There is a possibility of complications. In some cases, they can be quite easily avoided.

The postpartum period, which depends on the individual characteristics of the woman, can continue six to ten weeks.

During this time, the woman's body as a whole, as well as its individual organs, are restored, returning to the state before childbirth. Unfortunately, this recovery may not always be easy and completely pain-free.

Mostly, complications after childbirth inflammatory diseases in the pelvic area can be considered.

Usually can cause urinary tract infections that were not cured during pregnancy.

Also reasons development inflammatory diseases may be: low immunity of a woman and non-compliance or negligence in relation to the rules of intimate hygiene.

Large blood loss during childbirth, poor blood clotting, beriberi, intervention during childbirth, remnants of the placenta or fetal membranes in the uterine cavity, cracked nipples, problems during childbearing and childbirth, a long anhydrous period during childbirth - these are the conditions that can support and develop inflammatory processes.

The most common postpartum complications are:

• postpartum endometritis (inflammation of the uterine cavity);
• pathological bleeding;
• chorioamnionitis (inflammation of the membranes of the fetus or uterus);
• mastitis (inflammation of the mammary glands);
• inflammation of the urethra.

Less common peritonitis (inflammation of the peritoneum), thrombophlebitis (inflammation) of the pelvic veins, sepsis (general infection of the blood), pyelonephritis (inflammation of the kidneys).

To avoid the appearance and further development of any complications, their diagnosis is necessary at the first manifestations.

Even more the best option disease will be prevented through the implementation of preventive measures for those who are most susceptible to them.

Consider the most common complications after childbirth.

Postpartum endometritis

As is known, endometritis(inflammation of the mucous membranes of the uterus) is one of the most common complications that most women have to face in the period after childbirth. In 7% of women in labor this disease occurs, mostly women who have undergone.

After childbirth, the uterus is a big wound. Exist two stages of healing: inflammation and restoration of the mucous membrane.

Through these stages, the uterus inside is cleansed. But if any pathogens are present, the inflammation can become chronic.

How to recognize?

Distinguish severe endometritis, which can appear on the second or fourth day after childbirth, and mild endometritis, he can overtake a little later.

Wherein the temperature rises to 38 ° C, the pulse quickens, the body is shivering, there is pain in the lower abdomen and lower back, which may intensify during breastfeeding.

Unpleasant brown discharge appears, which soon becomes purulent. The uterus with this disease is reduced more slowly than usual.

But the increased temperature (for example, 37.5 ° C) and weakness in the early days may be due to the arrival of milk, and not the inflammation that has arisen.

Prevention and treatment

Before childbirth (and preferably before pregnancy), it is imperative to identify and try to get rid of any infectious diseases.

In cases of a high risk of endometritis, and only as directed by a gynecologist, antibiotics are allowed for prevention.

Pathological bleeding after childbirth

In fact, it cannot be called a symptom of pathology; this phenomenon is completely natural for this period.

After childbirth the uterus spontaneously returns to its previous size. With such contractions of the uterus, blood is released from the vagina. This contraction process is similar to menstruation of a profuse nature.

Under normal flow in the first week after birth, they are plentiful, have a thick consistency and a bright red color. After some time, they turn pale, grow lean and completely stop after one and a half to two months.

When breastfeeding such bleeding stops earlier, and those who have had a caesarean section, on the contrary, last a little longer.

But it also happens that the discharge becomes pathological.

How to recognize?

If bleeding two weeks after delivery the same plentiful, has a bright red color, besides, it has acquired an unpleasant odor, and even worse turned into a purulent one, you should be on your guard.

All of the above may be the beginning of a developing complication that requires the help of a doctor.

Also dangerous and delayed postpartum hemorrhage. This indicates the bending of the uterus or its slow contraction. In this case, there is heaviness in the abdomen, chills, a significant decrease in secretions.

Preventive measures

Firstly, it is necessary to observe the following rules for hygiene of the genital organs: during bleeding and when there is, it is recommended to wash with cool clean water and every time after going to the toilet.

Secondly, sanitary napkins should preferably be changed every four hours and should not be tight for the first week.

The inflammatory process can be caused by microbes that come from the vagina or from the place of origin of a chronic infection inside the body.

• timely cure all possible infections, in particular gynecological;
• do not use hygienic tampons;
• so that the uterus contracts faster after childbirth, try to lie on your stomach more;
• go to the toilet on time;
• if the birth was successful, without complications, try to start moving as soon as possible.

Chorioamnionitis (inflammation of the membranes of the fetus and uterus)

This complication appears in case of premature rupture of the membranes of the fetus.

And the longer the anhydrous period lasts, the greater the likelihood of infection of the fetus while it is still in the womb.

How to recognize?

Due to the long anhydrous period, and this is from 6 to 12 hours, the woman in labor is observed: fever, frequent heartbeat, chills, purulent discharge from the vagina appears.

As the statistics show, in every fifth woman after childbirth, chorioamnionitis is able to turn into endometritis.

Treatment of chorioamnionitis

When chorioamnionitis occurs perform emergency induction of labor(in case of lack of strength during childbirth - caesarean section) with the help of antibacterial and infusion therapy.

Postpartum mastitis (inflammation of the mammary glands) and lactostasis (milk stasis)

This disease can only overtake nursing mothers. The causative agent is Staphylococcus aureus.

They can become infected through nipple cracks (unlike mastitis, lactostasis progresses without cracks).

Basically, mastitis appears in those who gives birth for the first time (in 2-5% of cases), it can begin both in the third week after childbirth, and in a month.

How to recognize?

Postpartum mastitis occurs with fever (up to 38.5 ° C and above), headache, weakness, chills, characteristic pains in the mammary gland, swelling of the chest, redness appears.

With manual examination painful seals are revealed. Feeding or pumping with developed mastitis, they are accompanied by acute pain, while with lactostasis, on the contrary, relief is felt.

Lactostasis must be distinguished from mastitis. With lactostasis milk is expressed freely and after that it becomes easier, the temperature returns to normal, there are no redness and swelling, the pain subsides.

Preventive measures

These include:

• complete pumping of breast milk after each feeding, avoid stagnation;
• correct attachment of the child to the breast (the nipple and halo must be fully covered);
• timely treatment of cracks in the nipples, lactostasis;
• compliance with the rules of hygiene and breastfeeding techniques;
• wearing a non-tight bra;
• carrying out air baths for the chest (10-15 minutes after feeding).

Inflammation of the urethra

considered normal if in the first days after childbirth, a woman experiences pain during urination, as well as a burning sensation.

How to recognize?

Symptoms of inflammation:

• difficult and painful urination, or the presence of desire, but no urine output, or scanty output;
• elevated temperature;
• cloudy urine and pungent odor;
• the presence of pain on both sides of the lower back.

Causes of occurrence:

• use of a catheter during childbirth;
• in violation of the integrity of the bladder during natural childbirth;
• low bladder tone (especially after epidural anesthesia);
• injuries during the use of obstetric forceps.

Preventive measures

Good advice- drink as much liquid as possible. Not too sweet cranberry juice will be very useful, as it has an antimicrobial effect due to the high content of tannin in its composition, which in turn prevents the development of bacteria in the bladder.

More tips:

• wash more often, this will lead to additional stimulation of urination;
• when using toilet paper after using the toilet, do it from the anus back;
• try to urinate completely (you can lean forward a little).

Every woman after the birth of a child changes the usual rhythm of life, daily routine, nutrition, and so on. This causes a storm of emotions that a young mother cannot always cope with. Against the background of all these changes, many women can develop postpartum depression, so the symptoms and treatment of this ailment should be studied in detail.

Causes of Postpartum Depression

Childbirth-related depression gradually develops in a woman for a variety of reasons. Usually this condition progresses in an unfavorable family atmosphere. The prerequisites for the development of this disease can be divided into several groups.

Hormonal changes - main reason development of depression. Changes in the endocrine system are usually observed in a young mother within a week after childbirth. During this period, the initial stage of postpartum depression begins.

Physical disorders

The following disorders can worsen mood:

• difficult childbirth, accompanied by injuries, ruptures and other injuries;
• an insufficient amount useful substances in the body;
• excess weight.

The woman ceases to feel attractive. Her physical condition worsens, causing psychological disorders.

Psychological reasons

These include:

• an unexpectedly difficult process of childbirth, for which the woman in labor was not ready;
• fear of not coping with the role of mother;
• fear of difficulties in the financial support of the baby, usually this factor is groundless;
• the appearance of an unplanned child;
• fear of the birth process;
• previous unsuccessful experience of bearing or giving birth to an unhealthy baby.

These are the most common reasons why a woman develops depression.

Important! Women who have had cases of depression in their relatives are prone to this disease. Also at risk are young mothers with mental disorders or diseases.

Social background

These reasons include the following factors:

• lack of support from loved ones after the birth of a child;
• insufficient experience in caring for a baby;
• poor relations between the parents of the born child;
• tense situation in the family.

Also, this pathology can develop as a result of such factors:

1. Features of the character of a woman. If she was characterized by selfishness, then sharing time for herself with a child would be quite difficult.
2. period of lactation. Painful sensations that are caused by this process can cause a stressful state in a woman.
3. Absence of sexual life. At first, sexual relations are contraindicated for a woman, and constant fatigue simply displaces thoughts about them. Problems begin with a partner, which negatively affects the emotional state of the young mother.

Some of these factors cause the gradual development of depression after childbirth. A woman is frightened by the fact that she already has to be responsible not only for her life, but also for the life of the baby.

Important to remember! The entire period of bearing a child and the postpartum period is required to provide the expectant mother with care and confidence in the future!

Symptoms of depression

How does depression manifest itself in new mothers? This pathology in women causes sudden and unreasonable mood changes from joy to sadness, from sadness and anxiety to anger. The most pronounced depression manifests itself 3 months after birth. A young mother has the following signs of pathology:

• chronic fatigue;
• any pleasant moments cease to cause joy;
• complete loss of strength;
• refusal to communicate with loved ones, friends, acquaintances;
• loss of interest in their appearance and development, as well as in the baby;
• sleep disturbance;
• inattention;
• loss of sexual desire and arousal;
• loss of appetite.

In especially severe cases, a woman may even have thoughts of suicide. Protracted postpartum depression disappears a year after childbirth with proper complex treatment.

Diagnosis of pathology after childbirth

Clinical diagnosis presents difficulties in identifying the disease. This is due to the fact that the doctor attributes the signs of postpartum depression to the character traits and whims of a woman. Which doctor should I contact with a problem? Specialists in this matter are a pediatrician who regularly examines a baby from the first days of life, or a gynecologist. If they reveal a suspicion of the development of pathology, then they are sent for consultations to a psychologist or psychiatrist. These specialists diagnose postpartum depression by testing the new mother. This testing should be done every week. If positive dynamics is not observed, then complex therapy is prescribed.

How to deal with postpartum depression? Recovery and treatment of a woman after childbirth in psychological terms is carried out, taking into account the severity of the condition, and also depending on the individual characteristics of the course of the disease. Typically, complex therapy includes the following activities:

1. Visiting a psychologist This is one of the most effective ways to overcome depression. A psychologist helps to solve worrisome problems, give advice or recommendations on many issues. The woman will feel relief after each consultation.
2. Antidepressants. This is a fairly effective group of drugs, but these pills have many side effects. Therefore, their use is contraindicated during breastfeeding. But you can consult with your doctor, who will select the most effective and safe antidepressants.
3. Normalization of hormonal background. The use of hormonal drugs is required only in cases where depression is caused by changes in the endocrine system.

Also, doctors advise to adhere to such rules during the treatment period:

• we should not forget that postpartum depression is a temporary phenomenon, with correct therapy, the depressed state passes quickly enough;
• it is not required to strive to become the best mother, because for a child this moment does not need proof;
• more rest and sleep, the baby needs a rested and happy mother;
• involve relatives and friends in the process of caring for a newborn;
• take time for yourself, 30 minutes a day is enough to balance the mental state;
• spend as much time outdoors as possible. This is useful for both the baby and the mother, especially since he will sleep all this time;
• receive positive emotions- do things that brought pleasure before the birth of the child;
• allocate time to communicate with a partner in private;
• eat right and regularly.

Compliance with the above rules during the treatment period will allow you to get rid of postpartum depression in a short time.

Important to remember! If a woman failed to avoid this pathology, this does not mean that she is a bad mother!

Treatment with folk remedies

How to cope with this pathology on your own? Alternative medicine can be used to combat postpartum depression. They can replace the use of antidepressants, which negatively affect the development of the baby during breastfeeding. There are many recipes for the preparation of such funds. Most effective methods impact should be considered in more detail.

St. John's wort

To prepare a decoction, you need 2 tsp. dried St. John's wort, which should be poured with 1 cup of boiling water. Leave to infuse for 10 minutes. Take this medicine 3 times a day.

Schisandra chinensis

You should take 20 g of crushed berries of this plant, add 100 ml of medical alcohol. Infuse the medicine for 10 days in a dark place. After the time has elapsed, open the container, squeeze and remove the berries. Leave to brew for 3 more days. Then strain the tincture again and take 1 tbsp. l. 3 times a day.

Also, one should not forget about the use of complex vitamins to normalize the physical condition of a woman.

It's important to know! Funds traditional medicine Never take it with antidepressants! This can have the opposite effect, that is, the woman's condition will worsen.

Prevention of pathology

How to avoid postpartum depression? To do this, you must adhere to the following rules:

Important to remember! Pathology should not be ignored, as it can lead to unpleasant consequences!

Consequences of postpartum depression

Why is this pathology dangerous? It can lead to unpleasant consequences for the child. The baby may develop insomnia and emotional disturbances in the future. Also, against the background of the disease in women, postpartum depression in men can develop. Therefore, in order to protect your replenished family from negative impacts, you need to competently prepare for the process of childbirth and the postpartum period.

During pregnancy, the woman had a lot of worries, but now the birth is over, and it would seem that she needs to calm down, take care of her recently born child and enjoy a new life. But in some women, after childbirth, specific changes in brain activity and the functioning of the nervous system occur, leading to a violation of the state of mind and loss of peace, constant depression and anxiety. Often this state of anxiety flows into postpartum depression - this is a medical term, a serious pathology, and should not be taken as a way for a young woman to shirk her duties.

Postpartum depression as a social problem

Due to the nature of the character, the influence of various external factors or health problems, the birth of a child does not always become an emotionally bright and joyful event for a woman. Acquiring a new social status, many mothers experience constant experiences, anxieties, and instead of joy and tenderness, enjoying motherhood. Continuous tension, worries, fears and poor health turn into a depressive state. This is referred to in medicine as postpartum depression.

The older generation, and sometimes the woman's husband, can take serious symptoms for a whim, whims or character traits, fatigue, and do not attach importance to what is happening, do not sound the alarm and do not force the mother to see a doctor. And then all this can lead to tragedy both in relation to the life and health of the child, and the youngest mother up to

It is important that relatives and the woman herself know that postpartum depression is a serious psycho-somatic disorder that requires attention and control, and sometimes active medication. For most mothers, such a disorder has a short course and a favorable outcome, but for some it requires close attention and consultation with a doctor.

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If a change in the psycho-emotional background and negative moods last more than 5-7 days, there is every reason to suspect depressive disorders. If the mother shows negativism, detachment or indifference towards the desired and long-awaited child, it is important to immediately seek help.

How long does postpartum depression last?

Such a condition without full assistance can drag on for many months, seriously affecting the quality of life and attitude towards the child. A mother with a similar disorder develops apathy with a loss of interest in any manifestations of life. Over time, the manifestations can be smoothed out, but at the same time, the course of depression itself becomes chronic.

The biggest difficulty for success in treatment is the fact that a woman is not ready to admit her problem and take any action to eliminate it. At the same time, relatives and spouse silently agree with her decision and also do nothing about what is happening.

The statistics on the frequency of occurrence of such a disorder is relentless - every fifth mother who has recently given birth suffers from various manifestations depressive disorders during the first two years after childbirth. Psychological and emotional disorders after childbirth are typical for about 60-70% of women, but severe problems that are dangerous for others, for herself and the child are typical for 2-3%, and not everyone goes to the doctor with them.

Who suffers from such problems?

According to experts, postpartum depression is included in the category of major depressive disorders, due to the similarity of symptoms, manifestations and consequences.

Interesting fact!Postpartum depression can haunt not only the mother, but also the father of the child. Although the psyche of men is relatively more stable, the birth of children can also negatively affect their emotional background, but they usually have such a state for a relatively short time, and the symptoms are not so pronounced.

Such states in the father are associated with a change in habitual life and new obligations, a high degree of responsibility not only for himself, but also for his spouse and baby, who depend on him. This is their new role, which not all men are ready to accept with joy. In men, depressive manifestations can be both active and passive. With active ones, aggression with irritability is manifested, while with passive ones, isolation and detachment from the situation are typical.

Varieties of postpartum depressive disorders

Far from any psychological state of a woman after the birth of a baby can be attributed to depressive disorders, and bouts of apathy or a melancholy mood that occasionally occurs in each of us does not require anxiety and immediate treatment. However, there are also situations in which it is important to consult a doctor and seek help, and sometimes even inpatient treatment:

Causes of depression after childbirth

Even among those women whose children were very desired and long-awaited, postpartum depression is quite possible, and about one in five mothers have one or another of its signs. There is no single reason for the formation of such a disorder, but often a whole complex of provoking and irritating factors, negative events and conditions acts simultaneously. Often, both mental and physical negative factors simultaneously influence, which lead to an exacerbation of depressive moods and neuroses.

purely physiological factors

The birth act is a serious test for the female body, including the emotional one. A woman experiences severe pain, the balance of hormones changes dramatically, which leads to the fact that organs and systems, body tissues, as well as the nervous system work in a special mode. This forms ailments of the physical plane in the first days and in the future, forms fatigue and ailments, which makes it difficult to combine this with full-fledged care for the baby and constant household chores.

Operation may be affected. Moreover, among women who gave birth quickly, there are usually more problems in relation to emotions and the psyche than those who gave birth themselves. This is due to hormonal changes and fluctuations in hormone levels. With the natural birth of the crumbs, due to oxytocin, a hormone that performs leading functions in childbirth, the sensation of pain is dulled and then lactation is established faster. Thus, some of the factors that provoke postpartum depression are eliminated, and with a cesarean section, the restructuring of the body is not so fast, which leads to a violation of the natural balance of hormones.

Influence the formation of depression can and initial problems with the establishment breastfeeding, physical difficulties with breasts and milk deficiency, . This creates a conflict in the head between the desires and possibilities of the mother regarding what she can give the baby.

Reasons for the psychological plan

Often after childbirth, especially if they did not go exactly according to the scenario that was expected, there may be completely unhappy feelings and emotions, as well as a feeling of guilt that the image of ideal parents was not fully realized.

Children are not always born with perfect health, and everything in the maternity hospital goes by the books, and then the expectations with reality in the mother’s head diverge, which leads to psychological imbalance. Sometimes there is no time to fully restore physical strength after childbirth, not to mention the emotional and moral costs.

Often, a sense of guilt and dissatisfaction with oneself can be formed due to other reasons:

In addition, depression is typical for those mothers whose children were born with developmental anomalies, serious problems and require special care and rehabilitation. The mother subconsciously feels guilty before the baby for the fact that he was born special, and worries about his life only exacerbate depressive moods.

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According to statistics, depression is more typical for young mothers and older ones, after 35 years of age, who have problems communicating with their own mother, spouse, or those women who previously, before pregnancy, had emotional and psychological problems.

Symptoms of postpartum depression

Depression in the postpartum period does not begin in one day, it gradually increases in severity and severity of symptoms, and its first manifestations become noticeable after a few weeks after returning from the hospital. These include such alarming "calls" as:

Not necessarily in the presence of depression should appear all of the listed manifestations, it is quite enough for three or more in various combinations, and for the last point - it is enough one to seek help from a psychotherapist or psychiatrist.

Often, depression is formed in women due to the fact that their bright expectations from motherhood and their own feelings run counter to those ideas and thoughts that were before pregnancy and during it. This is quite normal, but not all women can realize and accept for themselves the “non-ideal” of their motherhood. Many women think that they will immediately, in the first minutes of the birth of a child, have maternal feelings, and they will immediately get used to the role of a mother. But in reality, the relationship between the baby and his mother is being established gradually, over several months.

You should not reproach and scold yourself for various emotions in relation to the crumbs, sometimes they can be negative, we are all living people. Perhaps a feeling of disappointment, irritability, fatigue, especially when mixed with constant lack of sleep and lack of time. Experiences can be fertile ground for the formation of complexes and the development of depression, especially if the mother takes only one full responsibility for the family and the baby. You should not refuse outside help, you need to take care of yourself and give yourself rest, from this not a single woman will become a bad mother, and physical and emotional exhaustion will not form.

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The pre-depressive state is supplemented by isolation from the previous social circle and the outside world, constant sitting at home and concentrating only on motherhood, you need to remember yourself as a woman, spouse, girlfriend and also pay attention to these areas of life.

Critical periods of depression after the birth of a baby

Psychologists distinguish certain critical periods during which all emotions and experiences are most powerful and dangerous by going into depression.

The most intense will be the emotional background in the period from the fourth to the ninth month of the baby's life, when the feeling of irritability and discontent, the feeling of continuous anxiety will increase.

This is the first critical period when postpartum depression is likely.

The second period when its late symptoms are possible is the period of nine to 15 months, when pessimism about the future and the disappearance of the desire to perform even elementary household chores are possible due to isolation from society and concentration on the worries of the crumbs. Often the situation will be aggravated by the fact that the mother is not aware of her problems and does not want to make any attempts to correct the situation.

How is this pathology diagnosed?

Unlike somatic pathologies, where in addition to complaints, one can rely on data from analyzes and additional studies, in the diagnosis of pathologies related to the mental sphere there is only a detailed questioning and heart-to-heart talk, as well as some information that can be obtained from relatives. Therefore, in identifying depression after childbirth, a special role is played by the clarification of anamnesis data (the life history of a woman, her family, and data on her pathologies and diseases).

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An important indication of possible problems there will be the fact that there were depressions among the closest relatives or the patient herself before the onset of pregnancy. It is a known fact that in half of the percent of cases, depression tends to relapse or exacerbate against the background of changes in life, including motherhood. . A single episode of depression in the past increases the likelihood of its recurrence by 50%.

In the diagnostic process, additional methods are used, such as:

• Hamilton Rating Scale for Detection and Severity of Depression
• Examination and questioning, identification and careful recording of all complaints of the mother
• Laboratory diagnostic methods to exclude somatic pathologies
• Screening studies, smears, cultures to exclude infections, including hidden ones, which can lead to constant fatigue and stress.

If there are signs of depression during pregnancy, or if there is a history of depression, diagnosis is needed already in the first weeks after childbirth.

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It is important to distinguish depressive manifestations from postpartum infections, against the background of which development is possible, therefore, in the clinic of obvious mental disorders, urgent hospitalization and differential diagnosis with the necessary treatment within the hospital are needed.

You also need to remember that postpartum psychosis can be a phenomenon of a special psychiatric diagnosis - bipolar disorder with affective attacks (previously this condition was called manic-depressive disorder).

It is usually expected in mothers with mental illness or on the background of schizophrenia, which have simply not been diagnosed before. Unlike classic depression, postpartum psychosis manifests itself a couple of weeks after the birth of the baby, they start as severe depression with the manifestations listed above and various psychiatric symptoms - mania, hallucinations, phobias, delusional thoughts and ideas. Therefore, with an early start of such manifestations, the mother needs a consultation not with a psychotherapist, but with a psychiatrist and a thorough examination, otherwise she can be dangerous for the child, herself and others.

How is postpartum depression treated?

When depression is diagnosed, a treatment plan will be based on its severity, developmental characteristics, and leading syndromes, as well as on what methods are available for treatment. So, some medications that can affect the baby are not applicable to nursing mothers.

The main goal in treatment is to reduce or completely eliminate the symptoms of depression and its progression, to help the mother restore lost social ties and bring her mental state to a stable one, preventing recurrent episodes of depression.

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In a hospital for treatment, mothers are placed extremely rarely, only if depression combines psychoses, severe somatic disorders and suicidal attempts.

In the treatment are applicable:

• Psychological correction (cognitive methods, consultations)
• Psychotherapy in a group and individually
• Family support and support of the environment (family psychotherapy).

Such methods will be effective and applicable in case of awareness of one's situation and diagnosis, desire for treatment and correction, motivation and mood for a long course of treatment. In addition, psychotherapy is needed for those women in whom antidepressants and other medications are contraindicated due to various circumstances.

Medical treatment of maternal depression

Often depression involves medication correction, without which the symptoms are not eliminated. It is usually based on hormonal drugs (estrogens) and a course selected in such a way that they do not affect lactation. Indications for taking psychotropic drugs are determined individually and only by a psychiatrist based on the severity of symptoms and the degree of danger of consequences. Indications for them will be affective manifestations, suicidal tendencies and thoughts, anxiety and obsessive fears with sleep disorders and somatic functions.

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The intake of all drugs against the background of lactation and the treatment of mothers is carried out only as prescribed by the doctor and only strictly under his supervision. No self-treatment in cases of depression and psychosis is unacceptable, including various folk methods!

If necessary, the appointment of antidepressants proceed from several principles:

In order for the therapy to give pronounced results, treatment must be started in a timely manner, at the first alarming manifestations, and you should not be shy about contacting a doctor.

Depression is a disease like many others, there is nothing shameful or illegal in it.

Often, its manifestations can be noticeable even in pregnant women, and in the early stages it is well treated with mild and gentle means and techniques, and a full course of psychotherapy and medication quickly and gently relieves symptoms, returning the joy of life and the enjoyment of motherhood. Often, herbal and sedative remedies that do not have serious side effects can help. side effects and contraindications, they can be used in women at risk from the period of pregnancy for the prevention of postpartum depressive disorders.

Choosing antidepressants after childbirth

It is worth repeating that antidepressant drugs should be selected only in conjunction with a doctor, excluding toxic effects on the baby and suppression of lactation.

If the patient suffers from anxiety and agitation (strong agitation, fussiness), a group of drugs with sedative effects (Amitriptyline, Pirlindol and others) is applicable to her.

If depression and depression predominate among the symptoms, drugs with stimulating effects (Paroxetine, Citalopam and others) are needed.

The drug is taken from the lowest possible therapeutic dose, gradually adding it to a stable clinical effect. At a similar dose, a woman is kept for about 4-6 weeks until her condition improves, both subjectively and on the basis of an external examination. As a remission or a persistent clinical effect, the drug is not abruptly canceled due to the possibility of exacerbation, but the dose is gradually reduced once a week with a smooth withdrawal throughout the month.

If the condition has improved, but has not fully recovered, the course of treatment is continued for another 1-2 months, and the results are evaluated every 4-5 weeks. If there is no improvement on the Hamilton scale by 50% or more, then a revision of the treatment regimen is necessary due to its ineffectiveness with the selection of other drugs.

How dangerous is postpartum depression?

Without treatment, the manifestations of depression are delayed for a period of a year or more, can progress and lead to more serious mental disorders. In addition, without treatment, depression can lead to tragic consequences:

• Attempts to harm the baby or relatives
• The development of psychosis
• Progression of depression
• Violation of relations in the family, its disintegration
• Disorders of the mental development of the child, negative influence on his psyche, the behavior of his mother and the methods of her upbringing.

What is postpartum depression?

- This is one of the forms of depressive disorders that women suffer after the birth of a child. You can also come across the term "postnatal depression". It negatively affects the condition of both the mother and the child. Despite the skepticism of many people about this kind of mental disorders, they are quite serious and require qualified treatment. Depression develops during the first months after the last birth.

According to statistics, up to 13% of all women in the postpartum period suffer from it. Most often, postpartum depression occurs in those women who suffered from depressive disorders in the past. They account for up to 50% of all episodes. Research in this area indicates that up to 70% of all women suffer from mild postpartum depression.

Causes of postpartum depression

Among the risk factors leading to the development of postpartum depression in a woman, the following can be distinguished:

Heredity. If the woman's mother experienced a similar condition after her birth, then it is possible that she reacted to strong stressful situations the woman herself will be likewise;

Hormonal changes that occur in the body. During the gestation of the fetus in every woman, the blood level of hormones such as estrogen and progesterone increases several tens of times. When a newborn is born, the concentration of these hormones begins to decline sharply. During the first three days, they return to normal levels. These jumps can negatively affect the psychological state of a woman. In addition, recent studies indicate that there is a relationship between depression that occurs after childbirth and the level of the hormone prolactin. Immediately after the birth of the child, it drops sharply, and then, over the course of several weeks, rises;

The hormones produced by the adrenal glands, namely cortisol and aldosterone, also affect the psychological state of a woman. Fluctuations in their levels in the blood are reflected in the occurrence of a depressive disorder. Moreover, it was found: the brighter the symptoms in a particular woman, the stronger the depression after childbirth;

Stress. The excitement that a woman experiences after the birth of a child, associated with the increased load on her, cannot but affect her emotional state. In addition, sleep is disturbed, it becomes restless and short, there is physical overwork, which also aggravates the problem;

Predisposition to depressive disorders. In this case, we are talking about the propensity of a woman to such conditions. That is, if depression took place before childbirth, then it is more likely to occur after them. At the same time, women who are prone to become depressed will suffer from it after the second and after the third birth;

Poor social status and low levels of well-being are aggravating factors. This also includes unemployment, lack of own housing or poor living conditions;

Premature birth or illness of the child can lead to feelings of guilt, which often transforms into depression;

Psychological problems in marriage;

Premature discharge from the maternity hospital, when the woman has not yet fully mastered her new role, has not gained the necessary knowledge and skills to care for the baby;

Stressful situations that occurred during pregnancy, for example, the death of relatives, a change of residence, and so on;

The beginning of the lactation period and the pain and lack of sleep associated with this process. Milk stagnation, lactation crises, the inability to breastfeed can lead to depression;

Features of the character of a woman. Often such a trait as selfishness leads to the formation of a problem;

Changes in appearance. An increase in body weight, the appearance of stretch marks, the lack of time for proper personal care - all this can adversely affect a woman's condition;

Violations of sexual relations with a partner. Fatigue, impossibility or unwillingness to enter into intimacy, decreased libido, dislike for sex are factors predisposing to depression;

Availability bad habits, in particular, drug addiction, both in the woman herself and in her husband;

The presence of a woman who gave birth to mental illness;

Negative experience of a previous pregnancy.

All these reasons can lead to the development of postpartum depression. Nevertheless, the question of triggering factors in the development of the problem is still open in medical science.

Symptoms of postpartum depression

The following symptoms indicate that a woman is developing or has already formed postnatal depression:

The woman begins to experience a persistent feeling of depression. She is not able to cope with this depressing feeling, which is especially intensified in the evening or morning (sometimes it appears both in the morning and in the evening);

Often thoughts arise in the head about the lack of meaning in later life;

A guilt complex may begin to form, especially if the child has any health problems;

Irritability grows, which manifests itself in the form of aggression directed at all family members (most often, the husband and older children suffer from these manifestations);

Distracted attention, the inability to concentrate on one activity is the most important symptom of most signs of postpartum depression;

Increased emotional sensitivity. It is expressed in excessive tearfulness, which appears at the most seemingly insignificant occasions. Against the background of the fact that a woman is experiencing emotional exhaustion, there is a breakdown;

The impossibility of a good rest, as the feelings that overwhelm a woman do not give her the opportunity to sleep peacefully. Therefore, it is a characteristic sign of postpartum depression;

Anhedonia, or the inability to enjoy any joyful moments of life. Accompanied by unwillingness to laugh at jokes, despondency, melancholy and apathy;

Excessive concern for the health of the newborn child. Moms with postpartum depression are frequent visitors to pediatricians and pediatricians with a narrower specialty;

Concerns about their own health. The woman begins to search and always finds signs of formidable diseases. Against this background, hypochondria begins to develop, which is accompanied by frequent complaints about one's own health, the perception of any ordinary sensations as signs of pathology, the belief in the presence of one or another disease;

Sometimes it also happens that a woman completely stops worrying about the baby, moreover, she feels a sense of rejection and hostility towards him. Such a state can lead to the fact that a woman convinces herself that the child is not her own, but a substitute in the maternity hospital;

There is a frequent change of mood, from a cheerful smiling woman, a young mother with depression can turn into a sobbing hysteria in a minute;

It is not uncommon for depressed women to experience memory lapses;

Against the background of developing postpartum depression, functional disorders may occur, for example, disorders of the gastrointestinal tract, the appearance. From the physical manifestations of depression, one can also distinguish discomfort in the joints, muscles, back, frequent;

A woman may lose her desire to eat, against this background, uncontrolled weight loss begins;

Changes in gait and speech. Most often, they are accelerated, although in rare cases, slowness and lethargy can be observed.

When a depressive state worsens, it can transform into one in which thoughts often arise about harming oneself, or even a child.

How long does postpartum depression last?

Depressive disorder after the birth of a child is not considered a severe mental illness. However, the time period immediately after childbirth poses the greatest danger in terms of the onset of the development of persistent emotional disorders. If we talk about the duration of postpartum depression, it is important to distinguish between postpartum psychosis and maternal melancholy.

On days 3-5, a woman can fully begin to experience the manifestations of maternal melancholy. It is expressed in inexplicable sadness and melancholy, increased tearfulness, lack of appetite, insomnia. The terms of maternal melancholy are quite lengthy, sometimes the feeling of despondency can last only a few hours, sometimes it can take several days. However, at the same time, the woman does not move away from the child, performs all the necessary actions to care for him, carefully and attentively treats the baby.

Therefore, maternal melancholy is not usually attributed to psychological abnormalities, since it is only a temporary manifestation of hormonal disorders occurring in the female body. However, if there are additional risk factors, after a few days, maternal melancholy can develop into postpartum depression.

Postnatal depression most often begins to form in the second or third week after the birth of the child. It often manifests itself when the mother and baby are discharged from the maternity hospital. Although sometimes suppressed emotions begin to overwhelm a woman a few months after the baby is born, when fatigue from constant worries about him reaches its climax. Postpartum depression can last from one month to several years.

If after a few weeks signs of a mental disorder continue to be observed, then it is reasonable to assume that the woman has experienced prolonged postpartum depression. Such a condition is rare, but in a particularly severe form, depression can last for years, acquiring the character of a chronic disease.

Certain categories of women are prone to prolonged postpartum depression. Among them, those who have a neurotic character, are hysterical, withdrawn, experience pathological fears (phobias) or uncontrollable desires (manias). In addition, women who in childhood did not receive emotional participation and response from their own mother have a predisposition to the development of protracted depression. In some particularly severe cases, even a qualified psychologist is not able to guess how long a woman's postpartum depression will last.

Rarely, in about one in a thousand women, against the background of depression, postpartum psychosis begins to form. In this case, it will not be possible to do without medical help, and the woman will need the help of a specialist in order to return to a normal psychological state and fully experience the joy of motherhood.

How to deal with postpartum depression?

There are some steps you can take to deal with postpartum depression on your own, without seeking help from a psychologist.

Here are the most important aspects:

Attractiveness. You need to try to remain attractive, for which you need to find time to care for your own appearance and body. For a normal emotional state, it is important for a woman to see her non-repulsive reflection in the mirror. Naturally, the postpartum period and caring for the baby takes a lot of time. However, you should try to set aside at least 15 minutes every day to carry out hygiene and cosmetic procedures. To facilitate the care of your own appearance, you can visit the salon and get a fashionable haircut that does not require a long time for styling. You should pay attention not only to walking clothes, but also to home clothes. It should be practical, comfortable, and at the same time beautiful;

Learn to listen to your child. In this case, we are talking about an adequate response to his crying about hunger or the need for hygiene procedures. Do not panic about the slightest cry, because most often it is the result of the natural development of the baby, and not a sign of any pathology. At this age, children need only food, timely care and closeness of the mother;

Communication with the baby. It is necessary to communicate as much as possible with the born child. Even if he is only a few days old, this is not a reason to spend all the time in silence. You need to talk to him, "coo" and coo. These simple actions will bring your own nervous system into balance. In addition, in communication there is a benefit not only for the mother, but also for the baby. Hearing her calm voice, he will develop better intellectually, verbally and emotionally;

Help. Do not refuse any help that allows you to unload a woman. This may be an offer to take a sleeping baby for a walk or a service in terms of housekeeping. Any help to the young mother will be helpful, as it will allow her to rest a little;

Relationship with a partner. A man who is nearby should not be an outside observer, but a full-fledged participant in the process of caring for a child. He, like a woman, finds it difficult to get used to the new role of a parent, he may not understand how to care for a child. Therefore, specific requests for assistance are needed, with an exact indication of the required set of actions, and not abstract complaints and claims;

Communication and leisure. You should not limit your social circle to your family and close yourself in the house. In order to diversify your leisure time, you can try to establish contact with the same young mothers walking on the street with their children. A joint discussion of problems, small achievements of the child, will allow you to find new friends with whom there will always be something to talk about. In addition, the Internet is useful in this regard. You can chat on forums, share your own experiences and problems;

baths. Relaxing baths can help fight postpartum depression. You can, for example, take a bath with rose petals, which only by its appearance and aroma will relieve fatigue and depression.

If a woman does not consider it necessary to seek psychological help, but feels that something is not quite right with her emotionally, you must, first of all, try to adhere to healthy lifestyle life. Active physical exercises in the morning, walking with the baby in the fresh air, normalizing the diet, healthy low-calorie food, giving up bad habits - all this is the key to a successful exit from depression after childbirth.

Also, do not try to become an ideal mother in everything and build a model of an impeccable family. As a rule, the impossibility of translating into reality everything conceived leads to depressive disorders. To restore peace of mind, you can consult with a close friend or relative who has gone through childbirth and faced similar difficulties.

It is important not to be shy about confessing to a loved one your experiences, feelings, emotions. Do not be shy to report the arising feeling of anxiety to a man. Perhaps your husband is no less worried than you about the birth of a child, and by talking with him, you will be able to solve not only your problem. Male postpartum depression is not as rare as it might seem at first glance.

If none of the tips helps get rid of a depressive disorder, and the condition continues to worsen, then you need to seek medical help. Perhaps a woman will need qualified treatment using medications.

What should a husband do during his wife's postpartum depression?

A husband who notices signs of postpartum depression in a woman is obliged to help her cope with this destructive condition. To do this, he needs to take on at least a small part of the household duties, even if previously they were performed only by a woman. In addition, it is necessary to help the wife not only with housekeeping, but also with meeting the needs of the child.

There is evidence that women who are not cared for by their husbands are most often affected by depressive disorders. If he does not take an active part in family affairs, does not offer his help to the young mother, then she is more likely to suffer from postpartum depression.

It is important to provide not only physical, but also psychological assistance. For a woman, it is necessary to see support in the face of her husband, his desire to listen, sympathize, give good advice, and not criticize and condemn.

A man must understand that postpartum depression is not a whim, but a disease that a woman suffers from. She is not able to simply take and forget about her own experiences, just as a patient cannot lower the level by sheer force of will.

For a woman after childbirth, it is simply necessary to feel loved and needed. readiness loved one to come to the rescue and unload her a little from household chores - this is the best that a man can offer to get a woman out of depression.

It will be useful for a woman to learn that not only she has psychological problems after childbirth. Many of the fairer sex have had the same problems and share tips on how they managed to cope with postpartum depression.

Alena, 28 years old. “Nothing and no one can help you get out of this state, except yourself. It's good to have people around who don't judge and understand you. Depression will go away on its own after a while. You will feel the love of life again. The main thing is not to doubt the feeling of love for the child, and so it will be.

Ulyana, 25 years old. “I felt the signs of postpartum depression not immediately, but about three weeks after the birth of my daughter. How then all these advisers pissed me off, and I generally took hostility to my husband’s proposal to seek help from a specialist. But it’s good that she changed her mind in time, and her beloved still insisted on her own. Three sessions with a psychologist - and everything fell into place.

Sveta, 31 years old. “When I went pregnant, I thought that the moment of the birth of the baby would be the happiest in my entire life. But then Kirill was born, and I felt a strong sense of loneliness. It was as if I had been deprived of all the usual joys of life. If earlier at work I simply bathed in attention, I was the most attractive, I could boast of proportional forms, now I am thin and scary. Meeting with friends, parties, traveling - all this is in the past. Now just a baby! But my husband found a way out - he rented a house in the countryside, and for the whole summer my nanny and I moved there. It was there that I was able to reflect on my behavior, to take a different look at changes in life. And it became easier for me, I realized that I love my baby madly and appreciate my husband. You should not think that I went crazy with fat, it was really hard for me then, but now everything has passed.

Nina, 25 years old. “I was so looking forward to pregnancy and wanted a child that I didn’t even think about any depression. But then it just hit me. Unreasonable sobbing, constant tears in her eyes, I thought that was all - she had gone crazy. The husband left, the mother unsuccessfully tried to support. It seemed that life had stopped. But one day I was walking in the yard and met the same mother, and she turned out to be a psychologist. We chatted for hours while the kids slept. Thanks to Lena, I returned to normal life, and my husband, by the way, also returned. We've all been fine."

Natasha, 28 years old. “Don't think that fatigue and depression are the same thing. When you have depression, everything is much more serious. I wanted a baby, gave birth, they helped me, my husband took care, everything was at home. But for some reason I hated myself and, no matter how terrible, my daughter. Time dragged on, I did everything like a robot, because I had to. For the first time I felt tenderness for my daughter at five months. And now she's almost three and I'm crazy about my baby. It’s even scary to think back to that time.”

Dasha, 21 years old. “When Sonya gave birth, my child was literally taken away from me. My mother and mother-in-law did everything for me, except for breastfeeding. So I lay stupidly in bed and watched TV. But everything changed when my mother-in-law went away for a month to visit, and my mother ended up in the hospital, I had to literally become more active. I worked like on batteries, but again I felt the taste for life, became active, cheerful and cheerful. Something like that".

Zhenya, 26 years old. “I was so sorry that I gave birth, I even wanted to give up Misha. But she was cured and stayed in the hospital. Now Misha is 2, everything can be experienced, everything has passed.

Julia, 24 years old. “I was so sick, the melancholy gnawed at me, I got angry, then I got bored, then I cried. But when my girl smiled at me, it was me, I realized that I was happy. And now, only a month ago I gave birth to a second princess, but now there is simply no place for melancholy in my life.

How is postpartum depression treated?

Depression can and should be treated.

There are several therapeutic options, including:

Cognitive therapy. It allows you to stop the development of a destructive psychological process. According to ongoing studies, the signs of a depressive disorder after childbirth are reduced after the first session, and after six there is a pronounced improvement in the condition. Only a specialist should use breathing and relaxation techniques;

Psychological consultation. It helps when the patient needs emotional support, objective advice to help find a way out and the current situation. It is worth setting up for several visits, as one consultation is not enough;

Use of antidepressants. The drug course should be accompanied by a visit to a psychologist. It is worth knowing that not all antidepressants can be taken while breastfeeding. Doctors recommend using selective serotonin reuptake inhibitors or tricyclic antidepressants (the exception is doxepin).

Treatment tactics will depend on the severity of the condition. Perhaps a woman will need to visit an endocrinologist and get tested for hormones. Sometimes the trigger mechanism for the formation of persistent depression can be, which is often observed in women who have given birth.

Therefore, if during pregnancy there was a low level of hemoglobin, then it is advisable to donate blood for a general analysis and exclude anemia.

Don't Forget the Principles proper nutrition. Studies point to a direct relationship between the amount of sugar a woman consumes and the incidence of postpartum depression. The same statement is true for chocolate. Therefore, sweet foods will need to be minimized.

Prevention of postpartum depression

Factors that reduce the risk of developing postpartum depression:

Support for loved ones, both during pregnancy and after childbirth;

Taking care of your own health, maintaining good physical shape;

Occupation exercise;

Complete nutrition;

Rejection of bad habits;

Consultations with a doctor in the presence of factors predisposing to depression;

Tactile and emotional contact with the baby;

More or less complete rest;

Daily walks in the fresh air, communication with new people;

The opportunity to be alone with your husband.

In general, the prevention of depression in the postpartum period comes down to maintaining normal physical and psychological health. A woman experiencing negative emotions, you should not hide them in yourself, you need to seek help from loved ones or a specialist.

Education: In 2005, she completed an internship at the First Moscow State Medical University named after I.M. Sechenov and received a diploma in Neurology. In 2009, she completed her postgraduate studies in the specialty "Nervous Diseases".