The word ‘postpartum’ commonly refers to the stage in a woman’s life from the time she gives birth until the end of the first year after birth. Many women face emotional challenges during the postpartum period, some that vanish on their own and some that range from mild, moderate, or severe and require professional evaluation and help.
The early postpartum period, the first few weeks after you give birth, is a time of great joy within your family. But it can also be physically and emotionally exhausting as well as overwhelming in the early days as you recover from childbirth and begin to live the reality of caring for your newborn. Thinking ahead is one of the best ways you can care for yourself during this period of adjustment. Read the Postpartum Wellness
page for ways to plan for the postpartum period.
Pregnancy, labor, and birth as well as the addition of a new family member are major life events that can result in stress for the body and emotions. And for many people, pregnancy and birth coincide with other major events and stressors. In addition, a woman experiences many physiological changes during pregnancy and birth that can lead to mood swings, broken or interrupted sleep and changes in lifestyle. And adjusting to life with a newborn may add additional stressors like increased sleep deprivation, irregular eating patterns, pressure to be the perfect parent and family expectations.
Baby Blues is the most common, well known and least severe of the postpartum reactions. Just as birth is the resolution of your pregnancy, for 50-75% of women the “baby blues” is the emotional cleansing that happens after birth. Mothers experiencing the blues need lots of emotional reassurance, extra sleep, good food, and increased support from family and friends. The blues are normal, usually appearing in the first week after birth causing mothers to feel emotionally ‘rocky’ and disappear on their own. The Baby Blues is not the same as Postpartum Depression and does not need medical attention.
Postpartum depression/Anxiety/OCD (PPD) is a health problem and is not the fault of any woman. Postpartum depression is more distressing and persistent than the “baby blues”. The major difference between PPD and the “baby blues” is that PPD tends to interfere with your daily functioning, your self-esteem and your relationship with your baby and/or family members.
The fact is that PPD is the #1 complication of pregnancy and occurs in 10-20% of new mothers, or one in eight, and typically begins any time from two weeks postpartum through the first year after birth. Any new mother, regardless of age, marital status, education, race, or income is at risk for PPD. It affects mothers who breastfeed and those who don’t, mothers whose babies are ill and those whose babies are thriving, mothers who have wonderful supportive births and mothers who had birth complications, mothers whose pregnancies were without complications and mothers who truly wanted to be pregnant. While shifting hormones certainly play a part, causes of PPD are also based on genetic as well as environmental factors. We can evaluate a woman’s personal risk factors, but we cannot predict the incidence of PPD with any certainty.
Risk factors can include:
- Depression during pregnancy
- A prior history or family history of depression or bipolar disorder
- A prior history of PPD
- A prior history of premenstrual dysphoric disorder
- A history of substance, emotional, physical, or sexual abuse
- A traumatic birth situation
- A preterm birth
- Lack of social support
- Recent stressful events such as: a job change, moving, loss of change of income, health changes, increased tension with a partner, or death of a loved one
Common symptoms of PPD can include:
- Crying and sadness
- Hopelessness or helplessness
- Loss of interest in food or eating too much
- Irritability or mood swings
- Trouble making decisions
- Anxiety or excessive worry about your baby
- Disinterest in your baby
- Severe fatigue or sleeplessness
- Loss of pleasure or joy
- Loss of interest in personal hygiene
- Feelings of profound isolation
- Intrusive or repetitive thoughts of harm coming to your baby
Fathers are also at risk for developing Postpartum Depression. Here is an article
with helpful information. If you or someone you know identifies with these feelings, please tell your provider or a trusted family member or friend. You are not alone. You are not to blame. Postpartum depression is the most treatable form of depression. Treatment can include nutritional supplements, exercise, support groups, medication and therapy, and most often combine some or all of these approaches. The earlier you receive help, the sooner you will begin to feel more like yourself.
Postpartum psychosis is a severe but rare (one or two in 1000) form of postpartum depression in which the symptoms are extreme.
Symptoms of Postpartum Psychosis may include:
- Extreme confusion
- Sleeplessness even when exhausted
- Refusing to eat
- Distrusting other people
- Seeing things or hearing voices that are not there
- Thoughts of suicide or hurting your baby or others
- Loss of touch with reality, which can include false beliefs or hallucinations leading to bizarre behavior
Postpartum Psychosis is a medical emergency and requires immediate medical attention. If you or someone you know fits this description, please seek medical help immediately by calling 911 or going to the nearest emergency department.
Resources for help with postpartum depression/anxiety and related disorders: