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The postpartum period is a time of readjustment and adaptation for the entire childbearing family but, especially for the mother. Should there be a better practice in place to detect factors that increase the patients’ risk of postpartum depression (PPD)? All women of childbearing age are at a naturally higher risk of suffering from any form of depression. The woman today may not necessarily get proper medical attention after the birth of a child, and many suffer from PPD as a result.  This Depression knows no boundaries; women of all races and social classes are at risk of suffering from PPD. Most researchers and professionals consider the actual numbers to be greater than known since most women are too ashamed to admit what they are feeling. This condition is mostly associated with women as opposed to men. In most cases, among those who are infected with this depression, it has been established that PPD becomes evident within the first four weeks after childbirth and in some instances after a miscarriage. Proper health care of postpartum women is a growing problem. This paper will focus on three main ideas, which are to discuss the causes of PPD, to inform you of the most obvious symptoms of the condition, and to bring awareness to the treatment or educative actions that could be taken to prevent or decrease PPD.

According to an investigation by Mayo Clinic, the PPD condition is not credited to any particular cause. There are, however, beliefs that the depression could result from physiological changes, emotional factors and lifestyle influences around a woman after giving birth or a miscarriage. Some physical changes after childbirth include a dramatic drop in hormones (estrogen and progesterone) in your body that may contribute to postpartum depression. Other hormones produced by your thyroid gland also may drop sharply, which can leave you feeling tired, sluggish and depressed. Some emotional issues that can occur when you are sleep deprived and overwhelmed are having trouble handling even minor problems. You may be anxious about your ability to care for a newborn. You may also feel less attractive, struggle with your sense of identity or feel that you’ve lost control over your life. Any of these issues can contribute to postpartum depression. In some cases, the new sense of being a mother and the worries of how to take care of the child also create emotional issues. Finally, financial problems ascribed to matrimony and a demanding baby is a part of the lifestyle changes that could cause the devastation of PPD.

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Postpartum depression may be mistaken for baby blues at first (typically occur within a few days after the baby’s birth and are self-limiting, lasting ten days or less), but the signs and symptoms are more severe and last longer, eventually interfering with your ability to care for your baby and handle other daily tasks. Symptoms usually develop within the first few weeks after giving birth but may begin later, possibly up to six months after birth. There are several characteristics, mostly mood swings, which could serve as indicators of the presence of the PPD condition. According to, Dr. Anna Glezer, a perinatal psychiatrist at the University of California, San Francisco, the presence of fewer than three of these symptoms is not enough to support to warrant leaping into the conclusion that a person is suffering from this kind of depression. Only a combination of more than three symptoms, usually after childbirth, could be a true manifestation of PPD in a person. Some of the major symptoms of PPD include emotional drainage and exhaustion, excessive crying, recurrent thoughts to commit suicide, a feeling of worthlessness, consistent insomnia and sleep deprivation, hatred towards the baby, lack of food appetite, withdrawing from family and friends, intense irritability, severe anxiety and panic attacks, difficulty bonding with your baby, and fear that you’re not a good mother.

Postpartum depression is not a permanent condition and can even dissipate without any remedial measures taken. Waiting for the symptoms to dissipate on their own can take years and hence there is a need to control this condition for those who cannot withstand the long waiting. Many women that are feeling depressed after childbirth, may be reluctant or embarrassed to admit it. If you experience any symptoms of postpartum depression, women should call their doctor and schedule an appointment. In the case where your symptoms do not fade after two weeks, are getting worse, make it hard for you to care for your baby, difficulty completing everyday tasks and any thoughts of harming yourself or your baby you need to seek help immediately.

Some recommended healing practices in restoring normalcy include Counseling.  The patient should visit a psychiatrist for counseling and advice on how to manage the condition. This could be very effective in correcting the feeling of worthlessness and hatred towards the baby. Another approach would be hormone therapy. This approach could prove effective where the cause of the depression is established to be a rapid drop in the level of estrogen in the body, where the hormone could be replaced, thus preventing the condition. However, I read the success of this method is limited and may not guarantee absolute success. A third practice would be the use of antidepressants. The use of antidepressants requires carefulness because, though it is a proven treatment, breastfeeding mothers can pass the drug to the child. Antidepressants should only be taken after visiting a physician. This helps to avoid a self-prescription that is not in tandem with the level of depression suffered.

            My biggest question is why do we not have a better practice in place to detect factors that increase the patient’s risk of postpartum depression? I read and experienced a case in which there were underlying factors in patients that could have easily shown that they are more susceptible to be affected by PPD and because they weren’t treated as such there were serious consequences. I feel that the information is there, but there is a lack of response from the doctors, nurses, and facilities when it comes to checking and rechecking for potential risk factors for PPD. These are their patients and should be checking for a history of depression, history or bipolar disorder, did they experience PPD for a previous pregnancy, is there a  family history of depression or mood disorders, have they experienced stressful events during the past year, does the new baby have health problems or other special needs, are there any problems in the relationship with their spouse,  do they have a weak support system, do they have financial problems, and was this pregnancy unplanned or unwanted. These are all questions that should be researched and answered before even letting the mother leave the hospital. I believe every new mom should undergo a psych evaluation prior to being discharged from the hospital. I know that some of this responsibility should also fall on the patient to provide the information, but you can not count on someone to reveal something especially if they are embarrassed by it. 

            One of my biggest regrets in life is not being knowledgeable enough to make a difference and help someone who was obviously experiencing a severe case of postpartum depression. My sister and best friend took her own life just five months after giving birth to my nephew. Beginning as early as when Amanda was fifteen years old, she had been diagnosed with a chemical imbalance as well as bipolar disorder. She had a very difficult time throughout her teens managing this while trying out different medications and other ways to control it. She was hospitalized a total of three times due to her condition (which would show in her medical record) and changed medications many more. She became pregnant at the age of nineteen. The father was verbally and physically abusive throughout her entire pregnancy. He even showed up to the birth of his son completely intoxicated. So, you can see there were many reasons why Amanda was at a huge risk to suffer from PPD.  Her actual childbirth went well amidst the father’s family as well as our family fighting the entire time right in front of the nurses and hospital staff. My nephew was born beautiful and healthy. Amanda was so proud. She was sent home a day later. No psych evaluation or any question of how she was to feel after leaving the hospital. Five months later after feeling the pressure of being a single mom, being harassed by the father, and I’m sure she was struggling with her own prior diagnosed disorder she chose to take her own life.

            In doing research on this topic I have discovered there are many similar cases in which this has happened or sadly harm has become of the children.

Postpartum is a manageable condition that could be easily averted if a corrective action is taken immediately. The right action involves visiting a health professional and avoiding the habits of self-diagnosing and prescribing. An even more important action to be taken is doing a better evaluation of the mother before sending her home with her new baby in case there are serious red flags that could help potentially save a life.

 

 

 

 

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