PRAMS, the Pregnancy Risk Assessment Monitoring System, is a surveillance project of the Centers for Disease Control and Prevention (CDC) and health departments. PRAMS is able to provide data not available from other sources. These data can be used to explore topics related to reproductive health and health problems among mothers and infants. Please see the PRAMS CDC website (https://www.cdc.gov/prams/index.htm) for more information.  

Indiana began participating in PRAMS beginning with 2017 births and has survey response data up through 2021 births. It is important to note that only one year of Indiana data (2018) has met the response rate required for the CDC weighting to make sample statistics generalizable. Because of this, Indiana-specific PRAMS data is impacted by this low response and is limited in its ability to represent experiences across Indiana beyond the individuals completing the survey. Please use caution when interpreting any changes or trends in this data. In future years, we hope to have higher response rates so that we can have a better understanding of experiences across Indiana. 

For this metric and the data shown to the left, the question PRAMS respondents answered was:  

‘During your post-partum check-up, did a doctor, nurse, or other health care worker do any of the following things? 

• Ask me if I was feeling down or depressed’ 

Additional Context on Post-Partum Mental Health:  

• Approximately 1 in 10 women will experience postpartum depression after giving birth, with some studies reporting 1 in 7 women.
• Postpartum depression generally lasts 3 to 6 months, however, this varies based on several factors.
• It is estimated that nearly 50% of mothers with postpartum depression are not diagnosed by a health professional.
• 80% of women with postpartum depression will achieve a full recovery

https://www.postpartumdepression.org/resources/statistics/   Last accessed: 4/8/2024.

WHO estimates that worldwide, 10% of pregnant women and 13% of women who have just given birth experience a mental disorder, primarily depression. Perinatal depression, which encompasses both categories of women, impairs a woman’s ability to function and also hinders the development of the child. While pregnant women everywhere are susceptible to perinatal depression and other mental illnesses, the problem is greatest in developing countries, where WHO estimates that 20% of mothers experience postpartum depression.

https://online.regiscollege.edu/blog/womens-mental-health/    Last accessed: 4/8/2024.

Some normal changes after pregnancy can cause symptoms similar to those of depression. Many mothers feel overwhelmed when a new baby comes home. But if you have any of the following symptoms of depression for more than 2 weeks, call your doctor, nurse, or midwife:

• Feeling restless or moody
• Feeling sad, hopeless, or overwhelmed
• Crying a lot
• Having thoughts of hurting the baby
• Having thoughts of hurting yourself
• Not having any interest in the baby, not feeling connected to the baby, or feeling as if your baby is someone else’s baby
• Having no energy or motivation
• Eating too little or too much
• Sleeping too little or too much
• Having trouble focusing or making decisions
• Having memory problems
• Feeling worthless, guilty, or like a bad mother
• Losing interest or pleasure in activities you used to enjoy
• Withdrawing from friends and family
• Having headaches, aches and pains, or stomach problems that don’t go away

https://www.womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression  Last accessed: 4/8/2024. 

There is help. Your doctor can help you figure out whether your symptoms are caused by depression or something else. 

The common types of treatment for postpartum depression are:

• Therapy. During therapy, you talk to a therapist, psychologist, or social worker to learn strategies to change how depression makes you think, feel, and act.

• Medicine. There are different types of medicines for postpartum depression. All of them must be prescribed by your doctor or nurse. The most common type is antidepressants. Antidepressants can help relieve symptoms of depression and some can be taken while you're breastfeeding. Antidepressants may take several weeks to start working.

  The Food and Drug Administration (FDA) has also approved a medicine called brexanolone to treat postpartum depression in adult women.⁶ Brexanolone is given by a doctor or nurse through an IV for 2½ days (60 hours). Because of the risk of side effects, this medicine can only be given in a clinic or office while you are under the care of a doctor or nurse. Brexanolone may not be safe to take while pregnant or breastfeeding.

  Another type of medicine called esketamine can treat depression and is given as a nasal (nose) spray in a doctor's office or clinic. Esketamine can hurt an unborn baby. You should not take esketamine if you are pregnant or breastfeeding.

• Electroconvulsive therapy (ECT). This can be used in extreme cases to treat postpartum depression.

These treatments can be used alone or together. Talk with your doctor or nurse about the benefits and risks of taking medicine to treat depression when you are pregnant or breastfeeding.

Having depression can affect your baby. Getting treatment is important for you and your baby. Taking medicines for depression or going to therapy does not make you a bad mother or a failure. Getting help is a sign of strength. 

Source: https://www.womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression   Last accessed: 4/8/2024. 

Some women don’t tell anyone about their symptoms. New mothers may feel embarrassed, ashamed, or guilty about feeling depressed when they are supposed to be happy. They may also worry they will be seen as bad mothers. Any woman can become depressed during pregnancy or after having a baby. It doesn’t mean you are a bad mom. You and your baby don’t have to suffer. There is help. Your doctor can help you figure out whether your symptoms are caused by depression or something else. 

https://www.womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression  Last accessed: 4/8/2024. 

Indiana began participating in PRAMS beginning with 2017 births and has survey response data up through 2021 births. It is important to note that only one year of Indiana data (2018) has met the response rate required for the CDC weighting to make sample statistics generalizable. Because of this, Indiana-specific PRAMS data is impacted by this low response and is limited in its ability to represent experiences across Indiana beyond the individuals completing the survey. Please use caution when interpreting any changes or trends in this data. In future years, we hope to have higher response rates so that we can have a better understanding of experiences across Indiana.