Postnatal depression: what can a health visitor do?

Postnatal depression has been a subject that has provoked interest and research for many years. Marce published a paper in 1858 on puerperal and lactational psychoses, and since then many other writers have pursued different avenues of interest, primary cause, affect and treatment. A great deal of this work over the years has been done by psychiatrists and physicians, principally being interested in the more severe postpartum psychosis, when many of those suffering are admitted to an acute psychiatric hospital. However, as research has continued the less severe forms of postnatal depression and the upsetting effect they have on the patient's family continue to be a source of concern, not only to the professionals themselves, but more importantly, to the mothers who are suffering from this very upsetting problem. Professor Cox stated that he found it ironical that primary care workers regularly visited mothers in the puerperium and only rarely recognized postnatal depression. This led me to believe that we, as health visitors, should set about trying to put this right. As Professor Cox rightly said, it's a sad paradox that considering the medical scrutiny mothers receive over the antenatal and postnatal period, many depressed mothers still are not identified. The author therefore attempts to devise some kind of strategies for health visitors to identify mothers suffering from postnatal depression, and considers whether any links can be found between those suffering from postnatal depression.