Lee-Anne Mosselman-Clarke knows firsthand what it’s like to battle with postpartum mental health crises. She experienced difficulties after the births of her two children.
“I have an 11 and 9 year old and I didn’t actually know that I had postpartum anxiety with my oldest. He had very significant health problems and I just thought I am having an awful first journey as a new mum,” she said. “It wasn’t until I got pregnant with my second that the midwife said, ‘I’d like you to talk to somebody because I think you are at risk for having postpartum depression again.'”
Mosselman-Clarke, of Brant County, Ontario, Canada, has a background in social work and now works as a postpartum doula, supporting women through pregnancy and childbirth. When she heard about a new Canadian study involving group peer-delivered therapy for people battling postpartum depression, she applied immediately and was accepted as a peer facilitator. The sessions have been her passion since then.
“The peer program is an incredible way to be able to talk to other people who have struggled the way you struggle without judgment or guilt or shame. And it gives an opportunity to not feel alone and to feel a lot less isolated,” Mosselman-Clarke said.
The study, published Aug. 31 in Acta Psychiatrica Scandinavica, had some considerable findings. Postpartum depression patients who received treatment from their peers were 11 times more likely to experience remission, the researchers found.
“We think that this work is important for a number of reasons,” said lead author Dr. Ryan Van Lieshout, an associate professor of psychiatry at McMaster University in Hamilton, Ontario. “One is that even though up to 1 in 5 birthing parents will have postpartum depression, as few as 1 in 10 get the treatment that they need.”
According to the March of Dimes, women with postpartum depression may experience persistent feelings of sadness, anxiety and tiredness after the birth of their child that make it hard to take care of themselves and their baby.
Untreated postpartum depression can have serious consequences, including higher risks for emotional problems in both mother and child, the researchers noted.
The study included 183 new mothers living in Ontario who were determined via the Edinburgh Postnatal Depression Scale to be suffering with postpartum difficulties. They were randomly assigned to receive either treatment as usual alone or treatment as usual plus the nine-week online peer-delivered group cognitive behavioral therapy (CBT) intervention. Those in the control group were placed on a waitlist to receive the peer-delivered group CBT after nine weeks.
Of those who received the group therapy immediately, 64% met the criteria for major depressive disorder at the time of enrollment. After nine weeks of therapy, that number dropped to 6%. For the control group, 66% met the criteria for major depressive disorder at the beginning of the study, and 43% still met the criteria nine weeks later.
Peer facilitators of the therapy like Mosselman-Clarke received a three-day training in advance of the program and also observed the nine-week intervention delivered by experts in a hospital setting. Facilitators then delivered the intervention in pairs.
“The reason the study is so novel is it addresses issues with accessibility,” said Dr. Thalia Robakis, a psychiatrist at Mount Sinai in New York City.
“Psychotherapy is an important and well-established intervention for depression generally and also for depression in the postnatal period,” said Robakis, who was not part of the study.
“New mothers have trouble accessing it either because it’s difficult to find an individual therapist, because that’s like a very highly trained person and the availability can be low. And also because new moms have a lot of other things going on,” she explained. “They have a young infant to care for and that limits their ability to take the time to go participate in psychotherapy treatments.”
Robakis also noted that, since the United States doesn’t have universal health care, it could also be more difficult to implement a curriculum similar to what the Canadian study modeled.
For more on postpartum depression, visit the March of Dimes.
SOURCES: Lee-Anne Mosselman-Clarke, postpartum doula, Ontario, Canada; Thalia Robakis, MD, PhD, psychiatry, Mount Sinai, New York City; Ryan Van Lieshout, MD, PhD, FRCP(C), associate professor, Department of Psychiatry and Behavioural Neurosciences University Scholar, McMaster University, Hamilton, Ontario, Canada; Acta Psychiatrica Scandinavica, Aug. 31, 2023
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