Perinatal Depression in Latina Mothers

Posted in Diversity, Equity, Inclusion Early Childhood Intervention  |  Tagged Brain Science

by Abby Lindsay (C’ 17), December 20, 2016

Mothers experiencing PD may fail to provide an enriching, developmentally supporting environment or developing a mutually beneficial relationship with their baby. A lack of toys, engaging language activities, and attention-provoking games during early stages of development may lead to poor cognitive and language development. In the long term, children of mothers with PD can show deficits in cognition, behavior, and academic performance (Bernard-Bonin, 2004). Children can demonstrate dysregulated attention, lower IQ than matched peers, and social and adaptive immaturities, and they are at higher risk for other challenges such as ADHD, anxiety, or depression) (Hay, Angold, Pawlby, Harold, & Sharp, 2003).

Often, PD is considered a condition that should be easy to “overcome” right? Women often hear that it is a phase that will pass or they should just “buck-up” But, for most it is much more complicated. Research indicates that the most successful antidote to Perinatal Depression is social support, such as home visits from family, friends, and professionals (McKee, 2001). Family therapy to teach coping strategies to the new mother, increase communication within the family about the illness, and foster resilience within the child can also be extremely helpful (Pearlstein, 2008). The active involvement of the father can be a very important buffer to provide support to the baby as well as the mother (McKee, 2001). Community organizations, including religious institutions and specialized programs, can provide further assistance. However, awareness of and access to these strategies is often inadequate, restricting women and families from using them. Even when accessibility does not pose a problem, many women experiencing PD will not accept the assistance given by community programs.

Data on prevalence of Perinatal Depression shows that certain demographics are more likely to experience PD. Due to the combination of risk factors the prevalence of PD in Latina mothers, is closer to 36%, which is significantly greater than the 12-20% national average (Baker-Ericzén, et. al., 2012). According to the US Census Bureau (2012), the majority of women giving birth are Latinas, indicating that there is a significant proportion of women who are at higher risk to experience PD. Additionally, Latinos in the U.S. are more likely to be low-income, have unwanted/unplanned pregnancies, and be single mothers. Latinos are also widely acknowledged to be far less likely to seek professionals regarding mental health concerns than are non-Hispanic whites (National Institute for Health Care Management, 2010). The combination of all of these factors makes the Latina mother population particularly worth considering for treatment options.

There are, however, intervention programs developed specifically for the Latina population. For example, the Perinatal Mental Health (PMH) Project is a culturally sensitive, short-term telemedicine intervention (Baker-Ericzén, et. al. 2012). The PMH Project involves an initial screening by a physician to determine maternal depression, followed by enrollment in the telemedicine program by a mental health assistant. The telemedicine curriculum itself contains a variety of modules that are completed by the mother with the mental health assistant. The modules are designed with specific cultural sensitivities in mind, but the primary mode of communication is in English. The modules focus on destigmatizing mental health problems, especially PD, and providing emotional support through cognitive-behavioral therapeutic strategies as well as coping and stress management techniques. The PMH plan was piloted in Southern California, and it found that contacting low-income, often single, Latina mothers by cell phone was an effective way of both transmitting culturally sensitive information about PD and providing resources to connect them with professionals (Baker-Ericzén, et. al. 2012).

Although its effects are still not fully understood by researchers, the PMH program was shown to be an innovative way to address problems with accessibility associated with clinics that were negatively perceived by many Latina mothers (Baker-Ericzén, et. al. 2012). Its large-scale effectiveness and long-term effects have not yet been determined, but this is certainly a program to consider furthering. Given the widespread prevalence of PD in Latina mothers, providers must find creative solutions to make treatment accessible to America’s increasingly diverse population.

References:

Baker-Ericzén, M. J., Connelly, C. D., Hazen, A. L., Dueñas, C., Landsverk, J. A., & Horwitz, S. M. (2012). A Collaborative Care Telemedicine Intervention to Overcome Treatment Barriers for Latina Women with Depression during the Perinatal Period. Families, Systems, & Health, 30.3, 224-40.

Bernard-Bonin, A. (2004). Maternal depression and child development. Paediatric Child Health, 9.8, 575-83.

Field, T. (2011). Prenatal depression effects on early development: A review. Infant Behavior and Development, 34, 1-14. doi: 10.1016/j.infbeh.2010.09.008

Hay, D.F., Angold, A., Pawlby, S., Harold, G.T., & Sharp, D. (2003). Pathways to Violence in the Children of Mothers Who Were Depressed Postpartum. Developmental Psychology, 39.6, 1083-94.

Mckee, M. (2001). Health-related Functional Status in Pregnancy: Relationship to Depression and Social Support in a Multi-ethnic Population. Obstetrics & Gynecology 97.6, 988-93.

National Institute for Health Care Management. (2010). Identifying and treating maternal depression: Strategies & considerations for health plans. NIHCM Foundation Issue Brief, June, 1–28.

Pearlstein, T. (2008). Perinatal depression: treatment options and dilemmas. Journal of Psychiatry & Neuroscience : JPN, 33(4), 302–318.

Phillips, M. L. (2011). Treating post-partum depression. American Psychological Association Monitor on Psychology, 42.2, 46. Retrieved from http://www.apa.org/monitor/2011/02/postpartum.aspx.

Teti, D. M., Gelfand, D. M., Messinger, D. S., & Isabella, R. (1995). Maternal depression and the quality of early attachment: An examination of infants, preschoolers, and their mothers. Developmental Psychology, 31(3), 364–376.

U.S. Census Bureau. (2004). Current populations survey, annual social and economic supplement: Ethnicity and ancestry statistics branch, population division. Retrieved from http://www.census.gov