Post Partum

by Susan Nofziger

Here’s the myth: having a baby doesn’t change your life very much, except for the better. To the contrary, the attempts to conceive, pregnancy, giving birth, and having a newborn are the most life-changing events a woman and a couple may experience.
Within days to weeks after giving birth, as many as nine out of ten moms experience the "baby blues." For a short time, a woman may feel irritable or tearful, or have difficulty eating or sleeping. Sleep and support are the best antidote to this condition most likely caused by changing hormones.

Another concern but still relatively mild is postpartum adjustment reaction. Perhaps because of additional stress in the home along with changes in sleep and hormones, a woman has difficulty adjusting to new parenthood. A woman can usually manage this by taking good care of herself, by getting help around the house and with the children, and will usually feel better in time.
In about 20% of postpartum moms these symptoms persist or become more severe. One mom may not be able to sleep or eat or may feel extreme confusion or fear. Another mom may have excessive worries and anxieties about herself and her baby and possibly panic attacks. A woman may have thoughts of worthlessness, suicide, or of hurting her baby. If a mom is having difficulty caring for herself or her baby, she needs to seek help immediately. Postpartum depression is treatable with counseling and medication. In general, the longer a woman waits before seeking counseling, the longer the healing period. There are a small number of mothers who will develop severe symptoms where they may be out of touch with reality. These women need medical intervention immediately.

There are certain situations which may increase your risk of postpartum distress. If you or a female relation have suffered from depression or anxiety before or you are a second time mom who has had a postpartum problem before, they you may be more susceptible. Be sure to let your doctor and those around you know about your history, so they can assist you sooner rather than later. It’s important to realize if you become depressed, that it’s not your fault.

One woman had postpartum depression with her first child. She was helped with counseling and medications. She spoke with her husband about her ideas to help herself and received his support. Before she became pregnant again, she interviewed doctors and midwives to find a good match. Once pregnant she joined a pregnancy support group. She hired a birth doula who supported her during her labor. She hired a postpartum doula who came into her home to "mother" her after birth. She joined a postpartum moms group. She had all of these things in place and realized that perhaps she wouldn’t need them and could always cancel something. And it worked! She had no postpartum depression the second time around!!

Another woman who had a history of depression prepared herself by interviewing psychiatrists and counselors before she gave birth. Since she did this groundwork, she had people to call immediately as her depression spiraled-down almost overnight a few weeks after delivery. She went back on antidepressant medications and met with her counselor, helping to restore her sense of well-being.

Just because you have been depressed before does not guarantee postpartum difficulties however. Another woman had a long history of counseling and had been on antidepressants before she became pregnant. She had no problems postpartum, other than the normal frustrations with a new baby.

The Baby Book by Dr. Sears has a helpful section on postpartum self-care that I recommend to all pregnant and new moms. He encourages women to do only those things you feel up to and focus on taking care of yourself and your new baby while others take care of the household chores and other details. If you have postpartum distress, read This Isn’t What I Expected: Overcoming Postpartum Depression by Kleiman and Raskin, or go to www.postpartum.net. For information regarding child development, read T. Berry Brazelton’s Touchpoints. This book discusses the varied emotional and behavioral development of babies.

Parenting can be a wonderful journey, although challenging physically and emotionally. If you’re experiencing postpartum difficulties, there’s no need to "suffer in silence." Some women find pregnancy and motherhood a time to make lifestyle changes for the better, like eating well and exercising to deal with stress. Many moms report new qualities like feeling more calm, wise, creative, or loving than before becoming a mother. If you are not enjoying being a parent, do something now to help yourself.
Susan Nofziger is a licensed clinical social worker and works part-time in the Birthplace at Longmont United Hospital. She also has a small private practice in Boulder with a special interest in pregnancy and postpartum concerns and she facilitates Mother’s Circle, a forum for new mothers to share their experiences and gather support. She may be reached at 303-579-2646.