In order to minimize or even eliminate risk of PPD, we need to better understand what causes it and then seek to “take care” of the contributing factors that are within our control.

“Postpartum depression (PPD) is a relatively common and potentially devastating disorder that develops in women within the 1st year after giving birth. Prevalence rates are high, with estimates of approximately 12% for major and 19% for minor depression. The implications of PPD extend beyond simply dampening the pleasure a new mother may feel after giving birth and in fact may result in serious risk to mother and infant. Even without overt risks to health, subtle interruptions in maternal-infant bonding may occur, with negative effects on infant behavioral and cognitive. Furthermore, these effects may last years beyond infancy and other family members, including partners and older children, may also suffer.” (JOGNN Sept/Oct 2005)


 


We’ve all heard of postpartum depression (PPD) but most are not aware that it can develop in the first year after giving birth. In order to minimize or even eliminate risk of PPD, we need to better understand what causes it and then seek to “take care” of the contributing factors that are within our control. It’s interesting to me that links have been made between iron deficiency as well as postpartum fatigue and postpartum depression (PPD).


 


In the study titled Fatigue as a Predictor of Postpartum Depression, which was released in Volume 31, Number 4 of JOGNN, their small sample of 38 healthy women recruited from hospital maternity units within 24-hours after an uncomplicated birth showed that “fatigue was predictive of postpartum depression.”  The study suggested that “women who reported the greatest level of fatigue in the hospital continued to report high levels of fatigue at each home visit and were the most likely to report the greatest number of depressive symptoms at day 28” postpartum. This study seemed to answer the question, “Is postpartum fatigue predictive of postpartum depression?”


 


In a study found in the American Journal of Obstetrics and Gynecology titled, Have we forgotten the significance of postpartum iron deficiency?, we learn “The functional outcomes of iron deficiency and iron deficiency anemia are well-documented among women of childbearing age.” Such outcomes include:




Impaired physical work capacity


Aerobic fitness

Endurance capacity

Work efficiency

Fatigue

Voluntary activity



Deficits in cognitive function and mood


Short-term memory

Verbal language

Attention span/concentration

Intelligence

Depressive symptoms



Reduced immune function

 


This same study also stated, “The increased iron requirements of pregnancy cannot be met by the typical US diet or the iron stores of most women. Therefore, if women are left unsupplemented during pregnancy, they bear a considerable risk of developing iron deficiency.” The study states further, “Observational data also highlight an association between maternal anemia and depressive disorders. A recent study reported significantly higher depressive symptoms at postpartum day 28 among women who were anemic on postpartum day 7 compared with non-anemic women, and a negative correlation between hemoglobin concentrations and depressive symptoms. Iron deficiency without anemia has also been associated with higher symptoms of depression and irritability among young women taking oral contraceptives.”


 


This study also pointed out that:


 



Iron is found in hemoglobin, myoglobin, oxidative enzymes, and respiratory chain proteins, and is therefore essential for oxidative energy production. All levels of iron deficiency adversely influence tissue oxidative capacity, and severe reductions in hemoglobin causing anemia disturb oxygen carrying capacity. It is not surprising, then, that randomized double-blinded, placebo controlled trials have shown that iron deficiency with and without anemia impair aerobic fitness, endurance capacity, and work efficiency.



 


This seems to indicate that if there is iron deficiency there is also fatigue, which has been shown to be related to postpartum depression. Therefore, increasing iron levels should decrease fatigue and in turn minimize and perhaps even eliminate postpartum depression.


 


After reading multiple studies regarding the connection of iron deficiency and postpartum fatigue to postpartum depression in the first year after giving birth it appears as though women now have some information they can use to help them prepare themselves for the increased iron needs of pregnancy and the postpartum period as well as the expected postpartum fatigue that have been linked to postpartum depression. This information is the leading reason many women are choosing placenta encapsulation after the birth of their baby.