Definition of postpartum period Some professionals refer to a post partum period as 'fourth trimester'. It is a time, when woman adjusts, both physically and psychologically, to the process of childbearing. Postpartum period is the period consisting of the months or weeks immediately after childbirth or delivery. It can last 6 weeks or until the body has completed its adjustments and has returned to the pre-pregnant state. Postpartum period or fourth trimester does not last necessarily 3 months, but the term fourth suggests continuity and the importance of the first several months after birth for the mother. Postpartum period involves a great deal of adjustment: woman has to take care of the baby and she also has to recover from childbirth herself. In some cases these adjustments are not easy. This is due to hormonal disturbances, which may lead to postnatal depression or even puerperal psychosis.
Categorization of postpartum period
This categorization is adapted from Brown (1979) and others:
1. Postpartum psychosis or puerperal psychosis
Postpartum psychosis or puerperal psychosis is a relatively rare disorder following childbirth with symptoms similar to general psychotic reactions. These symptoms are agitation, alterations in mood, confusion, delusions or auditory hallucinations, fatigue, feelings of hopelessness and shame, hyperactivity and rapid speech or mania.
2. Chronic depressive syndrome or moderate depression disorder
Chronic depressive syndrome or moderate depression disorder is more debilitating than the `blues' and more common than postpartum psychotic reactions. However this syndrome is still poorly defined. Its symptoms include anxiety, despondency, irritability, fatigue, feelings of inadequacy, guilt and tearfulness. Since researchers think that women experiencing this form of depression are rarely seeking treatment, they are only recently being studied.
3. Postpartum 'blues' or transitory minor affective disorder
Postpartum 'blues' or transitory minor affective disorder is the name most commonly used to describe the weeping and emotional instability which occurs during the first postpartum week. Symptoms of postpartum 'blues' or transitory minor affective disorder include irritability, frequent and prolonged crying, and a sense of vulnerability which may continue for several weeks, mood changes, poor sleep.
Researchers have suggested another category, called postpartum post-traumatic stress syndrome (PTS), which links the characteristics of PTS with birth, for example death of the infant, Caesarian birth, and other major stresses.
Symptoms of postpartum period illnesses
In this section I will try to explain physical and psychical symptoms, typical for postpartum psychosis, depression and baby blues.
Postpartum psychosis symptoms
Physical symptoms include refusal to eat, inability to stop activity and frantic excessive energy.
Mental symptoms may include hallucinations, extreme confusion, incoherence, loss of memory.
Woman may have following behavioral reactions: suspiciousness, irrational statements, preoccupation with trivia.
Postpartum depression symptoms
Physical symptoms include chest pain, heart palpitations, headache, hyperventilating, numbness, tingling in limbs.
Mental symptoms may include despair, inability to cope with baby and new situation, impaired concentration or memory feelings of inadequacy, hopelessness, strange thoughts, over concern for baby's health, thoughts of suicide
Woman may have following behavioral reactions: panic attacks, new fears or phobias, hallucinations, nightmares, no feeling or over concern for baby, guilt, feeling out of control or feeling like going crazy.
Postpartum 'blues' symptoms
Physical postpartum 'blues' symptoms include no energy, food cravings or loss of appetite, lack of sleep, feeling tired...
Mental postpartum 'blues' symptoms include anxiety, confusion, sadness, lack of confidence, nervousness, concern over physical changes.
Behavioral Reactions may include crying, hyperactivity, oversensitivity or feelings being hurt easily, irratability, lack of feelings for baby.
Treatment of postpartum period
The treatment of postpartum illnesses has to deal with the disputes that occur around the entrance of the baby into the house. But the treatment is also associated with physiologic problems that are in connection with depression and the eating or sleeping problems.
Social support during postpartum period is essential; Caplan (1974) claims that lack of social support and marital intimacy have long been linked with psychological distress. Woman in postpartum period is in period when she is in need for immense physical and emotional support. And if you don't have the luxury to be understood and supported, there is another form of help; it is called self-help. Self-help in a form of helping networks, intentional communities. Mutual help for example is a volunteer organization that makes its own policy, especially regarding the kind of help offered.
Thus, what is best to do when dealing with postpartum illnesses or even better- what to do to prevent them?
- Do not allow yourself to be unprepared- inform yourself and prepare for motherhood.
- You are not able to do everything alone! If you do not have partner, get help from parents and other relatives, and get help from dependable friends. Make friendships with others who are expecting a child.
- Do not overload yourself with unimportant tasks- cut down responsibilities and rearrange schedules and priorities.
- Get plenty of rest and sleep. Take time only for yourself and your relaxation.
- Do not move soon after the baby arrives or do not make any drastic changes.
- Reduce any kinds of environmental stress factors.
- Communicate with your partner and friends: discuss your plans and worries.
- If you need, mobilize additional emotional support systems.
- Take medications, but consult your doctor first if there is any other option besides anti-depressants.
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