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Many women identify the birth of a child as the happiest moment in their lives. But parenting brings many challenges, and many of those who look back so fondly on their children's infancy wouldn't choose to do it all again. For others those early weeks and months can be far from joyous. Trent psychology professor Elaine Scharfe's 'Transition to Parenthood' study supports other evidence that roughly 30% of women suffer some form of post-natal mood disorder. About ten per cent show "clinical" symptoms. Because many women are unwilling to acknowledge negative feelings around what society likes to celebrate as "the blessed event", physicians have tended to underestimate the number of patients struggling with post-natal disorders. But by any count, this is a condition taking a significant toll on the individual sufferers, and on their partners and families.

Trent's Dr. Scharfe is the lead hand in a community research project that has received $790,350 in funding from the Ontario Women's Health Council, Ministry of Health and Long Term Care, to look for ways to assist women suffering from post-natal depression. "This is a real community collaboration" Scharfe says a way to help local families, and the community, become healthier. Other partners are the Peterborough County-City Health Unit, the Women's Health Care Centre and the Peterborough Family Resource Centre. Through this demonstration project in Peterborough, best practices will be determined which can be applied in other communities.

Interviewed for the Trent Report last spring Elaine said, "Research has shown that the mother establishes the climate for the whole family. If she is depressed it affects everyone, including the physical and emotional well being of her child, which in turn can have long-term repercussions for the community. One of the strengths of this project will be the ability to determine not only which interventions work to reduce depressive symptoms, but which of these successful interventions women choose and then report are effective for them."

Before the project got underway, women interviewed indicated that available care in this smaller city was quite limited. For some, anti-depressants were not an acceptable option, but individual therapy was prohibitively expensive. Peterborough lent itself to this study because while pre-research indicated a lack of services in the community, the infrastructure was in place through the partnering organizations to add them. Seventy- five per cent of the funding is allocated to staff and services. The project has financed "people" resources, so that social workers and psychologists can provide group therapy and counseling for individuals and couples on an as-needed basis. Home visits by trained lay professionals are now available. Project funds also help the Peterborough Family Resource Centre to provide nutrition counseling, prenatal education, and parenting courses for the women in the project. Women are screened for risk through the hospital's pre-natal courses, and again at 48 hours after delivery, then at three weeks, two months and six months post-partum. One of the project's early successes has been in providing choices of treatment, and in educating women about those choices.

Postnatal depression knows no socio-economic barriers. The biggest risk factor is previous history of depression, and the next is number of children. (That popular "Juggling for the Complete Klutz" kit didn't deal with parenting!) Economic factors do play a role for some sufferers, though, and simply providing funds for taxi fare in a community with limited public transit, or paying for temporary child care, has removed significant barriers to treatment for some women. Tracking a woman's needs through the screening process and follow-up allows her to receive integrated supports and services, for example to move from a treatment which might be most suitable immediately post- partum to one which better meets her own and her family's needs if the symptoms change or are prolonged.

The project's funding will sustain its initiatives through March 2003. These have been so warmly embraced by local health care providers that it is hoped the screening and services will become part of the regular funding model in the future, not just in Peterborough but in similar communities throughout the province. Bravo to Elaine and her community partners for making a positive difference in the lives of so many women and their families!

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