A new pilot study at the University of Illinois Chicago indicates that fathers can and should be screened for postpartum depression. Given the intertwined effects of mothers’ and fathers’ physical and mental health, addressing the health of fathers may be a potent unutilized tool for ameliorating the ongoing maternal health crisis in the United States.
The researchers obtained permission from the mothers to interview and screen twenty-four fathers, thirty percent of whom screened positive for postpartum depression using the same instrument commonly used to screen mothers. This, according to lead author Dr. Sam Wainwright, demonstrates the significance of asking new fathers how they’re doing.
“A lot of dads are stressed. They’re scared. They’re struggling with balancing work and parental and partner responsibilities. Men are often not doing well, but no one is asking them about it,”
he said.
Depressed Partners
Talking to new dads about their mental health takes on additional importance when considering how it can impact their partners’ health.
A woman at risk for postpartum depression is much more likely to get postpartum depression if she has a depressed partner,
said Wainwright, assistant professor of internal medicine and pediatrics.
Other studies have estimated that 8% to 13% of new fathers have postpartum depression. Wainwright suspects this study’s rate was higher because nearly 90% of the participants identified as being from a racial or ethnic group that faces issues of structural racism and social determinants that can worsen mental health.
Navigating Parenthood
The investigation was conducted at the Two-Generation Clinic of UI Health. The clinic, which will open in 2020, was inspired by the realization that new mothers, particularly low-resource mothers of color who are navigating parenthood alongside a variety of structural obstacles, frequently do not prioritize their own health care.
However, they are often very diligent in bringing their children to the doctor, Wainwright explained. The Two-Generation Clinic capitalizes on children’s visits by offering moms primary care at the same time.
Yet, fathers were frequently excluded from this process. The clinic staff initiated conversations with fathers to determine their well-being. Wainwright stated that they frequently heard statements like, “I’m really stressed, but I don’t want my partner to know because I’m here to support her.” This investigation was inspired by those discussions.
Those conversations also sparked a larger research project, which Wainwright has begun, to learn more about the experiences of fathers, particularly in terms of their mental and physical health.
Opportunity to Reach Young Men
Perhaps well-baby visits aren’t the only place to reach dads, he said, so he’s started talking to fathers-to-be in the obstetrics waiting area, too. He’s also asking to screen dads for conditions like high blood pressure during these conversations.
Wainwright stated that the medical field struggles to connect with young men, who are frequently hesitant to visit a doctor, so reaching them as they enter fatherhood represents an essential opportunity. Some of the men in the postpartum depression study who did not have a primary care physician are now receiving medical care from Wainwright, while others have requested mental health services.
The overarching goal of this line of research is to better understand how to help men stay healthy so that their relationships and families are healthy, too, Wainwright explained.
“How can we show them that it’s important to take care of yourself for the sake of your baby, for the sake of your partner and for your own sake?”
he said.
Abstract
Background: Postpartum depression (PPD) impacts fathers as well as mothers, and is estimated to affect between 8 and 13% of fathers. Paternal PPD is a risk factor for worsened quality of life, poor physical and mental health, and developmental and relational harms in the father-mother-child triad. There are no current recommendations for PPD screening among fathers. Paternal PPD screening was piloted in an intergenerational postpartum primary care clinic.
Methods: The pilot was carried out in an intergenerational postpartum primary care clinic located at a Midwest urban academic safety net health system from October 2021 to July 2022. Fathers actively involved in relationships with mothers or infants receiving primary care in the clinic were approached with mothers’ permission. A novel survey instrument was used to collect demographic/social data, as well as mental health history and current stress levels; an Edinburgh Postnatal Depression Scale (EPDS) was also administered. Screenings were completed by social workers; data were collected in REDCap and descriptive statistics were calculated in SAS.
Results: 29 fathers were contacted and 24 completed screening (83%). Mean age was 31 years (range 19–48). Most (87%) identified as belonging to a racial or ethnic minority group. Fathers self-reported low rates of stress and preexisting mental health conditions, but 30% screened positive for PPD on EPDS (score of ≥ 8, or suicidal ideation). Gaps in health care were found, as one-quarter (26%) of fathers were uninsured and half (54%) did not have a primary care provider. After screening, two requested mental health services, and three established new primary care with a physician.
Conclusions: Participation was high in a PPD screening pilot for fathers in a primary care setting. This small sample of fathers demonstrated significant peripartum mental health challenges unlikely to have been identified otherwise. For some participants, engaging in PPD screening was an effective tool to prompt their subsequent engagement with general health care. This pilot is a step toward incorporating the health of fathers into models for supporting the health of families. Expanding screening for paternal PPD into routine primary care is necessary to reach more affected fathers.
Reference:
- Wainwright, S., Caskey, R., Rodriguez, A. et al. Screening fathers for postpartum depression in a maternal-child health clinic: a program evaluation in a midwest urban academic medical center. BMC Pregnancy Childbirth 23, 675 (2023). doi: 10.1186/s12884-023-05966-y
Last Updated on November 11, 2023