women
Q: What are postpartum blues?
A: The “baby blues” is a term used to describe the bouts of weepiness many women experience within a few days after delivery. It is thought that half of new mothers experience the blues. They are due to the enormous physical, hormonal, and emotional changes your body goes through as you adapt to a nonpregnant state. When this is combined with a lack of sleep, tender breasts, and changing hormone levels as milk begins to be produced, and the physical discomfort of stitches and bruising, many women feel down and find themselves weeping a few days after the baby is born. The treatment for these temporary blues is plenty of support and love, along with as much rest as you can get.
Q: How long do baby blues last?
A: The baby blues are the least severe postpartum illness. They don't usually last very long—sometimes just hours, starting from around the second or third day after the birth and lasting no longer than two weeks. During this time, you may feel tearful and irritable, but no medical treatment is needed. Although most women rapidly get over the blues, a few go on to develop more serious postpartum depression. If you find that you are feeling low and weepy after the first week, you should talk to your midwife or doctor as soon as possible.
Q: I had my baby three weeks ago and I'm feeling really low—is it just my hormones?
A: You may find that the weeks and months after your baby is born are not the happy time you expected. If you are feeling tired, confused, and unable to cope, you may be suffering from postpartum depression (PPD). Current medical opinion suggests that PPD occurs in around 1 in 10 women, with different degrees of severity. PPD has many symptoms, which can vary between individuals, but includes some or all of the following:
  • Lethargy and exhaustion.

  • Being unable to bond with your baby.

  • Feeling unmotivated and unable to perform everyday tasks; even caring for yourself and the baby may seem an impossible chore.

  • A sense of isolation from your partner, family, and friends.

  • Anxiety and panic attacks.

  • Feeling that your life is drained of pleasure.

  • Thoughts of self-blame and insecurity.

  • Feeling at risk of harming yourself or your baby.

PPD is an illness, so professional help is needed if the sufferer is to regain health and peace of mind. If you think that you may be suffering from PPD, it is important that you seek help as soon as possible. Talk first to your doctor or midwife. Antidepressants often form a part of the initial treatment. Although some women feel unhappy at the prospect of taking pills, these can play an important role, helping lift your mood while the possible causes of the depression, such as feelings of isolation, anxiety, and guilt, are tackled. Most antidepressants are nonaddictive, and some can be taken safely while breast-feeding (advise your caregiver if this is the case). Your doctor may also refer you for counseling sessions to help you to unravel the hormonal and situational basis of the depression, allowing you to come to terms with it. Also, The Postpartum Support International is one organization specifically run to help women with postpartum blues and depression. As well as offering advice and information covering all aspects of postpartum depression, it also arranges one-on-one support from its network of volunteer counselors across the US.

Q: My mom had postpartum depression. I don't want to get it too. What can I do to help myself?
A: The fact you have an awareness of PPD is a major help. You should mention its existence in your family to your doctor so that he or she is aware of it as a potential problem. Being prepared for life with a new baby may help you avoid depression. For example, before the birth try to prepare by seeking family and professional help. Contact a postpartum support group before the birth so you have resources to turn to. Make arrangements for household duties and the care of your other children. Lay in a supply of nutritious foods for use in the first few weeks after baby's arrival. Keep lines of communication open with your partner. Enlist the support of family and friends to help out after the birth. If it is thought that you are at a higher risk of developing PPD, for example, if you have a history of PPD or of depression, then it is important to discuss preventive measures such as counseling and pharmaceutical approaches. Antidepressants, sometimes administered during pregnancy or in the last month can prevent postpartum depression from occurring. It is very important that you seek the guidance of your midwife or doctor along with the services of a mental health specialist in making such decisions.
Q: I've heard that postpartum depression is more common in mothers of twins. Is this true?
A: It is the case that mothers of twins or more are more vulnerable to PPD simply because they are likely to be more exhausted and possibly struggling to cope. It's therefore important for couples expecting twins to think about their support network before the birth and try to arrange extra help. After the birth, it's important not to dismiss feeling low as simply being because of the extra workload of twins.
Q: We had our baby after IVF and were elated during pregnancy. Now I feel so low. How can this be?
A: After the emotional and physical turmoil of what could have been several years of trying to conceive, the reality of life with a newborn is bound to be a shock. Both you and your partner have been through a tremendous experience—not just the pregnancy but the process of becoming pregnant. Although all your anticipation and worries are hopefully replaced by caring for a baby and developing a new family life, that is not without its stresses. Feeling low in the week after birth as a result of changing hormone levels is common. Sleep deprivation also causes stress and extreme fatigue. Feeling low is particularly distressing when you have looked forward to having your baby and had to endure a lot to conceive him. You may feel guilty for feeling like this, or even feel that you can't deal with being a mother.

Having been through the process of IVF, your expectations were probably very high and you may not have been prepared for the fatigue and hard work that is the reality of having a baby. Rest assured that things will settle down after about six weeks, as your baby starts to develop some sort of routine and you become more used to your new role as a mother and start to gain confidence in caring for your baby.

If you continue to feel low after a week or two and are feeling tired, confused, and unable to cope, you may be suffering from PPD, in which case it is extremely important that you seek help as soon as possible. Talk to your doctor or midwife and try to enlist the support of family and friends because mild PPD can be helped by increased support.

Q: How is postpartum depression treated?
A: If you think you have PPD, talk to your doctor. There are a number of different forms of help available, including talking therapies, such as counseling, and antidepressant medicines. The most important step in treating PPD is acknowledging the problem and taking steps to deal with it. The support and understanding of your partner, family, and friends also plays a big part in your recovery.

Your caregiver can arrange counseling—your doctor may have on-site services, provide access to support groups, and crisis intervention service. A mental health professional can offer other forms of psychological treatment. Family counseling is especially critical in the treatment of postpartum depression. Often the partner of the affected mother feels they have failed and take on the responsibility and blame for the condition. Siblings may feel abandoned and feel they have caused the decline in their mother's health and that of their family. All members of the family need to be involved in prevention and management of the illness. The National Women's Health Information Center (NWHIC) serves as a clearinghouse for research, treatment and support. In addition, your county public health department can arrange for a home visit from a public health nurse who can offer guidance and support for you and your family. Support is also available from Postpartum Support International that has coordinators throughout the world who provide information and support.

Antidepressants are another line of treatment to consider, often used in conjunction with other medications and support. Use in the first few days postpartum may be recommended for those with a prior depression history.

Several important things to remember include: you are not crazy—this is a common treatable condition; many treatment regimens exist and one or many can work for you; if your feelings of unhappiness extend to the feeling that baby or your family would be better off without you, seek help immediately. If you ever feel that had your baby not been born, things would be better, seek help immediately. Postpartum depression hurts more than you; it affects everyone in your family and can be successfully treated if you take the first step. Lastly, if your partner or someone in your family thinks that you need help with the “blues” or depression, accept it and let them call upon the resources you need.

Q: We had a baby six weeks ago and my girlfriend seems so down. How can I help?
A: It is good that you are aware of your girlfriend's mood and are motivated to help her. If your girlfriend is suffering with PPD, there is no instant solution, but there are things that you can do to help her, such as simply being there for her and listening to how she feels. Take some pressure off her by helping out with babycare chores, and welcome family and friends who are willing to do something practical, such as ironing, walking the baby, or a supermarket trip. Your doctor and midwife will be experienced in dealing with PPD and will be used to supporting women and their families through such difficulties, so you can ask them for more advice.

It's important that you encourage your girlfriend to see her health-care provider—perhaps go together—since PPD is an illness that usually needs professional intervention if the sufferer is to regain their health and peace of mind fairly quickly. You could also seek support by contacting Postpartum Support International or other organizations that are run to help women with PPD.

Q: My partner is so depressed. Do dads get postpartum depression?
A: Although PPD is mainly a problem for mothers, it is recognized that new fathers can become depressed too, and it is thought that as many as 1 in 25 new fathers are affected. Having a baby is a major life event for men too, and as such it can be a factor in the onset of depression. The pressures of fatherhood, such as extra responsibility, increased expenses, a change in lifestyle, and the fatigue, all increase the risk of depression. New fathers are more likely to become depressed if their partner is depressed, if they aren't getting along with their partner, or if they are unemployed. If your partner is depressed, this will affect you too and may have an impact on how your baby develops in the first few months. Anyone suffering from symptoms of depression may find talking about their feelings with friends or family helpful. The sooner you seek help, the sooner you can develop coping strategies that will benefit your partner and family. Contact a family practice doctor or mental health professional as soon as possible.
Q: I had an awful birth and I can't stop thinking about the details. How can I get over it?
A: It is important to communicate your concerns, since many women are scared of getting pregnant again and going through another birth. Some women take steps to avoid pregnancy, such as avoiding sex, using multiple forms of contraception, or getting sterilized. Post-traumatic stress disorder (PTSD) that occurs after childbirth is a real problem, and if you are suffering from this you may benefit from psychotherapy. Extreme fear of childbirth is called tocophobia. The important thing is to examine your fears, look at how likely it is that the same thing will happen again, and look at steps you can take to reduce this likelihood. Many women say that before a traumatic birth they wanted more children, but the experience stopped them from planning another pregnancy.

A debriefing session with your midwife or doctor may be helpful. Prepare a list of questions since it can be an emotional consultation. Going through your notes can help you understand why things happened and may resolve some of your concerns. It may be worth contacting your midwife too.

Q: My partner has the “flu” every other day and wants me to take care of him. Is he jealous of the baby?
A: There may be several reasons for this, one of which could be jealousy. Talk to him without being critical. Does he need to feel more involved in the care of your baby? Suggest things he could do so he doesn't feel excluded, such as bathing the baby or taking him for a walk. Spend time with him as well as with the baby, since for both of you the focus of attention has shifted and this could feel like a loss. Also, dads present at the birth witness the pain of their partner; the feeling of helplessness for someone they love can be upsetting and this could be affecting his behavior. Fatigue may be a factor since disturbed sleep is exhausting, especially if he has returned to work. Your partner may be suffering from depression, which can occur in men after the birth of a baby; it may be worth visiting his doctor together if he is willing. Communication is vital, so make time to talk.
Q: We're thrilled and want to spend every minute with our baby. Does everyone feel like this?
A: Parenting ought to be an idyllic experience, but may not be once the realities of physical and emotional stress take their toll. However, many new parents do experience a sense of euphoria, which can be brief or last for a while. All of us have unique reactions to becoming a parent and expectations from childhood, family, and friends influence this, as does your experience of pregnancy. For families who don't feel as positive, there are ways to enhance the experience of parenthood, such as giving your baby a massage, taking family walks, and enjoying time together. Unfortunately, the need to return to some pattern of pre-baby life will probably arise, due to the necessity for one or both of you to return to work. Try scheduling family time so you can continue to delight in your baby.

Self-help measures

Following the birth, it's often the case that the attention that was focused on the mother during pregnancy shifts to the baby and, as a consequence, the mother's emotional needs may be neglected. There are steps you can take to help avoid postpartum depression, or to deal with it quickly if you think you are becoming depressed.

Keeping active:

Making sure you get out of the house during the day helps lift your spirits and provides a focus for the day.

  • Don't have unrealistic expectations of how you should be as a mother. Accept that you will make mistakes and that this is OK.

  • Get out of the house every day: walk to the park, go to a baby class, join postpartum groups, or arrange to meet friends or family.

  • Tell your partner and doctor how you are feeling. This will help you feel supported and your doctor may prescribe antidepressants.

  • Get some exercise and eat healthy, regular meals.

  • Arrange some time off, either alone, or to go out with your partner.

Highs and lows Your changing moods after the birth

You may not feel constantly low or always happy, but it is true that having a new baby and coping with the changes this brings can give you intense highs and terrible lows, as you swing between feeling ecstatic about your new baby one moment to feeling unbelievably exhausted the next.

The best advice to new parents is to be realistic about what parenthood involves. If you approach life with your new baby aware that you are both likely to be incredibly tired, that you will have far less time to yourselves, and that the structure of your life will change enormously, then you will be better placed to take the highs and lows of parenthood in your stride. Accepting that you are not “perfect” parents can help you view parenthood as a constant learning curve, and to enjoy this enriching experience. You and your partner can help each other deal with the demands of parenthood by being patient with each other and helping each other with the daily care of your baby. You can also make sure that you allow each other some regular time off to do something for yourselves, such as meeting up with friends or getting some exercise.

NOTE

Meeting the demands of a baby can be draining. Be aware of this and remind yourself that no one is a perfect parent

NOTE

Feeling low and anxious at times is normal. However, don't let this go on for too long and don't be afraid to ask for help

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