Pregnancy & Postpartum Wellness Program: Integrated care of postpartum mood disorders

Karen Savary Zimmerman (2007)

The Pregnancy & Postpartum Wellness Program (PPWP) integrates care of postpartum mood disorders set within Cheshire Medical Center/Dartmouth-Hitchcock, Keene (CMC/DHK) in Keene, New Hampshire. It builds upon the work of the existing Pregnancy Wellness Program (PWP) by recognizing that postpartum mood disorders often begin during pregnancy and are on a continuum that extends from pregnancy into the first postpartum year. This program proposes a collaborative approach to treatment and prevention of postpartum mood disorders through education, integration of services, and treatment designed to address individual biopsychosocial and cultural characteristics and needs of women and their families. Integration of the PPWP health psychology focus and the Women's Health, Primary Care, and Pediatric departments at CMC/DHK is described. Postpartum Blues, Postpartum Obsessive-Compulsive Disorder (PP OCD), Postpartum Depression (PPD), and Postpartum Psychosis (PPP) are defined with a description of symptom presentation, prevalence, etiology, treatment, and prevention given for each disorder. Attention is given to the recognition that PP OCD and PPD also affect fathers. The program design is based on the literature, input from medical personnel in Women's Health, community mental health providers, my clinical supervisor at DHK, and my experience as the PWP clinician and postpartum counselor for the past three years at DHK. The vision of the PPWP is stated, barriers to implementation are delineated with proposed solutions, and comments about the processes involved in the design of the program are stated.