Question

A gravida 2, para 2 patient comes in for her six-week postpartum check-up. She walks in with her partner, who is pushing their healthy baby daughter in a stroller and holding the hand of their 2-year-old. As the patient’s prenatal healthcare professional, you note that she is pale and not wearing her usual makeup. Her hair is uncombed, and her eyes are puffy and bloodshot. She is not affectionate with her children. When you ask Ann how she feels, she replies in a monotone voice, “I’m so tired. I haven’t slept for days. I keep crying, but I don’t know why.” The patient stares out the window. Her partner whispers to you, “She hasn’t been herself since she had the baby. She hardly eats anything and gets up at night, because she can’t sleep. She cries a lot and says she is a bad mother. She rarely picks up the baby and says she is afraid she will hurt her. I hope you can help, because I’m really worried. Our relatives live far away, and we have no one to help her until I get home from work. I hope she gets back to normal soon. Our neighbor says she probably just has the baby blues and that this is normal after having a baby.” Describe the differences between postpartum blues, anxiety symptoms, depressive symptoms, and psychosis Identify five signs or symptoms of postpartum depression.

Answer 1

Postpartum is period after delivery of the baby. During the postpartum period women undergoes various physical and emotional changes.

Postpartum blues : Often after the delivery of baby the women undergoes various changes. The pressure of caring for the baby can put the mother under undue stress resulting in postpartum blues. The postpartum blues begins 1-3 days after delivery of the baby. It is characterized by milder symptoms such as mood swings, crying spells, irritability, lack of sleep and anxiety. Postpartum blues does not need medication and can be managed through proper support and counselling.

Postpartum anxiety symptoms: postpartum anxiety symptoms also have the same effects as postpartum blues such as anxiety, unexplained crying, lack of sleep, fatigue, irritability and impatience but are moderate in nature. It may develop into postpartum depression. Postpartum anxiety requires psychological counselling.

Postpartum depression : develops about 2 weeks after postpartum. The symptoms include depression, anxiety, insomnia, poor concentration, fear of harming the baby, lack of interest, suicidal thoughts. The symptoms range from moderate to severe. Moderate functional impairment is seen. Postpartum depression requires medical support such as antidepressants and psychotherapy.

Postpartum psychosis: postpartum psychosis is a severe form of psychological impairment seen postpartum. It is characterised by severe symptoms such as delusions, hallucinations, insomnia, severe mood swing cycles, depersonalization, suicidal thoughts. It is characterized by severe form of functional impairments. The treatment includes anti psychotic and antidepressant drugs. Sometimes hospitalisation may be required.  

Five signs of postpartum depression are :

1. Insomina

2. Unexplained weeping or crying spells

3. Guilt

4. Fear of harming the baby

5. Lack of interest in self