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The need for amendment of postpartum depression laws

January 25, 2021

In the United States, the national average of women who are affected by postpartum depression is 13.2 percent, and in Delaware, we follow closely behind at 13.1 percent.

Title 16: Chapter 8D of the Delaware law focuses on Health and Safety of the Regulatory Provisions Concerning Public Health with a focus on Maternal Mental Health. According to the State of Delaware, 8D states that women should be provided with the necessary materials and screening upon presentation of signs of postpartum depression by their maternal healthcare provider. These materials are to provide information about symptoms of postpartum depression, ways to cope and treatment resources. The law also requires that hospitals and other health facilities provide materials to women after birth prior to discharge who present with signs of postpartum depression. Lastly, screenings are to be initiated by maternal-healthcare providers when symptoms of postpartum depression are recognized.

A close friend of mine was diagnosed with postpartum depression. She experienced two inpatient psychiatric stays, intensive outpatient counseling, a personal counselor, couples counseling, alcoholics anonymous, and a period living away from her partner and newborn baby while she recovered safely.

The unfortunate fact is that the screening and materials that are in place in Delaware to recognize postpartum depression are often offered too late. Postpartum depression can occur up to a year after childbirth, but most often is within the first three weeks. With this type of onset, signs of postpartum depression are not likely to be recognized in the hospital after birth and possibly not at a postpartum follow-up visit, making the current laws unlikely to positively identify postpartum depression in a timely manner. Often in Delaware, a new mother is not assessed for postpartum depression until her six-week postpartum appointment.

If my friend had been presented with materials and screenings sooner, and more frequently, the signs and symptoms of postpartum depression may have been recognized prior to the severity of her diagnosis. The opportunity for women to receive the help that they need immediately as symptoms arise would improve the quality of life for mothers, families and babies throughout the state. I present with a recommendation for an adjustment to Title 16: Chapter 8D.

Hospitals and healthcare facilities shall offer postpartum depression materials and education to new mothers and families prophylactically prior to discharge from the hospital before potential signs or symptoms of postpartum depression begin.

Maternal-healthcare providers shall contact new mothers to offer telephonic screening prior to their six-week postpartum visit. These telephonic screenings shall be offered during postpartum weeks two and four, an inpatient screening shall be provided at week six during the follow-up postpartum visit, and a telephonic screening provided at week eight.

Pediatricians shall provide a postpartum screening questionnaire to mothers at well-child visits during postpartum week 12, six months and one year.

With these changes to the provision, I believe we can help decrease the rates of untreated postpartum depression which may lead to increased hospital visits, inpatient stays, and unfavorable circumstances for mothers, families and infants in Delaware.

Kelly E. Knox, RN
Millville
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