Written by Tanya Terry, with featured photo by cottonbro studio on Pexels
One in eight women experience postpartum depression (PPD) after giving birth in the U.S., according to the Centers for Disease Control and Prevention (CDC).
PPD can contribute to higher rates of postpartum substance abuse, domestic violence, infant mortality, psychosis and even suicide.
Jennifer Johnson, PhD, chair and endowed professor of the Michigan State University College of Human Medicine Charles Stewart Mott Department of Public Health, in Flint, recently talked to the Courier about why she believes wider use of the ROSE Reach Out, Stay Strong Essentials (ROSE) program could make this situation much more hopeful. ROSE has demonstrated there is a cost-effective way to decrease the rate of PPD by an astounding 50%!
Johnson’s colleague, Zlotnick, Ph.D., of Brown University, developed the ROSE program.
“Part of the reason for it is the moms who are at most risk for postpartum depression are moms who are having stress and other things going on in their lives, and they’re less likely to get screened and connected to good care – to postpartum depression care,” stated Johnson. “So, she thought screenings and treatment is important…but what if we could prevent postpartum depression? She took principles from treatment for postpartum depression and made sort of a class for education that now has been shown in five randomized trials to prevent half the cases of postpartum depression.”
Risk factors for postpartum depression can include poverty, being on Medicaid or having past cases of postpartum depression.
41.0% of mothers who gave birth used Medicaid as the source of payment for the delivery. Johnson stated this number is likely even higher today.
Johnson also pointed out the moms most at risk are sometimes too depressed to even show up for treatment.
“So, actually as we’ve scaled ROSE nationally, we think it might be good if everyone had the chance to get it,” shared Johnson. “So, we’re doing a large, national study to show that shows that ROSE can help everyone, not just moms considered at risk – because sometimes we can’t really tell very well who’s at risk and who’s not. And I’m the lead of that study.”
Through the ROSE program, expecting mothers can get information on how to manage stress and take care of themselves.
“It starts with this general idea that the supports you have around you matter to your mood, and when you have a baby you’re going to need more help than usual,” said Johnson. “You don’t have to be a hero. It’s OK to get the help that you can.”
Participants are asked to identify who in their lives can be a source of support, as well as anyone who could be a source of stress. They are then taught to practice asking for things they need in a way that is neither passive or aggressive, but is instead clear. They are also advised to set up these practices ahead of time, rather than when they may be struggling or sleep deprived.
Community resources that could benefit participants are also discussed. These resources could include housing, food, mental health care or other resources a mother to be may need.
“We don’t offer those things directly, but we might be able to point moms to where they might be able to access these things.”
The program usually takes place during approximately four sessions during pregnancy. Then, during the postpartum period, a phone call check in is involved to see how the mothers are feeling and doing, as well as whether they have the help they need.
Johnson stated that ROSE is very inexpensive to offer, yet the costs associated with postpartum depression can be very large. Therefore, she said it would be less expensive to offer it to everyone.
After completing her undergraduate degree in physics, Johnson shared that she was sitting on the playground in family-student housing, unsure of what she wanted to do next. There, she heard moms talk about their lives, priorities, relationships and kids. It was then she decided she wanted to attend graduate school for clinical psychology to help the moms.
“Having a baby is genuinely hard. I don’t know of any other situation where you have a major surgery and are expected to go home and do something that requires sleep deprivation….Women are putting their lives and their bodies on the line to bring these babies into the world, and we should support them.”
For more information, or to participate in the nationwide study, visit https://publichealth.msu.edu/flint-research/flint-public-health-research/jennifer-johnson-phd/the-rose-sustainment-study
