The puerperium is the period between delivery and the return of the body to its normal state.
Doctors and midwives consider its duration between six to eight weeks and it is characterized by neuroendocrine and psychosocial changes.
It is common in the first days to have what is known as a postpartum
blues
or
maternity blues
, but when the discomfort increases and exceeds the first two weeks we could be facing a postpartum depression.
The psychiatrist Pau Camell of the Atiapsicologia center points out that the symptoms that appear are typical of depression: sadness, mood swings, irritability, apathy, social isolation, loss of energy, interest and reduced pleasure in the activities you used to enjoy, difficulty to eat and sleep well.
"In addition, there may be some more specific symptoms for this disorder, such as the inability to relate to the baby or fear of not being a good mother.
In this sense, in order not to increase the guilt or stigma towards the mother, it is important not to consider postpartum depression as a sign of weakness or personality defect, but as a complication of childbirth with causes and consequences that must be addressed comprehensively, "says the doctor.
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The director of Calma, the Center for Psychology, maternity specialists, Sabina del Río considers that some of the most common causes are hormonal imbalance, a complicated delivery, lack of sleep, physical pain after delivery, difficulties with feeding the baby , in addition to a multitude of changes to adapt to: new roles, identity and functions at a family and personal level, inexperience, not tolerating the absolute dependence of the baby, feeling that control of one's life has been lost, resignations feeling overwhelming implicit in raising a baby.
The psychiatrist Pau Camell tells us that during the months after childbirth the risk of having depression increases by two to three times due to several factors: “The levels of estrogens and progesterone are about 50 times higher than before pregnancy.
In the course of a few days these levels drop sharply to normal values at the same time that prolactin begins to secrete abundantly.
Each woman responds differently to these abrupt hormonal changes and some may notice changes in mood ”.
The doctor points out that women who have suffered a depressive episode during their life have a greater risk of reproducing it after childbirth, and this risk is even higher if there have been symptoms of depression or anxiety during pregnancy.
“People in situations of poverty are at higher risk for postpartum depression.
Having a sufficient support system, whether from your partner or from friends or family, is of vital importance during the puerperium.
On the other hand, having presented stressful events during pregnancy or the puerperium (illness of a loved one, the woman herself or the fetus / newborn, dismissal from work, financial problems, marital problems, etc.) increases the probability of present a depressive disorder after childbirth ”, says psychiatrist Pau Camell.
Jazmín Mirelman is a perinatal psychologist and director of the RedAfectiva project: “Metabolizing the condition of mother is not easy, neither from the physiological or psychological point of view.
Conceiving, gestating, giving birth and lactating are very demanding processes that require multiple adaptations.
Currently, social distancing due to the pandemic causes loneliness to reach extreme levels, which were already high in urban maternity wards, but which are now exacerbated by the absence of face-to-face visits to health centers, postpartum support groups and breastfeeding, family gatherings or meetings with friends.
This situation increases the risk of suffering depression or presenting depressive symptoms ”.
The idea that, in theory, the perinatal stage should be the happiest time of your life is not true.
This axiom responds to a social mandate that has nothing to do with reality.
"It is true that currently being a mother responds to a personal desire and decision, something that has not always been the case throughout history, and the fact that the achievement of that desire can generate some confusion on the part of the social environment , that is, having a baby in your arms generates discomfort instead of satisfaction.
But it is that the bond is something that is built little by little.
When we meet someone, we are not going to live with them immediately, nor do we share 24 hours a day, nor are we available in body and soul to that person.
And that is what a baby needs the first days, attention, availability and constant contact, during the day and at night.
It is a very strong demand, a great responsibility before a completely vulnerable being.
The woman then needs a network on which to lean, a lot of real help, but also symbolic ”, affirms the psychologist expert in postpartum depression Jazmín Mirelman.
The psychiatrist Pau Camell points out that first of all you have to ask for help.
“Fortunately, it is a disorder that can be treated.
The choice of this treatment must be carefully evaluated, based on the mother's mental state, the severity, the risks and the support it presents.
Non-pharmacological interventions should be considered first and are the first choice in mild to moderate depression ”.
Jasmine Mirelman adds: “The use of psychotropic drugs is indicated in certain cases and is not incompatible with breastfeeding, this is very important to say.
And also that the treatment with antidepressants must go hand in hand with a psychotherapeutic process, because it is not about silencing the symptoms, but on the contrary, giving them a voice ”.
Mirelman concludes with a good reflection: “The fact that more and more people talk about mental health and motherhood carries a certain risk of overloading mothers with the full burden of parenting, as if doing it expertly was a voluntary and conscious act.
This is not the case at all, in general mothers want to take the best possible care of their babies, but sometimes they encounter difficulties.
The task is to accompany them so that they are able, avoiding separations, intrusions, judgments and unsolicited opinions, favoring that the conditions are given so that she can perform her function, building her unique way of being the mother of that child.
It is essential to mention that to raise a child you need the whole tribe, this so hackneyed phrase reflects the importance of the involvement in raising the father figure, the extended family, the social environment and the public protection policies from day to day mother-baby ”.
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