aving a baby is a joyous time for most women. After childbirth, though, many mothers feel sad, afraid, angry, or anxious. Most new mothers have these feelings in a mild form called postpartum blues. Sometimes these feelings are called "baby blues." Postpartum blues almost always go away in a few days.
About 10% of new mothers have a greater problem called postpartum depression. Postpartum depression lasts longer and is more intense. It often requires counseling and treatment. Postpartum depression can occur after any birth, not just the first.
This pamphlet will help you learn about:
- The causes of postpartum depression
- What you can do to ease these feelings
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| Many new mothers feel sadness, fear, anger, and anxiety after having a baby. This is normal. |
Baby Blues
Many new mothers are surprised at how weak, alone, and upset they feel after giving birth. Their feelings don't seem to match the feelings they thought they would have. They wonder, "What have I got to be depressed about?" They fear that these feelings mean that they are bad mothers.
In fact, about 70–80% of women have baby blues after childbirth. About 2–3 days after birth, they begin to feel depressed, anxious, and upset. For no clear reason, they may feel angry with the new baby, their partners, or their other children. They:
- May cry for no clear reason
- May have trouble sleeping, eating, and making choices
- Almost always question whether they can handle caring for a baby
These feelings may come and go in the first few days after childbirth. This seems strange and scary at the time. The baby blues often go away in a few hours or a week or so without treatment.
Postpartum Depression
Women with postpartum depression have such strong feelings of sadness, anxiety, or despair that they have trouble coping with their daily tasks (see box). Without treatment, postpartum depression may become worse or may last longer.
Postpartum depression is more likely to happen in women who lack the support of a partner or who have had:
- Postpartum depression before
- A psychiatric illness
- Recent stress, such as losing a loved one, family illness, or moving to a new city
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When to Suspect Postpartum Depression
A new mother may be developing—or already have—postpartum depression if:
- The baby blues don't go away after 2 weeks.
- Strong feelings of depression and anger come 1–2 months after childbirth.
- Feelings of sadness, doubt, guilt, or helplessness seem to increase each week and get in the way of normal functions.
- She is not able to care for herself or her baby.
- She has trouble doing tasks at home or on the job.
- Her appetite changes.
- Things that used to bring her pleasure no longer do.
- Concern and worry about the baby are too intense, or interest in the baby is lacking.
- Anxiety or panic attacks occur. She may be afraid to be left alone in the house with the baby.
- She fears harming the baby. These feelings are almost never acted on by women with postpartum depression, but they can be scary. These feelings may lead to guilt, which makes the depression worse.
- She has thoughts of self-harm, maybe even suicide.
A new mother having any of these signs should take steps right away to get help. |
Postpartum depression does not seem to relate to the mother's age or number of children she has had.
A few new mothers will develop a more severe mental illness. This happens in 1–3 cases for every 1,000 births. Women are more at risk if they have had manic depression (bipolar disorder) or schizophrenia or if family members have had these diseases.
Reasons for Postpartum Depression
Postpartum depression is likely to result from body, mind, and lifestyle factors combined. No two women have the same biologic make-up or life experiences. This may be why some women have postpartum depression and others don't. It also may help explain why a woman can cope with the demands of everyday life but find the stress of a new baby hard to handle.
Body Changes
The postpartum period is a time of great changes in the body. These changes can affect a woman's mood and behavior for days or weeks.
Levels of the hormones estrogen and progesterone drop sharply in the hours after childbirth. This change may trigger depression in the same way that much smaller changes in hormone levels can trigger mood swings and tension before menstrual periods. Some women are more bothered by these changes than others. They may be more likely to have postpartum blues or depression.
Hormone levels produced by the thyroid may also drop sharply after birth. If these levels are too low, the new mother may have depression-like symptoms, such as mood swings, nervousness, fatigue, trouble sleeping, and tension.
Many women feel very tired after giving birth. It can take weeks for a woman to regain her normal strength. Some women have their babies by cesarean birth. Because this is major surgery, it will take them longer to feel strong again.
Also, new mothers seldom get the rest they need. In the hospital, sleep is disturbed by visitors, hospital routine, and the baby's feedings. At home, the baby's feedings and care must be done around the clock, along with household tasks. Fatigue and lack of sleep can go on for months. They can be a major reason for depression.
Emotional Aspects
Many emotional factors can affect a woman's self-esteem and the way she deals with stress. This can add to postpartum depression.
Feelings of doubt about the pregnancy are common. The pregnancy may not have been planned. Even when a pregnancy is planned, 9 months may not be enough time for a couple to adjust to the extra effort of caring for a baby.
The baby may be born early. This can cause stressful changes in home and work routines that the parents did not expect. If the baby is born with a birth defect, it may be even harder for the parents to adjust.
Mixed feelings sometimes arise from a woman's past. She may have lost her own mother early or had a poor relationship with her. This might cause her to be unsure about her feelings toward her new baby. She may fear that caring for the child will lead to pain, disappointment, or loss.
Feelings of loss are common after having a baby. This can add to depression. The loss can take many forms:
- Loss of freedom. This can include feelings of being trapped and tied down.
- Loss of an old identity. The mother may be used to someone else taking care of her or of being in control.
- Loss of a slim figure and feelings of having sex appeal.
Lifestyle Factors
A major factor in postpartum depression is lack of support from others. The steady support of a new mother's partner is a comfort during pregnancy and after the birth. It helps when partners are willing to assume household chores and share in child care. If a woman lives alone or far away from her family, support may be lacking.
Breastfeeding problems can make a new mother feel depressed. New mothers need not feel guilty if they cannot breastfeed or if they decide to stop. The baby can be well nourished with formula. Your partner can help with some of the feedings. This can give you more time for yourself or for rest.
The Role of Myths
Women who have an idea of the "perfect mother" are more likely to feel let down and depressed when faced with the needs of day-to-day mothering. Three myths about being a mother are common:
Myth #1: Motherhood Is Instinctive. First-time mothers often believe that they should just know how to care for a newborn. In fact, new mothers need to learn mothering skills just as they learn any other life skill. It takes time and patience. It takes reading child care books, watching skilled child caregivers, and talking with other mothers. As a mother's skills grow, she will become more sure of herself.
Mothers may also believe that they must feel a certain way toward their newborn or they are not "maternal." In fact, some women feel very little for their infants at first. Mother love, like mothering skills, does not just happen. Bonding often takes days or even weeks. When the special feelings of motherhood begin to emerge, they should be nurtured.
Myth #2: The Perfect Baby. Most women dream about what their newborn will look like. When the baby arrives, it may not match the baby of their dreams.
Also, babies have distinct personalities right from birth. Some infants are easier to care for. Others are fussy, have upset stomachs, and are not easy to comfort. A new mother may find it hard to adjust to the baby.
Myth #3: The Perfect Mother. For some women, being perfect is a never-ending goal. A mother may think she is not living up to the ideal. She may feel that she is a failure.
Of course, no mother is perfect. It is not true that every woman can "have it all." Most women have trouble finding a balance between caring for a new baby and keeping up with household duties, other children, and a job. They often feel this way even with a lot support.
What You Can Do
If you are feeling depressed after the birth of your child, there are some things you can do to take care of yourself and your baby:
- Get plenty of rest. Don't try to do it all. Try to nap when the baby naps.
- Ask for help from family and friends, especially if you have other children. Have your partner help with feedings at night.
- Take special care of yourself. Shower and dress each day, and get out of the house. Get a babysitter or take the baby with you. Go for a walk, meet with a friend, and talk with other new mothers.
- Spend time with your partner. Tell him how you feel. Often just talking things out with someone you trust can provide relief.
| It's important to take time for yourself, get out of the house, and to reach out to family and friends | |
Call your doctor if your feelings do not lessen after a few weeks and you have trouble coping. Blues that don't go away after a few weeks may be a sign of a more severe depression. Tell your doctor if you are afraid you might neglect or hurt your baby. Help is at hand.
Your doctor can refer you to experts in treating depression. These experts will give emotional support, help you sort through your feelings, and help you make changes in your life.
There are also hotlines and support groups for women with postpartum depression. Talk to your doctor about finding help in your area.
You may also be given medication to treat depression. If you are breastfeeding your baby, be sure to talk with your doctor about any side effects of the medication.
Sometimes a mother may develop a more severe depression. She may need to stay in the hospital until she can take care of herself and her child again.
To get well, women with postpartum depression need realistic goals and support. Learn how to nurture yourself as well as your family. Small, daily things can make a big difference. It's important to take time for yourself, get out of the house, and reach out to family and friends. Do only what is needed, and let the rest go.
Finally...
Many new mothers feel sadness, fear, anger, and anxiety after having a baby. This is normal. It does not mean that you are a failure as a woman or mother or that you have a mental illness. Having these feelings means that you are adjusting to the many changes that follow the birth of a child.
If the baby blues don't go away after a week or two, you may have postpartum depression. Talk with your doctor. Use resources for counseling and treatment. Even if your depression is severe, treatment can help you return to normal soon.
Glossary
Cesarean Birth: Delivery of a baby through an incision made in the mother's abdomen and uterus.
Estrogen: A female hormone produced in the ovaries.
Postpartum Blues: Feelings of sadness, fear, anger, or anxiety occurring about 3 days after childbirth and usually fading within 1–2 weeks (sometimes called "baby blues").
Postpartum Depression: Intense feelings of sadness, anxiety, or despair after childbirth that interfere with a new mother's ability to function and do not go away after a few weeks.
Progesterone: A female hormone that is produced in the ovaries and prepares the lining of the uterus during the second half of the menstrual cycle to nourish a fertilized egg.
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Having a baby is a joyous time for most women. After childbirth, though, many mothers feel sad, afraid, angry, or anxious. Most new mothers have these feelings in a mild form called postpartum blues. Sometimes these feelings are called "baby blues." Postpartum blues almost always go away in a few days.
