Depression During and After Pregnancy (Things We Don’t Know about Pregnancy Series #18)

Postnatal depression is thought to occur in ~1 in 10 mothers, making it a common form of mental illness. The onset and peak of the illness may be weeks or even months after the birth of a baby, and the condition lasts for weeks, months, or longer.

Symptoms

The condition is characterised by persistent negative feelings – towards yourself, your baby, and things you previously had an interest in. Most parents find their inability to bond to their baby most upsetting, and many feel guilty, hopeless, and even suicidal. Physical symptoms include disturbed sleep, tiredness, increased or decreased appetite, and difficulty decision-making.

We don’t know what causes postnatal depression

We don’t know what causes postnatal depression, although it’s associated with hormonal changes, such as a drop in one hormone called allopregnanolone. But these alone can’t explain everything. Women go through huge and varied hormonal changes during pregnancy and early motherhood, and postnatal depression doesn’t effect everyone. In fact, for a long time, people believed that pregnancy hormones were protective against depression, and it was simply something new mothers couldn’t get – leading to many undiagnosed sufferers^[1].

Worried Woman Image credit: RyanMcGuire (CC0 Public Domain via Pixabay)

Birth trauma (Things We Don’t Know about Pregnancy Series #17)

PTSD (post-traumatic stress disorder) is still a condition associated with soldiers. Men. But every year, estimates suggest 4% of births cause maternal PTSD ^[1]. We call this birth trauma.

Birth trauma was first recognised in the 1990s, when the American Psychiatry Association modified its definition of a traumatic event. It’s now thought that it may affect fathers who were present at the birth as well as mothers.

I recently visited the Oxford Spires – a midwife-led unit where mothers with no complications can give birth in a relaxed environment. It sits conveniently a few floors above the main hospital, so emergency treatment is only a lift journey away. But amongst the pools and mood lighting, the giant squashy birth aid balls and the ergonomic beds, I was struck by how much could go wrong during birth.

And I don’t just mean physically.

Obstetric forceps. Killian 1842 via Wikipedia Commons.