Extended postpartum blues may signal something else

The birth of a baby creates many changes in a woman’s life, from the immediate responsibility of caring for a little one to the state of her emotional health.

Every woman experiences a change in her emotions after giving birth as her estrogen and progesterone levels drastically decline. This drop in hormones can create postpartum blues, which causes a woman to feel depressed, anxious and upset for several days after giving birth. Women may cry for no discernable reason, have trouble sleeping, eating, making choices, and even question whether she is able to care for her child.

Women need to be reassured that postpartum blues is a natural part of childbirth, and will subside as their hormones level out and they become more confident as a mom. However, for more than 600,000 women each year the battle becomes stronger and lasts longer than normal. This is a sign that they are dealing with something much more serious called postpartum depression (PPD).

According to the American Psychological Association (APA), postpartum depression is a serious mental health problem that can have significant consequences for both a new mother and her family. It is estimated that up to 16 percent of women who give birth develop PPD. Research also has found that up to 40 percent of all women who have had PPD will experience it again after future births.

PPD can occur soon after birth to anytime within the first year of having a baby. According to the National Institutes of Health (NIH), the most common time of occurrence is about three months after childbirth. The exact cause of PPD is unknown, however, researchers have identified several factors that may cause a woman to be at a higher risk of developing it:

Stressful birth — Women who experience a stressful event during the pregnancy or delivery, including personal illness, death or illness of a loved one, a difficult emergency delivery, premature delivery or illness or birth defect of the baby.

History of depression — Women who have had depression, a bipolar disorder or anxiety disorder before their pregnancy, or with a past pregnancy. A family history of depression can also play a role.

Life circumstances — Women who are under 20 years of age, have a poor relationship with their significant other, have housing or money problems or have little support from family and friends. This includes women who did not plan the pregnancy or who have mixed feelings about becoming a mom.

Signs of PPD include feeling depressed, having a loss of energy, the inability to feel pleasure, weight loss or gain, appetite and sleep changes, feelings of excessive guilt or worthlessness, psychomotor agitation or retardation, and in more serious cases, suicidal thoughts. Women who are experiencing these symptoms should seek medical help as soon as they are able.

Thankfully, awareness of PPD has increased over the past several years. Physicians are sensitive to the warning signs and can prescribe therapies — including antidepressants, counseling and support groups – that can be used to help women return to normal function. Steps can also be taken ahead of a child’s birth to serve as an indicator for PPD. In fact, the American Congress of Obstetrics and Gynecologists (ACOG) recommends that every woman be tested by using the Edinburgh postpartum depression scale at least once during her pregnancy.


Rashmi Bolinjkar, MD, is an OB/Gyn physician with Premier Health Specialists who practices at Upper Valley Women’s Center in Troy.

Rashmi Bolinjkar, MD, is an OB/Gyn physician with Premier Health Specialists who practices at Upper Valley Women’s Center in Troy.

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