Genesee County, MI—Postpartum depression (PPD) is a form of depression that can occur after a mother gives birth. Sleep and eating problems, anxiety and worry, and avoiding contact with the baby and other people are among the symptoms of PPD, which affects as many as one in seven women

Jennifer Johnson, a professor of public health at MSU College of Human Medicine, said PPD takes a significant toll on both the wellbeing of new mothers and their families. 

“There’s this idea that right after a baby is born should be the happiest time of your life,” Johnson said. “But that is not always the case.” She noted that PPD “can cause real suffering for the mom and challenges for the family.” 

To that end, Johnson’s research team was awarded a $6.2 million National Institutes of Health grant to study the universal prevention of PPD. In early 2023, the trial of the Reach Out, Stand Strong, Essentials (ROSE) for New Mothers intervention will start enrolling 2,320 patients receiving prenatal care at the Henry Ford Health System. Johnson, a principal investigator of the clinical trial, said screening and treatment of the condition are critical, “but if we can prevent it altogether, that’s even better.” 

ROSE, which was developed by Caron Zlotnick of Brown University, a principal investigator of the trial, involves four sessions during pregnancy and a follow-up after childbirth. It includes education on the signs and symptoms of baby blues and PPD, skills for managing stress, techniques to help resolve relationship conflicts during childbirth and resources for support. 

Previously, four studies have shown that ROSE prevents roughly half of PPD cases among adult pregnant women on public assistance. Low-income status is a risk factor that doubles the incidence of PPD, and more than 40 percent U.S. births were covered by Medicaid in 2020, a government health insurance program for people with low income. In Genesee County, over half of the births were paid by Medicaid that year. 

ROSE has been cited by the U.S. Preventive Services Task Force as one of two interventions for pregnant mothers at risk of depression. But the trial that is set to enroll participants next year will help researchers understand whether all pregnant women or only those at risk of PPD should receive ROSE. 

In an ongoing study, Johnson and Zlotnick’s team shows that most agencies find providing ROSE for all pregnant women to be more feasible than adding the extra step of screening for PPD risk. When it comes to screening for PPD risk, there are bound to be false negatives, and the research group notes that the cost of each preventable case of PPD is $32,000, which is far higher than delivering ROSE at $50 to $300 per woman. Johnson added that women from vulnerable groups can feel stigmatized if they are identified to be at risk of PPD. 

“For example, we had an agency that had a lot of undocumented women,” Johnson noted. “If they said to the woman, ‘We think you’re at risk for postpartum depression, we’d like you to take this class,’ the mom would be afraid that she was going to go on a government list somewhere, that she would be deported.”

“It’s much less stigmatizing to say, ‘This is a class that we give to all of our pregnant moms,’” Johnson continued. “Then they’re not scared. They don’t feel stigmatized. They don’t feel singled out.” 

Resources for mothers in Genesee County

Johnson said any agencies in Genesee County that provide obstetric care can offer resources on PPD, though no agencies are currently providing ROSE. PPD resources are available at local support groups as well, like the peer support group Blossom.

“To any mom experiencing postpartum depression or depression during pregnancy, I would say, ‘You are not alone,’” Johnson said in an email. “Let someone know how you are feeling and ask for the help that you need.”

Materials and training for agencies seeking to offer ROSE, which can be taught by non-mental health professionals, are available here. Agencies in Genesee County that aim to provide ROSE can also contact Johnson at for more information.

The ROSE patient workbook for moms is available in English and Spanish for free. 

For more information about Blossom, contact

Nicholas is Flint Beat’s public health and education reporter. He joins the team as he graduates from Santa Clara University, Calif. Nicholas has previously reported on dementia and brain health, as...