Emotional Changes after Birth

Remember – each birth of every baby from every woman is unique. 

So you’ve had a baby! Now what?

You may be feeling relieved, scared, excited, depressed, worried, curious, impatient, grief, not in the slightest bit sexy or glamorous. These are all normal emotions which no amount of reading or research can prepare you for.  The most significant change is the demand on your time.  There will be new schedules, you won’t be able to just leave the house with your keys and a phone, it can be really overwhelming that you cannot think solely of yourself anymore – you are responsible for another human being 24 hours a day – 7 days a week.

Physically after birth the amount of progesterone in your body will fall from 150 nanograms per millilitre to 7 nanograms (ng) and then to zero.  The amount of oestrogen will also fall from 2000ng to 20ng ending up at around 10ng. With these sharp drops it is no wonder that there will be a knock on effect on your mood.  

You could also be experiencing a drop in potassium which can make you even tireder to make sure to include potassium rich food such as bananas or tomatoes in your post birth diet.

There is an increased chance of developing Post Partum Depression (PPD) if you have had a history of mental illness, have a family history of depression, have been a victim of sexual and/or physical abuse, your birth was not as you planned it to be, if you have had PPD in a previous pregnancy or have had other stresses such as moving house, financial issues or a lack of a support network.  Being open about any of these issues can allow for an earlier diagnosis which will mean early support which will make a big difference to you.

These are the physical and mental reasons why but there is also an anthropological theory that this is the mothers way of negotiating more involvement from other people in situations where they have a small support network. 

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Baby blues

Most women will have a dip in the first few days.  This drop can coincide with your milk coming in, which is caused by another shift in your hormones (this was one of the reasons that women were thought to get ‘milk fever,’ in the 19th century) Life can suddenly seem so complicated.  You may be sore.  The baby may not be feeding as well.  You’re fatigued.  Your hormones are all over the place as you’ve just given birth which is also a physically tiring process.  You are responsible 24/7 for someone else.  Your expectations of a beautiful birth weren’t met. Bits of you that have never hurt in your entire life are engorged, bruised or swollen.  You want intimacy but can’t face sex. You still have a baby belly.  Your partner has gone home and had a great nights sleep whilst you are left in hospital taking care of their baby.  It can be any one of those reasons or a combination  of all of the above but it is important to remember that it is just a ‘dip,’ that nearly every single woman who has given birth will go through the same thing.

Post partum mood and anxiety disorders

As many as one in ten women will experience emotional symptoms in the year after their baby has been born.  Post partum depression (PPD) is very different to baby blues.  This does not happen because they are weak or inadequate as parents but could be a reaction to the physical and emotional adjustments caused by pregnancy and birth. PPD impacts the lives of around 15% of women who have a baby and may begin anytime after birth to a year or so afterwards.  The symptoms are very similar to baby blues but are generally much more pronounced. 

They include:-

  • Crying
  • Irritability
  • Sleep problems – either too much or too little
  • Eating problems – too much or very little appetite
  • Persistent feelings of sadness, hopelessness or helplessness
  • Inability/lack of desire to take care of themselves or the baby
  • Social withdrawal
  • Loss of interest in sex
  • Anxiety
  • Erratic behaviour such as cleaning the house in the middle of the night
  • Aversion to the baby
  • Feelings of loneliness
  • Memory loss
  • Panic attacks
  • Breathlessness
  • Rapid heartbeat

So how to spot it? Mum is ‘fine,’ the house is spotless but she is not sleeping, has lost weight and/or not engaging with the baby or mum is down and nothing is working, she is exhausted, feeling inadequate and experiencing none of the positives that come from having just had a baby. With these feelings come intense guilt – ‘its easy for everyone else,’ ‘why can’t I get my act together?’

The tips for helping with the baby blues can be of use but if there is no improvement in a fortnight or things are worsening then it may be that you need more professional help. This is one of the big clues that this is more serious than the baby blues – the mother is ‘stuck,’ in a mood or pattern of behaviour and things are not changing. If you feel that you may have PPD then please consult your doctor so they can check that there is nothing medically wrong.  They may check your thyroid as that can produce erratic hormone levels which can impact your emotional stability.  If your levels are fine then ask for a referral to therapist who has experience in working with women with PPD.  If these feelings only happen when you initially breastfeed then it could be a sign of DMER, a condition where there is an imbalance in your dopamine levels caused by the release of hormones at the start of breastfeeding.  Remember that there can be a physical reaction going on in your body that is causing you to feel this way. The quicker the treatment then the greater the chance is that the depression will not impact you bonding with your baby or have any long term impact on your other relationships.  

 Post partum obsessive compulsive disorder (PPOCD)

Women with this condition may have PPD too (although it can happen on its own).  Symptoms include compulsive checking that the baby is ok, obsessive cleaning, or obsessive thoughts about harming the baby or leaving them somewhere (women with PPOCD are appalled by these thoughts and don’t act on them).  Like PPD treatment can be through therapy and/or with drugs.

Post partum psychosis

This is the most serious post partum mental illness.  Women suffer from hallucinations, loss of reality and/or delusions. Symptoms usually start to appear soon after birth. If you are experiencing suicidal thoughts, hearing voices or any other for of psychosis then go to the doctor immediately for help. This condition only effects one or two mothers in 1000.

Any new mother can get postpartum depression and every new mum will have emotional changes to some degree – it is not a reflection on you.  With help and support you will make it through this time.