The importance of prenatal and postnatal mental health
Emotional problems, mother's mental state, daily activities, work performance, marital relationship during pre-natal or post-natal period affect the development of the baby.
During pregnancy, mothers suffering from depression may have a higher risk of miscarriage and premature delivery. Research findings show that when a mother shows symptoms of depression or anxiety during pregnancy, she has a higher risk of developing postpartum depression and has more difficulty controlling her baby's emotions and behavior.
After childbirth, due to hormonal changes, role changes, challenges in infant care and family problems, mothers may be at higher risk of suffering from mood disorders. Postpartum depression can affect a parent's ability to care for their baby and can affect the baby's physical health, cognitive development, as well as emotional and behavioral development. Mothers with postpartum depression are at increased risk of emotional disturbances in family members as well. Thus, it is very important to take care of women's mental health during the prenatal and postnatal period.
Emotional disturbances may occur during the prenatal period
Being pregnant brings encouragement to the family. However, it cannot be forgotten that during pregnancy, mothers may experience different emotions, including anxiety, depression, and irritability. Pregnant women may experience many physical changes and discomforts. His lifestyle may need to be adjusted. Therefore, his feelings may be affected. A pregnant woman may have many concerns about the development of the fetus or the care of the baby after delivery.
Research findings suggest that certain factors are associated with postpartum anxiety or depression, such as the mother's self-esteem, her marital relationship, family relationships, and social support. In order to maintain emotional health during pregnancy, the mother must learn to respect herself, especially to be successful in meeting demands and to accept limits during pregnancy. She should also talk to other mothers to increase social support or talk to someone she can trust to get out of the crisis. If emotional disturbances persist, the mother should seek professional help as soon as possible.
A major risk factor for postpartum depression
The specific cause of postpartum depression is unknown. Research findings indicate that the factors listed in the table below are associated with an increased risk of postpartum depression:
Diagnostic factors
Depressive anxiety disorder included in the last psychological state
Prenatal depression or anxiety
Psychological factors
Anxiety-oriented personality
Lack of social support
Bad marital relationship
Dissatisfied relation of relatives
Domestic violence
Financial problems
A stressful life
Obstetric- and child-related factors
Perinatal complications
Emergency cesarean section
Recent miscarriage/difficulty in pregnancy
Unplanned pregnancy
Congenital disease/ prematurity
Postpartum mood problems
There are three main categories of postpartum mood problems: (1) postpartum blues, (2) postpartum depression, and (3) postpartum psychosis, each of which varies in prevalence, diagnostic presentation, severity, and management.
The postpartum blues
It affects approximately 40% - 80% of postpartum women
It is a transient condition that includes mood swings, tearfulness, sleep disturbances, and irritability. Symptoms usually appear 3 to 5 days after delivery
Symptoms are relatively mild and usually resolve spontaneously within a few days
Postpartum depression
It affects approximately 13% - 19% of postpartum women
Its symptoms are similar to those of depression experienced at other times. Onset is usually within 6 weeks but never within a year of the baby's birth
Most mothers with postpartum depression recover if they are identified early and given proper support by the family
Postpartum psychosis
It affects approximately 0.1% - 0.5% of postpartum women
Its main symptoms include hearing nonexistent voices, strange thoughts of harming others, and thoughts of self-harm or infant-harm. Symptoms usually begin within 14 days after delivery
This is an emergency situation related to psychosis. This requires immediate referral to a psychiatrist or hospital accident and emergency department
Rapid identification of postpartum depression
Major symptoms of postpartum depression include:
Persistent periods of bad mood, such as feeling depressed and sad, crying for no reason or wanting to cry but not crying
Losing interest in almost all activities (even losing interest in your child)
Problems with hunger
Difficulty sleeping
Most of the time there is fatigue or lack of energy
Difficulty concentrating or making decisions
Feeling guilty, worthless and depressed
Excessive anxiety and irritability
If the above symptoms persist for 2 weeks or more and the daily functioning of the woman is greatly affected, it is necessary to seek professional help as soon as possible.
Preventive measures
Proper preparation before pregnancy including proper family and financial planning.
Realistic expectations for parenthood to help adjust to life after childbirth.
Learn more about pregnancy, childbirth and babies to reduce anxiety through various means, for example, attending childcare and parenting workshops at maternal and child health centers, attending relevant talks and workshops organized by other organizations, etc.
Sharing experiences with other parents and increasing social support.
Communicate effectively with other members of friends and family to increase understanding and support.
Getting enough rest and sleep, for example arranging home and childcare support after delivery
Taking some time for leisure and relaxation activities, for example going for a walk, calling friends.
Eat a healthy diet. Do not smoke and do not consume alcoholic beverages.
How to get help?
Contact a family physician or obstetrician for initial assessment and management and, if necessary, refer for specialist services.
See a psychiatrist or diagnostic psychologist in private practice for professional evaluation and treatment
See a social worker or counselor for an evaluation and admission.
If the mother is suffering from postpartum depression, she can contact the Maternal and Child Health Center in her residential area for initial assessment and admission to appropriate services and referral to a nurse.
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