Recognizing and Screening for Postpartum Depression in Mothers of NICU Infants

Adv Neonatal Care. 2003;3(1) 

In This Article


Over 20 years ago, Welburn described the experience of postpartum depression (PPD) as "the black rose blooms and we know postnatal depression means mothers in despair; energy gone underground, flatness and grayness above ground; devastation, silence, withdrawal from life...It is like the night of the soul, the extinguishing of a flame. How the baby perceives this withdrawal as the cloud moves over the sun, we can only guess."[1] As this quote indicates, PPD can have devastating effects on both mothers and their infants.

Evidence is mounting that mothers of preterm infants and those who experience multiple births experience a higher rate of PPD than women who deliver full-term singleton infants.[2,3,4,5,6,7] Neonatal care providers have a unique relationship with mothers and a golden opportunity to identify symptoms and provide appropriate referrals and support. One of the most challenging aspects of PPD is how covertly women suffer; up to 50% of all cases of PPD go undetected.[8] Often mothers try to hide what they are feeling because of the stigma attached to mental illness, particularly after childbirth.

The purpose of this article is to assist neonatal caregivers in the recognition, support, and appropriate referral of mothers with signs and symptoms of PPD. A description of the lived experience of PPD, summarized from a growing body of qualitative research, is provided in an effort to sensitize bedside care providers to the impact of these pervasive mood disorders. An enhanced understanding of the spectrum of postpartum mood disorders and familiarity with reliable screening tools will aid in both the anticipation of and routine universal screening for PPD. The demonstrable effects of this pervasive mood disorder on infants and children will be reviewed along with specific pragmatic clinical implications for neonatal caregivers.


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