Skip to main content

Advertisement

SpringerLink
Log in

Prevalence and Risk Factors for Postpartum Depression Symptoms Among Women with Disabilities

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

The adverse consequences of postpartum depression on the health of the mother and her child are well documented. However, there is little information on postpartum depression among mothers with disabilities. This study examines the patterns of depression and depressive symptoms before, during and after pregnancy and the association between depression before and during pregnancy and postpartum depression symptomatology (PPD) among women with and without disabilities. Data from the 2009–2011 Rhode Island Pregnancy Risk Assessment Monitoring System (PRAMS) were analyzed in 2013. Almost 30 % (28.9 %; 95 % CI 22.8–35.8) of mothers with disabilities reported often or always feeling down, depressed or sad after childbirth compared to 10 % of those without disabilities (95 % CI 8.9–11.3). Compared to other women in the study, women with disabilities had a greater likelihood for PPD symptoms (RR 1.6, 95 % CI 1.1–2.2) after accounting for sociodemographics, maternal characteristics related to PPD, and depression before and during pregnancy. Adjusting for other covariates, self-reported prenatal diagnosis of depression was not associated with symptoms of PPD and depression during pregnancy was marginally associated with PPD symptomatology for women with disabilities. Women with disabilities are at a greater risk of experiencing symptoms of postpartum depression than other women. Screening for PPD among new mothers with disabilities and timely referral of those with PPD diagnosis are vital to the health of mothers with disabilities and their children.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Signore, C., Spong, C. Y., Krotoski, D., Shinowara, N. L., & Blackwell, S. C. (2011). Pregnancy in women with physical disabilities. Obstetrics and Gynecology, 117(4), 935.

    Article  PubMed  Google Scholar 

  2. Smeltzer, S. C. (2007). Pregnancy in women with physical disabilities. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 36(1), 88–96.

    Article  PubMed  Google Scholar 

  3. Iezzoni, L. I., Yu, J., Wint, A. J., Smeltzer, S. C., & Ecker, J. L. (2013). Prevalence of current pregnancy among US women with and without chronic physical disabilities. Medical Care, 51(6), 555–562.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Walsh-Gallagher, D., Sinclair, M., & Mc Conkey, R. (2012). The ambiguity of disabled women’s experiences of pregnancy, childbirth and motherhood: A phenomenological understanding. Midwifery., 28(2), 156–162.

    Article  PubMed  Google Scholar 

  5. Chakravarty, E. F., Nelson, L., & Krishnan, E. (2006). Obstetric hospitalizations in the United States for women with systemic lupus erythematosus and rheumatoid arthritis. Arthritis and Rheumatism, 54(3), 899–907.

    Article  PubMed  Google Scholar 

  6. Rogers, J., & Matsumura, M. (2005). The disabled woman’s guide to pregnancy and birth. New York City: Demos Medical Publishing.

    Google Scholar 

  7. Kelly, V. M., Nelson, L. M., & Chakravarty, E. F. (2009). Obstetric outcomes in women with multiple sclerosis and epilepsy. Neurology., 73(22), 1831–1836.

    Article  PubMed  Google Scholar 

  8. Bruce, M. L., Seeman, T. E., Merrill, S. S., & Blazer, D. G. (1994). The impact of depressive symptomatology on physical disability: MacArthur studies of successful aging. American Journal of Public Health, 84(11), 1796–1799.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Turner, R. J., & Noh, S. (1988). Physical disability and depression: A longitudinal analysis. Journal of Health and Social Behavior, 29(1), 23–37.

    Article  CAS  PubMed  Google Scholar 

  10. MacDonald, M. R., Nielson, W. R., & Cameron, M. G. (1987). Depression and activity patterns of spinal cord injured persons living in the community. Archives of Physical Medicine and Rehabilitation, 68(6), 339–343.

    CAS  PubMed  Google Scholar 

  11. Fullerton, D. T., Harvey, R. F., Klein, M. H., & Howell, T. (1981). Psychiatric disorders in patients with spinal cord injuries. Archives of General Psychiatry, 38(12), 1369–1371.

    Article  CAS  PubMed  Google Scholar 

  12. Vahle, V. J., Andresen, E. M., & Hagglund, K. J. (2000). Depression measures in outcomes research. Archives of Physical Medicine and Rehabilitation, 81(12 Suppl 2), S53–S62.

    Article  CAS  PubMed  Google Scholar 

  13. Disability and Health Data System (DHDS). (2013). http://dhds.cdc.gov.

  14. Chevarley, F. M., Thierry, J. M., Gill, C. J., Ryerson, A. B., & Nosek, M. A. (2006). Health, preventive health care, and health care access among women with disabilities in the 1994–1995 national health interview survey, supplement on disability. Womens Health Issues, 16(6), 297–312.

    Article  PubMed  Google Scholar 

  15. Centers for Disease Control and Prevention. (2008). Morbidity and mortality weekly report (MMWR). Prevalence of self-reported postpartum depressive symptoms—17 states, 2004–2005. CDC 57(14).

  16. Goodman, J. H. (2004). Postpartum depression beyond the early postpartum period. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 33(4), 410–420.

    Article  PubMed  Google Scholar 

  17. Vigod, S. N., Villegas, L., Dennis, C. L., & Ross, L. E. (2010). Prevalence and risk factors for postpartum depression among women with preterm and low-birth-weight infants: A systematic review. BJOG, 117(5), 540–550.

    Article  CAS  PubMed  Google Scholar 

  18. Beck, C. T. (1998). The effects of postpartum depression on child development: A meta-analysis. Archives of Psychiatric Nursing, 12(1), 12–20.

    Article  CAS  PubMed  Google Scholar 

  19. Luoma, I., Tamminen, T., Kaukonen, P., Laippala, P., Puura, K., Salmelin, R., et al. (2001). Longitudinal study of maternal depressive symptoms and child well-being. Journal of the American Academy of Child and Adolescent Psychiatry, 40(12), 1367–1374.

    Article  CAS  PubMed  Google Scholar 

  20. Nelson, D. R., Hammen, C., Brennan, P. A., & Ullman, J. B. (2003). The impact of maternal depression on adolescent adjustment: The role of expressed emotion. Journal of Consulting and Clinical Psychology, 71(5), 935–944.

    Article  PubMed  Google Scholar 

  21. Martins, C., & Gaffan, E. A. (2000). Effects of early maternal depression on patterns of infant-mother attachment: A meta-analytic investigation. Journal of Child Psychology and Psychiatry, 41(6), 737–746.

    Article  CAS  PubMed  Google Scholar 

  22. Weinberg, M. K., & Tronick, E. Z. (1998). The impact of maternal psychiatric illness on infant development. Journal of Clinical Psychiatry, 59(Suppl 2), 53–61.

    PubMed  Google Scholar 

  23. Marcus, S. M., & Heringhausen, J. E. (2009). Depression in childbearing women: When depression complicates pregnancy. Primary Care, 36(1), 151–165.

    Article  PubMed Central  PubMed  Google Scholar 

  24. O’hara, M. W., & Swain, A. M. (1996). Rates and risk of postpartum depression: A meta-analysis. Int Rev Psychiatry, 8(1), 37–54.

    Article  Google Scholar 

  25. Altshuler, L. L., Cohen, L. S., Moline, M. L., Kahn, D. A., Carpenter, D., Docherty, J. P., et al. (2001). Treatment of depression in women: A summary of the expert consensus guidelines. J Psychiatr Pract., 7(3), 185–208.

    Article  CAS  PubMed  Google Scholar 

  26. Dennis, C. L., & Vigod, S. (2013). The relationship between postpartum depression, domestic violence, childhood violence, and substance use: Epidemiologic study of a large community sample. Violence Against Women., 19(4), 503–517.

    Article  PubMed  Google Scholar 

  27. Dennis, C.-E., Janssen, P. A., & Singer, J. (2004). Identifying women at-risk for postpartum depression in the immediate postpartum period. Acta Psychiatrica Scand., 110(5), 338–346.

    Article  Google Scholar 

  28. Robertson, E., Grace, S., Wallington, T., & Stewart, D. E. (2004). Antenatal risk factors for postpartum depression: A synthesis of recent literature. General Hospital Psychiatry, 26(4), 289–295.

    Article  PubMed  Google Scholar 

  29. Clare, C. A., & Yeh, J. (2012). Postpartum depression in special populations: A review. Obstetrical & Gynecological Survey, 67(5), 313–323.

    Article  Google Scholar 

  30. Rhode Island Department of Public Health. (2009–2011). Pregnancy risk assessment monitoring system (PRAMS).

  31. Pregnancy Risk Assessment Monitoring System (PRAMS). http://www.health.ri.gov/programs/pregnancyriskassessmentmonitoring/.

  32. Leigh, B., & Milgrom, J. (2008). Risk factors for antenatal depression, postnatal depression and parenting stress. BMC Psychiatry. doi:10.1186/1471-244X-8-24.

  33. Liu, C. H., & Tronick, E. (2012). Rates and predictors of postpartum depression by race and ethnicity: Results from the 2004 to 2007 New York City PRAMS survey (Pregnancy Risk Assessment Monitoring System). Maternal and Child Health Journal, 17(9), 1599–1610.

  34. Robertson, E., Grace, S., Wallington, T., & Stewart, D. E. (2004). Antenatal risk factors for postpartum depression: A synthesis of recent literature. General Hospital Psychiatry, 26(4), 289–295.

    Article  PubMed  Google Scholar 

  35. Prilleltensky, O. (2003). A ramp to motherhood: The experiences of mothers with physical disabilities. Sex Disab., 21(1), 21–47.

    Article  Google Scholar 

  36. Nosek, M. A., Young, M. E., Rintala, D. H., Howland, C. A., Foley, C. C., & Bennett, J. L. (1995). Barriers to reproductive health maintenance among women with physical disabilities. Journal of Women’s Health., 4(5), 505–518.

    Article  Google Scholar 

  37. Office of the Surgeon General (US), Office on Disability (US). (2005). The Surgeon General’s call to action to improve the health and wellness of persons with disabilities. Rockville, MD: US Department of Health and Human Services.

  38. Breslin, M. L., & Yee, S. (2009). The current state of health care for people with disabilities. Washington, DC: National Council on Disability.

    Google Scholar 

  39. Mason, M. G., & Long-Bellil, L. (2012). Taking care: Lessons from mothers with disabilities. Lanham, Maryland: University Press of America.

    Google Scholar 

  40. Smeltzer, S. C. (2002). Reproductive decision making in women with multiple sclerosis. Journal of Neuroscience Nursing, 34(3), 145.

    Article  PubMed  Google Scholar 

  41. Llewellyn, G., & McConnell, D. (2002). Mothers with learning difficulties and their support networks. Journal of Intellectual Disability Research, 46(Pt 1), 17–34.

    Article  CAS  PubMed  Google Scholar 

  42. Ross, L. E., & Dennis, C. L. (2009). The prevalence of postpartum depression among women with substance use, an abuse history, or chronic illness: A systematic review. J Womens Health (Larchmt)., 18(4), 475–486.

    Article  Google Scholar 

  43. Larrabee, K. D., Monga, M., Eriksen, N., & Helfgott, A. (1996). Quality of life assessment in pregnant women with the human immunodeficiency virus. Obstetrics and Gynecology, 88(6), 1016–1020.

    Article  CAS  PubMed  Google Scholar 

  44. Ethier, K. A., Ickovics, J. R., Fernandez, M. I., Wilson, T. E., Royce, R. A., Koenig, L. J., et al. (2002). The perinatal guidelines evaluation project HIV and pregnancy study: Overview and cohort description. Public Health Reports, 117(2), 137–147.

    Article  PubMed Central  PubMed  Google Scholar 

  45. Chaaya, M., Campbell, O. M., El Kak, F., Shaar, D., Harb, H., & Kaddour, A. (2002). Postpartum depression: Prevalence and determinants in Lebanon. Arch Womens Ment Health., 5(2), 65–72.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  46. Forger, F., Ostensen, M., Schumacher, A., & Villiger, P. M. (2005). Impact of pregnancy on health related quality of life evaluated prospectively in pregnant women with rheumatic diseases by the SF-36 health survey. Annals of the Rheumatic Diseases, 64(10), 1494–1499.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  47. Weinberg, M. K., & Tronick, E. Z. (1998). The impact of maternal psychiatric illness on infant development. Journal of Clinical Psychiatry, 59(Suppl 2), 53–61.

    PubMed  Google Scholar 

  48. Thomas, C., & Curtis, P. (1997). Having a baby: Some disabled women’s reproductive experiences. Midwifery., 13(4), 202–209.

    Article  CAS  PubMed  Google Scholar 

  49. Mitra, M., Lu, E., & Diop, H. (2012). Smoking among pregnant women with disabilities. Womens Health Issues., 22(2), e233–e239.

    Article  PubMed  Google Scholar 

  50. Mitra, M., Manning, S. E., & Lu, E. (2012). Physical abuse around the time of pregnancy among women with disabilities. Maternal and Child Health Journal, 16(4), 802–806.

    Article  PubMed  Google Scholar 

  51. Lipson, J. G., & Rogers, J. G. (2000). Pregnancy, birth, and disability: Women’s health care experiences. Health Care for Women International, 21(1), 11–26.

    Article  CAS  PubMed  Google Scholar 

  52. Blackford, K. A., Richardson, H., & Grieve, S. (2000). Prenatal education for mothers with disabilities. Journal of Advanced Nursing, 32(4), 898–904.

    CAS  PubMed  Google Scholar 

  53. Andrade, S. E., Scott, P. E., Davis, R. L., Li, D. K., Getahun, D., Cheetham, T. C., et al. (2013). Validity of health plan and birth certificate data for pregnancy research. Pharmacoepidemiology and Drug Safety, 22(1), 7–15.

    Article  PubMed Central  PubMed  Google Scholar 

  54. Kane, D. J., & Sappenfield, W. M. (2014). Ascertainment of medicaid payment for delivery on the Iowa birth certificate: Is accuracy sufficient for timely policy and program relevant analysis? Maternal and Child Health Journal, 18(4), 970–977.

    Article  PubMed  Google Scholar 

  55. Mason, L. R., Nam, Y., & Kim, Y. (2014). Validity of infant race/ethnicity from birth certificates in the context of U.S. demographic change. Health Services Research, 49(1), 249–267.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This research is funded by a Grant from the National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health & Human Development. Grant Number: 1R01HD074581.

Author information

Authors and Affiliations

  1. Center for Health Policy and Research, University of Massachusetts Medical School, 333 South Street, Shrewsbury, MA, 01545, USA

    Monika Mitra, Jianying Zhang & Linda M. Long-Bellil

  2. The Mongan Institute for Health Policy, Massachusetts General Hospital, 50 Staniford Street, Room 901B, Boston, MA, 02114, USA

    Lisa I. Iezzoni

  3. Center for Nursing Research, Villanova University, 800 Lancaster Avenue, Villanova, PA, 19085, USA

    Suzanne C. Smeltzer

  4. Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA

    Bruce A. Barton

Authors
  1. Monika Mitra
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lisa I. Iezzoni
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jianying Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Linda M. Long-Bellil
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Suzanne C. Smeltzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Bruce A. Barton
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Monika Mitra.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mitra, M., Iezzoni, L.I., Zhang, J. et al. Prevalence and Risk Factors for Postpartum Depression Symptoms Among Women with Disabilities. Matern Child Health J 19, 362–372 (2015). https://doi.org/10.1007/s10995-014-1518-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-014-1518-8

Keywords

Search

Navigation