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Baby blue: A woman’s tragedy
Everybody in this world goes through certain life experiences, which trigger him or her to learn more about it or to resolve it. But this can only happen if you are able to identify an issue or realize that it is an issue. One of the issues that many of the women experience and don’t know is Baby blue or post partum depression.
An interview with my patient gave me an insight that many of our females suffers from this tragedy “Baby blue” and don’t even know that it has a major impact on mother as well as for the infant's development. My patient went through a post delivery period and she recalls that sometimes she had unusual thoughts and fears such as she felt if she’ll loose her child, she’ll forget her child in some shop, or she may harm her own child. These were very horrible thoughts that took my breath away. Sometimes she use to dream that someone has taken away her child or she is giving bath to her baby and suddenly her baby is out of her hands and gone inside the drain. After these kinds of thought and dream she used to become very restless, no sleep, she used to wake up even when a slightest noise is there. She became overprotected towards her child. Her husband many times commented that how do you know beforehand what does the baby wants? Because she was always making fuss about everything even telling her husband what to do and what not to do as if her daughter was only her property. After this interview I wanted to learn more about it that why she had these symptoms, what are the usual risk factors of it?
Baby blue or Post partum depression can happen a few days or even months after any childbirth, and not just the first child. It can be of mild and temporary form i.e. baby blue or postpartum blue as well as more severe that is psychotic form. In its mild form it is mostly treated as harmless unworthy of any treatment and thus neglected by the person herself or by the family members, which may lead to its severe form. According to Lusskin S.I & Misri,S Baby blue is characterized by feeling of changes in “sleep, energy level, appetite, weight, gastrointestinal functioning, and libido” are the most common symptoms of postpartum blue along with additional symptom such as “significant anxiety often with panic attacks, intense irritability and anger, feeling of guilt, sadness, weeping, fatigue, loss of interest in usual activities, overwhelmed or unable to care for the baby, feeling of inadequacy or failure as a mother and no bonding with the baby , which further exacerbates feeling of guilt and shame and leads women to suffer in silence”.
Te prevalence of Baby Blue in developing countries is increasing from 16% to 35 %. In Pakistan its prevalence is said to be very high. Several studies have been conducted to get the estimated prevalence regarding this topic in hospitals of Pakistan, but no overall statistics are found.
There are many risk factors of postpartum depression some of them are discussed here such as:
1) In post delivery period there is sudden decrease in hormones level which add up with the other risk factors thus causing postpartum depression. 2) Psychological factors also play a major role in postpartum depression. According to Rahman.A, “in many of the studies a major complaint reported by the new mothers was a feeling of `inadequacy’ regarding childbearing”. Further problems arise if mother is of low age. The childbirth trauma and change in their role itself gives stress to the young mothers. Therefore proper antenatal teaching is required during the visits to doctors and midwifes, even the husband should be encouraged to attend these session. 3) Rahman, A’s study in a rural community states that “Antenatal depression often precedes postnatal depression”. Over half of mothers who are depressed in the third trimester of pregnancy, continued to be depressed one year after giving birth. It is important for a health care professional to identify the signs of the depression in early pregnancy and do interventions, which can help in preventing postpartum depression. 4). The problematic relationship among husband and wife, violence by husband and Psychological and physical abuse especially during pregnancy, lack of empowerment of the women leads her towards emotional instability and distress, which can further add up to postpartum depression.
If we see our Pakistani women who are not very literate or illiterate and less empowered they are more prone to get postpartum depression. The woman firstly faces her husband who if not very supportive can be the cause of her emotional instability. She is further not able to take any decision but when the time comes for giving birth to the child she is expected to give birth to only male gender and not female. Not coming up to the expectation of her husband and in laws she is further tortured by verbal abuse or physical abuse. Living in joint family system where she is the only one who is taking care of the whole family, giving less time to herself, could add up to her mental stresses. It is necessary for a woman not to expect too much from herself. She should express her feelings with her partner. Should not get overwhelmed by the work and do one thing at a time. Get medical support if identifies this kind of emotions. It is necessary that today’s women should be educated toward her physical and mental health. But the question arises can she do anything for herself. Yes she can but she requires social support love and certain amount of empowerment to take decision for herself. The life partners can play a key role in not only helping in wife’s emotional stability but also in preventing other stressors in life which are making her more vulnerable to baby blue.
My recommendations are that further studies are required to be conducted in future focusing on prevalence and screening of baby blue. The husband’s role in prevention can be studied in great detail. Detection of women for developing postnatal depressive symptoms can be done during late pregnancy in antenatal care clinics. Finally I would like to conclude that the postnatal period is very important because of the impact of maternal depression on the infant's development. By knowing the risk factors, symptoms can by identified early, proper antenatal teaching and extra support; love and affection could improve outcomes in both mothers and their infants.
References:
Rahman.A & Creed.F. (2007) Outcome of prenatal depression and risk factors associated with persistence in the first postnatal year: Prospective study from Rawalpindi, Pakistan Journal of Affective Disorders; 100(1-3): 115–121
Rahman, A; Iqbal, Z &Harrington, R. 2003 Life events, social support and depression in childbirth: perspectives from a rural community in the developing world. Psychological Medicine 33:1161–1167.
Lusskin S.I & Misri,S (2008) Postpartum blues and depression Literature review version
About the Author
Ms. Karima Ali Muhammad
Badfinger - Baby Blue (Kenny Rogers Show 1972)
