POSTPARTUM PERIOD

 THE POSTPARTUM PERIOD

The weeks after childbirth present challenges for many new parents and their offspring. This is the postpartum period    the period after childbirth or delivery that lasts for about six weeks or until the mother's body has completed its adjustment and has returned to a nearly prepregnant state. It is a time when the woman adjusts, both physically and psychologically, to the process of childbearing.  The postpartum period involves a great deal of adjustment and adaptation. The adjustments needed are physical, emotional, and psychological.  A woman's body makes numerous physical adjustments in the first days and weeks after childbirth (Mattson & Smith, 2011). She may have a great deal of energy or feel exhausted and let down. Though these changes are normal, the fatigue can undermine the new mother's sense of well-being and confidence in her ability to cope with a new baby and a new family life (Runquist, 2007).

 

PHYSICAL ADJUSTMENTS

A concern is the loss of sleep that the primary caregiver experiences in the postpartum period (Gunderson & others, 2008). In the 2007 Sleep in America survey, a substantial percentage of women reported loss of sleep during pregnancy and in the postpartum period. The loss of sleep can Contribute to Stress, marital Conflict, and impaired decision making. Alter delivery, a mother s body undergoes sudden and dramatic changes in hormone production. When the placenta is delivered, estrogen and progesterone levels drop steeply and remain low until the ovaries start producing hormones again.

Involution is the process by which the uterus returns to its prepregnant size five or six weeks after birth. Immediately following birth, the uterus weighs 2 to 3 pounds. By the end of five or six weeks, the uterus weighs 2 to 3V2 ounces. Nursing the baby helps contract the uterus at a rapid rate.

 

 

EMOTIONAL AND PSYCHOLOGICAL ADJUSTMENTS

Emotional fluctuations are common for mothers in the postpartum period. For some women, emotional fluctuations decrease within several weeks after the delivery, but other women experience more long-lasting emotional swings.  As shown in Figure 3.11, about 70 percent Of new mothers in the United States have what are called the postpartum blues. About two to three days after birth, they begin to feel depressed, anxious, and upset. These feelings may come and go for several months after the birth, often peaking about three to five days after birth. Even without treatment, these feelings usually go away after one or two weeks.  However, some women develop postpartum depression which involves a major depressive episode that typically occurs about four weeks after delivery. In other words, women with postpartum depression have such strong feelings of sadness, anxiety, or despair that for at least a two-week period they have trouble coping with their daily tasks. Without treatment, postpartum depression may become worse and last for many months (Nolen-Hoeksema, 2011). And many women with postpartum treatment don't seek help. For example, one recent study found that 15 percent of the women reported postpartum depression symptoms but less than half sought help (McGarry & others, 2009). Estimates indicate that 10 to 14 percent of new mothers experience postpartum depression.

Several antidepressant drugs are effective in treating postpartum depression and appear to be safe for breast feeding women (Logsdon, Wisner, & Hanusa, 2009). Psychotherapy, especially cognitive therapy, also is an effective treatment of postpartum depression for many women (Beck, 2006). Also, engaging in regular exercise may help in treating postpartum depression (Daley, Macarthur, & Winter, 2007).

Can a mother's postpartum depression affect the way she interacts with her infant? A recent research review concluded that the interaction difficulties of depressed mothers and their infants occur across cultures and socioeconomic status groups, and encompass less sensitivity of the mothers and less responsiveness on the part of their infants (Field, 2010). Several caregiving activities also are compromised, including feeding (especially breast feeding), sleep routines, and safety practices. To read about one individual who specializes in women's adjustment during the postpartum period.  Fathers also undergo considerable adjustment in the postpartum period, even when they work away from home all day. Many fathers feel that the baby comes first and gets all of the mother's attention; some feel that they have been replaced by the baby. The father's support and caring can play a role in whether the mother develops postpartum depression or not. A recent study revealed that higher support by fathers was related to lower incidence of postpartum depression in women (Smith & Howard, 2008).