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Nurse extends helping hand to mums with postnatal depression

New Zealand,Mothers Helpers,midwives,nurses,postna
Photo: Mothers' Helpers' Kristina Paterson
Registered nurse Kristina Paterson experienced antenatal and postnatal depression for 18 months before she was eventually diagnosed and on the path to receiving much-needed treatment.

Despite being at-risk for postnatal depression, the New Zealand nurse was never screened or assessed by a midwife or a Well Child nurse.

And when she sought help from her GP, she was given medicine but was not referred to a counsellor or provided with any information about postnatal depression and recovery.

It was these glaring gaps in the health system that prompted the nurse, who lives in Northland with her son, to found Mothers’ Helpers in 2010.

While mums with severe perinatal depression are well supported in New Zealand, there remains little support for mums with mild to moderate perinatal depression.
The charity is working to provide support to women under stress and at risk of perinatal depression with a unique education course on recovery, while it’s also campaigning for mandatory screening to improve early detection, support and recovery for mums.

University of Auckland research, in the Growing Up in New Zealand survey, found one in eight Kiwi mums suffer from depression symptoms during their pregnancy.

Mothers’ Helpers estimates postnatal depression and anxiety affects between 15 to 20 per cent of mums but with inadequate screening, the charity concedes it’s difficult to pinpoint the extent of the problem.

Mothers’ Helpers recently conducted a survey of 100 Kiwi mums, who have experienced postnatal depression, which revealed significant delays in diagnosis and inadequate treatment options.

Kristina, a nurse of 18 years who has worked in general medical/surgical acute nursing, paediatric nursing and community nursing such as practice nursing, Well Child nursing and educational roles, says the gaps are an “enormous concern”.

“With inadequate education, delays in diagnosis and treatment, we have mothers whose depression is at risk of becoming severe,” she says.

“There are very real risks of maternal suicide, there is the risk of partner depression, relationship breakdowns, and poor attachment between mother and child - resulting in social, emotional and cognitive issues for that child throughout their life.

“With regards to screening, midwives screen for diabetes and pre-eclampsia and yet it is maternal suicide that is the leading cause of maternal deaths but we are not screening for anxiety/depression - even though the majority of those deaths happen during pregnancy.”

The Postnatal Depression in New Zealand and Feedback on Maternal Health Services survey found 96 per cent of respondents were at risk of developing postnatal depression yet only 28 per cent were assessed for depression by their midwife, 43 per cent by their GP while 34 per cent failed to be assessed.

It revealed 63 per cent of women experienced symptoms during pregnancy or one week postpartum but only 19 per cent were diagnosed during that stage.

Forty-two per cent of women were not provided with any information about postnatal depression during their pregnancy while half were not provided with information when they sought help.

Kristina says early detection is regarded as best practice internationally, and would deliver better outcomes for mums, partners and their children.

“This survey is showing that there is a big gap in detecting antenatal depression and anxiety,” she says.

“At the very least, we would encourage screening of mothers who are at-risk of developing PND, (that nurses and midwives) become familiar with those risk factors and monitor/screen those mothers for depression and anxiety.”

Mothers’ Helpers recommends perinatal health professionals use the internationally-recognised Antenatal Risk Questionnaire and the Edinburgh Postnatal Depression Scale (EPDS) to assess mums.

“In New Zealand, Well Child nurses are screening for PND but by the time mothers are reaching them they may have been experiencing these symptoms for a long period of time,” Kristina says.

“They access Well Child nurses six weeks postpartum, and this is if they choose to access a Well Child nurse at all.

“The screening tool used by Plunket is the PHQ-2 with a third question. Research shows it can pick up seven in 10 mothers with PND, whereas the EPDS picks up eight in 10.

“This means that one in 10 mothers are being missed and we feel that is too many - the EPDS is actually a simple tool to use and more internationally recognised than the PHQ-2.”

Kristina is urging midwives, GPs and Well Child nurses to refer mums identified as at-risk or diagnosed with perinatal depression or anxiety to Mothers’ Helpers, enabling the charity to provide urgent support to mums in need.

The survey also highlighted a lack of education on PND for mums.

Mothers’ Helpers runs a 10-week recovery course, the only known course of its kind in the nation, for women with mild to moderate perinatal depression and anxiety.

The charity is seeking the financial support of a District Health Board or large primary health organisation, in a bid to extend the course beyond Auckland to mums right across the nation.

“We have had overwhelming positive feedback from mothers…all mothers who have attended the course, their depressive symptoms have improved,” Kristina says.

“Our data has shown that the majority of our mothers have moderate to severe depression symptoms prior to the course and no depressive symptoms after the course.”

PND Awareness Week runs from October 31 to November 8.

* Midwives and nurses can access resources, seminars and conferences at Perinatal Mental Health New Zealand.

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Karen Keast

Karen Keast is a freelance health journalist who writes news and feature articles for HealthTimes.

Karen regularly writes for some of Australia’s leading health news websites and magazines.  In a media career spanning 20 years, Karen has worked as a senior journalist in newspapers and television. She has covered the grind of daily news and worked as a politics reporter at countless state and federal elections.

Since venturing into freelance writing five years ago, Karen has found her niche in writing about the health sector for editors, businesses and corporations.

Karen has interviewed the heads of peak health organisations in Australia and overseas, and written hundreds of news and feature articles covering the dedicated work of health professionals who tread the corridors of hospitals and health services, universities, aged care facilities and practices, day in and day out.

Follow Karen Keast on Twitter @stylemywords