinks at one time — before they became
pregnant. Six percent drank alcohol during pregnancy.
• 20 percent of mothers smoked cigarettes before pregnancy, 9 percent smoked throughout pregnancy and 6 percent of
new moms said their infants were exposed to cigarette smoke on a daily basis.
• 8 percent of mothers surveyed were physically abused by a current or ex-husband or partner in the year before
pregnancy and 6 percent were abused during their pregnancy. Among 20 PRAMS states surveyed, only 5 states had
higher rates of preconception abuse than New Mexico.
• 63 percent of new mothers had adequate or better than adequate prenatal care. Those who had the highest proportions
of inadequate prenatal care were Native American, had less than a high school education, were 18-19 years old or were
without prenatal health insurance.