Baby Blues which is defined by general sadness, worry, fear and/or anger that occurs within the first days immediately following birth. Not so unlike the normal ups and downs of regular cyclic changes, these feelings subside shortly without treatment and are believed to relate to the sudden shift and rebalancing of hormone levels. Even though they are short lived, there are still ways such as homeopathics, herbs, flower remedies and nutritional supplements that can aid in these feelings and help stave off the potential for more serious depression. Any negative feelings that continue beyond a few days, specifically more than 2 weeks or are severe or debilitating are not just Baby Blues, but Postpartum Depression.
Postpartum Depression can occur any time within the first two year after giving birth. It can occur in any woman, but women with a history of depression or mental health imbalance, traumatic birth or a lack of support system tend to be at higher risk. Whether you have a history or not, reach out to someone who will support you. There are many safe for you, safe for baby, natural means to help you through this. You do not have to suffer alone.
Creating an environment during the months of pregnancy, of safety, support and self-care can aid significantly in preventing the conditions that lead to PPD. We know that most occurrences of both Postpartum Depression and Psychosis can be avoided altogether by proper preparation. Understanding the normal physiological and biochemical changes that happen to a woman’s body during pregnancy are the first step. Having an understanding before you are in the midst of these changes and the effects they have on your body is key. An ounce of prevention is worth a pound of cure. Many of us spend a tremendous time planning and preparing for the lifestyle and family changes that come with pregnancy; schedules, jobs, products and baby items. However, the real preparedness has to be about caring not just for a new baby, but caring for the body, mind and soul that will grow, nourish and care for that baby.
It is also important to note that an often overlooked subject of Baby Blues and Postpartum Depression is the mother who hasn’t given birth, in the case of adoption. Mothers are mothers and they respond to their babies emotionally, physiologically and spiritually no matter how they came into motherhood. There are absolutely shifts for these mothers, including hormone changes, which can come not only as a big shock, but be overlooked and disregarded.
We know that mothers who live in cultures where women are supported, nourished, allowed to rest, recover and are cared for by other women fare much better and rates of PPD are low to almost non-existent. Traditionally, the postpartum period, specifically the month following birth, has been deemed the 4th trimester. It takes approximately 280 days for a human cell to develop into a full term baby that is capable of living outside of the womb. The physiological changes that occur within the female body in order to prepare for, create and sustain gestation are tremendous. We know that a woman’s body generally requires a full year to completely recover from these changes. It is not only absurd but detrimental to assume or portray the idea that women ought to bounce back and have returned to “normal” by the 6 week check-up that is common practice in the US. Pregnancy and birth change the female body permanently and time is needed to heal, rebalance and adjust to the changes. The pressures of society, especially with bombardment of social media, offers a litany of negative and unrealistic expectations. Giving your body time to heal will yield the best results in the end. Forcing your body into activities you are not recovered enough for can cause harm and set you back significantly and in some cases cause permanent physical damage. Postpartum recovery rule of thumb is 1 week in bed, 1 week on the bed and 1 week near the bed.
New mothers need sleep, all new mothers. No matter how fit, healthy, young or consumed with the euphoria of new motherhood. A lack of sleep eventually catches up with everyone and is definitively a factor in the onset of Postpartum Depression. Your body is recovering from almost a year of creating another human. Even if you have chosen not to breastfeed, your body is working hard to recover, balance your body chemistry and adjust to the physical changes. Sleeping when baby sleeps is essential. If you have other children at home, preparing ahead to have help around the clock for at least the first month postpartum, will make a world of difference and give you the chance to sleep, rest and recover during the most crucial time. It is too easy and too common for mamas to feel like their children ought to be their first consideration, which often means the neglect of their own needs and their own health. If that is your concern, then know this is for your baby and your other children as well. You cannot be the best mama if you don’t take care of yourself. Postpartum infection, hemorrhage, depression among other risk factors, will certainly not allow you to be available for your children. Taking proper care of yourself and allowing for others to support and help you will. Also understand that not only is every woman and every woman’s body different, but every baby and every pregnancy and recovery is different. Your last pregnancy could be very similar to your sisters or your friends, or even your own previous pregnancy or it could be entirely different from all of the above. Just having another child or children changes the entire dynamic of the situation.
That being said, it is absolutely necessary to have the kind of help at your disposal that you need. Making a plan for this support well in advance will not only give you the opportunity to prepare yourself and your family, but any well-meaning, but not so helpful people in your life to get comfortable and accept your choices. This also gives time for those you seek to help from to be available and/or you time to prepare financially for the help of a Postpartum Doula, housekeeper, nanny, etc. Waiting until you are in despair and in a position to just accept whatever aid is available, is only 1 step above going it alone, and can even exacerbate the situation. This is not about what makes your friends or family feel good. This is about what aids and supports your physiological and emotional wellbeing, as well as a time for you to bond with your baby.
Daddy absolutely needs to be involved with care of you, baby and your family. Dad can often serve as the best gate-keeper; protector to your well-being and environment of peaceful recovery. It is okay to say no to visitors, no to phone calls and absolutely no to drop-in guests. Social media can be an aid to ensuring no one takes it personally. Again, planning ahead and sharing with friends and family what your boundaries will be can help to prevent hurt feelings. It can also be effective to fall back on the say-so of your Midwife, Doula or Doctor, not only for yourself but your baby. “The Midwife said it is best for us to avoid visitors and rest” can sometimes be easier than the arguments and well-meaning insistence of loved-ones. If your husband isn’t the type that can stand up to his mom or even the neighbor lady, seriously consider a professional gate-keeper in the form of a Postpartum Doula. Often a healthcare provider acting in an official capacity can get through to the otherwise pushy or easily offended friends and family.
Resting or laying-in, doesn’t mean you have to be secluded or out of the loop. Nothing about this should bring you anxiousness or frustration. The idea is to prepare for and allow yourself the time and space for recovery. If having your little, or not-so-little ones close by or to snuggle with you, watch a movie together, etc, brings you joy and peace, absolutely do it. Having someone available who can do the household chores, make and clean-up meals, bath and dress kids, wash and fold laundry, run errands, etc can make all the difference. If your husband works full time, having the help when he is home can also be paramount to your family’s peace. An overworked Dad isn’t going to be able to offer the emotional and psychological support you need. Having people around who are also well-rested and able to take notice of any physical or emotional/psychological needs or struggles you may experience can catch a case of PPD before it can take hold. It’s okay to say “no”, “I’m too tired” or “I’m just not ready for visitors”.
This resting period is also best for baby. Skin to skin contact stabilizes baby’s temperature, breathing, heart rate and blood pressure. It allows mama-baby bonding time where establishment of milk supply and breastfeeding can happen in a peaceful, relaxed environment.
- Feelings of hopelessness
- Lack of appetite
- Bad dreams
- New fears or phobias
- Erratic thoughts
- Feelings and/or thoughts of inadequacy
- Unexplained anger
- Suicidal thoughts
Approximately 1 in 1000 cases of Postpartum Depression progress to Postpartum Psychosis, an extreme mood disorder that most frequently occurs within the first few weeks after birth. Psychosis can be life-threatening and requires immediate treatment.
- Confusion and/or disorientation
- Obsessive thoughts regarding your baby
- Hallucinations and/or delusions
- Extreme sleep disturbances
- Feelings and thoughts of paranoia
- Attempts to harm yourself or your baby
Preparing for Help Prior to Birth
- Make a list of your daily responsibilities and what would need to be done on a daily, weekly, monthly basis
- List talk about and decide on who and how these tasks will be assigned. Asking friends and family ahead of time to be free and allowing them prep time will alleviate stress for everyone involved. Make sure to check back in and confirm with people as you near delivery, so you have time to reassign responsibilities if circumstances change.
- You can also assign an organized friend to schedule a meal list with friends and family.
- Hire a Postpartum Doula early on, just as you would a Midwife or Labour Doula to ensure you have time to meet and are comfortable with your choice and expectations.
- Set up your bedroom and bathroom to accommodate you, your baby and create the relaxing situation that will keep you wanting to rest. Having things you enjoy at your reach; books, music, knitting, coloring books and pencils or quiet activities for younger kids.
- If you do not have a Midwife, Birth Doula or Postpartum Doula who will be doing in-home visits and will be available for questions, it’s important to have an established contact for lactation questions.
- Hydration is essential for all bodily functions. Dehydration outside of pregnancy is prevalent and most people don’t realize the need to consume ½ your body weight in ounces daily (more if exercising, in hot temperatures or when consuming water-depleting foods such as coffee). Many resources suggest that breastfeeding mamas “drink to thirst” with the idea that if you aren’t thirsty, then you aren’t in need of water and aren’t dehydrated. This would seem to make sense, unless you understand that your body will adapt to dehydration, meaning your body will just stop signaling the brain that there is a need for water. Learning to drink an adequate amount of water is important for health.. If you are not already used to drinking an adequate amount of water, getting enough during pregnancy and while breastfeeding may present a challenge. Initially, absorption of fluids can be an issue, like a plant that has gone without water for a period and can only accept small amounts while the majority runs out the bottom of the pot. It can take some time to get beyond this and stop needing to run to the bathroom. As drinking regularly becomes a regular habit, this will subside, with of course the exception of the weight of pregnancy on the bladder. Herbal teas, fresh fruit and vegetable juices are also a great source of nutritious fluids.
- Low blood sugar can cause irritability and mood instability. Getting adequate nutrition whether breastfeeding or not is essential.
- Beyond physical support and having the time and space to heal, you need someone you can talk to. Someone who can hear your struggles or frustrations, beyond the stuff that needs to be addressed; just a sympathetic ear who will listen. We all need someone who is without judgment, who has no desire to compete with us or has the need to “fix” it, but who understands and is willing to listen when we have just had a difficult day or week. Someone aside from your husband can be a real bonus, because you might just need an outside source that won’t feel offended or frustrated by your thoughts or feelings. The changes that come with a new baby, whether it’s your first or sixth, can be a struggle and holding onto feelings can lead to unexpected despair.
- Fresh air, sunshine and grass under your feet. While you aren’t ready for an exercise routine yet, fresh air, even in the beginning when you need to stay in bed, can do wonders. Open up the windows, let the sunshine on your face. Obviously weather permitting, but grab every bit that you can. Airing out your room is a good idea for overall health anyway. Sunshine is incredibly beneficial and might be recommended by your Midwife or Doula for a jaundiced baby too. When you are ready to be up and about a bit, a short walk in the garden or a comfortable lounge chair in the yard can bring not just a change of scenery, but refreshment to your soul. Research shows that those who spend time in nature have significantly fewer incidence of depression and it can also aid in the recovery of depression.
- Don’t let fear keep you from asking the questions that come up. Whether they are aches and pains, bodily function, lactation or thoughts and feelings. It’s always worth an ask. I cannot imagine a question that hasn’t been posed to a female health care professional. If it happens to be that unique, I guarantee you are helping not only yourself, but other women, by asking! So many times when we address an issue right away, it is so much easier to deal with then when we let it go.
Though the choice to breastfeed is a personal one, it’s also important to understand the facts. The female body is designed physically and biochemically to nourish babies. Breast milk is not just the most perfect food; formulated for each individual baby at each and every feeding, it benefits the female body as well. Breastfeeding helps with the regulation of postpartum hormones, encourages maternal-infant bonding and encourages mama to take time out rest and focus on nutrition, thus, for all of these reasons, can be preventative of Postpartum Depression.