Depression during pregnancy
Find out what effects depression has on the baby if you're diagnosed with the condition while pregnant. Not to worry, 80% of patients can recover within months if detected early. Take a short test to see if you are depressed.
Help is at hand for mums-to-be to cope with the blues during and after pregnancy. In a study by National University of Singapore, findings conclude that antenatal depression affects 12% of pregnant women compared to 7% of post-natal depression of women in Singapore. It is not known why prenatal depression is more common.
According to The Straits Times, hospitals here have started screening pregnant women for both antenatal and post-natal depression. National University Hospital (NUH) started the programme since 2008. Singapore General Hospital (SGH) started screening for post-natal depression since 2004, and in 2011, antenatal depression. KK Women's and Children's Hospital (KKH) has trained its obsterticians to identify antenatal depression in women since 2008.
Ms Chin is now a mother of a 9 month old boy. When she was pregnant, she did a routine screening for depression on her first visit at NUH. She saw a psychiatrist during her second trimester, as she felt plagued by anxious thoughts. Her depression went away without medication as her psychiatrist provided her advice to overcome it. Even when it surfaced just before her baby was due, she was able to remain calm. Depression during pregnancy is not as recognized as post-natal depression, although both can have negative impacts on mother and child.
Can it be prevented or cured?
Depression can be cured but not entirely preventable. Unpleasant life events or illnesses are unexpectable risk factors that causes the onset of depression. Other factors such as having adequate preparation for motherhood, healthy and supportive marital relationship helps reduce the risk of depression. Mums-to-be are encouraged to seek physical and emotional support with family and friends.
KKH Mental Wellness Service, Dr Helen Chen, said that the number of pregnant women referred for psychological help has exceeded by almost double the number of post-natal depression women. The figure of depression for post-natal depression is lower than of depression during pregnancy is because the screening process has been well-documented and more established.
What are the effects on the baby?
Women diagnosed with depression during pregnancy have a 50% increased risk of giving birth to a child with developmental delay, and potentially giving birth prematurely by about two weeks. Also, they may turn to consuming alcohol and smoking to cope with depression, if left unchecked. This will have long term negative health effects on the baby. This is cited from a 2008 study in the United States, said Dr Chua Tze-Ern, associate consultant at KKH Mental Welfare Service. Dr Chen also added that antenatal depression often serve as an indicator to post-natal depression, and about half of the women remain depressed.
A study conducted by KKH has shown that with a combination of either medication or counselling, and both, helps about 80% of the patients to recover within months, if detected early. Mums-to-be are screened at every trimester and after birth. Whilst an obsterician at SGH guides the patient though the questionnaire adapted from The Edinburgh Post-natal Depression Scale, the patient completes the form on her own in NUH.
Screenings in Singapore
Both SGH and NUH offers the screening to all mothers, and appointments are made for those who registered high scores on the questionnaire. There are staff who will do the follow up to see if assistance is required. During a woman's before and after pregnancy, she may need to visit the doctor at least 10 to 15 times.
NUH has screened 12,000 women since 2008, of which over 9,000 were screened during their pregnancy. About 1 in 3, or 3,300 were at risk. But about 2,200 women agreed to follow up for further assessment. Depression is still generally unacceptable within society. About 2/3 out of the 800 diagnosed with depression have since recovered.
Dr Cornelia Chee, consultant psychiatrist and the director of the NUH Women's Emotional Health Service, said that the stigma of seeing a psychiatrist is still prevalent in society. Another obstacle would possibly be the cost of seeing a psychiatrist, although it is of no charge to fill up the questionnaire. Women should seek help as tragedies can be avoided if signs are recognized and heeded. A lack of manpower have shelved plans for fathers to be screened for depression.
Take a simple test
The Edinburgh Post-natal Depression Scale questionnaire can be found here. It is a rough guide to screen women for depression during and after pregnancy. If your score is 13 and above, please consult a psychiatrist to confirm the diagnosis.