美国国家公共电台 NPR A New Solution For Postpartum Depression: A Help Line For Obs

 

RACHEL MARTIN, HOST:

For 1 in 7 pregnant women and new moms, things can feel off. They can have trouble sleeping or feeling connected to their baby, feel weepy, have low energy. They could be clinically depressed¹, and depression during or after pregnancy² is very treatable if it's diagnosed. But only a small percentage of those women get the treatment that they need. Massachusetts is trying to change that. NPR's Rhitu Chatterjee has this story about how the state is tackling depression in pregnant women and new moms.

RHITU CHATTERJEE, BYLINE³: Jennifer Ford⁴ lives with her husband and two daughters in Oakham, Mass. As a young woman, she struggled with anxiety and depression and was on antidepressants through both her pregnancies⁵. While her first pregnancy and childbirth went smoothly⁶, things were different after the birth of her youngest.

JENNIFER FORD: That first week home - and almost immediately after I got home, all I could do was cry. I couldn't even communicate a full sentence about how I was feeling; all I could do was cry.

CHATTERJEE: Ford couldn't eat, sleep or take care of her newborn, and yet she couldn't accept that something was wrong - that she wasn't her usual self.

FORD: It's very hard to admit that something's not right, I mean, especially when you have a new baby in the house. And it's supposed to be this wonderful happy time, and that's not how it was.

CHATTERJEE: One afternoon, she was in her bedroom trying to take a nap but couldn't fall asleep. She felt overwhelmed by her emotions.

FORD: I wanted to take all of my pain meds and go to bed.

CHATTERJEE: Go to bed and not wake up. Ford told her husband how she felt.

FORD: That was when he was like, OK, obviously, something needs to change here. You're not going to do that. We're going to get help, and we're going to get it now.

CHATTERJEE: So they went to see her OB-GYN, Dr. Chris Conlan.

CHRISTOPHER CONLAN: She came in, and I could immediately see just in her face that she was having a very difficult time, and she needed help and didn't really know where to turn.

CHATTERJEE: Conlan gave Ford a questionnaire that confirmed that she was depressed, but he wasn't sure how to help her. Like most OBs, he wasn't trained to provide mental health care. He knew just enough to have prescribed her an antidepressant during her pregnancy because of her history with depression, but that medication wasn't helping⁷ her anymore.

CONLAN: The tools that I have in my everyday practice were kind of used up.

CHATTERJEE: So he turned to a new statewide program created specifically to help OB-GYNs provide mental health care to pregnant women and new moms. He called the program's helpline and was connected to an on-call psychiatrist⁸.

CONLAN: I was able to talk to the psychiatrist. They were able to give me some initial thoughts, and we decided⁹ that they should do an in-person consultation¹⁰.

CHATTERJEE: The psychiatrist suggested some changes to Ford's medication and made an appointment to see her in person.

FORD: Within a couple of weeks, I noticed a difference. I was taking the time to blow-dry my hair - simple things. I was taking the time to sweep the floor or to put my makeup¹¹ on or to wear something other than pajama pants.

CHATTERJEE: The program also connected Ford with a social worker, who in turn helped her find a longer-term therapist and a local support group for moms with postpartum depression. Psychiatrist Nancy Byatt at the University of Massachusetts Medical School helped launch this program about five years ago. It's called the Massachusetts Child Psychiatry¹² Access Program for Moms, or MCPAP for Moms.

NANCY BYATT: The mission of our program is to build the capacity of frontline providers to address depression.

CHATTERJEE: Ideally, she says, women and new mothers with depression would have access to a psychiatrist. But there's a dire¹³ shortage of mental health care providers, and the stigma¹⁴ around this kind of depression prevents women from admitting that they're depressed during pregnancy or after childbirth. For all these reasons, Byatt says, medical authorities recommend that OB-GYNs screen their patients for depression and help them get treatment.

BYATT: Every time that a woman is seen by an obstetric provider is an opportunity to, you know, detect depression, to educate them about it and to really engage them in treatment.

CHATTERJEE: But, as Byatt learned through her initial research, doctors in Massachusetts did not feel comfortable tackling the problem, even though they wanted to help.

BYATT: They said, we want to address this. We think it's so important. We don't know what to do. We haven't been trained. We don't have the resources. We need a lifeline, is essentially¹⁵ what they said.

CHATTERJEE: So Byatt and her colleagues created the help line for doctors. They held training sessions and provided a toolkit to educate OBs and nurse practitioners¹⁶ about perinatal depression.

BYATT: We've enrolled¹⁷ 74% of the practices in the state, and that covers 80% percent of deliveries.

CHATTERJEE: She says, over the years, OB-GYNs have become more comfortable treating mental illness.

BYATT: And now they're managing sometimes very complex illness. We have several practices that are - if a patient has bipolar disorder¹⁸, they're managing them because it's hard to find a psychiatrist.

CHATTERJEE: In fact, the program has now become a model for other states to tackle depression during pregnancy and postpartum. And its success has in turn helped to raise awareness¹⁹ among patients in Massachusetts, says Dr. Chris Conlan.

CONLAN: Patients are now realizing that this is a very common issue and that they're not alone and that it's better to speak up because we can help. They don't need to suffer in silence.

FORD: I really felt like there were people on my team.

CHATTERJEE: Jennifer Ford.

FORD: That I wasn't just alone in my room, feeling like I was a horrible person and a horrible mom.

CHATTERJEE: She says the changes in medication, the visit with the psychiatrist, the support group of mothers - all of it helped her manage her depression and, eventually, recover from it.

UNIDENTIFIED CHILD: He eats the rest of...

CHATTERJEE: Today, her youngest daughter, McKinley, is a healthy, happy 4-year-old. Addison, her oldest, is 7. Ford no longer struggles with depression. She's an active, engaged mother, and it's easy to see the bond between her and her daughters as she gets them ready for bed with their nightly ritual.

FORD: Ready?

JENNIFER FORD, ADDISON FORD AND MCKINLEY FORD: (Singing) You are my sunshine, my only sunshine. You make me happy...

CHATTERJEE: Rhitu Chatterjee, NPR News.

(SOUNDBITE OF MUSIC)

1 depressed   

adj.沮丧的，抑郁的，不景气的，萧条的

参考例句：

• When he was depressed,he felt utterly divorced from reality.他心情沮丧时就感到完全脱离了现实。
• His mother was depressed by the sad news.这个坏消息使他的母亲意志消沉。

2 pregnancy   

n.怀孕，怀孕期

参考例句：

• Early pregnancy is often accompanied by nausea.怀孕早期常有恶心的现象。
• Smoking during pregnancy increases the risk of miscarriage.怀孕期吸烟会增加流产的危险。

3 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

4 Ford   

n.浅滩，水浅可涉处；v.涉水，涉过

参考例句：

• They were guarding the bridge,so we forded the river.他们驻守在那座桥上，所以我们只能涉水过河。
• If you decide to ford a stream,be extremely careful.如果已决定要涉过小溪，必须极度小心。

5 pregnancies   

怀孕，妊娠( pregnancy的名词复数 )

参考例句：

• Since the wartime population needed replenishment, pregnancies were a good sign. 最后一桩倒不失为好现象，战时人口正该补充。
• She's had three pregnancies in four years. 她在四年中怀孕叁次。

6 smoothly   

adv.平滑地，顺利地，流利地，流畅地

参考例句：

• The workmen are very cooperative,so the work goes on smoothly.工人们十分合作，所以工作进展顺利。
• Just change one or two words and the sentence will read smoothly.这句话只要动一两个字就顺了。

7 helping   

n.食物的一份&adj.帮助人的，辅助的

参考例句：

• The poor children regularly pony up for a second helping of my hamburger. 那些可怜的孩子们总是要求我把我的汉堡包再给他们一份。
• By doing this, they may at times be helping to restore competition. 这样一来, 他在某些时候,有助于竞争的加强。

8 psychiatrist   

n.精神病专家；精神病医师

参考例句：

• He went to a psychiatrist about his compulsive gambling.他去看精神科医生治疗不能自拔的赌瘾。
• The psychiatrist corrected him gently.精神病医师彬彬有礼地纠正他。

9 decided   

adj.决定了的，坚决的；明显的，明确的

参考例句：

• This gave them a decided advantage over their opponents.这使他们比对手具有明显的优势。
• There is a decided difference between British and Chinese way of greeting.英国人和中国人打招呼的方式有很明显的区别。

10 consultation   

n.咨询；商量；商议；会议

参考例句：

• The company has promised wide consultation on its expansion plans.该公司允诺就其扩展计划广泛征求意见。
• The scheme was developed in close consultation with the local community.该计划是在同当地社区密切磋商中逐渐形成的。

11 makeup   

n.组织；性格；化装品

参考例句：

• Those who failed the exam take a makeup exam.这次考试不及格的人必须参加补考。
• Do you think her beauty could makeup for her stupidity?你认为她的美丽能弥补她的愚蠢吗？

12 psychiatry   

n.精神病学，精神病疗法

参考例句：

• The study appeared in the Amercian science Journal of Psychiatry.这个研究发表在美国精神病学的杂志上。
• A physician is someone who specializes in psychiatry.精神病专家是专门从事精神病治疗的人。

13 dire   

adj.可怕的，悲惨的，阴惨的，极端的

参考例句：

• There were dire warnings about the dangers of watching too much TV.曾经有人就看电视太多的危害性提出严重警告。
• We were indeed in dire straits.But we pulled through.那时我们的困难真是大极了，但是我们渡过了困难。

14 stigma   

n.耻辱，污名；(花的)柱头

参考例句：

• Being an unmarried mother used to carry a social stigma.做未婚母亲在社会上曾是不光彩的事。
• The stigma of losing weighed heavily on the team.失败的耻辱让整个队伍压力沉重。

15 essentially   

adv.本质上，实质上，基本上

参考例句：

• Really great men are essentially modest.真正的伟人大都很谦虚。
• She is an essentially selfish person.她本质上是个自私自利的人。

16 practitioners   

n.习艺者，实习者( practitioner的名词复数 )；从业者（尤指医师）

参考例句：

• one of the greatest practitioners of science fiction 最了不起的科幻小说家之一
• The technique is experimental, but the list of its practitioners is growing. 这种技术是试验性的，但是采用它的人正在增加。 来自辞典例句

17 enrolled   

adj.入学登记了的v.[亦作enrol]( enroll的过去式和过去分词 )；登记，招收，使入伍（或入会、入学等），参加，成为成员；记入名册；卷起，包起

参考例句：

• They have been studying hard from the moment they enrolled. 从入学时起，他们就一直努力学习。 来自《简明英汉词典》
• He enrolled with an employment agency for a teaching position. 他在职业介绍所登了记以谋求一个教师的职位。 来自《简明英汉词典》

18 disorder   

n.紊乱，混乱；骚动，骚乱；疾病，失调

参考例句：

• When returning back,he discovered the room to be in disorder.回家后，他发现屋子里乱七八糟。
• It contained a vast number of letters in great disorder.里面七零八落地装着许多信件。

19 awareness   

n.意识，觉悟，懂事，明智

参考例句：

• There is a general awareness that smoking is harmful.人们普遍认识到吸烟有害健康。
• Environmental awareness has increased over the years.这些年来人们的环境意识增强了。