Archives of Women's Mental Health

, Volume 11, Issue 2, pp 81–92 | Cite as

Desired assistance versus care received for postpartum depression: access to care differences by race

  • Kimberley Zittel-Palamara
  • Julie R. Rockmaker
  • Kara M. Schwabel
  • Wendy L. Weinstein
  • Sanna J. Thompson
Original Contribution


One in seven women who have a baby will experience postpartum depression. Although there are many treatments for postpartum depression, many women do not receive assistance. When left untreated, this condition can have a deleterious affect on the woman’s health/mental health, the child’s cognitive, psychological, emotional and social development, the marital relationship and ability to contribute to society. This study examined 45 women’s self-reported desire for PPD care and ability to obtain to these services in Erie County, New York. Results showed differences in desired care by race, differences in access to care by race and revealed the lack of PPD care in general.


Postpartum depression Race Access to care Women Mental health 



Special appreciation is given to Fantastic Sam’s for donating gift certificates to study participants. This project was support by the Buffalo State College Research Foundation.


  1. Ahn YM, Kim MR (2004) The effects of a home-visiting discharge education, on maternal self-esteem, maternal attachment, postpartum depression and family, function in the mothers of NICU infants. Daehan Ganho Haghoeji 34(8):1468–1476Google Scholar
  2. Appleby L, Hirst E, Marshall S, Keeling F, Brind J, Butterworth T, Lole J (2003) The treatment of postnatal depression by health visitors: impact of brief training on skills and clinical practice. J Affect Disord 77(3):261–266PubMedCrossRefGoogle Scholar
  3. Armstrong KL, Fraser JA, Dadds MR, Morris J (1999) A randomized, controlled trial of nurse home visiting to vulnerable families with newborns. J Paediatr Child Health 35(3):237–244PubMedCrossRefGoogle Scholar
  4. Bates C, Paeglis C (2004) Motherhood and mental illness. RCM Midwives 7(7):286–287PubMedGoogle Scholar
  5. Boath E, Cox J, Lewis M, Jones P, Pryce A (1999) When the cradle falls: the, treatment of postnatal depression in a psychiatric day hospital compared with routine primary care. J Affect Disord 53(2):143–151PubMedCrossRefGoogle Scholar
  6. Boulvain M, Perneger TV, Othenin-Girard V, Petrou S, Berner M, Irion O (2004) Home-based versus hospital-based postnatal care: a randomized trial. BJOG: International Journal of Obstetrics and Gynaecology 111(8):807–813CrossRefGoogle Scholar
  7. Brown S, Lumley J (2000) Physical health problems after childbirth and maternal depression at six to seven months postpartum. International Journal of Obstetrics and Gynaecology 107(10):1194–1201Google Scholar
  8. Campbell SB, Cohn JF, Meyers T (1995) Depression in first-time mothers: Mother-infant interaction and depression chronicity. Dev Psychol 31:340–357CrossRefGoogle Scholar
  9. Carter AS, Garritty-Roukas FE, Chazan-Cohen R, Little C, Briggs-Gowan M (2001) Maternal depression and co-morbidity: predicting early parenting, attachment security and toddler social–emotional problems and competencies. J Am Acad Child Adolesc Psych 40:18–26CrossRefGoogle Scholar
  10. Cattel DL, King EA (1996) Estrogen for postnatal depression. J Fam Pract 43(1):22–23Google Scholar
  11. Centers for Disease Control and Prevention (CDC) Pregnancy Risk Assessment Monitoring System (PRAMS): PRAMS and postpartum depression. Department of Health and Human Services. Cited September 10, 2007
  12. Chaudron LH, Szilagyi PG, Kitzman HJ, Wadkins HI, Conwell Y (2004) Detection of postpartum depressive symptoms by screening at well-child visits. Pediatrics 113(3 Pt 1):551–558PubMedCrossRefGoogle Scholar
  13. Chaudron LH, Kitzman HJ, Peifer KL, Morrow S, Perez LM, Newman MC (2005) Self-recognition of and provider response to maternal depressive symptoms in low-income Hispanic women. J Women’s Health 14(4):331–338CrossRefGoogle Scholar
  14. Chen CH, Tseng YF, Chou FH, Wang SY (2000) Effects of support group intervention in postnatally distressed women: a controlled study in Taiwan. J Psychosom Res 49(6):395–399PubMedCrossRefGoogle Scholar
  15. Civic D, Holt VL (2000) Maternal depressive symptoms and child behavior problems in a nationally representative normal birthweight sample. Matern Child Health J 4:215–221PubMedCrossRefGoogle Scholar
  16. Clark R, Tluczek A, Wenzel A (2003) Psychotherapy for postpartum depression: a preliminary report. Am J Orthopsychiatr 73(4):441–454CrossRefGoogle Scholar
  17. Cooper PJ, Murray L, Wilson A, Romaniuk H (2003) Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression: IImpact on maternal mood. Br J Psychiatry 182:412–419PubMedCrossRefGoogle Scholar
  18. Craig E, Judd F, Hodgins G (2005) Therapeutic group programme for women with postnatal depression in rural Victoria: a pilot study. Australas Psychiatry 13(3):291–295PubMedCrossRefGoogle Scholar
  19. Currie ML, Rademacher R (2004) The pediatrician’s role in recognizing and intervening in postpartum depression. Pediatr Clin North Am 51(3):785–801PubMedCrossRefGoogle Scholar
  20. Davey SJ, Dziurawiec SS, O’Brien-Malone A (2006) Men’s voices: postnatal depression from the perspective of male partners. Qual Health Res 16(2):206–220PubMedCrossRefGoogle Scholar
  21. Dennis CL (2004) Treatment of postpartum depression, Part 2: a critical review of non-biological interventions. J Clin Psychiatry 65(9):1252–1265PubMedCrossRefGoogle Scholar
  22. Edge D, Rogers A (2005) Dealing with it: black Caribbean women’s response to adversity and psychological distress associated with pregnancy, childbirth, and early motherhood. Soc Sci Med 61:15–25PubMedCrossRefGoogle Scholar
  23. Garg A, Morton S, Heneghan A (2005) A hospital survey of postpartum depression education at the time of delivery. J Obstet Gynecol Neonatal Nurs 34(5):587–594PubMedCrossRefGoogle Scholar
  24. Gjerdingen D (2003) The effectiveness of various postpartum depression treatments and the impact of antidepressant drugs on nursing infants. J Am Board Fam Pract 16(5):372–382PubMedGoogle Scholar
  25. Gregoire AJ, Kumar R, Everitt B et al (1996) Transdermal oestrogen for treatment of severe postnatal depression. Lancet 347:930–933PubMedCrossRefGoogle Scholar
  26. Grigoriadis S, Kennedy SH (2002) Role of estrogen in the treatment of depression. J Therapeutics 9(6):503–509CrossRefGoogle Scholar
  27. Hamilton JA, Sichel DA (1992) Postpartum measures. In: Hamilton JA, Harberger PN (eds) Postpartum psychiatric illness: a picture puzzle. University of Pennsylvania Press, Philadelphia, PA, pp 219–254Google Scholar
  28. Hearn G, Iliff A, Jones I, Kirby A, Ormiston P, Parr P, Rout J, Wardman L (1998) Postnatal depression in the community. Br J Gen Pract J R Coll Gen Pract 48(428):1064–1066Google Scholar
  29. Hickman SA, LeVine DL (1992) Postpartum disorders and the law. In: Hamilton JA, Harberger PN (eds) Postpartum psychiatric illness: a picture puzzle. University of Pennsylvania Press, Philadelphia, PA, pp 283–295Google Scholar
  30. Holopainen D (2002) The experience of seeking help for postnatal depression. Aust J Adv Nurs 19(3):39–44PubMedGoogle Scholar
  31. Honey KL, Bennett P, Morgan M (2002) A brief psycho-educational group intervention for postnatal depression. Br J Clin Psychol 41(Pt 4):405–409PubMedCrossRefGoogle Scholar
  32. Howell EA, Mora PA, Horowitz CR, Leventhal H (2005) Racial and ethnic differences in factors associated with early postpartum depressive symptoms. Obstet Gynecol 105(6):1442–1450PubMedGoogle Scholar
  33. Johnson J, Cohen P, Kasen S, Smailes E, Brook J (2001) Association of maladaptive parental behaviour with psychiatric disorder among parents and their offspring. Am J Psychiatr 58:453–460Google Scholar
  34. Kendell RE, Chalmers JC, Platz C (1987) Epidemiology of puerperal psychoses. Br J Psychiatry 150:662–673PubMedCrossRefGoogle Scholar
  35. Kersting A, Kuschel S, Reutemann M, Ohrmann P, Arolt V (2003) Outpatient psychotherapy for mothers: First empirical results. Psychiatry 66(4):335–345PubMedGoogle Scholar
  36. Klier CM, Muzik M, Rosenblum KL, Lenz G (2001) Interpersonal psychotherapy adapted for the group setting in the treatment of postpartum depression. J Psychother Pract Res 10(2):124–131PubMedGoogle Scholar
  37. Kostaras X, Fox D, Kostaras D, Misri S (2000) The impact of partner support in the treatment of postpartum depression. Can J Psychiatry 45(6):554–558PubMedGoogle Scholar
  38. Lindahl V, Pearson JL, Colpe L (2005) Prevalence of suicidality during pregnancy and the postpartum. Archives of Women’s Mental Health 8(2):77–87PubMedCrossRefGoogle Scholar
  39. Lumley J, Small R, Brown S, Watson L, Gunn J, Mitchell C, Dawson W (2003) PRISM (Program of Resources, Information, and Support for Mothers): protocol for a community-randomised trial. BMC Public Health 3:36–50PubMedCrossRefGoogle Scholar
  40. Maley B (2002) Creating a postpartum depression support group: out of the blue. AWHONN Lifelines 6(1):62–65PubMedGoogle Scholar
  41. Marcus SM, Barry KL, Flynn HA, Tandon R, Greden JF (2001) Treatment guidelines for depression in pregnancy. Int J Gynecol Obstet 72:61–70CrossRefGoogle Scholar
  42. Martinez-Schallmoser L, Telleen S, MacMullen NJ (2003) The effect of social support and acculturation on postpartum depression in Mexican American women. J Transcult Nurs 14(4):329–338PubMedCrossRefGoogle Scholar
  43. Mathers DC, Loncar D (2006) Projections of global morality and burden of disease from 2002 to 2030. PLoS Medicine, 3(11), e442 DOI  10. 137/journal.pmed.0030442.–1676/3/11/pdf/10.1371_journal.pmed.0030442-L.pdf
  44. Mauthner NS (1997) Postnatal depression: how can midwives help? Midwifery 13(4):163–171PubMedCrossRefGoogle Scholar
  45. Milgrom J, Negri LM, Gemmill AW, McNeil M, Martin PR (2005) A randomized controlled trial of psychological interventions for postnatal depression. Br J Clin Psychol 44(Pt 4):529–542PubMedCrossRefGoogle Scholar
  46. Moses-Kolko EL, Roth EK (2004) Antepartum and postpartum depression: healthy mom, healthy baby. J Am Med Women’s Assoc 59(3):181–191Google Scholar
  47. Murray L, Cooper PJ (1997) Postpartum depression and child development. Psychology Medicine 27:253–260CrossRefGoogle Scholar
  48. Murray L, Sinclair D, Cooper P et al (1999) The socio-emotional development of 5-year old children of postnatally depressed mothers. J Child Psychol Psychiatry 40:1259–1271PubMedCrossRefGoogle Scholar
  49. Murray L, Cooper PJ, Wilson A, Romaniuk H (2003) Controlled trail of the short- and long-term effect of psychological treatment of post-partum depression: IIImpact on the mother–child relationship and child outcome. Br J Psychiatry 182:420–427PubMedCrossRefGoogle Scholar
  50. NICHD Early Child Care Research Network (NICHD) (1999) Chronicity of maternal depressive symptoms, maternal sensitivity, and child functioning at 36 months. Dev Psychol 35:1297–1310CrossRefGoogle Scholar
  51. Nonacs RM, Soares CN, Viguera N, Pearson K, Poitras JR, Cohen LS (2005) Bupropion SR for the treatment of postpartum depression: a pilot study. Int J Neuropsychopharmacol 8(3):445–449PubMedCrossRefGoogle Scholar
  52. Oates M (2000) Perinatal maternal mental health services. Royal College of Psychiatrists, London, EnglandGoogle Scholar
  53. O’Hara MW, Swain AM (1996) Rates and risks of postpartum depression: a meta-analysis. Int Rev Psychiatry 8:37–54CrossRefGoogle Scholar
  54. O’Hara MW, Stuart S, Gorman LL, Wenzel A (2000) Efficacy of interpersonal psychotherapy for postpartum depression. Arch Gen Psychiatry 57(11):1039–1045PubMedCrossRefGoogle Scholar
  55. Olson MR, Cutler LA, Legault F (1991) Bittersweet: a postpartum depression support group. Can J Public Health 82(2):135–136PubMedGoogle Scholar
  56. Parke S, Hardy B (1997) Postnatal depression: making better use of health visitors and community psychiatric nurses. Prof Care Mother Child 7(6):151–152PubMedGoogle Scholar
  57. Peel D (2001) Infanticide happens when no real mental health care exists. Tex Med 97(9):15–17PubMedGoogle Scholar
  58. Scott D (1992) Early identification of maternal depression as a strategy in the prevention of child abuse. Child Abuse Negl 16:345–358PubMedCrossRefGoogle Scholar
  59. Scrandis DA (2005) Normalizing postpartum depressive symptoms with social support. J Am Psychiatr Nurses Assoc 11(4):223–230CrossRefGoogle Scholar
  60. Seidman D (1998) Postpartum psychiatric illness: the role of the pediatrician. Pediatr Rev 19(4):128–131PubMedCrossRefGoogle Scholar
  61. Simons J, Reynolds J, Mannion J, Morison L (2003) How the health visitor can help when problems between parents add to postnatal stress. J Adv Nurs 44(4):400–411PubMedCrossRefGoogle Scholar
  62. Small R, Brown S, Lumley J, Astbury J (1994) Missing voices: what women say and do about depression after childbirth. J Reprod Infant Psychol 12:19–22CrossRefGoogle Scholar
  63. Stuart S, Couser G, Schilder K et al (1998) Postpartum anxiety and depression: onset and co-morbidity in a community sample. Journal of Nervous and Mental Disorders 186:420–424CrossRefGoogle Scholar
  64. Ugarriza DN (2004) Group therapy and its barriers for women suffering from postpartum depression. Arch Psychiatr Nurs 18(2):39–48PubMedCrossRefGoogle Scholar
  65. United States Department of Health & Human Services (2005) Depression during and after pregnancy. Cited September 12, 2007
  66. Wiley CC, Burke GS, Gill PA, Law NE (2004) Pediatricians’ views of postpartum depression: a self-administered survey. Archives of Women’s Mental Health 7(4):231–236PubMedCrossRefGoogle Scholar
  67. Wood AF, Meigan M (1997) The downward spiral of postpartum depression. Am J Matern Child Nursing 22(6):308–316CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Kimberley Zittel-Palamara
    • 1
  • Julie R. Rockmaker
    • 2
  • Kara M. Schwabel
    • 3
  • Wendy L. Weinstein
    • 4
  • Sanna J. Thompson
    • 5
  1. 1.Social Work DepartmentBuffalo State CollegeBuffaloUSA
  2. 2.AmeriCorpBuffaloUSA
  3. 3.CreativisionBuffaloUSA
  4. 4.Psychiatry DepartmentBuffalo Medical GroupBuffaloUSA
  5. 5.School of Social Work, University of Texas at AustinAustinUSA

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