Dr. Amanda “Mandy” Allen: Postpartum Depression (PPD)
Joining us on the chat today is Dr. Amanda “Mandy” Allen, the newest OB/GYN at Cascadia Women’s Clinic. Mandy tackled the cold of Chicago for medical school, braved the heat of Las Vegas for her residency, and now is practicing at the perfect temperature here in Vancouver, WA. She schools us in just how common PPD is (spoiler alert, it’s more common than breast cancer), its diverse symptoms, and tests how many acronyms Melissa and Staci can actually internalize. We dive right into the murky water of PPD to clear things up a little by talking scales, screenings, and Pregnancy Centering.
When she’s not practicing, she enjoys spending time with her two dogs and two cats, hiking, snowboarding, rock climbing, and exploring the greater Portland/Vancouver area with her fiance, Dane.
Welcome Mandy!
If you are having thoughts of suicide, or are concerned about someone with thoughts of suicide please call or text 988 to get help.
Vocabulary Refresher:
Perinatal: anything around the time of birth including pregnancy
Antepartum: before birth
Postpartum: after birth
Baby Blues: Occuring after delivery through through about 2 weeks postpartum. About 80% of mothers will experience Baby Blues.
Postpartum Depression: after birth depressive symptoms that occur anywhere from 2 weeks after birth to up to a full year after delivery and include symptoms like: sad/ depressed mood, lack of interest in activities once enjoyed, appetite changes, sleeping changes, feeling worthless, feeling guilty, difficulties in concentration, crying, thinking of death or suicide, lack of interest or feeling lack of bonding around the baby, feelings of being a bad mother, fear of harming the baby or onesself. Estimates differ, but up to 1 in 7 mothers will experience Postpartum Depression.
Postpartum Psychosis: a more rare and more dangerous presentation of symptoms, may include: hallucinations, paranoia, delusions, sudden mood swings, being aggressive, violent, or agitated, disordered speaking, trouble concentrating, not sleeping - sometimes for days, thinking of or planning to harm your baby. Estimates vary but more along the lines of 1-2 mothers in 1000 will experience Postpartum Psychosis.
PostPartum Risk Factors: American Psychological Association Nov. 2, 2022 article
EPDS (Edinburgh Postpartum Depression Scale): Explained in the interview, and the standard practice scale used for Postpartum care.
PHQ9: Mentioned in the interview, a brief, self-disclosed, scaled diagnostic for patient depression.
Centering Healthcare / Centering Pregnancy: a new clinic model bringing together women of similar due-dates to experience the pregnancy process together.
Maternal Mortality Rates in the US: In the interview, Dr. Allen mentions that mental health conditions are one of the leading causes of maternal mortality in the US. In studies collected from 2017 - 2019 these were the leading causes of maternal mortality:
mental health conditions (e.g. deaths of suicide, overdose/poisoning related to substance use disorder) at 22.7%
Hemorrhage at 13.7%
Cardiovascular complications at 12.8%
Infection at 9.2%
Embolism at 8.7%
Since statistics move all the time, homicide has since replaced mental health conditions as the leading cause of death among pregnant women in the US, surpassing deaths caused by sepsis (infection), hypertensive disorders, and hemorrhage - see the abstract below:
Therapist Recommendations from Dr. Allen:
Brightside Health: online psychiatry and therapy with free assessments and some insurance accepted
Ohana Behavioral Health: specialists for Ante and Postpartum care available, telehealth available
Don’t miss our episode on Paternal Postpartum Depression & Anxiety with Sam Stevens and more local PPD Resources on his page. Also, if you would like to know more about 988, please listen to our episode with Debbie Dedrickson, Director of Clinical Operations at Lines for Life.
Get in touch with Cascadia Women’s Clinic: CascadiaWC.com
Schedule an appointment with Dr. Mandy Allen at: (360) 433-0022