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     Volume 7 Issue 5 | February 1, 2008 |

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Baby Blues

Syeda Shamin Mortada

First comes love, then comes marriage, then comes a baby in the baby carriage, goes the old rhyme. Having a baby can be a time of great joy and excitement for many new mothers. However few can actually anticipate the enormous amount of work that is involved in taking care of a newborn child until she actually starts to meet the daily challenges that motherhood has to offer. The initial period after childbirth is often filled with a multitude of mixed emotions. One moment a mother may feel excited and on top of the world while the next moment she might worry about the well being of her child or feel frustrated, inadequate and totally incapable to confront the new challenges. Being a mother of a newborn is a huge responsibility. It is a job for which we receive no prior training; we have to learn the skills instinctively, how to hold the fussy baby, cope with colic, change diapers and so on.

It is strange that while the past nine months you have done nothing but eagerly wait to hold the precious one in your arms, you suddenly start to feel anxious, nervous and sad when she finally arrives. If you are a new mother and are wondering what is wrong with you and feel unsure of yourself; perhaps it will give you a bit of consolation to know that these feelings are very common with mothers who have given birth recently and we call it the “Baby Blues”. According to Dr. Syeda Husna Akhter, Senior Consultant, Department of Gynae and Obstetrics, Bangladesh Medical College and Hospital, “Mothers are usually tense, irritable, depressed and at times unmindful after delivery. These sorts of feelings may start from the first week after the delivery and are usually seen to decline by itself.”

After giving birth, most women lapse into some sort of melancholy. Between 50 to 80 percent of mothers experience some form of the blues in the days after childbirth and it is said to be more common for the first time mothers. For most women the symptoms are mild and transient, characterised by a brief period of emotional instability that may manifest itself with episodes of unexplained crying and mood swings, lack of pleasure in almost all activities, decreased appetite, loss of energy, feeling withdrawn and socially isolated or unconnected, feeling of worthlessness, agitation and irritability, disturbed sleep patterns and at times negative feeling towards the baby. Researchers are not absolutely sure about what causes these blues but believe a variety of factors may be involved resulting in the blues. The physical changes during and after pregnancy contribute to the mood changes. The hormonal ups and downs take a toll on ones emotions. The extreme exhaustion caused by childbirth followed by the constant care for providing for the little one contributes to the baby blues. The new lifestyle, sleep deprivation, unrealistic role expectation, social isolation, psychological adjustments, overwhelming responsibility -- everything plays a part in the post partum blues.

Childbirth is so oversold as the woman's greatest achievement that women feel guilty and believe that something is wrong with them if they feel despondent at one point of time after childbirth. Many times it is not the problem of individuals but of the society that creates an unrealistic myth about motherhood. In our country many women suffer alone feeling miserable, unaware that postpartum mood disorders have a name. Husbands can play a major role to help wives through the motherhood blues. It is vital for men to be aware and sensitive to the feelings of their partners; they need to understand and be supportive and tolerant and help her handle the bouts of depression. Dr. Akhter further states: “Psychological support can work wonders for many women; husband and in-laws should be sympathetic and supportive. A change in environment can also help. The doctors need to play their part as well; they need to constantly assure the patient that these feelings are natural and that they will be feeling fine in no time.”

There is a lot these women can do for themselves which will help them to easily come out of the blues. Mothers should remember to express their feelings to those around them and ask for support and advice from close friends and relatives; adequate rest with a balanced and healthy diet can come a long way; they can consult with their partner about the division of responsibilities; learn to prioritise, and not try to be a super mom. Mothers should be encouraged to take time out for themselves, read books, watch movies or just take a relaxing bath, exercise and most importantly try to take a lot of rest. A positive attitude towards life will certainly help boost the mood. The baby blues usually pop up out of the blue and disappear all on their own.

However for about 10-15 percent of new mothers, the period of baby blues may become quite severe and disabling, resulting in a full blown illness that recently has been recognised by the medial community and subsequently been termed PPD or postpartum depression. In such rare cases the depression may escalate to dangerous levels, where women go on to develop more severe symptoms leading to an inability to function and perform the activities of daily living.

Treatment of the blues is variable, depending on the type and severity of symptoms that a woman may experience. These symptoms, whether mild or severe are temporary and in most cases treatable with the support of skilled professionals. Psychotherapy can be an important tool in helping the woman to identify factors that may be contributing to her depression. Individual or family counselling, along with participation in a support group involving other women who have experienced this disorder may prove beneficial. Treatment with antidepressant and anti-anxiety medications is case-specific and based on a risk-benefit ratio. Factors such as the mother's symptoms, the decision whether or not to breast-feed and the side effects of the medication all play a role in deciding if and what medications should be used. Overall it is widely accepted that the treatment for baby blues or post partum depression can be widely improved by preventative efforts.

The emotions of having a baby range from joy to panic and despair. It is the birth of not only a child but of a mother as well. Like the newborn the new mother needs love, affection, food, warmth, sleep and support. Like each baby each mother is different, so help her be confident and most importantly let her be herself!

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