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Pregnancy and birth are two of the key milestone changes in a woman’s life. It is a time for a celebration of the birth of their loved one, a new beginning. While physical changes are obvious changes and can easily be fixed, mental changes happen as well. These mental changes can be challenging to treat and they may stem from withdrawal from family and friends, insomnia, loss of energy and may even be as critical as difficulty bonding with their newborn. These mental changes and challenges are called postpartum depression and they affect teen and adolescent mothers. Postpartum depression is a “serious illness that can occur in the first few months after child birth. It can also happen after miscarriage or birth”. In Canada alone, during the postpartum period, 7.5 percent of women are reportedly to have depressive symptoms. Therefore, due to an increase in postpartum depression in adolescent mothers, health promotional strategies should be considered to improve the physical and mental well-being of pregnant mothers.
There is a huge health disparity with regards to postpartum depression in terms of women living in urban areas compared to women living in rural areas. Women in urban areas reported of less social support than women living in rural areas, for the reason that in the rural area is more family oriented. According to Simone Vigod (2013), who is a study author and psychiatrist at Women’s College Hospital states that, smaller areas have more support and it is more of a family oriented culture, whereas in larger cities there are more loved ones moving away and relocating, working long hours and most of the time would not be present. This is very alarming considering the geographical location because, most would think that pregnant women living in urban areas would have more social support and healthcare support due to easy hospital accessibilities but that is not the case. In addition, Canadian born women have a lower risk of having postpartum depression due to their lack of engagement in the healthcare system. This is supported by Simone Vigod (2013), as she states that “They may not be as engaged with the healthcare system in terms of getting care prior to delivery, so they may be less well-treated in terms of their depression prior which can increase their risk of postpartum depression”. Non-Canadian born women are not as knowledgeable when it comes to acquiring help when they start suffering from mild postpartum depression, instead they resort to assistance from their loved ones which has a small success rate given that they are living in an urban area. Lastly, with such health disparities that is occurring between rural-urban pregnant women, an effective promotion strategy must be in place to bridge the gap of disparities.
Eliminating health disparities in Canada is very crucial in order to eliminate postpartum depression in adolescent mothers. Canada should implement the United Kingdom’s National Institute for Health and Care Excellence (NICE) antenatal and postnatal framework. This guideline will recognize, assess, and treat mental health problems in women who have plans of pregnancy, is pregnant or pregnant in the past. In addition, NICE will also promote early detection and management of mental health problems to improve the quality of life for pregnant women. NICE is supported by Dr. Simone Vigod (2017) in which she states, “This way each jurisdiction would have a better map of the evidenced-based services that should be provided and might be provided, by different arms of the health and social service system”. Streamlining this health strategy will allow more women suffering from postpartum depression to be assured that there are ways to cope with their mental challenges in less complicated ways. Line ups for therapy and counselling will take a vast amount of time and waitlists are very long, by having strategies such as NICE there will be an impact in the health care industry. Similarly, due to line ups and long waiting list for counselling and physical therapy, online therapy for mothers suffering from postpartum depression is very useful as it can be easily accessed by pregnant mothers without leaving their homes, and it is also cheaper than attending physical therapy. Online therapy is called Therapy Assisted Online Cognitive Behavioral Therapy Program (TAICBT). TAICBT according to Patricia Tomasi (2017), has been making a good reputation in Canadian workplaces, for the reason that it is less expensive than in person therapy. It also suggests that TAICBT and in person therapy is as equally effective in treating mild to moderate depression and anxiety. By having both NICE and TAICBT as the two rubrics for eliminating health disparity such as postpartum depression in pregnancy, it will be easier for healthcare professionals to treat, diagnose, and cure such mental challenges.
The effectiveness of both TAICBT and NICE is very effective. Patricia Tomasi (2017) states that 50 new mothers from Saskatchewan were randomly assigned to receive TAICBT, and the women that received the online therapy group experienced a decrease in postpartum depression symptoms versus mothers who did not receive the treatment. It is also said that 20 percent of women who tried the online therapy have shown improvement, while 62 percent is considered to be recovered. In addition, 60 percent of mothers completed the whole therapy. Considering the statistics of the study, it is very clear that Therapy Assisted Online Cognitive Behavioral Therapy Program has a significant effect in treating mild to moderate depression in pregnant mothers. Connie Chow from Edmonton, Alberta, states ‘It really helped me when I couldn’t leave the house and was a good bridge to my mommy program. I wish I had known about it earlier. It would have helped me realize that my thoughts weren’t healthy and maybe I would have been able to enjoy the newborn experience more”. Similarly, NICE postnatal and antenatal framework has a positive effect on pregnant mothers, a questionnaire was sent to all the mothers who received the treatment and it showed a high level of satisfaction with the service. Also, on the ten year outcomes of the service there are no maternal deaths, no infanticides, and patients feedback stating that they are fulfilled with the service. Furthermore, NICE postnatal and antenatal framework serves no waiting lists, flexible appointments with different days, times and place which includes home visits as well. By taking into consideration these two health promotions, it is seen that both are very effective and with more funding and research that will be put onto it, postpartum depression will be a problem of the past.
To conclude, health disparities such as an increase postpartum depression in adolescent mothers occur due to language barriers, ethnic traditions, geographical location, financial, and social status. However, with these in mind there are health promotion strategies that can be used to combat such issues. Canadian government should follow United Kingdom’s NICE postnatal and antenatal framework which is very effective in making sure pregnant mothers get the care they need. It also acknowledges the care and treatment of the mother and educates them on the step by step procedure on how to provide care for their infants. In addition, it will also inform the mother the consequences of having no treatment post pregnancy and the pros and cons of getting treatment. Furthermore, health care professionals will be able to monitor and assess those mothers who currently have mental issues and those mothers at risk of developing mental issues. In contrast, Therapy Assisted Cognitive Behavioral Therapy (TAICBT) have also been deemed to be successful and thus require more health promotion strategies. With studies shown, TAICBT can follow up on pregnant mothers and gain contact with them in the comfort of their own homes. Longer lineups, child care responsibilities, and other health care appointments to receive therapy are also one of the main issues posed for pregnancy mothers and suffering from postpartum depression. TAICBT offers in home visits as well making sure that pregnant mothers can be assessed in a timely manner. However, to improve these strategies more media exposure on these health promotions should be in place to educate mothers and future mothers that are in need of help. Also, to further assist and cover Non-Canadian born mothers, financial assistance should be provided regardless of their financial situation. Lastly, NICE antenatal and postnatal framework and Therapy Assisted Cognitive Behavioral Therapy is not perfect at its state, but more research and funding should be provided to make sure it lasts in a desired amount of time for its longevity in the healthcare industry.
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