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Adoptive Parents Can Also Experience the “Baby Blues” – Here’s Why That Matters

By Nora Dennis, MD MSPH | November 12, 2021 | Industry Perspectives, Behavioral Health, Thought Leadership

Exhausted mom with her head in her hands sits next to young child

November is National Adoption Month, when our nation recognizes that families come in all shapes and sizes.

The celebration presents an ideal moment to think more deeply about ongoing efforts to improve our nation’s maternal health outcomes. This important work will need to be vast in scope, and some of it should take into account that not all new family relationships are biological. Newly adoptive and foster parents need support through challenges to health and well-being too.

Helping parents overcome postpartum depression is a significant component of any meaningful effort to improve maternal health. Few people realize, however, that adoptive parents can also experience “the baby blues,” or, post-placement depression.

Welcoming a new child into a family is a joyous occasion. Still, both biological and adoptive families will inevitably confront an array of complexities when the new child arrives. Providers should be ready to act when new parents exhibit signs that the new household dynamic is putting a strain on mental health.

The Causes of Post-placement Depression

There is a slim but growing body of research exploring the similarities in how biological and adoptive parents experience depression.

Adoptive parents don’t experience the sudden hormonal changes that typically follow any childbirth. But neurochemical change is not the only contributor to depression. Psychological and social changes also play powerful roles, and these factors are not unique to biological parents.

Dramatic increases in stress, changes in sleep habits, fatigue and shifts in lifestyle can lead to depression. More often than not, parenthood – whether biological or adoptive – brings all these changes. New parents also experience significant shifts in their support networks as caretaking responsibilities leave them with less time for social connection. Furthermore, parents who adopt are more likely to have experienced the challenges of infertility, which is significantly associated with depression.

It’s worth noting that depression isn’t limited according to gender either. Fathers and non-binary partners can experience it too.

Parents and providers should be on the lookout for these common symptoms:

  • Depressed mood
  • Lingering sadness
  • Indifference toward social or physical activities
  • Dramatic changes in weight and appetite
  • Changes in sleep patterns, chronic fatigue
  • Anxious feelings of inadequacy related to parenting skills; feelings of guilt and shame
  • Agitation and irritability
  • Indecisiveness and inability to concentrate

Integrating Physical and Mental Health: Positioning Primary Care Providers to Intervene

The quiet phenomenon of post-placement depression underscores the importance of integrating mental health into primary care.

The American College of Obstetricians and Gynecologists recommends that obstetric care providers screen patients for depression at least once after giving birth. But for new adoptive parents without this crucial point of contact, the primary care provider can play an essential role recognizing symptoms and coordinating a strategic mental health care response.

This exemplifies how the benefits of Blue Cross NC’s expertise in whole-person care ripple outward to reach family members, loved ones and communities. Greater awareness of post-placement depression will ensure that adoptive parents don’t face these challenges silently and alone.

Currently, there are more than 31,000 children and youth in North Carolina’s foster care programs. Integrating mental health and primary care helps ensure that these children and their families receive the support and care they need at that pivotal moment when new parents are adjusting to dramatic changes in the household. Intensive care management support during transition points is crucial for the long-term well-being of the children and families.

Improving Health Equity Strengthens Families and Our Communities

Together, postpartum and post-placement depression highlight the ways mental and maternal health intertwine. Unfortunately, data make it clear that some parents face more challenges accessing the resources that promote family well-being.

People of color experience significant disparities in maternal health and mental health. Eradicating these disparities is critical to positive health outcomes for individuals, to the well-being and security of families and to the vitality of our communities. That is why Blue Cross NC has placed both maternal and mental health at the center of an ambitious push to reduce or eliminate racial and geographical health disparities in North Carolina.

In October, Blue Cross NC committed $2 million to support evidence-based strategies to improve infant and maternal health outcomes, specifically addressing disparities among Black, American Indian and Hispanic communities. Our bold goal is to decrease racial disparities in maternal and child health care within the state by 50 percent in five years – aligning with the Blue Cross Blue Shield Association’s national health equity strategy and maternal health goal.

A second prong of investments in health equity will focus specifically on funding innovative approaches to improving and expanding access to behavioral health providers among rural and other underserved communities.

These grants will help unlock the full potential of localized resources and organizations best positioned to have an impact in the community. In all likelihood, some portion of these investments will focus on supporting new families through the experience of postpartum or post-placement depression. Why is this so important? Because mental and maternal health are foundational pillars of family well-being. When every family thrives, it’s not just individual households that benefit; healthy families hold the key to North Carolina’s brighter future.

A child’s opportunity to flourish starts at home, with family. Supporting parents through the experience of depression will ensure that every child has a foundation firm enough to grow their talents, stimulate their curiosity and support their long-term aspirations.