Dr. Jones: Your baby smiles and her whole little face lights up, but you can't smile back. What's wrong? Is it the baby blues or something more serious? This is Dr. Kirtly Jones from Obstetrics and Gynecology at University of Utah Health Care and we're talking about postpartum depression today on The Scope.
Announcer: Covering all aspects of women's health. This is the Seven Domains of Women's Health with Dr. Kirtly Jones on The Scope.
Dr. Jones: The birth of a child rewires a woman's brain for maternal behavior. There are huge shifts in the hormonal environment from pregnancy to the postpartum state, breastfeeding turns on the bonding hormone, oxytocin, and adds some sleep deprivation in a world turned upside down and it's no wonder that women can experience a roller coaster of emotions. What are the baby blues and what is postpartum depression, and what can a woman do, and her family do to get help?
Well, let's start with the baby blues. Seventy-five to 80% of new moms experience some emotional upheavals in the first couple of weeks after the birth of a child. It's common. It's hard to do research on new moms. No prospective randomized trials, and we don't have any great animal models for the baby blues, rats. But we do know that a big change in pregnancy hormones and a drop in the levels of endorphins that got a woman through her labor and delivery might be part of the reason that women experience the following: weeping and bursting into tears, sudden mood swings, anxiousness and hypersensitivity to criticism . . . who would criticize a new mom, anyway? Low sprits and irritability, poor concentration, and indecisiveness, feeling unbonded with the baby.
I remember wondering when my new baby's mother was going to show up, myself. The baby blues happened in the first couple of weeks after delivery and don't last more than a couple of weeks, often just a few days. This is the time where family should be around helping the new mom get settled and get as much rest as possible with the new baby. Women without family or partner support may struggle and good news is that it happens to most women and it gets better in about a week or so.
When is the time that baby blues is possibly postpartum depression? If the anxiety and sadness continue the first couple of weeks and gets worse, this is more likely postpartum depression. Postpartum depression affects 8 to 15% of women, about one in eight. The symptoms are similar to depression, in general, overwhelming fatigue or loss of energy, severe mood swings, withdrawing from family and friends, reduced interest in activities you used to enjoy, feelings of worthlessness, shame, guilt or inadequacy. This list makes me sad just to say it out loud.
Where baby blues are common and short-lived, postpartum could go on for months and it should be recognized and treated for the sake of the mom and the baby. The women who experience postpartum depression may not even know what's happening. Families and partners need to be aware that the new mom's in trouble. Treatment is very helpful and can include talk therapy with a psychological therapist and medication can be important. Women who realize they don't feel well emotionally should call their doctors or midwives, or pediatricians and they can be referred appropriately.
There's one other postpartum psychological problem that is a medical emergency. Postpartum psychosis is very rare but serious disease that can develop within the early weeks after childbirth that's marked by a loss of contact with reality. Women may have hallucinations, hearing or seeing things that aren't real that say bad things about them or their baby, they may have delusions about themselves or their babies that are paranoid or irrational, they may show extreme agitation or anxiety, they may have thoughts of harming themselves or their babies.
This is a devastating condition for the new mom and the family and needs immediate medical care. New mom showing these problems should be brought to the medical care right away and often need to be hospitalized to protect themselves and their babies. The good news is that we're better at recognizing and treating women with postpartum mood disorders. We need to get the word out so that women and their families, that it's okay to ask for help, and they can feel better. So let's all go smile and talk to that little baby and thanks for joining us on The Scope.
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