Coping and postpartum depression: An analysis of coping and depression during pregnancy and the puerperium

A sample of 92 women, interviewed initially during pregnancy, was followed up at about two months postpartum to investigate the relationship between coping and depression during pregnancy and the puerperium. When depression was assessed using the Structured Clinical Interview for DSM-III-R, 14% of women were diagnosed as having a major depression during pregnancy. Five of these women continued to report sufficient criteria for depression at the postpartum assessment. In addition to these women, seven women who were not depressed during pregnancy did meet criteria at the follow-up assessment, resulting in 13% of women being diagnosed as having a major depression during the postpartum period. Scores on the Beck Depression Inventory indicated a significant decrease in level of depressive symptomatology between the initial and the follow-up assessment periods.;The relationship between coping and depression was investigated using the Ways of Coping Questionnaire which contains a broad range of cognitive and behavioral strategies that individuals might use in a specific stressful encounter. Of the eight scales derived from this instrument, Escape-Avoidance emerged as the strongest predictor of both prepartum and postpartum depression. This was true for both depression diagnoses and severity of depressive symptomatology. As to the other coping factors, findings obtained with the SCID diagnoses of depression were somewhat different than those obtained with the BDI, underscoring the need to examine depression diagnosis separate from depressive symptomatology.;Analyses pertaining to changes in coping strategies following childbirth did not reveal a definite relationship to changes in level of depressive symptomatology. Trends were noted in that women reporting higher levels of depression during the postpartum period showed a relative increase in Escape-Avoidance types of coping and a relative decrease in Seeking Social Support types of coping when compared to women with lower levels of depression during the postpartum period. Implications for addressing problems of depression in women during pregnancy and the puerperium are discussed in light of the present findings.