October 28, 2021
Letter to the Editor of CTV News London and the Toronto Star
Allow us to set the record straight. Walking is NOT the answer to postpartum depression as the original headline to this article stated.
The original CTV News London headline was changed 24 hours after the article was originally published and just a few hours after many expressed outrage on our social media feeds this afternoon. It now reads: New study out of Western University says walking can help with mild to moderate postpartum depression.
24 Hours Later:
Let’s hope no damage was done in the 24 hours where the original headline appeared but there are still problems with the article and study which we’d like to highlight.
The Canadian Perinatal Mental Health Collaborative (CPMHC) is concerned about the CTV News London headline and article on walking and postpartum depression. Even the Toronto Star’s headline: Walking can help mild to moderate postpartum depression, though slightly less concerning, is still problematic and providing air time to an important issue, that of perinatal mental health, albeit, in the wrong direction. The second paragraph suggests walking may be “the answer” to postpartum depression and that only “some” severe cases may require traditional medical care.
Red flags everywhere.
But does this actually happen in real life? Are doctors telling people with postpartum depression to take a hike? Seems so. As soon as we posted the article on social media, our followers went to town.
Jennifer Shannon Johnson on Facebook writes: Oh, this boils my blood! Try taking a walk when you are recovering from a C-section that went horribly wrong. I couldn’t walk for six months! Typical for people to dismiss women’s health conditions as being not that significant.
@nat_edgar on Instagram writes: I ran a half marathon at 10 months postpartum with my first. I still had PPD and PPA (postpartum anxiety).
Obviously walking is good. Exercise is good. But the headline reduces postpartum depression to a temporary, mild discomfort for women only that a little “brisk” walk in the park can cure. To us, advocates, working tirelessly to improve perinatal mental health care across Canada, this simplistic view of postpartum depression is wrong, dangerous, and sets the movement backwards.
Would you tell someone struggling with anything that a walk may be the answer to what’s ailing them? Imagine finally having the strength to talk to your doctor about how you’ve been feeling since having a baby and their answer is to take a walk.
And what about the study itself? In three of the studies examined by the meta-analysis, mothers who were walking were also receiving antidepressant treatment. This fact was not mentioned in either article. The studies analyzed actually concluded that it was exercise plus social support plus coaching that were helpful and all the studies examined by the Western University meta-analysis received a quality rating of “some concerns” which means there is a risk that the studies likely had bias.
This article, unfortunately, is the kind of misinformation we at the CPMHC are fighting day in and day out. However, instead of further adding insult to injury, we’d love to turn our anger and frustration into an opportunity to create more awareness on a topic that deserves more of our attention.
So what is the answer to postpartum depression? First of all, the question is wrong. Instead, it should read: What is the answer to perinatal mental illness?
Postpartum depression is the term we are most are familiar with but it’s just one of numerous mental health conditions a pregnant or postpartum person or partner can develop. There’s also prenatal or postpartum anxiety, post traumatic stress disorder, panic disorder, obsessive-compulsive disorder, bipolar disorder, and psychosis.
Perinatal mental illness can be caused by a number of biological, psychological and environmental factors. You’re at a higher risk if you have a history of mental illness but some people experience mental illness for the first time during pregnancy or postpartum.
The most important point to remember is that perinatal mental illness is a biological, psychological, physical illness that requires medical attention and that can range from mild to severe. Anyone thinking they might be suffering from a perinatal mental illness should not simply take a walk. They should see their doctor who has hopefully been properly trained in perinatal mental health. Unfortunately, this is not always the case.
In a recent survey we did in partnership with the University of Calgary, 95% of health care providers believe current perinatal mental health services are insufficient in Canada.
In our 2021 report: Time for Action, we provide 15 recommendations to government on how to improve perinatal mental health care in Canada. We believe the answer lies in universal screening and timely access to treatment; specialized perinatal mental health services and specially dedicated spaces modelled after “Mother and Baby Units” in the UK; home care; increased training for health care providers; and legislation to create a national perinatal mental health strategy that prioritizes equitable health care across all Canadian jurisdictions.
The only way we are going to be able to tackle the mental health crisis in Canada and globally is by focusing on when most mental health issues develop in the first place – before birth. Perinatal mental health is the single greatest determinant of a child’s health over the life course. Infants of people with perinatal mental illness are at greater risk of developing mental illness in adulthood. By not focusing on perinatal mental health, we’re just perpetuating the cycle of mental illness.
As indicated in the article, the Government of Canada’s 2018/2019 survey on Maternal Mental Health showed that an average of 23% of Canadian women experienced postpartum depression alone.
Rates are higher for marginalized people and rates of self-reported perinatal depression and anxiety have doubled during the COVID-19 pandemic period.
Indigenous mothers are 20% more likely to suffer from prenatal and postpartum depression than their white counterparts. Black mothers rates of postpartum depression are 40% higher and they and are four times more at risk of maternal mortality than white mothers. It is also believed that LGBTQ+ people experience higher rates of postpartum depression Ten per cent of fathers experience perinatal mental health issues.
Suicide is the 4th leading cause of maternal death in Canada and perinatal mental illness can have dire consequences across the family.
Only one in five people with perinatal mental health issues are currently accessing treatment.
With the right support, perinatal mental illness is treatable. With the proper assessment and diagnosis, someone suffering from a perinatal mental illness can recover through one or a combination of interventions such as cognitive behavioural therapy, interpersonal therapy, medication, peer support, and self-help which yes, may include walks. But walking alone isn’t and should never be touted as the answer to perinatal mental illness. To suggest otherwise has the potential to harm lives.
Patricia Tomasi & Jaime Charlebois
Executive Directors, CPMHC