Is it serendipity or just that we BFCs share brain-waves, but just as the PPD and pregnancy mental health issues have stimulated so much discussion, so much more material seems to be coming our way.  I really appreciated receiving the Breastfeeding Curriculum.

I have just come back from an excellent conference in Herzliah (near Tel Aviv) run by the Israeli chapter of the World Womens Mental Health Association and since this is a small country the delegates there were also members of the International Society for Psychosomatic Ob/Gyn and of course our counsellors from the Israel Childbirth Education Centre - and we all enjoyed the networking.

The keynote speaker was Shari Lusskin, associate professor of Psychiatry Ob/Gyn at New York U. who had been a keyworker at the first world conference on womens mental health in Washington DC three or four years ago.

While pooling the resources of all the speakers, we heard about the devastating effects of stress and depression during pregnancy not only for the mother but for the development of the fetus.    We heard that PPD is the number one source of maternal death in the UK and only this week I heard of the death of a mother of newborn twins near my own home town in Hampshire - two weeks after the birth she walked out into the motorway and was killed by a truck.

Yael Arbel, a hospital-based obstetrician discussed PTSD caused by the birth experience, not necessarily because of a traumatic birth but sometimes because of how the woman perceived the care (or lack of) that she received by the staff or other support persons.

Dr. Micki Bloch, a psychiatrist specializing in womens mental health (the crisis times in our lives are puberty, childbirth and menopause) talked about a multi-faceted approach to prevention and treatment: counselling, group support, family and societal support and medication.

As Shari Lusskin put it:  "There is no known drug that is 100% safe in pregnancy and during breastfeeding."
So the challenge is to weigh the risks and benefits of the available drugs against the risk of not treating a woman who is suffering from severe illness with all its consequences.

The consensus of opinion - and I think this has shifted over the years - was not to prescribe the most appropriate drug and automatically advise not to breastfeed.  Breastfeeding was high on the agenda and the challenge was to find the most appropriate drug which would enable the mother to continue.  The issue of comparative safety of drugs during pregnancy again weighs the known risks of a drug against the negative effects of untreated depression.

Although ECT was always considered an old-fashioned and rather barbaric treatment, it was considered as an option in these circumstances although it was pointed out that it is not usually successful alone without any medication, but it may reduce the use of drugs.

As one who suffered depression for years after childbearing  and only really got out of it as I approached menopause this really strikes a chord.  I don`t think that anyone who has not suffered from the lows of exhaustion and apprehension alternating  with the highs of agitation and anxiety can truly comprehend what a terrible disease this is. Fortunately for me, I was able to function and the busier I was and the more active I was as a mother, the better I felt - but this is is often not the case.
Nor can those who have not suffered, appreciate that when it lifts, as it did with me quite suddenly, it is like the sun shining on a foggy day, a cataract lifted from blinded eyes, a colour picture developed from a grey negative.

Sorry for the long long letter but this conference was a wonderful opportunity to explore all these issues and raise the awareness of the health professionals who attended.

Have a good weekend.
Wendy Blumfield

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome