Postpartum Depression Among Low-Income U.S. Mothers

Introduction

Postpartum depression is a major issue, which takes place after a woman gives birth. The problem is more prominent and more prevalent among mothers who have a low-socioeconomic status. Therefore, the topic is centered around postpartum depression among low-income U.S. mothers. The purpose of the paper is to analyze the major risk factors involved in the occurrence of the given issue, where a wide range of influences is assessed.

Problem Description

The problem of postpartum depression is one of the most invasive and underlying issues in regards to the pregnancy and birth-giving processes, where women are at higher risk of developing such a condition depending on their social characteristics, such as low-income. The problem affects around 20% of women who gave birth recently (Kozhimannil et al., 2011). It is important to note that it is a highly conservative estimate, and thus, the impacted population might be even larger.

The problem is measured through the definitive presence of depressive symptoms from observations, medical assessments, and self-reports. Among new White, Hispanic, and African American mothers with low-income backgrounds, nearly a third have strong depressive symptoms (Hutto et al., 2011). It is also directly linked with the fact that these groups tend to have a lower income because nearly 70% of such women are likely to be Hispanic ethnicities (Scheyer & Urizar, 2015). Thus, it is evident that ethnic and racial factors are in strong connection with low-income factors.

There is a possibility to accurately predict and make a prognosis on the potential risk of developing postpartum depression. Second trimester cortisol alterations were strong indicators of postpartum occurrence rate among women with lower socioeconomic status (Scheyer & Urizar, 2015). Another study suggests that mood change evaluation before and during pregnancy can be a strong predictor of postpartum depression (Hutto et al., 2011). In addition, postpartum depression was associated with a history of self-harm, history of anxiety, temporary living conditions, the mother’s status of being the first time, and being single (Kim et al., 2011). The additional barriers and facilitators of the depression among low-income women, which are support, life events, language and culture, referral barriers, referral facilitators, and referral and screening (Boyd et al., 2011). Therefore, the problem can be manifested among low-income U.S. mothers in a more frequent and severe fashion.

Conclusion

In conclusion, postpartum depression is more prevalent among women with low-income status, which is linked with their ethnic and racial backgrounds. The accurate predictions can be made during the second and third trimesters. Therefore, the focus needs to be put on understanding the causal relationships.

Author / Year	Location / Participants	Study Design and Sample Size	Key Findings	Strengths / Limitations / Implications
Boyd et al., 2011.	United States; Community healthcare workers, who actively encountered, interacted, and engaged with women with postpartum depression.	– Focus group analysis on six major themes in regards to postpartum depression. – 16 female community-based healthcare workers divided into three groups (Boyd et al., 2011).	– The analysis with three focus groups revealed that there were six major themes, which are support, life events, language and culture, referral barriers, referral facilitators, and referral and screening.	– Implications: The findings identify major barriers and facilitators, which can be used in the reforming process of community healthcare strategies. – Strengths: The study provides an in-depth qualitative data on both facilitators and barriers. – Limitations: The study primarily focuses on healthcare workers’ perspective, which might dismiss the underlying issues.
Hutto et al., 2011	Southeastern North Carolina; low-income Medicaid recipients.	– Cohort correlational study. – 61 participants, who were White, African American, and Hispanic low-income Medicaid recipients.	– The drastic mood changes prior and during pregnancy process signified the probability of postpartum depression.	– Implications: The findings can be used to design preventative measures for controlling mood alterations. – Strengths: The sample is analyzed in an accurate manner. – Limitations: The sample size is relatively small to be representative.
Kim et al., 2011	Minneapolis, Minnesota, United States; Newly delivered mothers at Hennepin County Medical Center (HCMC), who were approached under inpatient settings.	– Cohort study through questionnaire, who were drawn from HCMC and met the eligibility criteria. – 838 patients without insurance or on the program of Medical Assistance (Kim et al., 2011).	– Postpartum depression was associated with a history of self-harm, history of anxiety, temporary living conditions, the mother status of being first time, and being single. – 40% of participants called IVR, which meant that nearly half of all women were at risk for postpartum depression.	– Implications: The presence of major risk factors can be used to refer the susceptible women to interactive voice response systems. – Strengths: The study focuses on a fairly large sample size with a clear indication of them belonging to low-income people. – Limitations: The study does not necessarily prove that IVR call is linked to the risk of postpartum depression, and non-respondents might also have the depression.
Kozhimannil et al., 2011	New Jersey, United States; d New Jersey Medicaid administrative records were used in order to analyze the intricacies of postpartum depression.	– Retrospective cohort study from the database of Medicaid administrative claims. – 29601 women, who gave birth between the years of 2004 and 2007 (Kozhimannil et al., 2011).	– White women were more likely to initiate postpartum mental health care.	– Implications: The minority groups can be targeted to identify postpartum risks. – Strengths: The sample size and statistical conclusions are significant with a strong confidence interval. – Limitations: The study does not prove a causal relationship.
Scheyer & Urizar, 2015	California, United States; Participants involved women, who were recruited while they were waiting for their doctor’s appointment in southern California’s prenatal clinics.	– Randomized study on a group of women, who met the eligibility criteria, and who were compared to a non-randomized group. – 316 women, who were found eligible due to their ability to speak English or Spanish, being over 18, being less than 18 weeks pregnant, living in a close proximity to the prenatal clinic, and not taking medications and having no major medical conditions.	– 22% of the participants had a strong signs of postpartum depression, and the sample mainly consisted of people with low socio-economic characteristics. – Cortisol level alterations in the second trimester were the most substantial indicators of postpartum depression and were in relationship with the depression (Scheyer & Urizar, 2015).	– Implications: The results mean that the measurement of cortisol levels and its alterations can predict the occurrence rate of postpartum depression, which leads to more effective preventative measures. – Strengths: The study utilizes a randomized sampling method in conjunction with non-randomized one, which effectively support the findings. – Weakness: The majority of the sample were comprised of Latino or Spanish-speaking women, which might affect the representativeness of the sample.

References

Boyd, R. C., Mogul, M., Newman, D., & Coyne, J. C. (2011). Screening and referral for postpartum depression among low-income women: A qualitative perspective from community health workers. Depression Research and Treatment, 2011, 1-7. Web.

Hutto, H., Kim-Godwin, Y., Pollard, D., & Kemppainen, J. (2011). Postpartum depression among White, African American, and Hispanic Low-income mothers in rural southeastern North Carolina. Journal of Community Health Nursing, 28(1), 41-53. Web.

Kim, H. G., Geppert, J., Quan, T., Bracha, Y., Lupo, V., & Cutts, D. B. (2011). Screening for postpartum depression among low-income mothers using an interactive voice response system. Maternal and Child Health Journal, 16(4), 921-928. Web.

Kozhimannil, K. B., Trinacty, C. M., Busch, A. B., Huskamp, H. A., & Adams, A. S. (2011). Racial and ethnic disparities in postpartum depression care among low-income women. Psychiatric Services, 62(6), 619-625. Web.

Scheyer, K., & Urizar, G. G. (2015). Altered stress patterns and increased risk for postpartum depression among low-income pregnant women. Archives of Women’s Mental Health, 19(2), 317-328. Web.