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When New Mothers Experience Prenatal and Postpartum Mental Health Issues by Cathy Harlan, BScN, MSc, RSW, Former Coordinator for the Postpartum Depression Support Program at The Family Centre

posted Jan 24, 2011, 4:02 PM by Tascheleia Marangoni
Postpartum mental health issues were acknowledged by Hippocrates in 4 B.C. These issues have affected women and their families for centuries and worldwide.

During pregnancy, approximately 14-25% of pregnant women experience depressive symptoms ,such as low mood, tearfulness, irritability, emotional ups and downs, anxiety and insomnia.Normally, pregnant women experience these symptoms less frequently and with less intensity. When the symptoms affect the women’s functioning, treatment may include medications, and/or a referral to a therapist for counseling and support. Early identification is essential as about 50% of all women who experience prenatal depression also develop postpartum depression.

Postpartum blues or “the baby blues” are considered normal since about 50-80% of postpartum mothers experience this within the first 10 days following childbirth. Mothers may experience prolonged terafulness, fatigue, insomnia, anxiety, and feelings of being overwhelmed. These symptoms usually resolve within the first 10 days postpartum and are mild. This is caused by normal hormonal fluctuations, sleep disturbance and the emotional impact of childbirth and the mothering role.Mothers who experience the postpartum blues require education about the normal symptoms, reassurance, emotional and physical support, and when help would be needed.

Approximately 10-20% of postpartum women experience symptoms of postpartum depression (PPD). Women may experience difficulty making decisions, may feel trapped, alone or isolated. Anxiety and panic attacks are common, along with difficulty sleeping, fatigue, loss of appetite, and hypersensitivity. Some women have suicidal thoughts or thoughts of harming the baby. Mood swings can range from feelings of deep sadness to irritability or anger. PPD can be a serious illness and affects the total family. Education about PPD is essential so that the woman and family members realize the symptoms are typical for PPD. A referral to a physician is important to rule out medical causes, such as an underactive thyroid and to discuss possible treatments such as antidepressant medications or anxiety medications. Emotional support, such as a support group is important for the woman and family members.Individual counseling or marital counseling can help to resolve issues and improve communication skills.

The most serious postpartum mental health issues is postpartum psychosis. About .5-1 % of new mothers experience this disorder. These women experience extreme agitation, hallucinate, and are out of touch with reality. This is a medical emergency and the postpartum woman usually requires immediate hospitalization for her personal safety and the baby’s safety.

Some postpartum women experience postpartum obsessive-compulsive symptoms and high anxiety levels. They may require education about their symptoms, management of distressing symptoms, medications and counseling.

Early identification of prenatal and postpartum mental health issues is important so women and the their families can receive the help needed sooner.