Postpartum Depression:  Your Mental Well-Being

How does your mental well-being during pregnancy affect delivery, recovery, and your newborn?  A growing tide of prenatal-care practitioners are including well-beingness advice and counseling as part of their preventive care for pregnant women in an effort to stem postpartum complications, including depression.  Not only does this help keep post-delivery healthcare costs down, but pre-delivery planning and realistic expectations help new moms cope with the joys and challenges of parenthood.

In the past decade, we’ve increasingly heard the term “Postpartum Depression” as a condition affecting some new mothers, and many medical professionals, including the American Medical Association (AMA), recognize this phenomenon as a valid condition warranting therapy often in the form of psychotropic medications.  Is this really the safest route for new mothers to take?

According to the Journal of the American Medical Association (February 12, 2002), approximately 1 out of 10 new mothers feels depressed, some seriously, and some have related symptoms within 6 months of childbirth, including sadness, tearfulness, irritability, or mood swings, known as “baby blues”.   When these symptoms become more severe, such as emotional numbness or apathy, withdrawal from family or friends, intense worry or concern about the baby or lack thereof, fears of harming oneself or baby, it’s time to be proactive for the safety and welfare of both mother and baby.

“The jury’s still out on the safety of postpartum anti-depressant medications and I wouldn’t risk my baby on it,” concedes Kay Krueger, founder of Peaceful Arrivals, an organization established to offer aid and counseling to pregnant women and new mothers.  “In fact, a growing number of health care professionals are turning to a more pragmatic approach in treating new mothers with postpartum depression”.  Kay agrees that the condition is real, but offers safe and practical solutions rather than a strict regime of antidepressant medication to combat the problems associated with postpartum depression.  According to the Centers for Disease Control at the U.S. Department of Health and Human Services, approximately 70% of new moms choose to breast feed their newborns, raising a valid argument against passing these anti-depressant medications to their babies via breast milk, especially when long-term effects are unknown.

Kay suggests, “Above all, you want to keep the environment peaceful and secure for the newborn; and much of this begins with the prenatal environment.  An agitated mom often means an agitated baby, and thus, the cycle continues.  The irritations feed off of each other.” 

Indeed, developing data suggests that the mother’s positive mental outlook during pregnancy can contribute greatly to her success in delivery, her postpartum wellness, and to the contentedness of her baby, which is why extra care and precaution should always be given to pregnant women in order to prevent injury or mental duress to her or her baby.

Many mothers also find themselves unprepared for the demands of a newborn, even if she already has children.  “The more help you can solicit for at least the first few months, the better”, advises Kay.  “I remind women over and over again that it will become easier, you will get a good night’s sleep again.”  In the meantime, Kay recommends budgeting for and utilizing meal service professionals, grocery delivery, cleaning and laundry services, carpools and after-school activities for school-age children, and if affordable, at-home chiropractic or massage services for the over-stressed mother.  “Showering and dressing every day are vital to a new mother’s self esteem and should be encouraged and supported”, adds Kay.  “Also, don’t hesitate to accept help from friends or relatives, even if it’s to allow the mother to take a much needed nap.  Just as tired or sleepy children can begin to ‘swirl’, so can the mother of a newborn, leaving her feeling a bit overwhelmed.”

Sleep and nutrition are a huge factor in a new mother’s wellness.  A recent study authored by Signe Karen Dørheim, MD, PhD, a psychiatrist at Stavanger University Hospital in Stavanger, Norway, concluded that poor sleep is linked to postpartum depression independently of other risk factors including poor partner relationship, history of depression, depression during pregnancy, and stressful life events. The aspects of sleep most strongly associated with depression were sleep disturbances and subjective sleep quality.  These finding come as no surprise to Kay; she and her staff report the number one complaint of postpartum women is tiredness and confusion due to lack of sleep.

“We all seem to forget how important the basic needs are,” reminds Kay.  “This is especially true for new mothers learning to balance the demands of their infants with their own personal needs.  New mothers are especially vulnerable to sleep and nutritional deficiencies on top of their already erratic hormonal adjustments.  I remind new mothers to eat adequate amounts of high quality foods, continue taking their pre-natal supplements, especially the B complex vitamins (with their doctor’s approval, of course), and cope as best they can with the sleep interruptions until their babies begin to sleep for longer stretches.”

In fact, for many women, just knowing that their negative feelings are temporary and often part of the postpartum transition makes dealing with their emotions much more manageable.  Many new mothers mistakenly assume that this is what the rest of their lives will be about.  Fortunately, that’s rarely the case, and reassurances that these symptoms will improve over time go a long way in helping a new mom see that sleep and normalcy will return to her life.  More tips from Kay:  Keep your attention out, that is, avoid introversion.  Meet with friends once a week for a little “grown-up” time.  Go for a walk with the stroller being sure to look out as far as you can see and notice something new; or a take a drive in the car - babies love both of these activities, too.  Getting some fresh air and expanding your space can do wonders when your world starts feeling too small.  “And, for goodness sakes, don’t try to compete with other mothers or live up to an arbitrary expectation!  This is a special time for you and your baby – do everything you can to enjoy it!”

 

    

 

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