Impact of Mood Disorders on Women and their Children

In Durham Region, as many as one in five women will experience perinatal mood disorders (PMD) during their pregnancy and/or within one year of giving birth (https://www.durham.ca/en/health-and-wellness/postpartum-depression.aspx. Perinatal mood disorders are a cluster of disorders that include depression, anxiety, bipolar disorder, and obsessive-compulsive disorder. In Canada, the prevalence of postpartum depression averages at 13% while it is estimated that 15%-21% of pregnant and postpartum women in the United States experience symptoms of PMD (Byrnes, 2018). PMD can negatively impact not only the women who experience these disorders but also their families, specifically, their children as early as infancy (Byrnes, 2018). Effects of PMD on parenting and child development Mood and anxiety disorders during the perinatal period can lead to impaired maternal behavioral response which may lead to long-term behavioral and cognitive problems among exposed children. 

During the prenatal period of women experiencing PMD, there is generally inadequate level of prenatal care and poor nutrition which may result in higher incidences of preterm birth and low birth weight (Canadian Paediatric Society, 2004). As a result of PMD, interactions between infant and mother also get affected resulting in long-term behavioral problems and cognitive delays in children. A study by Field, 2010, shows that depressed mothers tend to be more irritable and hostile, and portray a general lack of warmth and engagement with their infants. The study also compares postpartum, depressed mothers, with non-depressed mothers who demonstrate a difference in the frequency and affectionate behavior towards their infants. Postpartum depressed mothers are seen to be more negative in their manner, as portrayed in the form of rough pulling and poking. There is also a difference in vocal behavior including the use of longer utterances, fewer explanations, suggestions or references to their infants’ behavior. Several caregiving activities also appear to be compromised as a result of postpartum depression effects.

 Parenting roles such as feeding practices, especially breastfeeding, sleep routines, and well-child visits and vaccinations (Field, 2010) were compromised. Mothers with high postpartum depression scores were significantly more likely to discontinue breastfeeding at 4 to 16 weeks postpartum, substituting breast milk with water or juice. In the same study, thoughts of harming infants are shown to be more frequent among depressed mothers. In one sample, 41% of depressed mothers compared to 7% of non-depressed mothers admitted to thoughts of harming their infant. More than half the depressed mothers had a problem with thoughts of harming their infant, fear of being alone with the infant, and an inability to care for the infant (Field, 2010). In toddlers, there is usually less creative play and interaction from their mothers, which may lead to passive noncompliance, less mature expression of autonomy, internalizing and externalizing problems, and lower cognitive performance. Among school ages, children, affective, anxiety and conductive disorders can be seen, attention deficit/hyperactivity disorder (Canadian Paediatric Society, 2004). 

Conclusion

 The information and data provided in this paper highlight the need and necessity of screening of maternal depression during the prenatal and postpartum period. Screening tools, such as the Edinburg postnatal depression scale are available and are highly recommended by The American College of Obstetricians and Gynecologists to be screened for depression and anxiety at least once during the perinatal period and once post partum (Byrnes, 2018). It is also important to recognize the risk factors for developing PMD, which can include socioeconomic factors, low education attainment, a lack of social support, and a history of mental illness (Byrnes, 2018). However, disturbances in the interactions between depressed mother and child are universal across all cultural and socioeconomic groups.

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