geburts abc

Postpartum Your Mood

After the monuments physical, hormonal and personal change that happens when you birth your baby it is to be expected that your emotions and mood are strong and sometimes unpredictable.
Transitioning to being a parent, learning how to care for a baby and yourself, opening up your family and home to a new person, societal (and your own) expectations on being a perfect parent, stress in your relationship can all be happening at the same time as you are sleep deprived and literally leaking all over the place.
Some women are more sensitive to hormonal changes after birth, but other factors contributing to your mood can be high stress levels, feeling isolated because you are a single parent or living far away from your support network, not being happy in your relationship with your partner, experiencing financial stress or low confidence. If you have a history of miscarriage, had a traumatic pregnancy or birth (now or previously), had your child admitted for special care in the neonatal intensive care unit (NICU) or have been struggling with breastfeeding you may be more likely to have mood challenges postpartum. It is very important that you find ways to deal with these emotions and depending on their severity you may need professional help.
Your mental health matters - get help if you need it. There’s no shame in asking for psychotherapy or counselling - it’s important for you, your baby and your family, too.

Dads need help too
New mums are not the only ones dealing with challenging emotions after birth - many times dads and partners are also having a hard time. Campaigns like #HowAreYouDad have helped raise awareness on these issues. Mental health services should be equally available for them.

How to ask for help
During your postpartum visits, your midwife or doctor should ask you how you are feeling emotionally and you should feel free to ask for psychological support. They should be able to connect you to local postpartum or reproductive mental health experts. If there are no services available locally, see if you are able to find counselling over video-conferencing. The type of therapy you need depends on how serious your problems are. They generally include talking to a professional about how you are feeling, about your mood triggers, changes in your life and how you are handling them.
Usually, if you are seeing a mental health professional you click well with you should be feeling better within a few weeks.

Baby blues
Many women experience something often called baby blues in the first few weeks after childbirth. Professionals generally believe this is a normal and temporary reaction to the changes that happen in your hormones after childbirth, like very intense PMS. Some symptoms include
• Crying
• Intense emotions
• Mood swings
• Irritability
It is worst immediately after birth and usually goes away about two or three weeks postpartum. Even though baby blues aren’t dangerous, you still need support to help you in the first few weeks. Having an extra pair of hands or more to help with you care for yourself, your baby and your household can help alleviate the baby blues.

Postpartum anxiety
Anxiety is normal in the first few weeks after you become a parent, as you adjust to your new role and everything happening in your life.
Anxiety can manifest itself as:
• Worries about whether you are doing things right
• Worries about whether the baby is doing well or not
• Wondering if your baby is ok or if you are up to the task of being a parent
• Loss of pleasure
• Trouble concentrating
• Isolation or feeling hopeless

You can have racing thoughts of worry and anxiety that can also become physical symptoms like:
• Problems with your digestive system
• Tightness in your chest
• Pounding heart
• Muscle tension
• Shortness of breath
• Restlessness
• Insomnia
However, there is a difference between the anxiety that is normal in early parenthood and the one that is serious, long-lasting and that affects your psychological and social functioning - this second, more serious anxiety requires support and treatment. Treatment can include psychotherapy or some other type of professional counselling, alongside self-help such as regular exercise, mindfulness practice, relaxation, massage and trying to get enough sleep.
You don’t have to have all the symptoms on the list to have the mood disorder. Just having some, but not all, is enough to seek help.

Postpartum depression (PPD)
Postpartum depression symptoms can begin immediately after pregnancy, but also a few months after birth; they can begin a few days after birth or after experiencing symptoms of baby blues. If they last more than two weeks, you must seek out professional help. PPD is a much more serious problem than baby blues and can affect from 10-15% of new mothers. Some risk factors for PPD include a having a history of depression, having a high-needs baby, not having enough support or going through a very stressful period in your life (in addition to becoming a parent). Having PPD does not make you a bad parent, it is an illness just like any other. PPD symptoms include:
• Crying often
• Frequent mood changes
• Depression and/or serious anxiety
• Losing interest in things that normally make people happy (including the baby)
• Changes in weight or appetite (although this can be related to postpartum transitions)
• Sleeping too much or too little (this too can be related to postpartum transitions)
• Feeling slowed down, restless or edgy
• Feeling overly guilty or useless
• Not bonding and/or not being able to take care of your baby
• Not being able to concentrate or think clearly (this can be related to a lack of sleep)
• Occasional thoughts about harming yourself, death or suicide

Treatment is similar to that for depression at any other point in your life - psychotherapy and antidepressants have been shown to be quite successful.

Before you are diagnosed with PPD or begin taking antidepressants, it is important that your doctor order blood tests for thyroid hormone levels – postpartum hypothyroidism can affect your mood, too.

A difficult birth
Before birth you had expectations of what your birth experience would be like, and your actual experience perhaps did not match up with this. Maybe you had a transfer from home birth or birth centre to hospital, had an unexpected caesarean, vacuum or forceps birth. Perhaps you felt unheard and disrespected during your birth experience. It is possible to be grateful that you and your baby are physically well and also be disappointed that you didn’t get the birth experience you wanted or expected; it’s also normal to take some extra time to bond with your baby as you process these emotions. These feelings can happen soon after the birth or weeks or months later - but they need to come out and be dealt with or they can boil under the surface and cause long-term problems. Some ways of doing this is writing your birth story without holding anything back or telling your story to a postpartum doula or trusted friend. Perhaps you might like to have a de-briefing session with an independent midwife who can help you process your experience. If you’d like to lodge a formal complaint with your midwife, doctor or hospital that’s a good idea. Don’t worry if it takes you a few months to do it, and if you need help writing ask a doula, maternity rights advocate or independent midwife to help you.
Writing a letter or complaint is especially useful if your clearly expressed wishes weren’t respected. Don’t use it as a sort of revenge, though - it’s more helpful to vent your anger and disappointment in a counselling session. An experienced therapist or counsellor can help you process your emotions and understand your feelings about your birth experience. There may be long-lost feelings and experiences that the birth has called forward and that are difficult to handle on your own, especially if they distract you from your baby.
No matter how you gave birth, you are a good mother with all the skills and love your baby needs.

Post-traumatic stress reaction (PTSR)
Some women experience PTSR after having a traumatic pregnancy and/or birth experience. Some symptoms of PTSR include:
• Nightmares
• Flashbacks
• Feeling vulnerable, anxious or fearful when you are in a similar situation (e.g. at the dentist’s office)
• Avoiding passing by or seeing the place you gave birth
• Feeling numb towards your partner and/or baby
• Checking on baby more often than usual, like a number of times every night
• Recurring negative thoughts
• Recurring negative emotions
• Trouble sleeping
• Feeling irritable and isolated
PTSR begins after a traumatic event or overwhelming event that does not have to seem obviously extraordinary or dangerous - it is enough that you felt you or your baby were at risk because of something you felt, heard, saw or concluded yourself, even if you were not in actual danger. Some factors that contribute to trauma symptoms include:
• Poor medical care, treatment or unnecessarily painful treatments
• Care that was not evidence-based
• Poor communication with healthcare providers
• Feeling fully out of control because of staff who did not respect your wishes during birth
• Physically traumatic birth (premature baby, emergency caesarean section, episiotomy, vacuum birth)
• Your baby having a physical injury
• Separation from your baby, especially if she was in the neonatal intensive care unit
PTSR is treated with psychotherapy or other professional counselling. In cases where the symptoms appear within one month of birth and last at least a month, it is possible that you have a serious trauma, or post-traumatic stress syndrome (PTSD).
Having PTSR can be a normal reaction to a traumatic event – your brain needs time to process what happened. You are still a strong person who can handle challenging or difficult situations.