Rolling Thunder: Slowing the Storm of Perinatal Depression

Rolling Thunder:  Slowing the Storm of Perinatal Depression
In the winter of 1990-91, two young mothers who had been our patients, committed suicide when their babies were each approximately 2 months old.  This triggered an intense review of our practice to identify if there was anything we could have done to prevent these senseless deaths.  In true Magnet fashion, maternity nurses innovatively pioneered the development of a hospital-based, screening, education and follow-up program for Perinatal Depression.   
In 2005, the Idaho Pregnancy Risk Assessment Tracking Survey (PRATS), an anonymous survey distributed by the Idaho Bureau of Clinical and Preventive Services to new mothers,18 years of age or older, at approximately 6 months postpartum, revealed that 66% of new mothers (67% of Hispanic mothers) acknowledged significant symptoms of postpartum depression. Our own screening identifies that 30-35% of our maternity patients score at moderate to severe risk.  The many voices of these women cry out for a consistent approach to the storms that depict perinatal depression.
Perinatal depression, in its multiple manifestations, is the most frequently missed and most commonly misunderstood complication of pregnancy and the postpartum period.   Unfortunately, it is uncommon to find a hospital maternity service providing the screening, education, and follow-up necessary for a comprehensive, prevention-focused safety net for mothers at risk. 
This presentation demonstrates that bedside nurses, who understand the basic brain physiology of perinatal depression and are willing to intervene systematically, can decrease the severity of these “storms” or possibly prevent some of them from “rolling in”  for new mothers and make a major positive difference for this patient population.   By working in partnership with community professionals and agencies, the many voices of the healthcare village can minimize or help prevent the occurrence of Perinatal Depression. 
By understanding the relationship between the manifestations of perinatal depression (e.g. sleep and appetite disturbance, emotional lability, irritability, anger, anxiety, isolation, suicidality, etc) and the physiology behind these symptoms,  the nurse can design individualized plans of care within a consistent model of intervention.   A handout illustrating these will be provided. 
This presentation will illustrate the roles of the office nurse, the bedside nurse, the advanced practice nurse, the NICU nurse and the follow-up nurse and specific tools they can use to assess and facilitate appropriate intervention.  We will also share data from our research studies to validate use of our tools and upgrades in our program.
National award-winning, patient-family education materials will be show-cased  and steps to develop a cost effective, local program for risk assessment, preventive care and follow-up of Perinatal Depression will be clearly outlined. 
Our collective mission has been to:
1.     decrease the stigma of Perinatal Depression which engenders fear and repression,
2.     decrease the impact of Perinatal Depression on the new mother, her newborn, her family and her community, and
3.     increase understanding among people with influence on policy/legislation. 
Over the last 15 years, this Magnet hospital has provided screening, education and follow-up for 14,000+ new mothers at a cost of less than $20 per patient.