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The Baby Blues

July 09, 1999

Post Partum DepressionBy KATE COLEMAN / Staff Writer

photo: KEVIN G. GILBERT / staff photographer




You've been waiting to have a baby for what seems like forever, and now that perfectly healthy, beautiful bundle of joy is here.

Couldn't be happier?

Why are you crying?

[cont. from lifestyle]

It's the baby blues. You're not crazy. You're not a bad mother. It happens to 50 to 80 percent of new moms, according to Dr. Miriam Rosenthal, psychiatrist and associate professor of obstetrics and gynecology at Case Western Reserve University in Cleveland, Ohio.

Postpartum blues should be considered a normal part of the recovery process after childbirth, says Dr. David H. Solberg, an obstetrician and gynecologist in practice in Hagerstown.

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New mothers are emotional and cry easily. They obviously are tired, Rosenthal says.

It happened to Cindy D'Aquino of Hagerstown.

D'Aquino, a licensed day-care provider, has cared for eight children, ages 5 months to 9 years. Her son Christopher is 2 1/2 years old. Baby Collin arrived May 24.

Her first three days home from the hospital were pretty rough, D'Aquino says.

Collin was delivered by Caesarean section, so D'Aquino couldn't move too well. She was used to a houseful of kids, people coming and going all day. She had to adjust to being with just her toddler and newborn. She felt guilty about the time and attention she wasn't giving Christopher. She felt overwhelmed.

D'Aquino found herself crying a couple of times - for no reason, she says. She told her husband she felt totally neurotic. He agreed.

Crying is a normal part of postpartum blues, says Dr. Leah Dickstein, a psychiatrist at University of Louisville in Kentucky.

New mothers may feel depressed or sad and may experience forgetfulness, elation, lack of concentration, anger, anxiety or tension - things not ordinarily associated with feeling blue, according to Misty Warren, family educator at Shenandoah Maternity Center in Martinsburg, W.Va.

What causes postpartum blues?

Delivery brings hormonal changes. Levels of estrogen and progesterone are low. Loss of blood during childbirth is a suspected factor, and fatigue is a part of it, Warren says. Social stressors such as a difficult pregnancy or delivery, a bad marriage or pressure to return to the workplace also may come into play.

The phenomenon is seen in countries around the world, but is less apparent in cultures where the mother has lots of family around, as in Mexico and India, Rosenthal says.

"Women need women," says Beth Hudak, who provides day care in her Hagerstown home. She's quoting psychologist Dr. James Dobson, but that also has been her experience. Hudak has five children, ranging in age from 16 to 24. Hudak says her greatest gifts as a young mother were a wonderful husband who was home at 5 p.m. and her female friends.

Such support is important for a new mother, someone to be with her - not just to be with the baby when she's not there, Rosenthal says.

Postpartum blues may occur intermittently for four or five days, according to psychologist Barbara Lewin, clinical director of the Center for Postpartum Depression in Philadelphia. The good news is that baby blues resolves by itself.

In addition to the blues, there are two other postpartum depressive syndromes, postpartum depression and postpartum psychosis, according to Rosenthal. Symptoms of the most extreme - postpartum psychosis - include delusions and feelings of helplessness, hopelessness and being trapped. The woman may be out of touch with reality, even suicidal, Rosenthal says. Unfortunately, there is a high correlation with infanticide, Lewin says.

Fortunately, it's rare. Postpartum psychosis occurs only in one to three women in 1,000, according to Lewin.

Some women - 10 to 15 percent of new moms - experience postpartum depression, according to Rosenthal. It usually hits about two weeks after the birth, she says.

The best predictors of postpartum depression are severe premenstrual syndrome or a history of depression, Rosenthal says. Women also should consider their general medical status, Dickstein advises. She recommends that all women be screened for thyroid disease and says that diseases such as diabetes and cancer also can lead to depression.

Symptoms include being in a very low mood, irritable and sad. The woman can't sleep - even when the baby is asleep. A change in eating patterns, either not eating or eating all the time, can be a sign of depression. So can the inability to focus or concentrate, according to Rosenthal. It is an anxious depression, with weeping, some obsession, a tendency to worry a lot. Even if a doctor tells her the baby is fine, the mother is inconsolable, Lewin says. Or she may not be able to bond with the baby, Dickstein says.

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