Paternity Leave and Paternal Postpartum Depression

New dads in the UK will now be able to take up to six months of paternity leave, under new legislation announced on January 28, 2010.   This is in addition to the currently provided 2 weeks of leave at the time of a child's birth. Women will retain their paid nine months leave, but if they choose to return to work after six months, their child's father can take the remaining three months, paid. They can also add on an additional three months unpaid.  "Paid" leave means up to 123 British pounds (about $200 USD) per week.

 

This compares to zero time paid paternal leave for US fathers, and a generous combined leave of up to 12 months in Canada.  Sweden and Norway have very generous leave policies, as well, with 16 months paid parental leave, to be divided as desired between the parents.  The most generous maternal/paternal leave system is in Lithuania, where new parents are provided 8 weeks of 100% paid leave before the due date, 100% pay in the first year, and 85% in the second year.  An additional third year may be taken unpaid, and the leave may be split as desired between the parents. This is in addition to one month of paternal leave immediately after the child's birth.

Paid paternity leave would have several benefits, including extending the time an infant is cared for by his/her own parents.  This would also relieve some of the stress of taking care of a newborn off of the new mother, who may prefer, or may need to, return to work earlier rather than staying home.  It may also be financially beneficial in the case where the mother outearns her partner. Paid paternity leave would also be a victory for gender equity and shared parenting.  

The psychiatry literature also suggests that paid paternity leave may also prevent the development of paternal postpartum depression, which is just starting be studied more extensively. Yes, while not widely known, it is true that new fathers, not just new mothers, can suffer from depression after the birth of a child.  This is known as paternal postpartum depression.  This disorder was brought into headlines recently when a popular professor at New York University committed suicide, in what was reported to be a possible case of paternal postpartum depression. 

 

Expectant mothers generally feel some anxiety mixed with eager anticipation in the months leading up to their baby's due date, but most women expect to feel mainly joy once the baby is born. Giving birth to a baby is a life-changing event that brings up powerful emotions, including joy and excitement, but often also anxiety and depression. Between 40 and 80 percent of women experience a temporary form of depression after childbirth, known as the "baby blues,"  which is distinct from postpartum depression.  The baby blues are characterized by rapid mood swings that appear within the first few days after delivery, and usually eases within a few weeks with adequate rest and support.

 

In contrast to the self-limited baby blues, postpartum depression can affect up to 20 percent of women, or one in five mothers. Women who suffer from depression in the first year after a baby's birth have what is known as postpartum depression, characterized by sad mood, crying spells, difficulty sleeping, loss of appetite, and in severe cases, thoughts of suicide. As with the baby blues, hormonal changes after childbirth are one trigger for this condition. A more severe mood disorder in the postpartum period, known as postpartum psychosis, can develop within a few weeks after delivery. The symptoms of postpartum psychosis include the above symptoms as well as confusion, hallucinations, paranoia and attempts to hurt oneself or the baby.  Postpartum depression is common and significant enough that the American College of Obstetrics and Gynecology just issued a recommendation that all pregnant women be screened for depression both during and after pregnancy.  Although the baby blues and postpartum depression can affect any woman who has given birth, there are certain risk factors, which include a previous history of depression, marital conflict, stress, childcare issues, and a family member's history of depression.

 

What is known about paternal postpartum depression?  

 

Not all that much. In fact, the criteria used to formally diagnose this is the same used to diagnose postpartum depression in new mothers.  But there is not enough research to know if these criteria are valid for men.  Because the existing studies focus heavily on Caucasian, middle-class, married fathers, there is even less known about depression in fathers of different cultural and socioeconomic backgrounds.  That said, the best estimates currently in the psychiatry literature suggest that 4% of new fathers experience postpartum depression.  This is based upon a study conducted by Dr. Paul Ramchandani at the University of Oxford, who conducted a study of 26,000 parents in England. The causes of paternal postpartum depression are thought to be similar to the causes in new mothers: stress with the care for a new child, as well as hormonal changes.  Some studies have suggested that there is a drop in testosterone levels, as well as other hormones, during a partner's pregnancy. Low testosterone has been correlated to the development of depression. Further,  having a partner with postpartum depression greatly increases the chances of the father developing postpartum depression, with a comorbidity rate of between 25-50%.

 

 

Postpartum depression can directly influence the emotional wellbeing of mothers, marital relationships, mother-infant bonding and infant behavior. Postpartum depression of any degree of severity needs to be treated. Without treatment, recovery may be delayed. Children of women whose postpartum depression is not treated may develop behavioral issues, including difficulty with sleeping and eating, temper tantrums and hyperactivity.  In men, there is the additional concern of possible violence: some research has shown that among mothers in the postpartum period, an alarming one-fourth reported violence from their partners with 69 percent being the first occurrence. Further, paternal postpartum depression is a risk factor for child abuse and infanticide. 

 

 

Well established research in maternal postpartum depression underscores the fact that any support which can decrease the stress of being a new mother can reduce the risk of postpartum depression, which is dangerous to both mother and child.  As we're finding out, the same can be said for the mental health of the father as well.  Childcare issues and a depressed family member are two of the main risk factors for the development of postpartum depression.  A guarantee of paid paternal leave will make it possible for new fathers to share more equally in the care of their newborn child.  This could ultimately benefit the new father, the new baby, and the family unit as a whole.  This is an idea which is long overdue. 

 

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Resources for New Parents:

 

Postpartum Support International

www.postpartum.net

1-805-967-7636

 

Postpartum Men

http://www.postpartummen.com/resources.htm

 

National Suicide Prevention Lifeline

1-800-273-TALK (1-800-273-8255); TTY: 1-800-799-4TTY (4889)