{"id":14495,"date":"2014-05-09T01:05:44","date_gmt":"2014-05-09T08:05:44","guid":{"rendered":"http:\/\/amicuscuria.com\/wordpress\/?p=14495"},"modified":"2015-01-17T03:36:30","modified_gmt":"2015-01-17T10:36:30","slug":"tibbits-shivers-arrested-for-assault-on-2-mont-old-baby","status":"publish","type":"post","link":"https:\/\/amicuscuria.com\/wordpress\/tibbits-shivers-arrested-for-assault-on-2-mont-old-baby\/","title":{"rendered":"Tibbits &#038; Shivers arrested for assault on 2-month old baby"},"content":{"rendered":"<p style=\"text-align: justify;\"><em><strong>Editor&#8217;s Note:<\/strong><\/em>\u00a0<em>This site was attacked early on the morning of 1-16-15 w\/the goal of deleting the following images of alleged perpetrators and victim. The hacker(s) used the ip #\u00a099.101.5.121 and Chrome as their browser. Windows 7 was used as the OS and AT&amp;T as the internet service provider. (Does this sound like anyone you know w\/motive?&#8211;if so, leave a comment as to who, etc.) The images are safely stored offline and, of course, were restored for the public&#8217;s benefit. If convicted, the accused could face up to life in prison. Notice was filed an exceptional sentence\u00a0is being sought\u00a0in this case. Judge Sheldon was affidavited (removed) by one of the defendants (Shivers). Bob Brungardt, esq. is the attorney of record representing\/defending Tibbits. Both defendants were released on $75,000 bond\/bail. A protection order and no contact order to prevent harm to the child has been entered by the court. Restitution for emergency medical\/hospital costs incurred by the infant (Avery Denise Michelle Tibbits) is being sought from each of the defendants. Speedy trial has been waived by both defendants. The trial is currently scheduled to begin sometime in early to mid-spring of 2015.<\/em><\/p>\n<div id=\"attachment_16359\" style=\"width: 730px\" class=\"wp-caption alignleft\"><a href=\"http:\/\/amicuscuria.com\/wordpress\/?attachment_id=16359\" rel=\"attachment wp-att-16359\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-16359\" class=\"wp-image-16359 size-full\" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/ChadAllenLesterTibbits.jpg\" alt=\"ChadAllenLesterTibbits\" width=\"720\" height=\"960\" srcset=\"https:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/ChadAllenLesterTibbits.jpg 720w, https:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/ChadAllenLesterTibbits-225x300.jpg 225w\" sizes=\"auto, (max-width: 720px) 100vw, 720px\" \/><\/a><p id=\"caption-attachment-16359\" class=\"wp-caption-text\">Chad Allen Lester Tibbits, 21<\/p><\/div>\n<div id=\"attachment_14499\" style=\"width: 639px\" class=\"wp-caption alignleft\"><a href=\"http:\/\/amicuscuria.com\/wordpress\/?attachment_id=14499\" rel=\"attachment wp-att-14499\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-14499\" class=\"wp-image-14499 \" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMTibbitselfie-150x150.jpg\" alt=\"KatarinaMTibbitselfie\" width=\"629\" height=\"629\" \/><\/a><p id=\"caption-attachment-14499\" class=\"wp-caption-text\">Katarina M. Shivers\/Tibbits, 20, w\/child<\/p><\/div>\n<div style=\"width: 642px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMTibbitsbaby4.jpg\" alt=\"KatarinaMTibbitsbaby4\" width=\"632\" height=\"842\" \/><p class=\"wp-caption-text\">Katarina M. Shivers\/Tibbits w\/newborn<\/p><\/div>\n<p><em>by Natalie Johnson (reporter for Mason County Journal)<\/em><\/p>\n<p><strong>Shelton, WA. &#8212;<\/strong> A Union couple pleaded not guilty, Tuesday, to charges they beat and starved their 2-month old child, Avery Denise Michelle Tibbits.<\/p>\n<p style=\"text-align: justify;\">Chad Allen Lester Tibbits, 21, and Katarina M. Shivers, 20, were arrested Monday evening on suspicion of assault of a child in the 1st degree, and criminal mistreatment in the 1st degree. Katarina may be a descendant of Ezra Meeker, the \u00a0founding pioneer of Puyallup, WA. and where the Meeker Mansion historical site is open to the public today.<\/p>\n<p style=\"text-align: justify;\">Both made their first appearance in Mason County Superior Court on Tuesday afternoon where they were formally charged, entered their pleas and were each granted $75,000 bail.<\/p>\n<div style=\"width: 645px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMTibbitsbaby2.jpg\" alt=\"KatarinaMTibbitsbaby2\" width=\"635\" height=\"850\" \/><p class=\"wp-caption-text\">Chad Allen Lester Tibbits w\/baby, Avery Denise Michelle Tibbits<\/p><\/div>\n<p style=\"text-align: justify;\">While neither has any violent criminal history, Mason County Prosecutor Mike Dorcy cited the &#8220;devastating injuries&#8221; to the child when asking for bail.<\/p>\n<p style=\"text-align: justify;\">According to court documents, the 2 defendants are charged with intentionally committing assault against the child and criminally mistreating the child, or &#8220;withholding any of the basic necessities of life,&#8221; between Feb. 22 and April 28.<\/p>\n<div style=\"width: 649px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMShivers2-150x150.jpg\" alt=\"KatarinaMShivers2\" width=\"639\" height=\"639\" \/><p class=\"wp-caption-text\">Katarina M. Shivers\/Tibbits taking Selfie w\/newborn<\/p><\/div>\n<p style=\"text-align: justify;\">The maximum penalty for assault in the first degree against a child is life in prison.<\/p>\n<p style=\"text-align: justify;\">According to probable cause documents prepared by the Mason County Sheriff&#8217;s office, occupants of the \u00a0home, where Shivers and Tibbits lived, called 911 at 11:50 pm on April 28 to report that a baby was &#8220;barely breathing.&#8221;<\/p>\n<div style=\"width: 659px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMTibbits2.jpg\" alt=\"KatarinaMTibbits2\" width=\"649\" height=\"865\" \/><p class=\"wp-caption-text\">Expectant Mom, Katarina M. Shivers\/Tibbits , 20 w\/Chad Allen Lester Tibbits, 21<\/p><\/div>\n<p>Medic units responded and called law enforcement when they found signs of abuse.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMTibbitsbaby3.jpg\" alt=\"KatarinaMTibbitsbaby3\" width=\"664\" height=\"885\" \/><\/p>\n<p style=\"text-align: justify;\">The 66-day-old baby was taken first to Mason General Hospital, then airlifted to Seattle&#8217;s Harborview Medical Center with head trauma and a fractured skull, fractured ribs, legs, bruising, dehydration, one collapsed lung and one partially collapsed lung, and other injuries and chronic conditions.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KaterinaMTibbitsAvery.jpg\" alt=\"Katerina M. Shivers TibbitsAvery\" width=\"671\" height=\"671\" \/><\/p>\n<div style=\"width: 673px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMShivers4.jpg\" alt=\"KatarinaMShivers4\" width=\"663\" height=\"884\" \/><p class=\"wp-caption-text\">30 SE Mill Creek Rd, Shelton, WA 98584-8318<\/p><\/div>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMShivers3.jpg\" alt=\"KatarinaMShivers3\" width=\"664\" height=\"498\" \/><\/p>\n<p>Some of the injuries showed healing, according to court documents.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMShivers.jpg\" alt=\"KatarinaMShivers\" width=\"663\" height=\"663\" \/><\/p>\n<p style=\"text-align: justify;\">The child, who is also underweight, due to &#8220;chronic nutritional neglect,&#8221; according to the probable cause report, is now recovering at \u00a0Seattle&#8217;s Children&#8217;s Hospital, Dorcy said.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMShivers5.jpg\" alt=\"KatarinaMShivers5\" width=\"663\" height=\"663\" \/><\/p>\n<p style=\"text-align: justify;\">According to court documents, Tibbits and Shivers told detectives that the baby caused many of her own injuries.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMShivers7.jpg\" alt=\"KatarinaMShivers7\" width=\"659\" height=\"494\" \/><\/p>\n<div id=\"attachment_14497\" style=\"width: 659px\" class=\"wp-caption alignleft\"><a href=\"http:\/\/amicuscuria.com\/wordpress\/?attachment_id=14497\" rel=\"attachment wp-att-14497\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-14497\" class=\"wp-image-14497 \" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KaterinaMTibbitsAvery.jpg\" alt=\"Katerina M. Shivers\/Tibbits w\/Avery\" width=\"649\" height=\"649\" srcset=\"https:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KaterinaMTibbitsAvery.jpg 960w, https:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KaterinaMTibbitsAvery-150x150.jpg 150w, https:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KaterinaMTibbitsAvery-300x300.jpg 300w\" sizes=\"auto, (max-width: 649px) 100vw, 649px\" \/><\/a><p id=\"caption-attachment-14497\" class=\"wp-caption-text\">Katerina M. Shivers\/Tibbits w\/Avery<\/p><\/div>\n<p style=\"text-align: justify;\">Doctors at Harborview Medical Center concluded that the parents&#8217; explanations for the baby&#8217;s injuries were &#8220;unreasonable&#8221;.<\/p>\n<div id=\"attachment_14516\" style=\"width: 727px\" class=\"wp-caption alignleft\"><a href=\"http:\/\/amicuscuria.com\/wordpress\/?attachment_id=14516\" rel=\"attachment wp-att-14516\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-14516\" class=\"wp-image-14516 size-full\" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMTibbitsbaby.jpg\" alt=\"KatarinaMTibbitsbaby\" width=\"717\" height=\"960\" srcset=\"https:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMTibbitsbaby.jpg 717w, https:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMTibbitsbaby-224x300.jpg 224w\" sizes=\"auto, (max-width: 717px) 100vw, 717px\" \/><\/a><p id=\"caption-attachment-14516\" class=\"wp-caption-text\">Avery Denise Michelle Tibbits<\/p><\/div>\n<p><a href=\"http:\/\/amicuscuria.com\/wordpress\/?attachment_id=14515\" rel=\"attachment wp-att-14515\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-large wp-image-14515\" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMTibbitsbaby5.jpg\" alt=\"KatarinaMTibbitsbaby5\" width=\"640\" height=\"480\" srcset=\"https:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMTibbitsbaby5.jpg 960w, https:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMTibbitsbaby5-300x225.jpg 300w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/a> <a href=\"http:\/\/amicuscuria.com\/wordpress\/?attachment_id=14514\" rel=\"attachment wp-att-14514\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-large wp-image-14514\" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMTibbitsbaby4.jpg\" alt=\"KatarinaMTibbitsbaby4\" width=\"640\" height=\"853\" srcset=\"https:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMTibbitsbaby4.jpg 720w, https:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMTibbitsbaby4-225x300.jpg 225w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/a><\/p>\n<p style=\"text-align: justify;\"><strong><em>Post Partum Depression<\/em><\/strong> (PPD), also called <em><strong>post natal depression<\/strong><\/em>, is a type of\u00a0<a class=\"mw-redirect\" title=\"Clinical depression\" href=\"http:\/\/en.wikipedia.org\/wiki\/Clinical_depression\">clinical depression<\/a> which can affect women after <a title=\"Childbirth\" href=\"http:\/\/en.wikipedia.org\/wiki\/Childbirth\">childbirth<\/a>. Symptoms may include sadness, <a title=\"Fatigue (medical)\" href=\"http:\/\/en.wikipedia.org\/wiki\/Fatigue_(medical)\">low energy<\/a>, changes in sleeping and eating patterns, reduced desire for sex, crying episodes, <a title=\"Anxiety\" href=\"http:\/\/en.wikipedia.org\/wiki\/Anxiety\">anxiety<\/a>, and irritability. While many women experience self-limited, mild symptoms postpartum, postpartum depression should be suspected when symptoms are severe and have lasted over two weeks.<\/p>\n<p style=\"text-align: justify;\">Although a number of risk factors have been identified, the causes of PPD are not well understood. Hormonal change is hypothesized to contribute as one cause of postpartum depression. The emotional effects of postpartum depression can include sleep deprivation, anxiety about parenthood and caring for an infant, identity crisis, a feeling of loss of control over life, and lack of support from a romantic or sexual partner.&#8221;\u00a0Many women recover with treatment such as a support group, counseling, or medication.<\/p>\n<p style=\"text-align: justify;\">Studies report prevalence rates among women from 5% to 25%, but methodological differences among the studies make the actual prevalence rate unclear. Among men, in particular new fathers, the incidence of postpartum depression has been estimated to be between 1% and 25.5%.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMShivers6.jpg\" alt=\"KatarinaMShivers6\" width=\"640\" height=\"640\" \/><\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #252525;\">Symptoms include sadness, fatigue, changes in sleeping and eating patterns, reduced libido, crying episodes, anxiety, and irritability. Although a number of risk factors have been identified, the causes of PPD are not well understood. Many women recover with a treatment consisting of a support group or counseling.<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMTibbits2.jpg\" alt=\"KatarinaMTibbits2\" width=\"641\" height=\"855\" \/><\/p>\n<p><span style=\"color: #252525;\">Symptoms of PPD can occur anytime in the first year postpartum.<\/span><\/p>\n<p><span style=\"color: #252525;\">These include, but are not limited to, the following:<\/span><\/p>\n<ul>\n<li>Sadness<\/li>\n<li>Hopelessness<\/li>\n<li>Low self-esteem<\/li>\n<li>Guilt<sup id=\"cite_ref-OBOS_5-4\" class=\"reference\"><a style=\"color: #0b0080;\" href=\"http:\/\/en.wikipedia.org\/wiki\/Postpartum_depression#cite_note-OBOS-5\">[5]<\/a><\/sup><\/li>\n<li>A feeling of being overwhelmed<\/li>\n<li>Sleep and eating disturbances<\/li>\n<li>Inability to be comforted<\/li>\n<li>Exhaustion<\/li>\n<li>Emptiness<\/li>\n<li><a style=\"color: #0b0080;\" title=\"Anhedonia\" href=\"http:\/\/en.wikipedia.org\/wiki\/Anhedonia\">Anhedonia<\/a><\/li>\n<li>Social withdrawal<\/li>\n<li>Low or no energy<\/li>\n<li>Becoming easily frustrated<sup id=\"cite_ref-OBOS_5-12\" class=\"reference\"><a style=\"color: #0b0080;\" href=\"http:\/\/en.wikipedia.org\/wiki\/Postpartum_depression#cite_note-OBOS-5\">[5]<\/a><\/sup><\/li>\n<li>Feeling inadequate in taking care of the baby<sup id=\"cite_ref-OBOS_5-13\" class=\"reference\"><a style=\"color: #0b0080;\" href=\"http:\/\/en.wikipedia.org\/wiki\/Postpartum_depression#cite_note-OBOS-5\">[5]<\/a><\/sup><\/li>\n<li>Decreased\u00a0<a class=\"mw-redirect\" style=\"color: #0b0080;\" title=\"Sex drive\" href=\"http:\/\/en.wikipedia.org\/wiki\/Sex_drive\">sex drive<\/a><\/li>\n<\/ul>\n<h3 style=\"font-weight: bold; color: black;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMTibbits5.jpg\" alt=\"KatarinaMTibbits5\" width=\"645\" height=\"446\" \/><\/h3>\n<h3 style=\"font-weight: bold; color: black; text-align: justify;\"><span style=\"color: #252525;\">Postpartum depression usually begins in the first few months after childbirth. In\u00a0<\/span><a class=\"mw-redirect\" style=\"color: #0b0080;\" title=\"Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition\" href=\"http:\/\/en.wikipedia.org\/wiki\/Diagnostic_and_Statistical_Manual_of_Mental_Disorders,_Fourth_Edition\">Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition<\/a><span style=\"color: #252525;\">\u00a0it is defined as depression with onset within 4 weeks after childbirth. Postpartum depression can also affect women who have suffered a miscarriage.<\/span><span style=\"color: #252525;\">\u00a0It usually begins around two weeks after childbirth.<\/span><span style=\"color: #252525;\">\u00a0It may last up to several months or even a year.<\/span><\/h3>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMShivers3.jpg\" alt=\"KatarinaMShivers3\" width=\"652\" height=\"489\" \/><\/p>\n<h3 style=\"font-weight: bold; color: black;\"><span id=\"Psychosis\" class=\"mw-headline\">Psychosis<\/span><\/h3>\n<p style=\"text-align: justify;\"><span style=\"color: #252525;\">Postpartum psychosis is a separate mental health disorder which is sometimes erroneously referred to as postpartum depression. It is less common than PPD, and it involves the onset of\u00a0<\/span><a class=\"mw-redirect\" style=\"color: #0b0080;\" title=\"Psychotic\" href=\"http:\/\/en.wikipedia.org\/wiki\/Psychotic\">psychotic<\/a><span style=\"color: #252525;\">\u00a0symptoms that may include thought disturbances, hallucinations, delusions and\/or disorganized speech or behavior. The prevalence of postpartum psychosis in the general population is 1\u20132 per 1,000 childbirths, however the rate is 100 times higher in women with bipolar disorder or a previous history of postpartum psychosis. Bipolar disorder and, to a lesser extent, schizophrenia have elevated prevalences in postpartum psychosis.\u00a0Previous research looked at the relationship between childbirth and postpartum psychosis. Using data on 54,000 births over a 12-year period, researchers found that psychiatric admissions were seven times more likely in the first 30 days after childbirth than in the prepregnancy period and among women who developed postpartum psychosis after childbirth, 72%\u201380% had bipolar disorder or schizoaffective disorder and 12% had schizophrenia. Indicators of a possible bipolar diagnosis include a history of missed or misdiagnosed mood episodes, any previous mania or hypomania, and a family history of bipolar disorder or postpartum psychosis.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #252525;\">Treatment for Postnatal Psychosis is essential; it will not go away without medical attention.<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMTibbits4.jpg\" alt=\"KatarinaMTibbits4\" width=\"651\" height=\"488\" \/><\/p>\n<h3 style=\"font-weight: bold; color: black;\"><span id=\"Effects_on_the_parent-infant_relationship\" class=\"mw-headline\">Effects on the parent-infant relationship<\/span><\/h3>\n<p style=\"text-align: justify;\"><span style=\"color: #252525;\">Postpartum depression may lead mothers to be inconsistent with\u00a0<a class=\"mw-redirect\" style=\"color: #0b0080;\" title=\"Childcare\" href=\"http:\/\/en.wikipedia.org\/wiki\/Childcare\">childcare<\/a>.\u00a0Women diagnosed with postpartum depression often focus more on the negative events of childcare, resulting in poor coping strategies (Murray).<\/span><span style=\"font-size: xx-small;\"><span style=\"line-height: 10px;\">\u00a0<\/span><\/span><span style=\"color: #252525;\">There are four groups of coping methods, each of which is divided into a different style of coping subgroups.\u00a0<\/span><a style=\"color: #0b0080;\" title=\"Avoidance coping\" href=\"http:\/\/en.wikipedia.org\/wiki\/Avoidance_coping\">Avoidance coping<\/a><span style=\"color: #252525;\">\u00a0is one of the most common strategies used (Murray).<\/span><span style=\"color: #252525;\">\u00a0It consists of denial and behavioral disengagement subgroups (for example, an avoidant mother might not respond to her baby crying). This strategy however, does not resolve any problems and ends up negatively impacting the mother\u2019s mood, similarly of the other coping strategies used (Honey).<\/span><\/p>\n<ul>\n<li>Avoidance coping:\u00a0<a style=\"color: #0b0080;\" title=\"Denial\" href=\"http:\/\/en.wikipedia.org\/wiki\/Denial\">denial<\/a>, behavioral disengagement<\/li>\n<li>Problem-focused coping: active coping, planning, positive reframing<\/li>\n<li>Support seeking coping: emotional support, instrumental support<\/li>\n<li>Venting coping: venting,\u00a0<a style=\"color: #0b0080;\" title=\"Blame\" href=\"http:\/\/en.wikipedia.org\/wiki\/Blame#Self-blame\">self-blame<\/a><\/li>\n<\/ul>\n<h3 style=\"font-weight: bold; color: black;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMTibbits3.jpg\" alt=\"KatarinaMTibbits3\" width=\"642\" height=\"642\" \/><\/h3>\n<h3 style=\"font-weight: bold; color: black; text-align: justify;\"><span style=\"color: #252525;\">Multiple factors must be considered when evaluating the capacity of a seriously depressed mother to provide a safe-enough care giving environment that can support the healthy development of her baby and her relationship with that baby.<\/span><span style=\"color: #252525;\">\u00a0Such factors, including maternal attachment history, present social supports, insight, and ability to accept help are often best considered by an interdisciplinary professional treatment team that includes infant mental health specialists or other mental health practitioners with experience in working with children and families.<\/span><\/h3>\n<div style=\"width: 652px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMTibbitsbaby.jpg\" alt=\"KatarinaMTibbitsbaby\" width=\"642\" height=\"860\" \/><p class=\"wp-caption-text\">Avery Denise Michelle Tibbits<\/p><\/div>\n<h2 style=\"color: black;\"><span id=\"Causes\" class=\"mw-headline\">Causes<\/span><\/h2>\n<p style=\"color: #252525; text-align: justify;\">The\u00a0<a style=\"color: #0b0080;\" title=\"Etiology\" href=\"http:\/\/en.wikipedia.org\/wiki\/Etiology\">etiology<\/a>\u00a0of PPD is not well understood. It is sometimes assumed that postpartum depression is caused by a lack of vitamins.\u00a0Other studies tend to show that more likely causes are the significant changes in a woman&#8217;s hormones during pregnancy.\u00a0Yet other studies have suggested there is no known correlation between hormones and postpartum mood disorders,\u00a0and hormonal treatment has not helped postpartum depression victims. Further, fathers, who are not undergoing profound hormonal changes, suffer PPD at relatively high rates.\u00a0Finally, all mothers experience these hormonal changes, yet only about 10\u201315% suffer PPD. This does\u00a0<i>not<\/i>\u00a0mean, however, that hormones do not play a role in PPD.\u00a0For example, in women with a history of PPD, a hormone treatment simulating pregnancy and parturition caused these women to suffer mood symptoms. The same treatment, however, did not cause mood symptoms in women with no history of PPD. One interpretation of these results is that there is a subgroup of women who are vulnerable to hormone changes during pregnancy. Another interpretation is that simulating a pregnancy will trigger PPD in women who are vulnerable to PPD for any of the reasons indicated by Beck&#8217;s meta-analysis as summarized above.<\/p>\n<p style=\"color: #252525; text-align: justify;\">Profound\u00a0<a style=\"color: #0b0080;\" title=\"Lifestyle (sociology)\" href=\"http:\/\/en.wikipedia.org\/wiki\/Lifestyle_(sociology)\">lifestyle<\/a>\u00a0changes brought about by caring for the\u00a0<a style=\"color: #0b0080;\" title=\"Infant\" href=\"http:\/\/en.wikipedia.org\/wiki\/Infant\">infant<\/a>\u00a0are also frequently claimed to cause PPD, but, again, there is little evidence for this hypothesis. Mothers who have had several previous children without suffering PPD can nonetheless suffer it with their latest child.\u00a0Plus, most women experience profound lifestyle changes with their first pregnancy, yet most do not suffer PPD.<\/p>\n<p style=\"color: #252525; text-align: justify;\">In 2009, researchers at the\u00a0<a style=\"color: #0b0080;\" title=\"University of California, Irvine\" href=\"http:\/\/en.wikipedia.org\/wiki\/University_of_California,_Irvine\">University of California, Irvine<\/a>, reported that the levels of placental\u00a0<a style=\"color: #0b0080;\" title=\"Corticotropin-releasing hormone\" href=\"http:\/\/en.wikipedia.org\/wiki\/Corticotropin-releasing_hormone\">corticotropin-releasing hormone<\/a>\u00a0(CRH) during the 25th week of pregnancy may help predict a woman&#8217;s chances of developing postpartum depression.<\/p>\n<p style=\"color: #252525;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMTibbitsbaby5.jpg\" alt=\"KatarinaMTibbitsbaby5\" width=\"640\" height=\"479\" \/><\/p>\n<h3 style=\"font-weight: bold; color: black;\"><span id=\"Risk_factors\" class=\"mw-headline\">Risk factors<\/span><\/h3>\n<p style=\"color: #252525; text-align: justify;\">While the causes of PPD are not understood, a number of factors have been suggested to increase the risk of PPD:<\/p>\n<ul>\n<li><a style=\"color: #0b0080;\" title=\"Childbirth-related posttraumatic stress disorder\" href=\"http:\/\/en.wikipedia.org\/wiki\/Childbirth-related_posttraumatic_stress_disorder\">Birth-related psychological trauma<\/a><\/li>\n<li><a style=\"color: #0b0080;\" title=\"Birth trauma (physical)\" href=\"http:\/\/en.wikipedia.org\/wiki\/Birth_trauma_(physical)\">Birth-related physiological trauma<\/a><\/li>\n<li>Elevated\u00a0<a style=\"color: #0b0080;\" title=\"Prolactin\" href=\"http:\/\/en.wikipedia.org\/wiki\/Prolactin\">prolactin<\/a>\u00a0levels<\/li>\n<li><a style=\"color: #0b0080;\" title=\"Oxytocin\" href=\"http:\/\/en.wikipedia.org\/wiki\/Oxytocin\">Oxytocin<\/a>\u00a0depletion<\/li>\n<li>Formula feeding rather than\u00a0<a class=\"mw-redirect\" style=\"color: #0b0080;\" title=\"Breast-feeding\" href=\"http:\/\/en.wikipedia.org\/wiki\/Breast-feeding\">breast-feeding<\/a><\/li>\n<li>A history of depression<\/li>\n<li>Cigarette smoking<\/li>\n<li>Low self-esteem<\/li>\n<li>Childcare stress<\/li>\n<li>Prenatal depression during pregnancy<\/li>\n<li>Prenatal anxiety<sup id=\"cite_ref-Beck-200109_20-3\" class=\"reference\"><a style=\"color: #0b0080;\" href=\"http:\/\/en.wikipedia.org\/wiki\/Postpartum_depression#cite_note-Beck-200109-20\">[20]<\/a><\/sup><\/li>\n<li>Low social support<\/li>\n<li>Life stress<\/li>\n<li>Poor marital relationship<\/li>\n<li>Infant temperament problems\/<a style=\"color: #0b0080;\" title=\"Baby colic\" href=\"http:\/\/en.wikipedia.org\/wiki\/Baby_colic\">colic<\/a><\/li>\n<li><a style=\"color: #0b0080;\" title=\"Maternity blues\" href=\"http:\/\/en.wikipedia.org\/wiki\/Maternity_blues\">Maternity blues<\/a><sup id=\"cite_ref-Beck-200109_20-8\" class=\"reference\"><a style=\"color: #0b0080;\" href=\"http:\/\/en.wikipedia.org\/wiki\/Postpartum_depression#cite_note-Beck-200109-20\">[20]<\/a><\/sup><\/li>\n<li>Single Marital Status<\/li>\n<li>Low socioeconomic status<\/li>\n<li><a style=\"color: #0b0080;\" title=\"Unintended pregnancy\" href=\"http:\/\/en.wikipedia.org\/wiki\/Unintended_pregnancy\">Unplanned\/unwanted pregnancy<\/a><\/li>\n<\/ul>\n<p style=\"color: #252525; text-align: justify;\">Of these, formula feeding, a history of depression, and cigarette smoking have been shown to be additive effects.<\/p>\n<p style=\"color: #252525;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/amicuscuria.com\/wordpress\/wp-content\/uploads\/2014\/05\/KatarinaMTibbits.jpg\" alt=\"KatarinaMTibbits\" width=\"632\" height=\"843\" \/><\/p>\n<p style=\"color: #252525; text-align: justify;\">These factors are known to\u00a0<a class=\"mw-redirect\" style=\"color: #0b0080;\" title=\"Correlation\" href=\"http:\/\/en.wikipedia.org\/wiki\/Correlation\">correlate<\/a>\u00a0with PPD. &#8220;Correlation&#8221; in this case means that, for example, high levels of prenatal depression are associated with high levels of postnatal depression, and low levels of prenatal depression are associated with low levels of postnatal depression. But this does not mean the prenatal depression causes postnatal depression\u2014they might both be caused by some third factor. In contrast, some factors, such as lack of social support, almost certainly\u00a0<i>cause\u00a0<\/i>postpartum depression. (The\u00a0<i>causal<\/i>\u00a0role of lack of social support in PPD is strongly suggested by several studies, including O&#8217;Hara 1985, Field et al. 1985; and Gotlib et al. 1991.) Anthropologists Kruckman and Stern tested the idea cross culturally, and their pioneering study determined six ways in which postpartum rituals, including the use of the postpartum ritual, la cuarentena, in Chicago Latina mothers, to protect or cushion the expression of mood disorders.<\/p>\n<p style=\"color: #252525; text-align: justify;\">In addition to Beck\u2019s meta-analysis cited above, other academic studies have shown a correlation between a mother\u2019s\u00a0<a class=\"mw-redirect\" style=\"color: #0b0080;\" title=\"Race (classification of human beings)\" href=\"http:\/\/en.wikipedia.org\/wiki\/Race_(classification_of_human_beings)\">race<\/a>,\u00a0<a style=\"color: #0b0080;\" title=\"Social class\" href=\"http:\/\/en.wikipedia.org\/wiki\/Social_class\">social class<\/a>\u00a0and\/or\u00a0<a style=\"color: #0b0080;\" title=\"Sexual orientation\" href=\"http:\/\/en.wikipedia.org\/wiki\/Sexual_orientation\">sexual orientation<\/a>\u00a0and postpartum depression. In 2006 Segre et al., conducted a study &#8220;on the extent to which\u00a0<a class=\"mw-redirect\" style=\"color: #0b0080;\" title=\"Race (classification of human beings)\" href=\"http:\/\/en.wikipedia.org\/wiki\/Race_(classification_of_human_beings)\">race<\/a>\/ethnicity is a risk factor&#8221; for PPD.\u00a0Studying 26,877 postpartum women they found that 15.7% were depressed. Of the women who suffered from PPD, African American women suffered at a rate of 25.2%, American Indian\/Native Alaskan women at 22.9%, Caucasian women at 15.5%, Hispanic women at 15.3%, and 11.5% for those reporting Asian\/Pacific Islander. Even when &#8220;important social factors such as age, income, education, marital status, and baby\u2019s health were controlled, African American women still emerged with significantly increased risk for\u2026PPD&#8221;.<\/p>\n<p style=\"text-align: justify;\">These above factors are known to <a class=\"mw-redirect\" title=\"Correlation\" href=\"http:\/\/en.wikipedia.org\/wiki\/Correlation\">correlate<\/a> with PPD. This correlation does not mean these factors are causal. Rather, they might both be caused by some third factor. Contrastingly, some factors almost certainly attribute to the cause of postpartum depression, such as lack of social support.<\/p>\n<p style=\"text-align: justify;\">Not surprisingly, women with fewer resources indicate a higher level of postpartum depression and stress than those women with more financial resources. Rates of PPD have been shown to decrease as income increases.\u00a0Women with fewer resources may be more likely to have an unintended or unwanted pregnancy, increasing risk of PPD. Single mothers of low income may have fewer resources to which they have access while transitioning into motherhood.<\/p>\n<p style=\"text-align: justify;\">Studies have also shown a correlation between a mother\u2019s <a class=\"mw-redirect\" title=\"Race (classification of human beings)\" href=\"http:\/\/en.wikipedia.org\/wiki\/Race_(classification_of_human_beings)\">race<\/a> and postpartum depression. For race, African American mothers have been shown to have the highest risk of PPD at 25%, while Asians had the lowest at 11.5%, after controlling for social factors such as age, income, education, marital status, and baby\u2019s health were controlled. The PPD rates for American Indians, Caucasian and Hispanic women fell in between.<\/p>\n<p style=\"text-align: justify;\"><a title=\"Sexual orientation\" href=\"http:\/\/en.wikipedia.org\/wiki\/Sexual_orientation\">Sexual orientation<\/a>\u00a0has also been studied as a risk factor for PPD. In a 2007 study conducted by Ross and colleagues, lesbian and bisexual mothers were tested for PPD and then compared with a heterosexual sample. It was found that lesbian and bisexual biological mothers had significantly higher Edinburgh Postnatal Depression Scale scores than heterosexual women in the sample.<sup id=\"cite_ref-Ross_26-1\" class=\"reference\"><a href=\"http:\/\/en.wikipedia.org\/wiki\/Postpartum_depression#cite_note-Ross-26\">[26]<\/a><\/sup> These higher rates of PPD in lesbian\/bisexual mothers may reflect less social support, particularly from their families of origin and additional stress due to homophobic discrimination in society.<\/p>\n<p style=\"color: #252525; text-align: justify;\">Segre et al., also found a correlation between a mother\u2019s\u00a0<a style=\"color: #0b0080;\" title=\"Social class\" href=\"http:\/\/en.wikipedia.org\/wiki\/Social_class\">social class<\/a>\u00a0and PPD. Not surprisingly, women with fewer resources indicate a higher level of postpartum depression and stress than those with more financial resources. Rates of PPD decreased as income increased as follows:\u00a0Women with fewer resources are also more likely to have an unintended or unwanted pregnancy, further increasing risk of PPD. Beck (2001) concurs with this, stating that these women are at risk for PPD because they may experience stressors such as financial difficulties. Single mothers of low income may have fewer resources they have access to while transitioning into motherhood.<\/p>\n<table class=\"wikitable\" style=\"color: black;\">\n<tbody>\n<tr>\n<th>Income<\/th>\n<th>PPD rate<\/th>\n<\/tr>\n<tr>\n<td>&lt;$10,000<\/td>\n<td>24.3%<\/td>\n<\/tr>\n<tr>\n<td>$10,000-$19,000<\/td>\n<td>20.0%<\/td>\n<\/tr>\n<tr>\n<td>$20,000-$29,000<\/td>\n<td>18.8%<\/td>\n<\/tr>\n<tr>\n<td>$30,000-$39,000<\/td>\n<td>15.3%<\/td>\n<\/tr>\n<tr>\n<td>$40,000-$49,000<\/td>\n<td>13.7%<\/td>\n<\/tr>\n<tr>\n<td>$50,000+<\/td>\n<td>10.8%<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p style=\"color: #252525; text-align: justify;\">Likewise, a study conducted by Howell et al. in 2006 confirms Segre\u2019s findings that women who are not Caucasian and in lower socioeconomic categories have more symptoms of PPD.<\/p>\n<p style=\"color: #252525; text-align: justify;\">In a 2007 study conducted by Ross et al., lesbian and bisexual mothers were tested for PPD and then compared with a heterosexual sample. Ross et al. found that &#8220;lesbian and bisexual biological mothers had significantly higher Edinburgh Postnatal Depression Scale (EPDS) scores than the\u2026sample of heterosexual women.&#8221;\u00a0The Ross study suggests that PPD may be more common among lesbian and bisexual mothers. From a study conducted in 2005 by Ross, the higher rates of PPD in lesbian\/bisexual mothers than heterosexual mothers may be due to less &#8220;social support, particularly from their families of origin and\u2026additional stress due to homophobic discrimination&#8221; in society.<\/p>\n<h3 style=\"font-weight: bold; color: black; text-align: justify;\">Research suggests that PPD is a functional component of human reproductive decision-making, research supports the notion that PPD caused mothers to decline investment in their offspring.<\/h3>\n<p style=\"color: #252525; text-align: justify;\">Human infants require an extraordinary degree of care. Lack of support and insufficient investment from fathers and\/or other family members will increase the costs borne by mothers, whereas infant health problems will reduce the evolutionary benefits to be gained.\u00a0If ancestral mothers did not receive enough support from fathers or other family members, they may not have been able to afford raising the new infant without harming any existing children, or damaging their own health (nursing depletes mothers&#8217; nutritional stores, placing the health of poorly nourished women in jeopardy).<\/p>\n<p style=\"color: #252525; text-align: justify;\">For mothers suffering inadequate social support or other costly and stressful circumstances, negative emotions directed towards a new infant could serve an important evolved function by causing the mother to reduce her investment in an overly taxing infant, thereby reducing her costs. Numerous studies support the correlation between postpartum depression and lack of social support or other childcare stresses.\u00a0Kruckman, using observations from anthropological field work, suggests that supportive rituals and knowledge, if projected to the mother in a meaningful and sincere fashion, can affect the hypothalamus, pituitary and adrenal function and the production of endocrine signal molecules, and reduce the expression of anxiety or panic in postpartum women.<\/p>\n<p style=\"color: #252525; text-align: justify;\">Mothers with postpartum depression can unconsciously exhibit fewer positive emotions and more negative emotions toward their children, are less responsive and less sensitive to infant cues, less emotionally available, have a less successful maternal role attainment, and have infants that are less securely attached; and in more extreme cases, some women may have thoughts of harming their children.\u00a0In other words, most mothers with PPD are suffering some kind of cost, like inadequate social support, and consequently are mothering less.<\/p>\n<p style=\"color: #252525; text-align: justify;\">In this view, mothers with PPD do not have a mental illness, but instead cannot afford to take care of the new infant without more social support, more resources, etc. Treatment should therefore focus on helping mothers get what they need.<\/p>\n<p style=\"color: #252525; text-align: justify;\"><em><strong>VIOLENCE<\/strong><\/em><\/p>\n<p style=\"color: #252525; text-align: justify;\">A meta-analysis reviewing research on the association of violence and postpartum depression showed that violence against women increases the incidence of postpartum depression.\u00a0About one-third of women throughout the world will experience physical and\/or sexual violence at some point in their lives.\u00a0Violence against women occurs in conflict, post-conflict, and non-conflict areas.\u00a0It is important to note that the research reviewed only looked at violence experienced by women from male perpetrators, but did not consider violence inflicted on men or women by women. Further, violence against women was defined as \u201cany act of gender-based violence that results in, or is likely to result in, physical, sexual, or psychological harm or suffering to women\u201d.\u00a0Psychological and cultural factors associated with increased incidence of postpartum depression include family history of depression, stressful life events during early puberty or pregnancy, anxiety or depression during pregnancy, and low social support.\u00a0Violence against women is a chronic stressor, so depression may occur when someone is no longer able to respond to the violence.<\/p>\n<h2 style=\"color: black; text-align: justify;\"><span id=\"Prevention\" class=\"mw-headline\">Prevention<\/span><\/h2>\n<p style=\"color: #252525; text-align: justify;\">Early identification and intervention improves long term prognoses for most women. Some success with preemptive treatment has been found as well. A 2013 Cochrane review found evidence that psycho-social or psychological intervention after childbirth helped reduce the risk of postnatal depression.\u00a0These interventions included home visits, telephone-based peer support, and interpersonal psychotherapy.<\/p>\n<p style=\"color: #252525; text-align: justify;\">A major part of prevention is being informed about the risk factors, and the medical community can play a key role in identifying and treating postpartum depression. Women should be screened by their physician to determine their risk for acquiring postpartum depression. Also, proper exercise\u00a0and nutrition appears to play a role in preventing postpartum, and\u00a0<a style=\"color: #0b0080;\" title=\"Depression (mood)\" href=\"http:\/\/en.wikipedia.org\/wiki\/Depression_(mood)\">depressed mood<\/a>\u00a0in general.<\/p>\n<p style=\"color: #252525; text-align: justify;\">In the US, the\u00a0<a class=\"mw-redirect\" style=\"color: #0b0080;\" title=\"American College of Obstetricians and Gynecologists\" href=\"http:\/\/en.wikipedia.org\/wiki\/American_College_of_Obstetricians_and_Gynecologists\">American College of Obstetricians and Gynecologists<\/a>\u00a0recommends that the first prenatal visit include screening for depression, stress, support, and whether the pregnancy was planned.\u00a0However providers do not consistently provide screening and appropriate follow-up.\u00a0Currently, Alberta is the only province in Canada with universal PPD screening which has been in place since 2003. The PPD screening is carried out by Public Health nurses in conjunction with the baby&#8217;s immunization schedule.<\/p>\n<h3 style=\"font-weight: bold; color: black; text-align: justify;\">Pregnant, nursing and postpartum women are strongly encouraged to seek the medical advice of their\u00a0<a class=\"mw-redirect\" style=\"color: #0b0080;\" title=\"Obstetrician\" href=\"http:\/\/en.wikipedia.org\/wiki\/Obstetrician\">obstetrician<\/a>,\u00a0<a style=\"color: #0b0080;\" title=\"Primary care physician\" href=\"http:\/\/en.wikipedia.org\/wiki\/Primary_care_physician\">primary care physician<\/a>,\u00a0<a class=\"mw-redirect\" style=\"color: #0b0080;\" title=\"Registered dietitian\" href=\"http:\/\/en.wikipedia.org\/wiki\/Registered_dietitian\">registered dietitian<\/a>, or midwife regarding optimal nutrition during pregnancy and after birth.<\/h3>\n<p style=\"color: #252525; text-align: justify;\">The following nutritional information may be beneficial in achieving a well-balanced diet during and after pregnancy, but studies are needed to confirm their role in preventing postpartum depression.<\/p>\n<p style=\"color: #252525; text-align: justify;\"><span style=\"color: #252525;\"><strong><em>Omega 3 Fatty Acids:<\/em><\/strong> Some experts believe that postpartum depression can be attributed to depletion of\u00a0<a class=\"mw-redirect\" style=\"color: #0b0080;\" title=\"Omega-3 fatty acids\" href=\"http:\/\/en.wikipedia.org\/wiki\/Omega-3_fatty_acids\">omega 3 fatty acids<\/a>\u00a0from the mother&#8217;s brain to support development of the brain of the fetus or breast fed infant. This can be prevented by ensuring that sufficient omega 3 fatty acids are provided in the mother&#8217;s diet.\u00a0Good natural sources of omega 3 fatty acids include edible linseed oil, certain fish, grass fed rather than grain fed meat, and eggs from chickens fed on flax seed or other feed high in omega 3 fats. Omega 3 fatty acids can also be purchased in capsule form as a dietary supplement.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #252525;\"><em>Omega 3 fatty acids\u00a0<\/em>can be found in a wide variety of foods. Some examples follow: 3 ounces of most meat products contain 25\u00a0grams of protein, 3 large eggs have approximately 19\u00a0grams, and 3 ounces of Swiss cheese have about 15\u00a0grams.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #252525;\"><strong><em>Water:<\/em><\/strong>\u00a0One of the most important roles in any diet (especially for pregnant and nursing mothers) is that of hydration. Physicians may recommend that pregnant women consume ten 8-ounce glasses of water every day. Mothers who are nursing are strongly urged to drink a tall glass of water, milk or juice before sitting down to breastfeed their child. Women should consult with their physicians about caffeine and alcohol consumption postpartum.<\/span><\/p>\n<p style=\"color: #252525; text-align: justify;\"><strong><em>Nutrition:<\/em><\/strong>\u00a0A pregnant and postpartum woman should speak with her physician for information about, and a recommendation for, a daily prenatal\/postnatal\u00a0<a style=\"color: #0b0080;\" title=\"Vitamin\" href=\"http:\/\/en.wikipedia.org\/wiki\/Vitamin\">vitamin<\/a>\u00a0supplement.<\/p>\n<p style=\"color: #252525; text-align: justify;\"><em><strong>Vitamins:\u00a0<\/strong><\/em>Some limited research has indicated that the intake of B vitamins, specifically\u00a0<a style=\"color: #0b0080;\" title=\"Riboflavin\" href=\"http:\/\/en.wikipedia.org\/wiki\/Riboflavin\">riboflavin<\/a>, can help reduce the chance of post partum depression.\u00a0<a style=\"color: #0b0080;\" title=\"B vitamins\" href=\"http:\/\/en.wikipedia.org\/wiki\/B_vitamins\">B vitamins<\/a>\u00a0are water soluble and must be replenished each day. B-6 vitamins are also important to maintain the proper plasma levels and helps control the omega 3 to omega 6 ratio.<\/p>\n<p style=\"color: #252525; text-align: justify;\"><strong><em>Diet:<\/em><\/strong>\u00a0If a woman finds herself with a loss of\u00a0<a style=\"color: #0b0080;\" title=\"Appetite\" href=\"http:\/\/en.wikipedia.org\/wiki\/Appetite\">appetite<\/a>\u00a0or other eating disturbance, she should consult her physician. This may be a sign of postpartum depression and therefore should be discussed with a doctor.<\/p>\n<h2 style=\"color: black;\"><span id=\"Treatment\" class=\"mw-headline\">Treatment<\/span><\/h2>\n<p style=\"color: #252525; text-align: justify;\">Numerous scientific studies and scholarly journal articles support the notion that postpartum depression is treatable using a variety of methods. If the cause of PPD can be identified, as described above under &#8220;social risk factors&#8221;, treatment should be aimed at mitigating the root cause of the problem, including increased partner support, additional help with childcare, cognitive therapy, etc. Non-professional interventions can be effective.<\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #252525;\">Women need to be taken seriously when symptoms occur. This is a twofold practice: First, the postpartum woman will want to trust her intuition about how she is feeling and believe that her symptoms are real enough to tell her significant other, a close friend, and\/or her medical practitioner; erring on the side of caution will go a long way in the treatment of PPD.\u00a0<\/span><span style=\"color: #252525;\">Second, the people in whom she confides must take her symptoms seriously as well, aiding her with treatment and support. Partners, friends and physicians may notice changes in a postpartum mother that she may not. Knowing that PPD is treatable with a variety of methods can make persistence in seeking treatment easier.<\/span><\/p>\n<p style=\"color: #252525;\">Various treatment options include:<\/p>\n<ul>\n<li>Medical evaluation to rule out physiological problems<\/li>\n<li><a style=\"color: #0b0080;\" title=\"Cognitive behavioral therapy\" href=\"http:\/\/en.wikipedia.org\/wiki\/Cognitive_behavioral_therapy\">Cognitive behavioral therapy<\/a>\u00a0(a form of\u00a0<a style=\"color: #0b0080;\" title=\"Psychotherapy\" href=\"http:\/\/en.wikipedia.org\/wiki\/Psychotherapy\">psychotherapy<\/a>)<\/li>\n<li>Possible medication<\/li>\n<li>Support groups<\/li>\n<li>Home visits\/Home visitors<\/li>\n<li>Healthy diet<\/li>\n<li>Consistent\/healthy sleep patterns<\/li>\n<\/ul>\n<p style=\"color: #252525; text-align: justify;\">An experienced medical professional will work\u00a0<i>with<\/i>\u00a0a postpartum mother to develop a treatment plan that is right for her. This plan may include any combination of the above options, and might include some discussion or feedback from\/with a partner. If a woman suffering from PPD does not feel she is being taken seriously or is being recommended a treatment plan she does not feel comfortable with, she will want to seek a second opinion.<\/p>\n<p style=\"color: #252525; text-align: justify;\">A 1997 study conducted by Appleby\u00a0<i>et al.<\/i>, confirms that postpartum depressed mothers\u2019 symptoms promptly improved at similar rates when treated with cognitive behavioral therapy or the antidepressant\u00a0<a style=\"color: #0b0080;\" title=\"Fluoxetine\" href=\"http:\/\/en.wikipedia.org\/wiki\/Fluoxetine\">fluoxetine<\/a>. &#8220;A group of 61 depressed mothers completed a 12-week treatment program with or without the antidepressant plus one session versus six sessions of counseling.&#8221; Improvement followed after &#8220;one to four weeks of either treatment&#8221;.\u00a0The findings of Appleby et al.\u2019s study conclusively showed that combining counseling with drug therapy\u00a0<i>did not<\/i>\u00a0add to the improvement of just drug therapy or just counseling.\u00a0This suggests that counseling is equally as effective a treatment for PPD as medication, and that &#8220;the choice of treatment [psychotherapy vs. medication] may\u2026be made by the women themselves&#8221;.\u00a0Other forms of therapy (like group therapy and home visitors) are also effective treatments for PPD.<\/p>\n<p style=\"color: #252525; text-align: justify;\">A woman will want to discuss the various treatment options available with her physician and, if considering drug therapy, should speak about which medications are safe to take while\u00a0<a style=\"color: #0b0080;\" title=\"Breastfeeding\" href=\"http:\/\/en.wikipedia.org\/wiki\/Breastfeeding\">breastfeeding<\/a>.<\/p>\n<p style=\"color: #252525; text-align: justify;\">Treatment for PPD can reduce the length of suffering and its severity. Untreated, the Baby Blues may go away on its own (and does in most cases). PPD may or may not go away without treatment. Speaking to a health care provider as soon as symptoms occur is the safest way to ensure prompt treatment and return to normal life.<\/p>\n<p style=\"color: #252525; text-align: justify;\">According to The National Institutes of Mental Health, studies show that the childbearing years are when a woman is most likely to experience depression in her lifetime. Approximately 15% of all women will experience postpartum depression following the birth of a child.\u00a0When the mental health of the mother is compromised, it affects the entire family.<\/p>\n<h2 style=\"color: black;\"><span id=\"Epidemiology\" class=\"mw-headline\">Epidemiology<\/span><\/h2>\n<p style=\"color: #252525; text-align: justify;\">Postpartum depression and illnesses similar to it are found across the globe, with rates of incidence varying from 11% to 42%.<\/p>\n<h2 style=\"color: black;\"><span id=\"Society_and_culture\" class=\"mw-headline\">Society and culture<\/span><\/h2>\n<p style=\"color: #252525; text-align: justify;\">The Malay culture holds a belief in a spirit known as Hantu Meroyan that resides in the placenta and amniotic fluid. When this spirit is unsatisfied and venting resentment, it causes the mother to experience frequent crying, loss of appetite, and trouble sleeping, known collectively as &#8220;sakit meroyan&#8221;. The mother can be cured with the help of a shaman, who performs a s\u00e9ance to force the spirits to leave.\u00a0Some cultures believe that the symptoms of postpartum depression or similar illnesses can be avoided through protective rituals in the period after birth. Chinese women participate in a ritual known as &#8220;doing the month&#8221; in which they spend the first 30 days after giving birth resting in bed, while the mother or mother-in-law takes care of domestic duties and childcare. In addition, the new mother is not allowed to bathe, wash her hair, leave the house, or be blown by the wind.<\/p>\n<p><em><strong>EVOLUTIONARY PSYCHOLOGY<\/strong><\/em><\/p>\n<p style=\"text-align: justify;\">Research suggests that PPD is a functional component of human reproductive decision-making, supporting the notion that PPD allows mothers to decline investment in their offspring when resources are limited.<\/p>\n<p style=\"text-align: justify;\">Human infants require an extraordinary degree of care. Lack of support and insufficient investment from fathers and\/or other family members increase the costs that are borne by mothers, whereas infant health problems reduce the evolutionary benefits to be gained.\u00a0If ancestral mothers did not receive enough support from fathers or other family members, they may not have been able to afford to raise the new infant without harming any existing children, or damaging their own health (nursing depletes mothers&#8217; nutritional stores, placing the health of poorly nourished women in jeopardy).<\/p>\n<p style=\"text-align: justify;\">For mothers suffering inadequate social support or other costly and stressful circumstances, negative emotions directed towards a new infant could serve an important evolved function by causing the mother to reduce her investment in an unaffordable infant, thereby reducing her costs. Numerous studies support the correlation between postpartum depression and lack of social support or other childcare stressors.\u00a0Kruckman, using observations from anthropological field work, suggests that supportive rituals and knowledge, if projected to the mother in a meaningful and sincere fashion, can affect the hypothalamus, pituitary and adrenal function and the production of endocrine signal molecules, and reduce the expression of anxiety or panic in postpartum women.<\/p>\n<p style=\"text-align: justify;\">Mothers with postpartum depression can unconsciously exhibit fewer positive emotions and more negative emotions toward their children, are less responsive and less sensitive to infant cues, less emotionally available, have a less successful maternal role attainment, and have infants that are less securely attached; and in more extreme cases, some women may have thoughts of harming their children.\u00a0In other words, most mothers with PPD are suffering some kind of cost, like inadequate social support, and consequently are mothering less.<\/p>\n<p style=\"text-align: justify;\">In this view, mothers with PPD do not have a mental illness, but instead cannot afford to take care of the new infant without more social support, more resources, etc. Treatment should therefore focus on helping mothers get what they need.<\/p>\n<h2 style=\"color: black;\"><span id=\"See_also\" class=\"mw-headline\">See also<\/span><\/h2>\n<ul>\n<li><a style=\"color: #0b0080;\" title=\"Antenatal depression\" href=\"http:\/\/en.wikipedia.org\/wiki\/Antenatal_depression\">Antenatal depression<\/a><\/li>\n<li><a style=\"color: #0b0080;\" title=\"Psychiatric disorders of childbirth\" href=\"http:\/\/en.wikipedia.org\/wiki\/Psychiatric_disorders_of_childbirth\">Psychiatric disorders of childbirth<\/a><\/li>\n<li><a style=\"color: #0b0080;\" title=\"Sex after pregnancy\" href=\"http:\/\/en.wikipedia.org\/wiki\/Sex_after_pregnancy\">Sex after pregnancy<\/a><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Editor&#8217;s Note:\u00a0This site was attacked early on the morning of 1-16-15 w\/the goal of deleting the following images of alleged perpetrators and victim. 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