Examining Rates of Postpartum Depression in Active Duty U.S. Military Servicewomen.

Background: Postpartum depression (PPD) is understudied in military populations. The present descriptive transversal study evaluated the incidence of PPD diagnoses in U.S. military electronic health records, based on International Classification of Diseases, Ninth Revision (ICD-9) and ICD-10 codes, among active duty military servicewomen between 2001 and 2018. Methods: Data on 3,724 active duty military servicewomen who served between 2001 and 2018 were drawn from the Defense Medical Epidemiological Database and stratified by race, age, marital status, service branch, and military pay grade. Single sample chi squares were used to examine observed versus expected differences in diagnosis rates. Results: The incidence rate of PPD among all U.S. military servicewomen was the lowest in 2001 (1.96 per 1,000) and the highest in 2018 (29.95 per 1,000). Servicewomen most often diagnosed with PPD were white (60%), married (74%), in the enlisted pay grades of E-1 to E-4 (60%), in the Army (43%), and were between 20 and 24 years old (46%). Statistically significant differences (p < 0.001) were found between observed and expected counts across all five demographic variables. Conclusions: This is the first population-based study to assess the incidence rates of PPD among all active duty military servicewomen. Findings that some groups were over- and underdiagnosed within each demographic category, and that PPD incidence rates have increased between 2001 and 2018, underscore the importance of further research to inform policies and interventions supporting this vulnerable population.

Mothering very young children after wartime deployment: A case report.

Parenting very young children in the context of military service, deployment separations, and war-related trauma can be challenging for many families. Female active duty personnel represent one of the fastest growing segments of the military, and recent policy changes have led women to pursue serving in combat positions at much higher rates. While not much is known about service member mothers, some studies have shown that they experience significant symptoms of distress, depression, and anxiety during the deployment cycle, feelings of disconnection from family during reintegration, and higher rates of childhood trauma histories than their male counterparts. Service member mothers who experience the combined stressors of deployment separation, combat exposure, and adverse childhood experiences-a triple threat-may be at serious risk of posttraumatic stress and depressive symptomatology, which can negatively influence the quality and nature of their parenting and parent-child relationships. This case report describes the participation of a young single service member mother and her preschool-aged daughter in a home-based, reintegration program designed for military families with very young children (ages 0-5). The paper illustrates how this relationship-based, reflective parenting intervention was effective in increasing the mother's sense of competence in her parenting and strengthening the parent-child relationship.

Criar a niños muy pequeños en el contexto del servicio militar, las separaciones debido a asignaciones militares de trabajo y el trauma relacionado con la guerra pueden representar un reto para muchas familias. Las mujeres, como miembros del personal activo con asignaciones militares, representan uno de los segmentos que aumentan más rápidamente dentro del campo militar, y los cambios recientes en las regulaciones han llevado a las mujeres a dedicarse al servicio en posiciones de combate en porcentajes mucho más altos. Aunque no mucho se sabe acerca de las madres que son miembros del servicio militar, algunos estudios han mostrado que ellas experimentan síntomas significativos de angustia, depresión y ansiedad durante el ciclo de asignación militar de trabajo, sentimientos de desconexión de la familia durante la reintegración, y más altos porcentajes de historias de trauma en la niñez que sus compañeros varones. Las mujeres en el servicio militar que experimentan la combinación de factores de estrés por la separación debido a la asignación de trabajo, el estar expuestas al combate, y las adversas experiencias de la niñez - una triple amenaza - pudieran encontrarse bajo un serio riesgo de estrés postraumático y sintomatología depresiva lo cual puede influir negativamente la calidad y naturaleza de la crianza y las relaciones progenitor-niño. Este reporte de caso describe la participación de una madre joven soltera miembro del servicio militar y su hija de edad prescolar dentro de un programa de reintegración con base en el hogar diseñado para familias militares con niños muy pequeños (edad 0-5). El ensayo ilustra cómo esta intervención de crianza con reflexión con base en la relación afectiva fue eficaz en lograr aumentar el sentido de competencia de la madre en cuanto a la crianza y fortalecer la relación progenitor-niño.

Le parentage de très jeunes enfants dans le contexte du service militaire, des séparations de déploiement et du trauma lié à la guerre peut s'avérer difficile pour bien des familles. Les femmes des forces armées représentent l'une des segments à la croissance la plus rapide des forces armées américaines et des changements politiques récents aux Etats-Unis ont amené les femmes à s'intéresser aux positions de combat à des taux beaucoup plus élevés qu'auparavant. Bien qu'on sache peu de choses sur les mères dans les forces armées, certaines études ont montré qu'elles font l'expérience de symptômes importants de détresse, de dépression et d'anxiété durant leur cycle de déploiement ainsi que de sentiments de déconnexion de la famille durant leur réintégration, et font preuve d'une incidence d'histoire de trauma de l'enfance bien plus élevée que leurs contreparties hommes. Les mères dans les forces armées qui font l'expérience d'une combinaison de facteurs de stress comme la séparation du déploiement, l'exposition au combat, et des expériences adverses de l'enfance - une triple menace - peut être à risque sérieux de stress post traumatique et d'une symptomatologie dépressive qui peut influencer la qualité et la nature de leur parentage et des relations parent-enfant de manière négative. Cette étude de cas décrit la participation d'une mère des forces armées jeune et célibataire et sa fille d'âge préscolaire dans un programme de réintégration à domicile pour les familles de militaires avec de très jeunes enfants (âges 0-5). Cet article illustre la manière dont cette intervention réflective, basée sur le parentage, était efficace pour l'augmentation du sens de compétence et confiance en son parentage de la part de la mère ainsi que pour le renforcement de la relation parent-enfant.

Finding meaning in times of family stress: A mixed methods study of benefits and challenges amongst home-front parents in military families.

Family stress theory explains how demands placed on the family system interact with capabilities to influence family adaptation. One capability that some military families may use naturalistically is that of benefit-finding, the recognition of value and benefit after a stressful or traumatic experience. In this mixed methods study, authors explore the perception of benefits associated with military service amongst 26 home-front mothers. Methods incorporate a self-report questionnaire adapted for this population and a qualitative interview aimed at understanding challenges and benefits associated with these women's experiences as members of a military family. Results revealed that more women than not endorsed meaningful changes that they have experienced as a result of their family's military service, despite a wide range of challenges and negative experiences. Four themes of benefits emerged from analyses: (a) financial, educational and career benefits; (b) cultivating strength; (c) friendships and community; and (d) pride. These findings illuminate the diverse ways in which women find meaning in their family's military service and upon replication and elaboration of these results, have clinical implications for the development of future prevention and intervention work with military families.