Transcript for:
Postpartum Period and Depression

okay the postpartum period and this is where we're going to talk about postpartum depression so this is a name given to the period after childbirth or delivery it's going to last about six weeks or until mom's body has completely adjusted or completed its adjustment so typically what you see during this period is there's a lot of fatigue and hormonal changes we talked about when it comes to miscarriage how you know even miscarriage your body has these pregnancy hormones it takes a long time to adjust and so this is going to involve a great deal of adjustment and adaptation and we talked about any kind of situation and it involves a lot of adaptation and adjustment is going to be stressful um there's going to be physical emotional psychological adaptation going on and if we talk about physical well physical mom may have a great deal of energy so normally we think ton exhaustion but she also may have a great deal of energy or she can feel exhausted and let down this fatigue which is a little bit i think more of your typical response can undermine the new mom's sense of well-being and confidence in her ability to cope with the new baby in her new family life we all know what feeling exhausted can do to us um so that's a huge thing there and then we start considering well what's part of this fatigue as well loss of sleep um and loss of sleep is related of course stress but marital conflict a lot of times then the two start fighting um impaired decision making you know what it's like when you haven't slept for a long time things just don't go exactly right and so this kind of starts eroding the kind of happy healthy kind of situation that may have been in place um so poor you know really when it comes down to postpartum depression though it's not necessarily the lesser amount of sleeps that are being linked with postpartum depression it's poor quality sleep poor quality sleep is the real problem and this kind of sleep is that disrupted fragmented is the real problem that has been linked with postpartum depression and so not so much the lower amount the lesser amounts of sleep it's the fragmented sleep if you want to torture someone that sounds awful i'm not giving torture advice but what happens in torture situations they wake you up wait till you fall asleep wake you up wait till you fall asleep wait you up wait till you fall asleep that will make anyone go crazy and so that's what's happening to these new parents that they fall asleep and the baby starts crying and needs to be fed they fall asleep baby starts crying and you know if you've studied um the sleep cycle and gen site you know that maybe then you're never getting to rem sleep or deep sleep those really productive stages of sleep or maybe you're getting to like deep sleep and then you're being jolted out of it which is really disorienting and can kind of cause this feeling of sleep drunkenness at least at least for a little while if not for an extended period of time it's debatable um but that's the problem fall asleep wake up fall asleep wake up fall asleep wake up it messes you up okay and then also there's these major hormone hormone changes okay um when the placenta is delivered estrogen and progesterone levels drop steeply and they remain low until the ovaries start producing the hormones again so you have estrogen and progesterone levels drop steeply and remain low until the ovaries start producing the hormones again so you're just in a different place hormonally so now we have to talk about the emotional and seventy percent this is high of mothers in the us have what are called postpartum blues and this is about two or three days that's a really high percentage y'all after birth they begin to feel depressed anxious and upset and to have these feelings right after you've had a baby is really sometimes upsetting and mom can feel guilty or feel like something's wrong with her why is this happening i'm supposed to be happy right now i'm supposed to be this must be the most wonderful moment of my life um you know i'm not a good mother because instead i'm feeling depressed these feelings can really mess with with someone and so we need to know and we need to you know educate everyone that this is completely normal because of what's going on in you you know physiologically but also you know what's going on in your environment a lot of change has happened so this is totally normal um now these feelings may come and go for several months often peaking at about three to five days after birth and we've got to remember this as people that are supporting women that are having babies you know if it's not ourselves we still have to remember this because we need to think about take care of mom take care of mom it's not just about taking care of the baby and don't disappear on her so you know three to five days after birth may be the peak but then you know there's concerns after that what's going to happen you know they usually do go away after one or two weeks but some women develop postpartum depression and there isn't going to be any shame in this again this is something we need to talk about this is something that's normal in a lot of ways so this is going to characterize women who have such strong feelings of sadness anxiety and despair you study any kind of psychological disorders in the process of diagnosis what you're going to see is functioning is impaired so you they have these strong feelings status anxiety and depression and it ends up that they end up having trouble coping with daily tasks so these feelings are so strong that they end up having trouble coping with daily tasks so functioning goes you see dysfunction and you know if you're also looking at how do you do you um look for well is someone just if someone you know uh does their kind of state warrant a psychological diagnosis well dysfunction is at present is distress present remember we talk about this in genocide it's danger present is deviants present and so we definitely see um distress and dysfunction going on here and yeah danger too because if mom is is not if mom falls into these feelings too much she's not going to be able to be there for baby and it can also postpone depression can take on a psychotic um kind of uh a way onset can start dream pregnancy where all you know it gets to this place that her functioning goes or typically within four weeks of having the baby it has to last for at least two weeks in order to get a diagnosis um for postpartum depression so above you know those um you know postpartum blues that's instead just it's gonna go away after one or two weeks you know often it's just for a couple days um this is it lasts for two weeks at least and typically much longer and what the diagnosis in the dsm the diagnostic and statistical manual of mental disorders the diagnosis is major depressive disorder with peripartum concept is what the official diagnosis is okay 50 we talked about okay some people get the onsets during pregnancy other people it's within the first four weeks after having the baby but 50 begin prior to having the baby i think that's interesting so we already need to be watching for this during pregnancy um mom can experience severe anxiety panic attacks and it can take on a psychotic quality psychotic features can lead to fantasize this is where they actually end up killing the baby it's awful awful but we've got to understand that there's a lot that leads up to this point that we should have recognized mom struggling in pregnancy we should have recognized hey things aren't going right we need help here um so hopefully you know this is normally prevented but what can happen is when it takes on that psychotic quality psychosis is separation from reality so either they're having hallucinations or they're having delusions hallucinations are hearing and seeing things that aren't there and so you can have command hallucinations is what they're called these are basically commanding them to kill the infant or they can have delusions illusions are i think we've talked about this in class before it's not that you're hearing and seeing things that aren't there you're putting the dots together in a way that doesn't make any sense with reality so we talked about how oh all of a sudden president trump comes on the tv and you think he's communicating to you in some kind of special code that you've got to start some kind of program some kind of mission to save i don't know who um so you see it that's delusional it's not you're connecting the dots or you're interpreting stimuli that's actually there in a way that's not collect connected with reality so delusions you know a delusional thought with the baby and with this this kind of situation would be that the infant is possessed the infant is possessed and evil and you have to take them out of the world this is really hard to understand but this is something that that happens and something that we need to watch for and again it brings us back to having a baby isn't just about caring for the baby caring for mom caring for mom is extremely important and if you care for mom then the baby ends up okay you know if you have a healthy mom healthy baby um so we need to to put mom's care you know in a lot of ways at least equal to the hair of the baby if not first okay um postpartum depression is in about postpartum not the psychotic stuff just postpartum depression occurs in about 10 to 14 of new moms 15 had symptoms is what they're saying but less than half sought help is what the book says so risk factors for postpartum depression the history of depression depression and anxiety during pregnancy neuroticism low self-esteem postpartum blues poor marital relationship low level of social support history of physical abuse postpartum physical complications perinatal complications infant health and temperament issues um the type of delivery like c-section can also um uh be problematic so one of the things i have highlighted i typed love that was that was nice i didn't mean to type love low level of social support is a huge concern and typically if we provide mom with social support during pregnancy after pregnancy we can prevent postpartum depression ever happening and a lot of times that support one of the things is to strengthen that marital relationship or the partnership um there okay so we can look at treatment for postpartum depression typically antidepressants are used and especially if we're talking about after delivery um it's important to note that they're saying that antidepressants are safe when it comes to breastfeeding psychotherapy so talk therapy is used um especially um cognitive therapy or cbt cognitive behavioral therapy cbt is extremely effective in relieving depression oh regular exercise is always good now let's talk a little bit about dad issues paternal issues the father goes through postpartum adjustment too dad gets overlooked in a lot of these situations y'all and this is something we need to watch for because okay we think healthy mom healthy baby but healthy dad healthy mom healthy baby because how do we keep mom healthy she needs social support what's your number one social support dad so we've got to care about debt we should care about dad just because we care about him period but you know if really you just care about baby well you got to hear about mom and care about mom because you care about baby you got to care about dad so dad matters and dad is often ignored so this is a huge transition period for anyone and everyone involved and typically dad gets depressed when mom when wife gets depressed and also there's this big issue that dad often feels like feels that baby comes first and gets all the attention some report feeling they have been replaced all of a sudden all mom's attention and love is going to that baby and you know part of it is just like i don't know instinctual but she's got to protect that baby that baby comes first and that baby is vulnerable you know we talked about before how you know this hierarchy of you know who's the most important or who gets you know the most kind of love and attention you know these can cause all kinds of different issues and and so we just need to know that dad often feels replaced and a lot of times maybe he is replaced maybe there isn't time for mom to focus on her relationship with her husband maybe they're not doing different kind of things together or going out to you know having any kind of date date nights or anything like that it's all just about baby and then when they do sit down and meet maybe they just talk about the baby um and so this is a real concern because we need to keep the marriage healthy in order for the baby's life to be healthy um and so we know his support and care can play a role in whether the mother develops postpartum depression and so we need to give attention to the fact that he's feeling replaced he feels he's not getting enough attention because if he goes with that he ends up feeling hurt and resentful or whatever else and he can't be there for mom there's just going to be marital discord um and it's just bad all around and things spiral from there okay bonding bonding is this close formation of a connection especially a physical bond between parents and the newborn um we talked about this a lot you know when we were talking about kangaroo care we're talking about bonding um and you know i have some quotes here that sometimes hospitals seem to deter um or they're like determined to deter bonding to stop bonding and there's some people that believe um that some of the drugs that are given to make delivery less painful can take away um mom's ability to be present in the situation she may feel drowsy she may not be able to respond to and stimulate the newborn um you know back in the day mom was separated from the baby after delivery um pre if they're preterm they're isolated from their mothers all of this kind of stuff can stop the bonding process which we we're going to talk with attachment psychology how important that bond is that emotional attachment provides this foundation for optimal development in years to come and so the hospitals are adjusting because of all these concerns and so you see this not being as big of a concern anymore you heard molly's mom kind of describe that they recognize the importance of this bonding okay so bonding is important um let me see what else we have we're kind of at the end here but i have let's see um if we talk about sleep let me clear the screen and just put some random couple notes and then i'll kind of land this plane baby spend newborn spend about 18 hours a day asleep okay um we have this range about 10 to 21 hours but by six months by six months um they approach adult like sleep patterns um there's a bunch of stuff we can talk about well let me get it down to just the important stuff rem sleep rem sleep we talk about this in gen psych this is when you dream rent sleep is when you're dreaming and this is present more in infancy than childhood in adulthood adults spend one-fifth in rem mean it normally takes adults about an hour after non-rem sleep to enter rem sleep babies begin infants begin the sleep cycle in rent this is crazy begin sleep cycle in ren and they spend way more of their time in run they spend half of their sleep in so ram is when they're dreaming so what do we think this has to do with you know at three months it starts to change we're unsure why this is the case but um why are there these large amounts of rem sleep because we think it provides an infant we mentioned this before in class with added self-stimulation stimulation they spend so little time awake that when they do go to sleep they need their brain to be active right and if you look at brain waves while someone's in rem they're really similar to when someone's awake because that's when dreaming happens so your brain's jumping all over the place so they need that further brain development this provides self-stimulation so large amounts of rem may provide infants with added cell stimulation and this is important since they spend all this time asleep this promotes brain development okay um sleep is linked to cognitive development four-year-olds who had long who had slept longer at night as infants engaged in higher level executive functions um it's really good okay something about sleeping that we have to cover is typically the recommended trend is to avoid infant parent bed sharing especially until the infant is at least six months of age and this is where we would talk about sudden infant death syndrome but i will post another video on this there's concerns about that um you know the babies i'm breathing somehow getting blocked um you know if we want to put a baby you know to sleep we should put them in a crib with nothing else with them um that's the best thing laying on their back we talked about that for the in-person class and we'll talk about it for the online later um and so i know that you know i'm not here to to guilt or anyone that has you know done infant parent bed sharing with a young infant it's okay you know it's up to you we're going to talk about with the history of parenting we parents have to be able to trust themselves and we can't go on with the pressure and the shame you know the society's constantly bombarding us with um but we do want to provide the proper kind of recommendations out there for the best type of situation and right now the proper recommendation is to avoid infant parent bed sharing now they do have these little cribs that can attach onto the bed um where you can still have the baby clothes um but they have their own little crib okay so come on come on let's play in my plane oh breastfeeding again with these kind of things well what is the um recommended thing when it comes to um the baby in eating breast feeding is taught the growing consensus is that breastfeeding is superior to bottle feeding and again i'm not trying to shame anybody that's been bottle-fed there's a lot of situations and it's isn't going to say that oh someone's development is going to end up horrible because they were bottle-fed this is just like if it's possible we should go with breastfeeding um or it's better for the infant and for the mother we got to also consider though that a lot of this research that proves this is correlational so maybe it's not you know talking about any kind of causation um you know typically let's see i have something here that says typically the moms that breastfeed have a lot of other things going on in their life let's look um women who breastfeed are typically wealthier older more educated likely and more health-conscious moms um than their bottle feeding counterparts which may explain why their infants are healthy or their children are healthier there's a lot of other things going on um you know influencing this situation um okay so breastfeeding though is better than bottle feeding and we recommend that exclusive breastfeeding that mom does exclusive breastfeeding for the first six months followed by continued breastfeeding as complementary foods are introduced okay and further breastfeeding for one year or longer um there's tons of positives associated with breastfeeding fewer gastrointestinal infections fewer infections are the lower respiratory tract they're protected against wheezing they're less likely to develop middle ear infections less likely to become overweight or obese um breast feeding reduces risk of obesity by about 20 percent breast fed lower breastfed infants have lower rates of weight gain than bottle fed they're less likely to develop type 1 diabetes they're less likely to experience sudden infant death syndrome so there's all these positive tons of positives for the baby um for mom the positives lower risk of breast and ovarian cancer so you see this reduction in the risk of type 2 diabetes um but sometimes it it's not possible for mom to breastfeed and that's okay um it we cannot talk about it we cannot guilt moms and you know there's this problem that a lot of moms a lot of moms feel guilty if they terminate breastfeeding early but you've got to look at the whole situation i don't like but i don't mean you can but isn't it a lot cheaper too to oh to breastfeed yes yes it's provided you make it right yeah you know but part of the problem is i think that you know especially as moms take on more and more responsibilities if you have like a full-time job you get away from baby and you're not breastfeeding often enough your body stops producing it i know that this has happened with a lot of my friends so that you need to be around your infant consistently um your body responds you know when you're around them and when you're breastfeeding every you know couple hours and so if you can't be around them you need a pump and all this it's like do you have the time and space to pump does society provide you you know that kind of opportunity or a lot of our jobs not recognizing the importance of all of this are a lot of careers not developed for mothers and this is something that i'm really passionate about working on actually um is kind of making more businesses supportive um for mom's needs sometimes we're able to do this um because yeah there's a it is cheaper when it comes down to it it is healthier but there's a lot of things that are impacting the situation and so you know sometimes mom feels super guilty if they're not able to breastfeed or often their body stops making um breast milk um and they can't and well you know i i'm thinking about how sometimes we got to look at the situation i i had a friend who um they were so committed to um just doing only only breastfeeding um exclusive breastfeeding for the entire you know however long two one year or whatever it was and she was working full-time and her body wasn't producing enough and she had to stop herself one day and realize her baby's too thin because her baby's not eating enough because she's only you know producing so much and so she had to take that hard step to realize hey you know i have these unrealistic expectations i gotta look at the situation and stop feeling guilty about it i gotta do what's best for my baby um so there's there's complicated things here okay um motor development oh i gotta stop i gotta stop i gotta stop gotta stop y'all can i talk about reflexes how long oh my gosh and i just i'm just gonna put this when you're talking about motor development and you know development is babies need to be provided with the opportunity um i swear i'll stop in five minutes okay okay i'm gonna stop it when it says 146. all right motor development um it's not a it's not a passive process i love this baby stuff okay in which jeans dictate the unfolding of a sequence of skills over time it's not just like this thing that happens no the infant's going to be actively putting together a skill to achieve a goal within the constraint set by the infant's body and environment and so we have to provide this environment that is good for the baby to kind of develop these kind of skills so to develop motor skills infants must perceive something in their environment that motivates them to act and use their perceptions to define to their movements they need opportunities they need opportunities we need to provide these opportunities it's not just going to happen by itself i mean they're doing gross motor skills and they're also doing fine motor skills um when i think about fine motor skills i think about heather's little baby ollie i remember last time i saw her she was trying to pick a little mole off of my chest she's like what is this you shouldn't say that it's like what is she doing trying to pick the small off my chest and i think one time she started looking at a pimple on my face it's like these little tiny things and trying to reach out and grab them all this kind of stuff is a big deal for them developing all their skills and then the last thing i was going to put was basic reflexes the baby in the beginning you know typically babies are completely thought about completely helpless but they're not reflexes make the new boring not completely helpless their reflexes help them they support them they made them you know automatically able to survive you don't need the environment to develop these reflexes you're born with these um so for example you put a baby in water the baby's automatically going to hold its breath it doesn't need to learn to do that it's automatic it contracts its throat holds its breath and contrasts its throat to keep water out um they have the sucking reflex you know that helps with them um eating so that survival they have the rooting reflex if you stroke an infant side of their cheek or their mouth they're going to turn its head to the side that was touched and they have the grasping reflex you know so if you put your finger out they're going to hold on to it um they have that startle reflex so you can kind of act like you're going to drop a baby a little bit i'll post some videos of doctors doing it so it's not just people being crazy and the baby goes yeah you know you and part of you know with assessing them with that apgar scale is making sure they have all these reflexes intact um but the grasping reflex it's automatic people always think oh the baby loves me so much they're just holding onto my finger that's how much they love me no that's just they're not even thinking about that that's automatic just survival they need that so they're not helpless okay so on my very last note just because this is kind of cool it's is random when it comes to sensory and perceptual development the baby can hear during the last two months of isn't that pregnancy i think that's cool just a random note on sensory development so the sun is starting to set here i don't know if y'all can tell chad's family probably thinks i'm crazy because i've been working this whole time but oh the connection's not working good hopefully y'all can still see the internet's not working it's starting to look really pretty out here i appreciate you guys so much giving up your time on a friday molly and shauna i'm gonna stop the recording so i'm gonna say bye to everyone else that's watching this later and then i'll say bye to you too okay so bye to everyone that's watching this later thank you so much for taking the time to watch this let's see how do i stop the recording bye