Postpartum Emotional Adjustments

For most women, the first weeks and months after childbirth is a time of emotional upheaval. Intense feelings of joy, exhaustion, fatigue, confusion, loneliness, disappointment, anger, fear, and happiness are all common.

This transition to parenthood is referred to as a normal “life crisis.” Life will never be quite the same. You redefine who you are and find that you are often expected to put your baby’s needs before your own. It sometimes feels as though caring for a totally dependent infant is too heavy a burden. It’s not unusual to feel that your life has changed too radically and all that’s left is feeding, changing, and soothing an infant.

You are likely to feel that you have less time for your older children, your partner, and yourself. The depth of your feelings may be related to hormonal changes, fatigue and lack of sleep, and to the pain of incisions, swollen breasts or sore nipples. It may also be related to the level of support you have at home, your feelings about your childbirth experience, and the individual needs of your baby.

What to Expect
It’s normal to feel exhilarated and to have difficulty resting or sleeping in the first few days following childbirth. You may find yourself reliving the birth experience and trying to understand the sequence of events leading up to your baby’s birth. Once you are home, the enormity of the 24-hour-a-day responsibility of caring for a baby sets in. You may feel overwhelmed and confused about what your baby needs. You might be more irritable than usual or might cry easily. If your breasts become swollen you can feel uncomfortable when breastfeeding. These symptoms characterize the “Baby Blues.” A majority of women experience these symptoms. They are temporary and may last only a few hours or as long as two weeks. Getting sleep and rest, reducing household demands, concentrating only on baby care, and getting help with infant feeding, if needed, all help diminish these blues.

Postpartum Mood Disorders (PPMD)
PPMD occur less commonly than the baby blues. It is estimated that 20 to 40 percent of women experience PPMD. PPMD can occur anytime in the first year after childbirth. Symptoms are more pronounced and long lasting in comparison to the blues. Women with PPMD often feel inadequate, despondent, unable to cope with everyday life, and hopeless. They may feel very anxious or have panic attacks. They may feel life is spinning out of control and may become obsessed with getting some order into their lives. It is common to have great fears about their baby’s health or their own. They may experience headaches, chest pains, rapid heart rate, inability to sleep, and loss of appetite (or overeating). Some women describe feeling irritable, anxious, not wanting to be with people or fear being alone, having nightmares or scary thoughts, feeling as though they are in a deep, dark pit and are “going crazy.” Women often feel irritable or angry with their husband or partner. Some women have these symptoms as a result of a difficult or unexpected childbirth experience. Mothers whose babies have been born early or have needed special care in the nursery are at particular risk for PPMD. You should contact your physician or midwife if these symptoms occur frequently and cause you to be unable to care for your baby and/or yourself, if you feel no joy in life, or if the feelings last longer than a week.

Postpartum Psychosis
This is a rare condition occurring in only one to two women per 1,000. Onset is usually in the first several weeks following childbirth and symptoms are the same as PPMD, but far more severe. Women with postpartum psychosis may exhibit frantic, excessive activity, are unable to eat, are incoherent or very confused, and make irrational statements. They may have hallucinations, loss of memory and thoughts of harming themselves, their baby, or others. Postpartum psychosis must be treated immediately by a physician specializing in treating this type of psychosis. Call your doctor or midwife for help.

Helpful Suggestions:

• Talk openly about your feelings with your care provider at your postpartum visit.
• Learning to be a mother takes time and resources. Ask you nurse, doctor or midwife for hospital and community resources.
• Ask for emotional and physical help from your husband, partner, family, and friends.
• Seek-out other new parents; you are likely to discover that you’re not alone and that they share similar feelings.
• The Parent-Baby classes offered at the hospital are not only informative and educational, but also a good way to meet and talk with other new parents.
• Get plenty of rest, eat good food, and exercise. Avoid caffeine and alcohol.
• Limit your responsibilities, but stay involved with your interests as much as possible.