Pregnancy and childbirth are moments of joy and fulfillment. Untarnished instants where there should be no room for trouble or worry. However, with this joy comes the added responsibility of motherhood, multiple lifestyle changes, increased workload and a severely disrupted sleep-wake schedule; at least for the initial few months. These clubbed with the hormonal changes in the mother, can lead to tremendous exhaustion that may exhibit as post partum disorders of pregnancy blues, depression or psychoses.
Almost 80% of women experience 'blues' following childbirth with restlessness, irritability, tearfulness, excessive worrying, impaired concentration, feeling of isolation and neglect, and long-lasting headaches. However all these are transient and subside within few days once the hormonal changes subside. Blues can set in a month prior to childbirth and are a pre-warning to watch out for the more complicated problems that can arise.
Pregnancy related depression
A more severe form of disturbance is post partum depression, which results in sadness of mood, low self-esteem, guilt, inability to be comforted, anger spells, and panic attacks. Post partum depression can strike at any time till the first year post delivery. It is very disabling since caring for the child becomes very effortful and the woman may indulge in denial, guilt, self-blame, or aggression. It is unrealistic and family sometimes cannot understand what’s going on. Some may culturally attribute it to black magic or the birth of a female child but these thoughts should be refrained from. The essential steps include ruling out physiological problems, offering a healthy diet, and a warm supportive environment. Cognitive therapy, and the use of antidepressants form the mainstay of treatment in port partum depression.
Pregnancy associated psychosis
Another rare problem that may come up around childbirth is post partum psychosis. This constitutes unusual behavior patterns, abnormal and irrational beliefs, extreme anxiety, fearfulness, hearing voices, memory lapses, and inability to care for the baby. This is comparable to the other forms of psychosis; the etiology is simply different. This is a lot more severe than depression and warrants immediate treatment with medication. Hospitalization may also be required in extreme cases. Prompt medication decreases the duration of the illness. Success rates with treatment are 100% but it should be initiated at once, to prevent danger to, and neglect of the child; which commonly occurs and may have very disastrous consequences in this disorder.
Hormones and the mind
Female hormones closely influence neurotransmitter systems in the brain. This leads to emotional and behavior change during menses, pregnancy as well as menopause. Hormonal changes need to be dealt with sensitively. Women are not to be blamed, although they do need to accept responsibility for their behavior. Family and friends need to know this and offer all the help possible during these mood swings. If there were a way out, every woman would choose it. It’s something women and their partners have to accept gracefully and handle perceptively.
All under control
One-to-one counseling for pregnant mothers, as well as the fathers-to-be helps in enhancing awareness of the post partum responsibilities and roles that are to be adopted. Also, warning signs and symptoms are explained so that the problem is detected and treatment can be initiated well in time. Small doses of medication that are safe for the mother and the child can be initiated. Support form family members in caring for the baby while the mother recovers is imperative too, Response rates are usually 100%. The new mother needs to be in the highest spirits to raise her child right.
Aggression and impulsivity
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