The Postpartum Experience
Riding the Emotional Waves of Motherhood
Having a baby and becoming a mother can often bring a mix of contradictory feelings. Pregnancy and childbirth are a happy and joyous time for some women, but for others the experience can be one of anxiety, fear, and confusion. Due to the fact that our society holds pregnancy and motherhood in high regard, many women suffer in silence when their experience is anything less than sublime, fearing they will be negatively judged. Speaking about one's negative feelings challenges powerful cultural myths. These myths tell us that becoming a mother should be the happiest time in a woman's life, that all women possess an all-powerful maternal instinct, that motherly- love is limitless and unwavering, and that the baby is supposed to provide the mother with total fulfillment. These myths/messages about mothering, that are everywhere, can be intimidating and harmful. They set mothers up to feel ashamed for any negative feelings they may be having. These myths create powerful deterrents to speaking freely about one's struggles with motherhood. And they can also make it difficult to know whether these feelings are the normal mood fluctuations of pregnancy and the postpartum period, or symptoms of a more serious problem.
It is healthy and necessary to speak about and wrestle with the ambivalences, doubts and losses inherent in becoming a new mother. By acknowledging these feelings, it is possible to hold dear the whole experience and to celebrate the enormous gains in motherhood, of unfathomable love and the glory of a child's trusting smile.
It is when mothers feel they can't or shouldn't express the negative feelings of this experience that trouble looms. Denying or struggling all alone with intense negative emotions usually just makes them worse and these can turn into serious postpartum disorders. The full range of postpartum disorders is discussed below. For each condition, treatment is not only available, but usually highly successful. In some cases, it may be as simple as finding another mother who will listen. Other cases may require more involved counseling/therapy and medication. It can also be good to get a full medical exam including a full thyroid screening. Fatigue and depression can be a sign of postpartum thyroiditis.
Baby Blues
Studies show that 60 to 80 percent of women experience what is commonly
known as the "baby blues." The blues can occur during the first
few days after delivery. Symptoms may include crying for no apparent reason,
over-sensitivity, impatience, irritability, restlessness, anxiety, and
possibly some lack of feeling for the baby. The blues are often attributed
to the severe drop in hormone levels, which take place during the first
postpartum days. New mothers also recount feeling let down after the emotionally
charged experience of birth. The symptoms of baby blues usually let up
after a few days or weeks and are never severe in nature.
Postpartum Depression
A more debilitating postpartum reaction is postpartum depression. Although
as many as one in 10 new mothers experience varying degrees of postpartum
depression, it still remains one of the least identified and diagnosed
reactions. Although it's treatable, many women suffering from postpartum
depression do not recognize that they have it. A study of postnatal depressed
women showed that over 90 percent realized something was wrong, however
less than 20 percent reported their symptoms to a health care provider.
It is estimated that only 20 percent of the women with postpartum depression
receive mental health treatment.
Postpartum depression can occur within days of delivery or appear gradually, sometimes up to a year later. This is a good fact to keep in mind when listening to friends throughout their postpartum year. They may be depressed and benefit from more help even though their child is 10 or 12 months old. Although postpartum depression does not take the same form for every woman, all of the symptoms can be equally distressing and often leave the woman feeling ashamed, guilty and isolated. Different women may experience any combination of one or more symptoms, which range from mild to severe. The woman may also be changeable, with good days alternating with bad. Some of the most common symptoms are: nervousness and anxiety, uncontrollable crying, sluggishness, exhaustion, sadness, hopelessness, appetite and sleep disturbances, headaches, poor concentration, memory loss, confusion, feeling "out of control" or like you are "going crazy" over concern for the baby, lack of interest in the baby, feelings of guilt and inadequacy, and fear of harming oneself or the baby.
Postpartum Anxiety
Some women may not feel depressed, but may feel very anxious. This is
postpartum anxiety, and/or panic, and it is characterized by intense anxiety
and/or fear, rapid breathing, fast heart-rate, palpitations, sense of
doom, hot or cold flashes, chest pains or discomfort, shaking, dizziness,
insomnia, and feelings of wanting to run away.
Obsessive-Compulsive
Another variation can also occur, which is obsessive-compulsive thoughts
and behaviors. A woman may have thoughts that are scary and perceived
as being out of character for her. These thoughts, things that one would
never want to happen, are symptoms of the illness. Other symptoms include:
intrusive, repetitive thoughts (may include thoughts of harming baby or
others), obsessive thoughts and behaviors (e.g., the baby being harmed
by germs and obsessive cleaning), avoidance behavior, anxiety and/or depression,
and ruminating on obsessive fears.
Postpartum Psychosis
There is one more postpartum reaction, which is the most severe. This
is postpartum psychosis, which has come to light a few years ago in the
case of Andrea Yates. It is the most severe postpartum mood disturbance,
involving a loss of touch with reality. About one in 1,000 women suffer
symptoms, which usually occur within the first two weeks after delivery.
Symptoms are very exaggerated and may include insomnia, refusal to eat,
excessive energy, agitation, hallucinations, and bizarre feelings and
behavior such as suspiciousness, irrational statements and preoccupation
with trivia. At the furthest end of the spectrum, untreated postpartum
psychosis can lead to the horror of suicide, infanticide or both. Postpartum
psychosis is a serious emergency and requires immediate medical attention.
Conclusion
What mothers and fathers want most is to be able to give their best to
their children. An important part of realizing this parenting goal starts
during pregnancy and postpartum; with understanding and being able to
recognize the range of pre and postpartum symptoms. For each of these
conditions, some women experience symptoms not only after childbirth,
but also during pregnancy, following miscarriage or stillbirth, or termination
of a pregnancy, and also after adoption. At whatever time these difficulties
are encountered, knowing when and where to get help can make an enormous
difference in a family's experience of becoming parents.
Friends Can Really Help
What can be tricky is identifying mothers who are afraid to come forward.
If you feel a friend is having trouble, or if she says, "oh, I'm
fine" yet you feel in your gut that she may not be telling the truth,
you can make a difference. Sharing a "taboo" feeling or experience
of your own may help. You can also let the mother know that feelings of
anxiety or depression are not uncommon for any new mother and suggest
a mother's group, counseling or other support services.
