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T he Postpartum Period

T he Postpartum Period. Postpartum Period. Lasts for approximately six weeks Mom’s body goes back to its nearly pre-pregnant state A time of physical and psychological adjustment to the process of childbearing. Physical Adjustments.

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T he Postpartum Period

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  1. The Postpartum Period

  2. Postpartum Period • Lasts for approximately six weeks • Mom’s body goes back to its nearly pre-pregnant state • A time of physical and psychological adjustment to the process of childbearing

  3. Physical Adjustments • Estrogen and progesterone drop sharply and remain low until ovaries start producing hormones again • Mom may either have a great deal of energy or feel exhausted and let down. • Loss of sleep is a huge stressor. • Involution: the process of the uterus returns to its pre-pregnant size • Uterus contracts from 2-3 pounds immediately after pregnancy to 2 -3 ½ oz. • Nursing helps contract the uterus.

  4. Notice Kate's postpartum tummy

  5. Postpartum issues with Mom • Vaginal bleeding (called lochia) occurs for up to 6-8 weeks. Small clots are normal, but large clots may require medical attention. • Episiotomy or tearing wounds take time to heal. Sitz baths and ice packs are helpful. • Uterine contractions can be painful (reminiscent of labor) as uterus shrinks back to size. • Urination may be painful or difficult for a few days. • If Mom isn’t breastfeeding, breasts become swollen and painful for several days.

  6. The Baby Blues • At least 70% of new mothers feel anxious, depressed, moody, and upset starting 2-3 days after birth. • Peaks around 3-5 days but these feelings can come and go for weeks or months or even the 1st year. • Probably related to the drop in estrogen & progesterone. Women vary in their sensitivity to these hormonal fluctuations.

  7. Postpartum depression • A more serious bout of the baby blues that affect between 10-15% of new mothers (41% of mothers who have had PPD before). • Most women who get it have had a previous bout of depression or were depressed during pregnancy. • Persistent feelings of sadness turn into a major depressive episode • Onset is usually about 4 weeks after delivery and interferes with daily functioning • Less than half of the women affected seek help. • Some antidepressants are safe for breastfeeding moms. • Cognitive-behavioral therapy and exercise can also help.

  8. Video about Postpartum Depression • http://www.youtube.com/watch?v=MJ6ALUrwSRM

  9. Effects of postpartum depression on the family • Children of depressed moms are 2-5 times more likely to develop behavior problems. • Mom’s interaction with baby and older children suffers when she’s depressed; less emotionally available • Insecure attachment pattern is more common in babies of depressed mothers. • The more extreme the mom’s depression and the more stressors in her life, the more the parent-child relationship suffers.

  10. More about postpartum depression • By the time a baby is 6 months old, he/she shows emotional symptoms such as negative, irritable mood and attachment difficulties. • Depressed mothers have inconsistent discipline, leading to adjustment problems in children. • Children may become clinically depressed themselves or mimic their mother’s anger, becoming antisocial, impulsive, and aggressive. • Marriage suffers as well.

  11. What about Fathers? • Fathers have considerable adjustment after a baby is born, although most find wife’s pregnancy more stressful than either the birth or the postpartum period. • May feel resentful and jealous of attention baby gets from mom; some feel replaced by baby. • Father’s support & caring can buffer Mom against postpartum depression (Persson et al., 2011). • Women who have a lot of support from the father have a lower incidence of postpartum depression (Smith & Howard, 2008).

  12. Depression in New Fathers • As many fathers as mothers have symptoms of depression after the baby’s birth. • Depressed dads interact less with their children and report having a lack of social support • First-time fathers are stressed and often disappointed by their post-baby sex life. • Almost all couples experience a dip in marital satisfaction after the birth of a child, and this pattern remains in place for at least 4 years after the child is born (Doss et al, 1999; Lawrence et al., 2008). • Planned pregnancies are related to less stress & depression & less marital dissatisfaction.

  13. Postpartum Psychosis • Affects about 1 in 500 women, especially those with certain risk factors (e.g., bipolar disorder before pregnancy) • http://www.youtube.com/watch?v=a4WBaO4g83c

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