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Acon­cerned fam­ily who just had their first baby asked. “Ba Doc­tor, My wife has been fail­ing to look after the baby we just had. She has been look­ing for­ward to hav­ing our son through­out preg­nancy. But it has been 2 months since she de­liv­ered and she has changed. She is not her usual self and stopped com­mu­ni­cat­ing”

Did you know that up to 85 % of women ex­pe­ri­ence some type of mood change after de­liv­ery (post-par­tum pe­riod). The preg­nancy pe­riod and de­liv­ery is a ma­jor life event which for many women ends up as the most stress­ful pe­riod of their life. For most women the behavioral changes/fea­tures (symp­toms) are tem­po­rary and mild; how­ever, some women ex­pe­ri­ence a more dis­abling and per­sis­tent form. Al­though post de­liv­ery mood disor­ders are rel­a­tively com­mon, Low mood/ un­happy (de­pres­sive symp­toms) behavior that emerges after de­liv­ery are fre­quently over­looked by moth­ers. This of­ten leads both the mother and baby at risk.

Pre­ven­tion is the best medicine. There is need to un­der­stand what Post-de­liv­ery blues are and how to treat them. Post de­liv­ery is a time of in­creased risk for the de­vel­op­ment of men­tal health ill­ness in women.

Men­tal health ill­ness oc­cur­ring within the first year after child­birth, es­pe­cially when the behavioral fea­tures are present after the first 4 weeks after de­liv­ery raises con­cern.

The grow­ing of mood chal­lenges fol­low­ing days and weeks after de­liv­ery is of­ten over­looked or ig­nored by moth­ers due to lack of aware­ness. It is con­sid­ered nor­mal in our com­mu­nity and at times an at­ti­tude prob­lem. Less than onethird of women with post de­liv­ery ill­ness seek pro­fes­sional help.

In post de­liv­ery women, men­tal ill­ness is typ­i­cally di­vided into three cat­e­gories: (1) Baby blues/Post de­liv­ery blues, (2) Post-de­liv­ery de­pres­sion, and (3) Post de­liv­ery loss of re­al­ity/per­cep­tions (psy­chosis). There may be sig­nif­i­cant over­lap be­tween these three sub­types.


After a women de­liv­ers, sig­nif­i­cant body (phys­i­o­log­i­cal) and mind (psy­choso­cial) changes oc­cur. The im­pact of psy­choso­cial fac­tors in the de­vel­op­ment of mood weak­ness dur­ing the post de­liv­ery pe­riod can­not be un­der­es­ti­mated. Given the mul­ti­ple fac­tors ex­plained be­low it is not straight for­ward to point out who will ex­pe­ri­ence mood dis­tur­bance. Age, mar­i­tal sta­tus, num­ber of chil­dren, ed­u­ca­tion level, and so­cioe­co­nomic sta­tus (fi­nan­cial sup­port). All these have a role to play. High rates of post de­liv­ery de­pres­sion is a com­mon find­ing in young (ado­les­cent) moth­ers. At Chainama, it is a com­mon trend and records re­veal that first time moth­ers are more vul­ner­a­ble to post de­liv­ery men­tal ill­ness than moth­ers who have pre­vi­ously de­liv­ered. Moth­ers who un­dergo var­i­ous com­pli­ca­tions at the time of de­liv­ery (e.g., pro­longed la­bor, emer­gency/ un­planned cae­sarean sec­tion, still­birth) are at in­creased risk of de­pres­sion.

Stress­ful life events dur­ing preg­nancy or near the time of de­liv­ery ap­pear to in­crease the like­li­hood of weak­ened men­tal health. One of the most con­sis­tent find­ings is that among women who re­port mar­i­tal or inad­e­quate so­cial sup­port which is the case in many Zam­bian women (who have poor so­cial sup­port from com­mu­ni­ties and fam­ily or un­planned preg­nan­cies), are more prone to post de­liv­ery de­pres­sion.

CLIN­I­CAL FEA­TURES TO Post de­liv­ery De­pres­sion de­mands the same treat­ment as de­pres­sion that oc­curs at other times; the ear­lier the treat­ment is ini­ti­ated, the bet­ter the out­come. de­liv­ery and go away by the (Range of 10 to 15 %.) tenth day. Blues are time­lim­ited. While some women re­port the While the oc­cur­rence sud­den low mood shortly after of baby blues does not neces­de­liv­ery, Low mood com­monly sar­ily re­flect an ill­ness in the de­vel­ops grad­u­ally over the mother, some women with first 6 months after de­liv­ery. blues will go on to de­velop de­pres­sion. Many women ac­tu­ally ex­pe­ri­ence Es­pe­cially if it lasts the on­set of low mood symp­toms dur­ing preg­nancy. The signs and symp­toms are low mood, ir­ri­tabil­ity, lack of in­ter­est in usual liked hob­bies and ac­tiv­i­ties, poor sleep habits, and feel­ing weak with lack of en­ergy are fre­quently re­ported. Neg­a­tive feel­ings to­ward the baby are noted among moth­ers. It is com­mon for a woman to ex­press doubt or con­cerns about her abil­ity to care for her child. In its most se­vere form, it may re­sult in com­plete loss of in­ter­est. (The mother de­taches her­self from ev­ery­thing) Sui­ci­dal thoughts are also of con­cern among many moth­ers.


As post de­liv­ery blues are usu­ally mild in sever­ity and re­solve spon­ta­neously, no med­i­cal treat­ment other than sup­port and re­as­sur­ance is re­quired. Al­though the symp­toms may be dis­tress­ing, they typ­i­cally do not af­fect the mother’s abil­ity to func­tion and to care for her baby. Moth­ers should be in­structed to visit the near­est health posts. Or pri­mary care provider if the symp­toms per­sist longer than two weeks to en­sure the early iden­ti­fi­ca­tion of a more se­vere ill­ness. Moth­ers re­quire fam­ily and so­cial sup­port to get past this pe­riod.

Post de­liv­ery De­pres­sion de­mands the same treat­ment as de­pres­sion that oc­curs at other times; the ear­lier the treat­ment is ini­ti­ated, the bet­ter the out­come.

Non Med­i­cal Ther­apy: Coun­selling ther­a­pies are fre­quently used in the treat­ment of de­pres­sion. In­ter-per­sonal fam­ily coun­selling ther­apy (so­cial sup­port, re­la­tion­ship sup­port with the spouse, and in­ter­ac­tion with the baby.) Cog­ni­tive-behavioral ther­apy which fo­cus on is­sues spe­cific to new moth­ers with de­pres­sion, LOOK OUT FOR.

Baby Blues: (post de­liv­ery blues) oc­cur within the first week after de­liv­ery. (30 to 85 %) Women with baby blues re­port a va­ri­ety of symp­toms, in­clud­ing lack of in­ter­est, mood fluc­tu­a­tion, ir­ri­tabil­ity, tear­ful­ness, un­easi­ness and in­som­nia (poor sleep pat­tern or in­abil­ity to sleep). These symp­toms typ­i­cally peak on the fourth or fifth day after more than a month.

Post De­liv­ery De­pres­sion: Ma­jor de­pres­sive ill­ness is rel­a­tively com­mon after one un­der­goes preg­nancy and de­liv­ery. While the oc­cur­rence of baby blues does not nec­es­sar­ily re­flect an ill­ness in the mother, some women with blues will go on to de­velop de­pres­sion. Such as the in­abil­ity to cope with the de­mands of car­ing for a child, per­ceived lack of sup­port and ab­sence of en­joy­able ac­tiv­i­ties.

Med­i­cal Ther­apy: Mood sta­bilis­ers, and An­tide­pres­sant med­i­ca­tions are avail­able and proven to help im­prove the men­tal strength. In­pa­tient Hos­pi­tal­i­sa­tion In cases of se­vere de­pres­sion may be re­quired. Par­tic­u­larly for moth­ers who are at risk for sui­cide.

It is not pos­si­ble to re­li­ably pre­dict which women in the general pop­u­la­tion will ex­pe­ri­ence post de­liv­ery mood dis­tur­bance how­ever we can look out for signs by ask­ing a preg­nant women the fol­low­ing:

In sum­mary, the need for aware­ness of preg­nancy and the emo­tional bur­den it has on the preg­nant women needs to be un­der­stood.

It is not just the phys­i­cal changes that one needs to fo­cus on in to­days fast evolv­ing re­al­ity but also the psy­cho­log­i­cal and so­cial fac­tors that need to be taken care of dur­ing preg­nancy. It is not a one man show and it is not just about hav­ing a baby. It is a lot more. Get in­volved and lets help take the stigma away from men­tal health. Lets Talk Men­tal Health. A healthy mind equals to a healthy body.

After a women de­liv­ers, sig­nif­i­cant body (phys­i­o­log­i­cal) and mind (psy­choso­cial) changes oc­cur.

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