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One in four new mothers in Oklahoma report symptoms of maternal depression after giving birth, according to a recent study conducted by the Oklahoma State Department of Health (OSDH). Using the Pregnancy Risk Assessment Monitoring System (PRAMS), an ongoing statewide survey of maternal behaviors and experiences, OSDH officials found that 40 percent of Oklahoma mothers did not discuss postpartum depression, or PPD, with their health care provider. Of special concern were adolescent mothers, who were 2.5 times more likely to indicate symptoms of PPD as mothers age 35 and older.

''These findings are of major concern to health care professionals and should place families on alert to watch out for signs and symptoms of depression in new mothers,? said Secretary of Health and Commissioner of Health Dr. Michael Crutcher. He noted that special task forces commissioned by the governor and attorney general have found that Oklahoma has the highest rate of severe mental illness in the nation at 10.4 percent.

The symptoms of postpartum depression include loss of interest in pleasure in life; change in appetite; less energy and motivation to do things; having a hard time falling asleep, staying asleep, or sleeping more than usual; increased crying and tearfulness; feeling worthless, hopeless or overly guilty; feeling restless, irritable or anxious; and having unexplained weight loss or gain. Additional symptoms include feeling like life isn't worth living, having thoughts of hurting yourself or worrying about hurting the baby, or someone else hurting the baby.

Among the stressors found to increase the risk of depression symptoms are arguing with a partner more than usual during pregnancy, having bills one cannot pay, and having an unintended pregnancy.

''We know from previous PRAMS surveys that about one-third of the pregnancies in Oklahoma are unintended, so we have a potential for high risk of postpartum depression in Oklahoma,'' Crutcher said.

Additional highlights from the Oklahoma PRAMS survey on PPD include the following:

- Women ages 20 to 24 were twice as likely to indicate symptoms of depression when compared to women 35 or older.

- Women with infants placed in the Neonatal Intensive Care Unit (NICU) were at a higher risk for depression. Mothers are at special risk for postpartum depression when caring for infants born prematurely or infants with special health care needs.

- Women who did not receive a postpartum checkup were also at a higher risk for symptoms of postpartum depression when compared to women who did receive their postpartum checkup.

To address PPD, OSDH public health officials recommend the following:

- Screen every woman in Oklahoma for maternal depression, before and up to one year postpartum at a late-term prenatal visit, a postpartum checkup, WIC visits, well woman checkups, and/or pediatrician visits.

- Ensure that all women understand the importance of returning for their postpartum checkup around six weeks after delivery.

- Provide information for parents with infants in the NICU to learn about support groups near their homes and in the hospital, and include information on PPD.

- Educate Medicaid providers on the new maternal and infant health licensed clinical social work services available to patients with SoonerCare/Medicaid. Providers can call 1-800-522-0114 to obtain information from SoonerCare/Medicaid on maternal and infant health licensed clinical social work services in their area.

- Provide education about PPD awareness, referrals for treatment and follow-up care to providers in delivery hospitals, obstetrics clinics, pediatric clinics and family medicine practices.

- Encourage new mothers with signs and symptoms of depression to call the Oklahoma Warmline for Postpartum Depression at 1-405-474-6720 or the PSI national hotline 1-800-944-4PPD. Information is also available at http://www.postpartum.net.

-Screen all pregnant and postpartum adolescents for depression. Physicians may choose to treat, co-treat with a counselor, or refer the adolescent for mental health services. Schools and school counselors should provide support for pregnant and postpartum adolescents to cope with the stress of motherhood, schoolwork and feelings of isolation.

-Find a way to incorporate mental health into school health curricula to reduce the stigma surrounding mental health problems.

For information about postpartum depression and services available, contact the OSDH Strengthening Families Coordinator, Patricia Damron M.Ed., LPC,
at (405) 271-7611.