Postpartum period: the time following childbirth, lasting about six weeks or until the mother's body has adjusted.
Main challenges: fatigue, hormonal changes, significant physical, emotional, and psychological adaptation.
Physical Changes
Energy levels: Can vary; some mothers feel energetic, others feel exhausted.
Fatigue: Common and undermines well-being and confidence.
Loss of sleep: Leads to stress, marital conflict, and impaired decision-making.
Key issue: Poor quality sleep (disrupted, fragmented sleep) is closely linked to postpartum depression.
Hormonal Changes
Estrogen and progesterone levels: Drop sharply after placenta delivery and remain low until the ovaries resume hormone production.
Emotional and Psychological Adaptation
Postpartum blues: About 70% of mothers experience postpartum blues (feelings of depression, anxiety) 2-3 days after birth.
Normal due to physiological and environmental changes: These feelings typically peak 3-5 days post-birth and usually remit within 1-2 weeks.
Importance of support: Family and friends need to prioritize the mother's care.
Postpartum Depression
Signs and symptoms: Strong feelings of sadness, anxiety, despair, leading to trouble coping with daily tasks. Dysfunction and distress are key indicators.
Criteria for diagnosis: Long-lasting (at least two weeks), strong feelings that impair functioning.
Prevalence: Affects about 10-14% of new mothers, though 50% may experience symptoms prior to childbirth.
Severe cases: Can lead to psychosis, marked by hallucinations, delusions, sometimes resulting in harmful behaviors towards the baby.
Risk Factors
History of depression/anxiety
Poor marital relationship
Low social support
History of physical abuse
Postpartum physical complications
Infant health and temperament issues
Treatment and Prevention
Antidepressants: Considered safe during breastfeeding.
Psychotherapy: Especially cognitive-behavioral therapy (CBT).
Regular exercise: Beneficial for mental health.
Social support: Crucial in preventing postpartum depression.
Focus on strengthening marital relationships: Helps provide the necessary support for the mother.
Paternal Issues
Father's role: Fathers also undergo postpartum adjustment and may experience depression, especially in the presence of maternal depression.
Feelings of being replaced: Fathers often feel sidelined and need attention to maintain family harmony.
Bonding
Importance: A critical connection, both physical and emotional, between parents and newborn.
Practices: Kangaroo care, ensuring minimal separation post-delivery.
Impact: Essential for child’s emotional development and fosters parental attachment.
Sleep in Newborns
Patterns: Newborns sleep about 18 hours a day; by six months, they develop more adult-like sleep patterns.
REM Sleep: Infants begin sleep in REM and spend about 50% of sleep time in REM.
Cognitive development: Longer sleep durations linked to higher executive function in later years.
Breastfeeding
Recommendations: Exclusive breastfeeding for the first six months, continued breastfeeding with complementary foods up to one year or longer.