Postpartum Depression

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Introduction
When a woman gives birth to a child, it can be one of the most joyous and exciting moments in her life, yet it can also be difficult and stressful. There are a range of emotional, behavioral, and physical changes that occur shortly after a woman gives birth. These changes are common; however, many women who experience these emotions may have postpartum depression, with symptoms ranging from mild to severe. Many women require medical treatment. Although all causes of postpartum depression are unknown, there are many factors that can put a woman at risk. This essay provides an overview of postpartum depression, the impact it has on the individual client, the newborn, and the family, the physical and mental assessment findings, and its impact on my future nursing practice. Overview

Postpartum depression is an illness that consists of severe mood swings and feelings of inadequacy that occur within six months to a year after giving birth. These symptoms may be so severe that they may cause suicidal thoughts or an inability for a mother to care for her newborn. According to Diana Barnes (2008), “50 to 80% of mothers will experience some change in mental health within the first year after delivery…10 to 15% are at risk for postpartum depression” (para. 2). The risk for postpartum depression increases if there is a history of depression, a weak support system, an unplanned or unwanted pregnancy, or a stressful situation (marital conflict, illness, or pregnancy complication). The etiology of postpartum depression is unknown. According to Smith and Jaffe (2007), within 48 hours after delivery there is a dramatic decrease in estrogen, progesterone, cortisol, and thyroid gland hormones, along with changes in the immune system, metabolism, and blood pressure that may all trigger depression. Emotional factors include feeling less attractive, struggling with a new identity, feeling a loss of control, and anxiety about caring for the newborn. Some lifestyle influences may include difficulty breastfeeding and financial problems. Impact on individual client, newborn, and the family

Postpartum depression has potentially serious consequences for the mother, the newborn, and their families. The impact of postpartum depression causes a mother to frequently feel exhausted, emotionally empty, and guilty because she cannot show love to her baby. The mother feels overwhelmed by feelings of harming her baby and may lack the emotional energy to relate to her newborn, which prevents her from perceiving the baby’s attempts to communicate. Depressed mothers are less likely to play with, read to, or even breastfeed their baby and tend to be inconsistent in their care causing a disruption in the bonding process. Many mothers are embarrassed to get help out of shame. Postpartum depression also has an extremely high impact on the newborn. Katja Gaschler (2008) states, “three-month-old infants of depressed mothers look at their mothers less often and show fewer signs of positive emotion than do babies of mentally healthy mothers” (p. 65). Postpartum depression during the first few months of life may also cause negative effects on a child’s development including: social problems (difficulty establishing relationships, social withdrawal, and acting out destructively); behavioral problems (temper tantrums, sleep problems, hyperactivity, and aggression); cognitive problems (walking and talking late and learning difficulties); and emotional problems (low self-esteem and anxiety). The family as a whole is also greatly impacted by postpartum depression and goals of treatment must address the emotions of the entire family, especially the marital couple. A woman’s husband or partner may have his own feelings regarding the birth of their child, his new role in the family, as well as concerns about his partner’s health. Other members of the family may struggle with their own hidden emotions as well. The family should offer...
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