Pregnancy & Postpartum Emotional Health:
What Every Parent, Grandparent & Practitioner Should Know
“A new baby is like the beginning of all things-wonder, hope, a dream of possibilities” (Eda J. Le Shan). Most families excitedly prepare for a baby expecting the “wonder, hope and great possibilities” of bringing a new life into the world. However, having a baby also brings with it many unexpected emotional changes and families may find themselves wondering, “Why didn’t anyone warn me it could be so hard?” I’ve experienced Postpartum Depression and Anxiety four times and I can tell you, it’s a rough way to start parenthood–feeling alone and like you’ll never be better. But as a Clinical Psychologist specializing in Perinatal Mood & Anxiety Disorders I can testify you are not alone and you will be better, especially if you get the help you need.
Today I share a few basic principles of pregnancy & posptartum emotional health that I think everybody should know, especially if you’re consdering having a baby, have already had one, love someone who’s having a baby, or if you are working with pregnant or postpartum moms and dads.
The “emotional roller-coaster” that mothers often experience following birth is a normal consequence of the fluctuations in hormones, lack of sleep and many physical and psychological demands faced during and after childbirth. Up to 80% of new mothers will experience the “Baby Blues” with symptoms like irritability, weepiness, frustration, and sadness. Dads can also experience the “Baby Blues;” it is therefore important for couples to realize this is a temporary condition that should go away on its own with sleep, support and practical help. Also, couples need to remember to be patient with one another during this crazy time when the baby seems to have all the control!
Perinatal Mood and Anxiety Disorders
If symptoms of the “Baby Blues” intensify or persist two weeks or longer, then the mother may be experiencing a Perinatal Mood or Anxiety Disorder. Postpartum Depression, the most commonly known disorder, affects up to 20% of new mothers, with symptoms like sadness, despair, hopelessness, sleep and appetite changes, and irritability. ut though many families and practitioners have heard of postpartum depression, most still do not understand the wide spectrum of emotional disorders that can seriously interfere with the family’s postpartum experience.
The term “Perinatal Mood and Anxiety Disorders” (PMADs) describes this spectrum of disorders, which occur during pregnancy and/or throughout the first year postpartum. These disorders include: depression and anxiety in pregnancy, Postpartum Depression, Postpartum Anxiety, Postpartum Obsessive-Compulsive Disorder, Postpartum Posttraumatic Stress Disorder, Postpartum Panic Disorder, and the rare Postpartum Psychosis, which affects approximately 1 in every 1,000 women. Symptoms for these disorders range from mild to severe and affect women regardless of race, age, culture or socieoeconomic status. In fact, in 2009 alone we can estimate as many as 800,000 mothers in the US experienced a perinatal mood or anxiety disorder, based on live birth statistics (http://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_01.pdf).
It is also estimated that up to 11% of dads experience postpartum depression. Together, Perinatal Mood Disorders have been called the most common complication associated with childbirth. (For more specific information on each type of disorder, please visit my website, www.postpartumcouples.com or Postpartum Support International).
Impact on the Family
When a mother experiences a Perinatal Mood Disorder, the entire family unit suffers. In fact, maternal depression is the number one factor associated with future cognitive and behavioral problems in a newborn. Also, the first year postpartum has the highest divorce rate than any other time in a couple’s lives. Yet, so many families and providers have not received the proper education to allow them to identify and treat PMADs, resulting in the unnecessary suffering of mothers, fathers, and families. The good news is, with proper identification and understanding, Perinatal Mood Disorders are nearly 100 treatable!
What Can We do?
Practitioners working with pregnant and postpartum women can make a difference in the family’s perinatal experience by becoming aware of the serious nature of Perinatal Mood & Anxiety Disorders and becoming more educated on the identification and treatment of these disorders. Physicians, such as Obstetricians, Pediatricians, Family Practitioners and others, can play a key role in identifying a Perinatal Mood Disorder through routine screening and questions regarding the emotional well-being of the mother. Physicians can also help families navigate the often difficult path to recovery by assisting them in locating reliable treatment options to suit their needs. Treatment options typically include social support, psychotherapeutic intervention and sometimes psychotropic medications. Physicians can take the time to identify referral sources in their community and provide the family with options for recovery.
Mental health practitioners working with pregnant and postpartum families, including counselors, psychologists and psychiatrists, can become educated on the proper methods for the treatment of Perinatal Mood Disorders through personal study or continuing education through organizations such as the Arizona Postpartum Wellness Coalition or Postpartum Support International. Together, medical and mental health practitioners can work to provide a seamless continuum of care for postpartum families.
Families can prepare for the possibility of a Perinatal Mood Disorder before the baby comes. They can seek education about PMAD’s by visiting such websites as Postpartum Support International’s, http://www.postapartum.net/. They can locate resource options in their community, including: practical support from friends, family or the faith community, knowledgeable doctors or therapists, and where available, a postpartum support group. Families can also contact a postpartum support volunteer by calling Postpartum Support International’s toll-free hotline, 800-944-4PPD to receive support and resource options. Finally, families can seek to remember the motto of PSI, “You are not alone. You are not to blame. With help, you will be well.”
Together, practitioners and families can create a healthy pregnancy and postpartum experience. Through awareness, education, and strong treatment options families may expect a healthy “beginning of all things” and find peace in the words of an unknown author: “A baby will make love stronger, days shorter, nights longer, bankroll smaller, home happier, clothes shabbier, the past forgotten, and the future worth living for.”
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