Friday 19 January 2018

One-in-six mums-to-be suffers depression but is too afraid to talk about it

Veronica O’Keane, Prof of Psychiatry at Trinity. Photo: Gareth Chaney Collins
Veronica O’Keane, Prof of Psychiatry at Trinity. Photo: Gareth Chaney Collins
Eilish O'Regan

Eilish O'Regan

Depression can strike as many as one-in-six pregnant women in Ireland - with potentially serious complications for mother and baby, a study reveals today.

The condition may afflict 11,000 mothers-to-be annually, although the suffering often goes unrecognised.

Unlike postnatal depression, which is widely discussed, there can be a taboo about expectant mothers admitting to the debilitating illness because they feel they are supposed to be happy and joyful.

The study of more than 5,000 women in six maternity units by Irish Obstetrics Services in Trinity College Dublin is the first time that rates of prenatal depression have been tracked in the country.

It found 16pc of women attending a number of maternity hospitals are at probable risk - but this rises to 22pc for under-18s.

Hormonal changes which occur during pregnancy can contribute to development of the depression, said lead researcher, Veronica O'Keane, Prof of Psychiatry at Trinity.

Rates are highest among women from lower socio-economic backgrounds and those with poorer levels of education. Women who have had several pregnancies and births are also at greater risk.

Prof O'Keane pointed to growing scientific evidence that women who suffer from depression while pregnant are at higher risk of pre-eclampsia, which raises blood pressure, and also having a caesarean section and epidural during labour. It also increases their chances of giving birth prematurely or having a low-weight baby.

The condition also places the baby at higher risk of suffering setbacks in intellectual development and behaviour during infancy, while also leaving them more prone to mental health problems in childhood and later life.

"This is why it is so important that depression is screened for during pregnancy and that women are encouraged to look for support," she said.

However, this screening - involving a series of questions - is not routine in our maternity units and there is a dearth of perinatal mental health services and psychiatrists who specialise in this area.

There are only four part-time consultant psychiatrists who specialise in the care of women around pregnancy, with few other perinatal mental health professionals, despite some 67,000 births annually.

"If we don't screen as a systematic part of our antenatal care plan, we are putting women at risk, not only of suffering distress, but of being compromised before birth and so less able to cope with the additional stresses of caring for a baby," she said.

The 'Well Before Birth' study indicated that prevalence rates of depression among women giving birth in Ireland are high, and may be greater than those recorded in other OECD countries, where they range from 10pc to 15pc.

"Properly caring for the mental health during pregnancy protects the longer-term mental health of both mother and child," Prof O'Keane said.

"Antenatal depression, as we are seeing with this study, is common. Rates of depression during pregnancy among women in Ireland are at least as high, and probably higher, than in other EU countries."

The survey questioned women aged 18 to 49 attending the National Maternity Hospital, Dublin; Rotunda Hospital, Dublin; Cork University Hospital; Mayo General Hospital; University Hospital Limerick; and Community Antenatal Clinics, Tallaght, Co Dublin.

Irish Independent

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