Abstract: Post partum mood disorders are not uncommon . While the medical treatment of these conditions is similar regardless of religious background, certain social conditions within the halacha observant community should be taken into consideration. In some segments of the community, there remains a reluctance to seek psychological help . Familial patterns such as closely spaced children or the mother as a major breadwinner may increase the stress under which an affected woman is trying to recover. Contraception during recovery  will raise religious issues as well.
Discussion: It is not uncommon for women to experience extremes in mood in the days after childbirth . Some feel very sad and weepy ("baby blues"), others feel euphoric and as if they could conquer the world, others swing from one extreme to the other . Any of these within the first two weeks, as long as there are no serious thoughts of harming oneself or the baby, are an expected phenomenon and are not a cause for concern . Simple interventions to assist the mother generally help her feel better. These include napping when the baby naps  and reducing to the absolute minimum any other household responsibilities of the new mother. Even better than waiting to see if the mother will have trouble is arranging support in advance  - a gift of household help is of greater use to most families than yet another outfit the infant will soon outgrow.
If the feelings to do not subside after two weeks, or occur later in the first year de novo, the diagnosis of clinical depression should be considered . True clinical depression can be distinguished from simply feeling sad because of the much greater impact on a woman's well being and functioning . Physicians working with women in this life stage should consider office routines to identify affected women, as embarrassment or depression induced apathy will prevent many women from actively seeking help . Standardized questionnaires can aid the busy clinician .
Treatment of the mother is important both for the mother and for the infant; studies have shown impacts such as decreased weight gain among of infants of depressed mothers . Depending on degree, treatment can include counseling, support groups, and/or medication . Should medication be needed, preparations compatible with breastfeeding are available . In general, if intervention begins sooner, the duration of postpartum depression and the associated suffering can be minimized.
Information specific to observant Jewish women can be obtained through NITZA - The Israel Center for Maternal Health. This organization was founded in 1997 as a grassroots organization supporting and financially assisting women across Israel suffering from the devastating effects of Pospartum Depression and its related syndromes. For information about NITZA contact: (02) 533-2810 or email@example.com or visit our their website at www.nitza.org.
General information about depression during and after pregnancy can be obtained by contacting the National Women's Health Information Center (NWHIC) at 1-800-994-9662 or the following organizations.
National Institute of Mental Health, NIH, HHS
Phone: (301) 496-9576
Internet Address: http://www.nimh.nih.gov
National Mental Health Information Center, SAMHSA, HHS
Phone: (800) 789-2647
Internet Address: http://www.mentalhealth.org
American Psychological Association
Phone: (800) 374-2721
Internet Address: http://www.apa.org
National Mental Health Association
Phone: (800) 969-NMHA
Internet Address: http://www.nmha.org
Postpartum Education for Parents
Phone: (805) 564-3888
Internet Address: http://www.sbpep.org
Postpartum Support International
Phone: (805) 967-7636
Internet Address: http://www.postpartum.net
Implications for Practice: Post partum depression is a common phenomenon. Some segments of the halacha observant population are less likely than the general population to request medical help for emotional issues. Therefore, it is important that the physician be proactive in looking for the symptoms and offering care when needed.
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