POSTPARTUM DEPRESSION

Postpartum depression, also called ‘postpartum blues’, usually occurs 3 – 4 days after delivery of the baby.

Women who have had postpartum depression in previous deliveries have a 50% more chance of developing it again.

It is suspected that most of the women who suffer from postpartum depression have an underlying psychiatric problem that is precipitated by the symptoms of pregnancy.

Women who complain during the pregnancy that the baby is unwanted or that she is having marital problems should be carefully watched during the postpartum period.

She is likely to develop depression to a greater or lesser extent.

Causes of Postpartum Depression :

• Prolonged or difficult labour- A prolonged and difficult labour leads to severe exhaustion in the woman. At this stage, if she is further burdened with the task of having to care for a newborn all alone, she is likely get depressed, and neglect the baby.

• Severe eclampsia- Pre-eclamptic toxemia (PET) cause edema (collection of fluid) in the brain. The women may be confused about herself and the baby and be severely depressed.

• Postpartum complications like infections, breast engorgement, breast abscess can cause severe postpartum depression or postpartum blues.

• Chronic fatigue with loss of sleep immediately after the delivery.

• Sudden let down of the excitement felt during pregnancy and labor.

• Fears of not being able to care for the baby.

• Anxiety of becoming unattractive to the spouse.

Signs and Symptoms of Postpartum Depression

• Headache, not controlled by medicines.

• Insomnia -inability to sleep- or other sleep disorders.

• Delusions /confusions about herself or the baby.

• Refusal of food.

• Manic depression - becoming completely cut off from her surroundings, people around her and the baby and losing complete interest in anything.

• Tendency to suicidal thoughts and infanticide.

Management / Treatment of Postpartum Depression

• Good Nursing care to make the woman as physically comfortable as possible.A breast pump to express out the breast milk and prevent breast engorgement and breast abscess, clean vaginal pads and a regular washing and bathing routine will do much to make the patient feel comfortable.

• Maintenance of good nutrition.

• Care of the bowels especially by managing constipation.

• Relieving the patient of some of the care of the baby.A nurse or a relative can look after the baby, while allowing the woman to breastfeed and handle the baby from the time to time.

• Sedative, anti-psychotic and anti-depressant drugs- Anti-depressants should be prescribed as soon as the woman shows mild signs of depression.This will help to bring the depression under control before it deteriorates further.

• Careful watch over the patient for any signs of tendency to commit suicide.

• Separating the baby from the mother in cases of manic depression and if there is a fear of infanticide.