You've had a baby - how are you?

you've had a baby - how are you pamphpletFeelings after birth
Caring for a new baby is hard, unrelenting work. No matter how well ą prepared you are or how much you looked forward to the arrival of your baby, you will find it difficult at times. You will probably experience a wide range of feelings, from joy and excitement to frustration and resentment, guilt and anxiety. This is quite normal, and you will need help, support and understanding from the people around you. Sometimes, however, these unhappy feelings become so intense that you feel overwhelmed, and out of control. If this happens, you may be suffering from Post Natal Depression and Anxiety. We can picture unhappy feelings after the birth of a baby like this:
Blues - PND - Psychosis

“The blues”
Up to 80 per cent of new mothers have “the blues” shortly after birth. For a few days you may feel anxious, tearful, tired and irritable.

Postnatal Psychosis
At the other end of the spectrum, the ‘deepest blue’, is a rare and very serious disorder called Postnatal psychosis, which affects one or two mothers per thousand. The mother’s thinking becomes seriously disturbed, and she needs immediate hospitalisation and treatment because she is a danger to herself and those around her.

Postnatal Depression and Anxiety
Between 10 and 30 percent of all mothers, in all circumstances, suffer from this middle-range depression. Unlike the other disorders, PND is less easy to identify and may develop slowly any time during the first year of the baby’s life. Untreated, it may continue as a chronic low-grade depression, becoming more acute with subsequent births. Every mother is different, and may have different combinations of symptoms. A mother may be more anxious or irritable than sad. It may be quite mild or very severe. Often mothers are afraid that they are ‘going mad’. Sometimes a mother has been depressed ever since her pregnancy, and sometimes ‘The Blues” don’t go away. Sometimes a mother seems to manage well for a while, and then her mood becomes darker and darker.


What causes PND?
There is no single cause of Postnatal Depression. It is not ‘just hormonal’, because fathers and adoptive mothers become depressed. It is our belief that a combination of factors contribute to the condition, such as: being a perfectionist; lack of support; a traumatic birth; financial and other stress; loneliness; an unsatisfactory relationship with the baby’s father; a previous history of depression. A woman is vulnerable when she has recently given birth, and the impact of too many stress factors at this time causes some woman to develop PND.

Treatment of PND
The PNDSA recommends a combination of three approaches in the treatment of PND:

Medication
Psychotherapy
Individual or group support

Being with other women who really understand how you feel is a great help. Anti-depressant medication can help to control the symptoms. Psychotherapy is expensive, but helpful in addressing underlying psychological and relationship difficulties.

What helps when you are feeling depressed?
Don’t be fobbed off with others telling you to “pull yourself together” and “you should be grateful╔.”
Speak to someone ą your clinic sister or doctor, a postnatal support telephone network.
Speak to your partner or a close friend.
Accept that this is not your fault.
Ask for help from others.
Plan for enough rest and time off.
Drop your standards; you can’t do as much as you used to around the home.
Join a support group where you can share this experience with 
others who understand how you feel.
Take one step at a time.

Why do so many mothers suffer in silence?
They hide their real feelings because they feel ashamed and guilty.
They may feel more anxious about the baby than depressed.
They may receive help for the physical symptoms of PND, like insomnia or tiredness, without examining the underlying causes.
Society expects women to be happy after the birth of a baby, and it’s hard to admit to being miserable.
Health professionals may not recognise the depression, or may not take it seriously.
Partners and families may not understand how the mother is feeling, and may try to tell her, “Pull yourself together”.

Does this sound familiar?
“I am so irritable and confused”
“I feel like crying for no apparent reason”
“I feel exhausted all the time”
“I feel helpless, inadequate and unable to cope"
“I worry all the time about the baby”
“I feel scared and panicky at times”
“I feel ashamed and guilty”
“I don’t know who I am any more”
“I have no interest in anything”
“I can’t sleep the way I used to"
“I don’t eat the way I used to"
“I don’t have any feelings for the baby”
“I don’t want sex any more”
“I sometimes think of hurting the baby or myself”

In case you are not sure whether or not you are experiencing Postnatal Depression, we suggest that you fill in the following scale, scoring yourself. If your score exceeds 12, please speak to your Clinic Sister, Midwife, GP or your Gynecologist, or call us on 082 8820072.

EDINBURGH POSTNATAL DEPRESSION SCALE
J.L. Cox, J.M. Holden, R. Sagovsky,1987 (Adapted by Liz Mills, for use during pregnancy)

In the past 7 days:

1. I have been able to laugh and see the funny side of things
As much as I always could [0]
Not quite so much now [1]
Definitely not so much now [2]
Not at all [3]

2. I have looked forward to things
As much as I ever did [0]
Rather less than I used to [1]
Definitely less than I used to [2]
Hardly at all [3]

3. I have blamed myself unnecessarily when things went wrong
Yes most of the time [3]
Yes, some of the time [2]
Not very often [1]
No, never [0]

4. I have been anxious or worried for no very good reason No, not at all [0]
Hardly ever [1]
Yes, sometimes [2]
Yes, very often [3]

5. I have felt scared or panicky for no very good reason
Yes, quite a lot [3]
Yes, sometimes [2]
No, not much [1]
No, not at all [0]

6. Things have been getting on top of me
Yes, most of the time I have not been able to cope at all [3]
Yes, sometimes I haven’t been coping as well as usual [2]
No, most of the time I have coped quite well [1]
No, I have been coping as well as ever [0]

7. I have been so unhappy that I have had difficulty sleeping
Yes, most of the time [3]
Yes, sometimes [2]
Not very often [1]
No, not at all [0]

8. I have felt sad or miserable
Yes, most of the time [3]
Yes, quite often [2]
Not very often [1]
No, not at all [0]

9. I have been so unhappy that I have been crying
Yes, most of the time [3]
Yes, quite often [2]
Only occasionally [1]
No, never [0]

10.The thought of harming myself has occurred to me
Yes, quite often [3]
Sometimes [2]
Hardly ever [1]
Never [0]

SCORE: [ ]

Understanding PND

Help for Family and Friends

Help for Depression in Pregnancy