Postpartum Depression

You are not alone

It is reported that 1 in 5 women experience perinatal mood disorders including postpartum depression (PPD) and anxiety (Podvey, 2018). Women in the fourth trimester have reported that having social support, engagement in meaningful activities, and spending time with people outside the home has a positive impact mental health (Negron et al., 2013; Feely et al., 2016). This page provides information on PPD and advocates for the role of occupational therapy in addressing related challenges.

Research and Impact

Psychological factors that influence postpartum mood disorders include acceptance of the maternal role, history of mental health diagnoses, and availability of social support (Delavari et al., 2018). These factors influence both the mother and the infant.

PPD is researched to influence mother-child attachment which is an essential component of child development (Delvari et al., 2018). Researchers have found that breastfeeding can promote bonding and decrease the effects of PPD by decreasing the adrenal response to stress (Sponseller et al., 2021; Pitonyak, 2014).

A study conducted with women experiencing PPD symptoms reported that engagement in meaningful activities and spending time with people outside of the home contribute to a decrease in symptoms (Feely et al., 2016). Participation in social activities can improve support and decrease isolation during the postpartum period. An occupational therapist can collaborate with the mother to identify positive emotional supports, meaningful activities, and conduct standardized assessments to assess mental wellness.

What Postpartum Depression can feel like...

Mind the mental health charity (2015)

Addressing the Stigma of PPD

Aubrey Harrison, TEDxTalks (2020)

Learn More About the Role of OT in Addressing PPD

The Role of OT in Interdisciplinary Care

How Occupations Promote Mental Health

Application of the OT Perspective to PPD

The Role of OT in Interdisciplinary Care

Feely and colleagues (2016) state that despite the available screenings and services provided to women during postpartum check-ups, these tools are not effective for educating mothers about postpartum or addressing individual concerns. These researchers identify primary needs for women in the fourth trimester including comprehensive physical care, emotional support, and participation in activities; stating that engagement in meaningful activities contributes to decreased PPD symptoms and decreased isolation (Feely et al., 2016).

Occupational therapy (OT) is an allied health profession that is equipped to address the psychological and social challenges that women may experience during the fourth trimester. OT practitioners can work with mothers to plan for postpartum by considering the family's individual contexts and preferences. Some previous activities that may now be more challenging include fulfilling self-care needs, completing household chores, and participating in adequate, restful sleep (Negron et al., 2013). OT practitioners are equipped to administer mental health screenings to identify postpartum mood changes, conduct assessments which help mothers to identify their meaningful activities and roles, and to assist the family with developing positive habits and routines for achieving life balance (Podvey, 2018).

How Occupations Promote Mental Health

Occupations include all activities that a person engages in on a daily basis (e.g., sleeping, eating, caring for children or pets, working, household management, going out with friends). All of these occupations fulfill some purpose or role within a person's daily life. The occupations that are meaningful to one person may look very different compared to someone else. Participation in meaningful occupations endorses health and well-being; it allows for development of personal identify which is critical for forming and maintaining social roles (Brown et al., 2011). When people engage in a variety of occupations within the home and the community, it promotes a sense of belonging and increases a person's perceived abilities. In fact, research suggests that individuals who participation in a variety of occupations, including employed work, rate their quality of life, health, and well-being higher than those who do not (Eklund et al., 2001 in Brown et al., 2011).

Application of the OT Perspective to PPD

Occupational therapists are equipped to administer mental health screenings and to provide strategies for improving maternal-infant attachment, management of physical issues, educate and train mothers to develop health habits and routines to achieve life balance within the new maternal role, and to refer to needed providers if the situation is beyond the scope and domain of occupational therapy. There are a variety of theorhetical models that provide a framework for occupational therapy practice in mental health settings, including:

The Canadian Model of Occupational Performance and Engagement (CMOP-E) is a theoretical framework used by OT practitioners that considers the physical, affective, cognitive, and spiritual influences within a client's occupations (Polatajko et al., 2007). When working with postpartum mothers, these influences are considered in regard to maternal self-care, child-rearing, productivity, and leisure (Slootjes et al., 2015). According to the CMOP-E model, occupations occur within various physical, institutional, cultural, and social environments. The interaction among the person, the occupation, and these environments influence successful engagement in the desired occupations. This model postulates that motivation for change (to perform at a higher level) comes from intrinsic factors. Therefore, when addressing postpartum concerns, the OT's goal is to facilitate the mother's ability to identify and engage in meaningful occupations.

The Ecology of Human Performance (EHP) is another practice framework that can be used by OT practitioners to address postpartum challenges. According to the EHP model, a person demonstrates healthy functioning when they are able to achieve a high level of performance within their meaningful activities (Cole & Tufano, 2020; Dunn et al., 1994). This engagement in occupations occurs as a result of transaction between the person, the task, and the context or environment. For new mothers, imbalances that may negatively impact occupational performance could include new child-rearing responsibilities, increased home management occupations, decreased social participation, and physical or mental health changes. The OT may support improved engagement in meaningful occupations by identifying and prioritizing the mother's wants and needs by completing a task analysis. Based on this collabortive effort to develop client-centered goals for participation, the OT then utilizes strategies to establish or restore performance in desired occupations, to alter, adapt, or modify the environment to promote successful engagement, to provide education and training to prevent further dysfunction, and/or to support health promotion and social justice by creating contexts that support optimal performance (Cole & Tufano, 2020).

References

Brown, C., Stoffel, V.C., & Muñoz, J.P. (2011). Occupational therapy in mental health: A vision for participation. F.A. Davis Company
Cole, M., & Tufano, R. (2020). Applied theories in occupational therapy: A practical approach (2nd ed.). SLACK Incorporated
Dunn, W., Brown, C., & McGuigan, A. (1994). The ecology of human performance: A framework for considering the effect of context. American Journal of Occupational Therapy, 48, 595-607.
Eklund, M. (2000).Applying object relations theory to psychosocial occupational therapy: Empirical and theoretical considerations. Occupational Therapy in Mental Health, 15(1), 1–26.
Feeley, N., Bell, L., Hayton, B., Zelkowitz, P., & Carrier, M. (2016). Care for postpartum depression: What do women and their partners prefer? Perspectives In Psychiatric Care, 52(2), 155-165. doi:10.1111/ppc.12107
Negron, R., Martin, A., Almog, M., Balbierz, A., & Howell, E. A. (2013). Social support during the postpartum period: mothers' views on needs, expectations, and mobilization of support. Maternal and child health journal, 17(4), 616–623.
Podvey, M. (2018). Maternal mental health and occupational therapy: A good fit. SIS Quarterly Practice Connections, 3(2), 17–19. https://www.aota.org/publications/sis-quarterly/mental-health-sis/mhsis-5-18
Polatajko, H. J., Townsend, E. A. & Craik, J. (2007). Canadian Model of Occupational Performance and Engagement (CMOP-E).
Slootjes, H., McKinstry, C., & Kenny, A. (2015). Maternal role transition: Why new mothers need occupational therapists. Australian Occupational Therapy Journal, 63(2), 130-133. https://doi.org/10.1111/1440-1630.12225

Page updated

Google Sites

Report abuse