Segre, L. S., O'Hara, M. W., Arndt, S., & Stuart, S. (2007). Social Psychiatry and Psychiatric Epidemiology, 42, 316-321.

Depression is the most common complication associated with pregnancy and childbirth. Beck (2008) has indicated that two areas of evidence are needed to advance the science in this area: (1) prevalence studies to account for racial and ethnic differences; and (2) studies of intervention strategies for depression in the childbearing year and their effectiveness.

Using a sample of 4,332 postpartum women, Segre et al. found 40% of women with low income suffered from clinically significant postpartum depression in contrast to only 13% of new mothers with higher incomes. Beck's second evidence-poor area was interventions, and now evidence on the effectiveness of intervention strategies for depression is growing. One study published (Manber, Kraemer, Arnow, Trivedi, Rush, Thase et al., 2008) reported that a combination of counseling and medication is the best possible treatment option for most depressed people, but a third intervention is joining medication and therapy as a treatment option, especially for women: listening visits. Developed in England by health visitors, the "listening visits" give mild to moderately depressed mothers an opportunity to talk through problems and receive support/guidance from a nurse. They potentially reach many low-income women who may lack understanding of depression, or access to professional mental health services and/or have barriers (finances/transportation, etc.) in accessing the services. Segre recently received a 5-year grant from the National Institutes of Health to evaluate the effectiveness of these "listening visits" in the United States. She is interviewing participating Healthy Start mothers before and after "listening visits" with nurses. Accumulating evidence suggests not only strategies for screening, but also interventions for treating depressed women in the childbearing year.

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