Postpartum Depression: Cultural Disorder?
Official American psychiatry repeatedly states that postpartum depression occurs in 10 to 20 percent of new mothers. The truth is that postpartum depression occurs in 10 to 20 percent of American mothers—not all mothers. A 2004 cross-cultural review inBMJ (formerly the British Medical Journal) reported that postpartum depression is rare in Fiji and in traditional African and Chinese populations. BMJ authors concluded that “structured social supports after childbirth are described in groups of women with low rates of postpartum depression.”
Medical anthropologists Ann Becker and Dominic Lee in “Indigenous Models for Attenuation of Post Partum Depression” (a chapter in the World Mental Health Casebook, 2002) report that postpartum depression occurs at a rate of 1 percent. For Fiji women after childbirth, there is mandated extended relief from domestic responsibilities such as laundry and cooking (for three to four months) as well as relief from work on the family farm (for one year). Given that a Fiji woman’s daily life consist of exhausting physical labor, this relief represents a serious commitment by the household and the culture to the new mother’s well being. In addition to this extended relief, a caretaker (often the woman’s mother or sister-in-law) is designated to assist in the caring of both the new mother and her infant.
In traditional Chinese culture there is the postpartum custom called peiyue, which means attending. Peiyue requires an elder female relative to help the new mother with domestic duties for a month. Becker and Lee report that in one Hong Kong study, women who did not observe peiyue were four times more likely to suffer postpartum depression than women who observed peiyue.
Structured social supports for women after childbirth are decidedly missing from U.S. culture. On a modest level, social supports would mean universal paid maternity and paternity leave. On a deeper level, it would mean rethinking our cultural priorities. However, the U.S. Congress and psychiatry officialdom have chosen a different kind of assault on postpartum depression.
In 2007 the U.S. House of Representatives passed the Melanie Blocker-Stokes Postpartum Depression Research and Care Act and sent it to the U.S. Senate, which renamed it the Mothers Act. In 2008 the Mother’s Act was included in the omnibus bill “Advancing America’s Priorities Act” (that has not yet passed).
In the “Findings” section of the Mothers Act we are told that postpartum depression is a “devastating mood disorder” and that “postpartum depression is a treatable disorder if promptly diagnosed by a trained provider.” The stated goal of the Mothers Act is to “ensure that new mothers and their families are educated about postpartum depression, screened for symptoms and provided with essential services and to increase research at the National Institutes of Health on postpartum depression.” Critics of the Mothers Act, such as those at the International Center for the Study of Psychiatry and Psychology (not funded by Big Pharma), believe that the Mothers Act will merely ensure that federal dollars are used to increasingly diagnose, often unreliably, depression in pregnant and postpartum women—and then convince them that antidepressants are safe and effective.
In the Mothers Act official findings, several inconvenient truths about postpartum depression are omitted. Not many in Congress would vote for legislation that stated the U.S. could eliminate much of postpartum depression by transforming American values, culture, and economics. The Mothers Act findings neglect to mention, for example, a 1996 British Journal of Psychiatry article that reported postpartum depression is associated with unemployment of the mother (no job to return to), unemployment of the head of the household, not breast-feeding, and unplanned pregnancies. The Mothers Act findings also omit relevant truths about Blocker-Stokes, the woman for whom the initial House bill was named. Blocker-Stokes was a pharmaceutical sales manager who began suffering severe symptoms of depression after the birth of her child. She was hospitalized three times in seven weeks, given four combinations of antipsychotic, anti-anxiety, and antidepressant medications, and underwent electro-convulsive therapy (electroshock). But despite her psychiatric treatment—or because of it—Melanie Blocker-Stokes jumped to her death from the 12th floor of a Chicago hotel.
Pregnant Women on Antidepressants
A study “Increasing Use of Antidepressants in Pregnancy,” published in theAmerican Journal of Obstetrics and Gynecology in 2007, is an analysis of the medical records of 105,335 pregnant women enrolled in Tennessee Medicaid from 1999 to 2003. Among the group of 13.4 percent women who took antidepressants at some time during pregnancy in 2003, 10 percent took antidepressants during the first trimester, 6.4 percent used them during the second trimester, and 5.9 percent used them during the third; white women were four times more likely than nonwhite women to have used antidepressants during pregnancy.
In June 2007 the CDC issued a press release stating “New Study Finds Few Risks of Birth Defects from Antidepressant Use During Pregnancy.” CDC epidemiologist Jennita Reefhuis concluded, “Overall, our results are generally reassuring with respect to the use of antidepressants during pregnancy.” This CDC press release was reported in 2007 by U.S. newspapers with headlines such as “Reassurance on Antidepressants in Pregnancy” (Wall Street Journal). However, the actual research findings are the opposite of reassuring.
In 2006 the Archives of Pediatric & Adolescent Medicine reported that 30 percent of infants who had prenatal exposure to antidepressants experience some withdrawal symptoms, with 13 percent of them experiencing severe ones, most notably tremors, respiratory distress, gastrointestinal problems, sleep disturbances, and high-pitched crying. Other withdrawal symptoms include rapid heartbeat, irritability, feeding difficulties, and profuse sweating. While Big Pharma and establishment psychiatry want Americans to hear about “crack babies,” they’d prefer they not know about “Paxil babies.”
There are several other serious problems that newborns are more likely to suffer when exposed in utero to antidepressants such as Prozac, Paxil, Zoloft, and other selective serotonin reuptake inhibitors (SSRIs). A 2006 U.S. Food and Drug Administration (FDA) alert stated, “A recently published case-control study has shown that infants born to mothers who took selective serotonin reuptake inhibitors (SSRIs) after the 20th week of pregnancy were 6 times more likely to have persistent pulmonary hypertension (PPHN) than infants born to mothers who did not take antidepressants during pregnancy.” In persistent pulmonary hypertension of the newborn, the newborn’s arteries to the lungs are constricted, limiting the amount of blood flow to the lungs and therefore the amount of oxygen into the bloodstream. The FDA alert also noted, “Neonatal PPHN is associated with significant morbidity and mortality.”
The CDC, it turns out, based its approval of antidepressant use during pregnancy on studies in which women were taking antidepressants the month before they became pregnant or in the first three months of pregnancy. However, the New England Journal of Medicine in 2007 reported that SSRI antidepressant use in first trimester was associated with more than double the risk of anencephaly (birth without forebrain), omphalocele (the child’s abdomen does not close properly allowing intestines and other organs to protrude outside the body), and craniosynostosis (premature closure of the joints between the bones of the skull before brain growth is complete).
What then is the rationale of those medical authorities who encourage antidepressant use among depressed pregnant mothers? Their claim is that while antidepressants might present some risks, the stress of not receiving medication for depression is more risky for the newborn and mother. In reality, the research simply does not back up this claim. Two major studies (American Journal of Psychiatry, 2007; Archives of General Psychiatry, 2006) comparing the health of newborns from depressed mothers who took antidepressants versus newborns of depressed mothers who did not take antidepressants show that newborns are better off with mothers not taking antidepressants. Plus, a 2002 Prevention & Treatment analysis of 47 depression studies on Prozac, Paxil, Zoloft, Effexor, Celexa, and Serzone revealed that in the majority of the trials, the antidepressant failed to outperform a sugar pill placebo.
