Scott Stuart, MD, director of the Women's Wellness and Counseling Services at UI Hospitals and Clinics, talks about the service:
What types of services does the Women's Wellness Service offer?
We offer services for women both during pregnancy and postpartum, as well as pre-pregnancy planning for any women who might be having mental health difficulties or psychiatric issues they want to address. We're excited about the services, particularly because the clinic is located in the Obstetrics and Gynecology clinic so we have the opportunity to liaison closely with the woman's OB or primary care provider and provide more comprehensive care than we have been able to do.
Which women will most likely use these services?
There are three primary groups:
- Women during pregnancy planning
- Women who may have had a history of depression. We work with them before they become pregnant.
- Women with depression, anxiety, and other psychological problems during pregnancy. We follow women for a year or two during the postpartum period as well.
How common is depression during a pregnancy?
It's more common than many people realize. Depression during pregnancy probably occurs in about 15 percent of women. The same is true for depression during the postpartum. Essentially that means that almost one in every six women is going to have some difficulty with depression. Anxiety appears to be just as common and can often be as disabling as depression during pregnancy and postpartum.
When is it ‘just feeling blue' versus depression in a pregnancy or after giving birth?
There is a very common syndrome called the ‘postpartum blues' which can last maybe two, three, or four days immediately after delivery and usually doesn't require treatment. We're concerned about women who:
- Are more severely depressed
- Have difficulty getting things done during the day
- Aren't enjoying spending time with their newborn
- Feel like they're unable to care for their newborn
We see a lot of women who tell us that they feel guilty, that they're just not able to do things like they used to be able to. Depression and anxiety both really interfere with a woman's family life and her ability to connect with her new baby.
When should a woman seek counseling for depression during a pregnancy?
We strongly suggest that if women or her provider has any concerns, that she stop for a consultation. That doesn't obligate anybody for treatment and we can provide an opinion about whether treatment is going to be helpful or not. There are many different types of treatment for women who are pregnant or breast feeding and concerned about medication. We have a wide array of counseling services that work very well for depression and anxiety during pregnancy and postpartum, also.
If a woman is diagnosed with depression in her first pregnancy, is she more likely to develop depression with all her pregnancies?
Yes, unfortunately. If a woman has a history of depression, either during pregnancy or the postpartum, she's going to be at higher risk during subsequent pregnancies. That's why we're interested in seeing women for pre-pregnancy planning. If a woman has had a very difficult postpartum course and had severe depression her first time around, it would be wonderful to meet with her and plan should that recur next time.
Will she be seen by a team of staff members?
We have a full team. Usually the woman meets with a single provider who gives her an opinion about her best treatment. If the treatment includes counseling, we can refer her to the outstanding psychologists in our clinic. Win addition, we have four psychiatrists in the clinic who can provide medication management. We have a whole array of personnel who can be of help. It wouldn't be unusual for a woman to be seen by a psychiatrist or psychologist to start with, and then she work with a psychiatrist and a psychologist if she is getting both medication and counseling. But we have the capability for really coordinating that very well.
What does treatment entail?
One of the things we feel strongly about is that it's our job to give women our opinions about what is going to be helpful and then work with them to find something they feel is going to be helpful. We have many women who feel strongly that they do not want to be on medication during pregnancy. We want to support that so we have an array of counseling services. During the postpartum, especially if a woman's not breast feeding, we have the option of using medication and counseling treatment. We do some lifestyle modification kinds of things as well. Again, we offer a whole array of treatment, but the primary thing is to find one that's comfortable and works for the woman.
What kind of research is being conducted within the Women's Wellness Service?
We are very focused on research. We invite women who are interested in participating in research projects to call us. We are starting a treatment trial comparing medication and psychotherapy for postpartum depression to see which one works best.
We have some studies looking at the prevalence or the frequency of anxiety during pregnancy and the postpartum period. And we have another interesting study in which we're using fish oil, which has been proven to be of some benefit during depression. So we're using fish oil supplements to treat depression during pregnancy, again, to avoid the medication exposure issue.
The open house is tomorrow night, February 28. What time will it start and where will it be held? How do people get there?
It will be Thursday, February 28, in the Melrose Conference Room, Pomerantz Pavilion, Level 5, in the Family Care Center. Parking is available in Ramp 4.
For people who come to the open house, what will they see and learn?
We're having a number of presentations, including one from the dean of the College of Medicine and the chairs of Psychiatry and OB will be there, as well. We'll be giving a presentation about the services that we provide, how women can access those services, and also how providers can make referrals. |
