Motherhood is one of the most cherished phases in any woman's life. It brings about various changes physically, emotionally and socially in a mother's life. It may require many adjustments especially if it is the first time. At times the onset of psychiatric illness at such juncture in time may be missed. It is important that we are aware of such psychiatric disorders as they concern both mother & newborn baby. Very young infants can be affected by and are highly sensitive to the environment and the quality of care. Prolonged or severe psychiatric illness affects the mother-infant attachment, breastfeeding and infant care. WHO states that in developing countries mental health issues might be seen in 15.6% during pregnancy and 19.8% after childbirth.
Psychological issues seen around delivery time:
Before delivery:- Anxiety related to pregnancy & delivery, pre-existing mood or anxiety or psychosis, the onset of a new psychiatric disorder during pregnancy
After delivery:- Baby blues ( most common), Postpartum depression, Postpartum psychosis
Risk factors:
First time as a mother
Young age
Single mother
Family history of psychiatric illness
Previous history of postpartum illnesses or other psychiatric illnesses in mother
Environment
Stressful pregnancy or delivery related to mother
Stressful events after delivery related to a newborn baby
Starts within a few days of delivery and resolves with good rest and sleep, adequate family and/or spouse support and counselling
Milder than Postpartum depression rarely may exceed more than 15 days
2) Anxiety in Puerperium
Constant worrying about the baby
Constantly checking on the baby
Fear of cot death
Staying awake & hypervigilant through the night
Insomnia
Also called maternity neurosis
3) Postpartum Depression
Starts within 2 weeks to 3 months post delivery
Seen in 10-15% of postnatal women
Constant low and sad mood
Poor energy levels
Decreased physical activity
Negative thinking about child & his/her wellbeing
Suicidal ideation
Poor interest in previously pleasurable activities
Disturbed sleep & appetite
Repetitive guilty thoughts regarding parenting techniques and caring for the baby
Depression causes decreased functioning & decreased care for child. Treating the depression of mothers leads to improved growth and development of the newborn and reduces the likelihood of infection and malnutrition among them.
Treatment
Admission to hospital in cases of suicidal ideas
Medication
Counselling to patient & relatives
Postpartum psychosis
Psychosis seen within days to 4 weeks post pregnancy
Patient shows signs of delusions and/or hallucinations
Increased physical or decreased physical activity
Disorganised or withdrawn behavior
Irrelevant talking
Irrational fears
Thoughts of harming baby
Treatment
Admission to hospital
Medication
Counselling
Let us care for mother and baby both. Postpartum psychiatric disorders are treatable. With awareness we will be able to get them help sooner and provide a better environment for mother & child both.