More than one out of eight mothers who give birth experience postpartum depression, or PPD.
But, according to Esther Kenigsberg, “Before Sparks opened I don’t remember anyone writing about it.” Kenigsberg, who lives in Boro Park, Brooklyn, and worked in schools counseling children, observed that many children were affected by postpartum depression in their families. This motivated her to found the Sparks organization – the initials come from its full mission, which is “Serving Pre- and postnatal women and families with Awareness, Relief, Knowledge and Support.”
“I’ve seen how many kids are in deep trouble, and it’s not their fault,” Kenigsberg said. She noted that when postpartum depression occurs, “the two primary victims are the mother and her infant.” When the newborn baby has problems bonding with the mother, that child later may experience emotional problems stemming from her mother’s depression during his or her early developmental stage. But other members of the family, including older children, become secondary victims, who also suffer from their mother’s depression.
Sparks, together with co-sponsors Jewish Family Services of Bergen and North Hudson and JFS of North Jersey, is offering a program on Oct. 28 to discuss “Dynamics of Family Life: The Health of the Mother Before and After Birth.” The event, which includes social worker Professor Susan Dowd Stone as its keynote speaker, a video presentation, and workshops on various aspects of PPD, is the first event run by Sparks in northern New Jersey. It is designed to raise awareness and provide resources for postpartum depression.
Who is at risk?
|Esther Kenigsberg Courtesy Sparks|
According to a 1996 research article in the International Review of Psychiatry, the prevalence of postpartum depression is approximately 13 percent. That meta-analysis of many varied studies combined data on 59 different studies on PPD, and included more than 12,000 subjects. The authors concluded that strongest predictors of PPD were women who had a “past history of psychopathology and psychological disturbance during pregnancy, poor marital relationships and low social support and stressful life events. Less family income and lower occupational status are associated with increased risk,” the report said. Social support available to the mother was a major factor in predicting risk, which underscores how important awareness and support networks are for all expectant and new mothers. Factors that did not appear to correlate with PPD risk included the age of the mother, her marital status, how long she had been in the relationship, her level of education, the number of children that she had, and her employment status during pregnancy.
In concert with that landmark study, the Sparks website, www.sparkscenter.org, encourages awareness and support networks for women who are at risk for PPD. It provides information, testimonials, support groups, and events, as well as newsletters about PPD. The website includes a video testimonial featuring Elie Abadei, M.D., who is both a physician and the rabbi of the Safra Synagogue in midtown Manhattan. He notes that Sparks provides “an all-encompassing approach: physical, psychological and spiritual” to address PPD.
“Postpartum depression changes the dynamics of the family,” Abadei says in the video. “Other children suffer greatly. The baby suffers greatly…” He explains that Sparks’ first goal is “public awareness … to bring the issue of postpartum depression to the community and let them know it’s something that exists… to see it as something not to be ashamed of and something that there is help for.”
Abadei also describes the work of “Esther [Kenigsberg, who] has dedicated her time, money and efforts to make sure that the organization serves the people…. It’s very professional, and at the same time very personable and very caring.”
“There are hormonal changes in life, perinatal, after birth, and during the monthly cycle,” said Kenigsberg, who not only founded Sparks but is now its executive director. “Doctors let you know about the physical issues, but don’t let you know about the anxiety and the emotional part. We have training, a hotline, support groups, and mentors.”
“We start with the awareness and continue with services that are needed until the mother is getting well,” she said. Postpartum depression occurs in “more than one in eight births. If the mother suffered once, she is at higher risk another time.”
Kenigsberg explained that PPD may appear to occur more in Orthodox Jewish families because they have more children. “Each birth is a risk,” she said. However, she added that “most phone calls [to the hotline] come in after the third child. For earlier births the mother may have had some symptoms but somehow controlled herself.” She said that it is not known why PPD occurs more often after the third child, but it is not merely the stress of having two other small children, since it is also observed when the first two children are older.
According to Kenigsberg, emotional triggers that could increase risk include such major life changes as divorce, moving, changing jobs. Physical stresses, such as lack of sleep, could trigger an episode. The mother “needs at least five uninterrupted hours of sleep,” she said. “Good nutrition is also important. She needs folic acid, amino acids, minerals…”
Ironically, infertility treatments can be a trigger for postpartum depression. Infertile women may have been exposed to high doses of hormones to induce ovulation and to maintain the pregnancy. Kenigsberg has observed that “because of the physiological responses to hormonal treatments [used for infertility] … couples who finally had the child they were so desperately waiting for” may be at high risk for PPD.
“We give education ““ what they can do to prevent it,” Kenigsberg continued. “We look at the whole gestalt and see what is going on. Is there a family history of depression, anxiety, bipolar disorder?
“The woman’s hormones are not in balance. It takes a year [after pregnancy] to go back to balance,” she said. “Because chemically everything is upside down we send the woman for a complete checkup. Thyroid testing, insulin levels, Vitamin B, we use medical and holistic approaches.
“We cover it from different angles,” she continued, and address “how to manage the stress. During that time don’t change jobs, don’t get divorced, make no major changes.
“Giving birth to a child causes changes in hormones, such that a trauma from 20 years ago, from childhood, can come up,” Kenigsberg said. “We say ‘when the ocean is moving a lot of garbage comes out.’ In easy cases, she is not at her best. In the worst cases, [a woman with PPD] can be suicidal or violent.”
Kenigsberg and Sparks also have spearheaded the publication of a new magazine, True Balance: Nourishing the Body, Mind and Spirit of Today’s Woman. This quarterly publication has features on health, relationships, and emotional growth. A recent issue had an article called “Love Your Baby,” as well as an article by psychiatrist Rabbi Dr. Abraham J. Twerski of Teaneck, who has been an advocate for Sparks.
“Untreated ante and postpartum disorders can be shattering to the life of the mother, infant and entire family…” Twerski wrote. “The public educational programs of Sparks and the services it provides are truly a precious gift to humanity.”
Dynamics of Family Life: The Health of the Mother Before and After Birth is scheduled for Sunday, Oct. 28, from 3 to 6 p.m. at Temple Avodat Shalom, 385 Howland Ave., River Edge. Speakers will include Professor Susan Dowd Stone, MSW, LCSW; Dr. James Forster; Elyse Goldstein; Rus Devorah (Darcy) Wallen, LCSW, ACSW; Sheila B. Steinbach, LPC; and Lauryn Tuchman, LCSW. The program is co-sponsored by Sparks, JFS of Bergen and North Hudson and JFS of North Jersey. Refreshments will be served and dietary laws strictly observed. Parking is available at the site. It is open to the entire community.
Information on Sparks can be found at www.sparkscenter.org. For information on True Balance magazine email firstname.lastname@example.org.