• Maternity Exercise, the best weapon against postpartum depression

  • Births Why in Spain one in four babies is born by caesarean section

  • Feminism 'My pregnancy and my delivery are mine': the new feminist revolution reaches delivery rooms

At the age of 36, 18 years ago, Alicia gave birth to her first daughter, a healthy and highly desired girl.

When she returns home, she should be radiant and enjoy those first 'crazy' days between diapers, dead sleepy and with the confusion typical of an inexperienced mother, but happy after all.

It was not so.

She dragged the consequences of a bad birth, a process that did not go as she had thought: "Everything was very fast. They could not give me the epidural and

I lost control

. I did not know how to apply the exercises that they taught me to push and I just screamed," she laments.

From there, things began to go wrong, even in the same hospital: "I looked at my roommate and felt that she

did everything better

than me."

That trail of guilt lasted for many, many years: she always looked askance at other women when they were pushing a cart and compared herself to all of them.

And she, in her opinion, was losing.

Although no one ever told her about

postpartum depression,

her physical and emotional situation deteriorated so much and so quickly that there was little to think about: before her daughter was one month old, she went to the doctor.

And from there, to the

psychiatrist

.

He spent a year in treatment.

"I went to my mother's house and she took care of my daughter. She was totally overwhelmed,

I felt incapable. I had a feeling of guilt

, but I just wanted to sleep."

"I know I'm not the only one, but people don't talk about it," she concludes.

Symptoms of postpartum depression and the 'baby blues'

The arrival of a baby is a cataclysm in anyone's life but, above all, it turns the mother's life upside down.

Pregnancy, childbirth and the puerperium go through her body in a decisive way, leaving a transforming mark on her.

For this reason, we can affirm that the woman who leaves the delivery room is not the same one that she entered.

Esther Ramírez Matos is an expert psychologist in perinatality;

teacher and coordinator at the European Institute of Perinatal Mental Health;

and in 2020 she published 'Postpartum Psychology'.

Explains that when giving birth, changes occur in women (hormonal, vital, identity, family system, couple, etc.) that lead, up to 80% of them, in fatigue, sadness, crying, irritability and strangeness with the feelings of motherhood and the responsibility that it entails.

"This period usually lasts two or three weeks and is known as

'baby blues' or 'maternity blues'

. If it lasts beyond this time, we can suspect something else," explains the psychologist.

"Giving birth is not trivial and despite the idealization of motherhood, those days are not always experienced as something wonderful and not all feel an immediate bond with their baby," adds Ramírez.

However, even after those weeks the symptoms pass, the expert clarifies that postpartum depression does not always happen right after, but can arise in the first year after.

"Symptoms such as guilt for being a bad mother and not loving him as they are supposed to lead to, for example, a

desire to hurt himself

can appear ," she says.

Other symptoms are sleep disturbances, either because the mother is hypervigilant and

cannot rest

even when her baby sleeps, or because the opposite is true: she cannot get out of bed.

"Also feelings of anxiety and anguish that something happens to the child are features that we can see in postpartum depression," she says.

Childbirth as a trigger

Shutterstock

A traumatic birth or one that has been lived with fear leaves the mother more vulnerable to suffering later depression.

"If she has experienced a very tremendous birth, that mother cannot be super happy afterwards," says Esther Ramírez Matos.

That was the case of Alicia and YS, when she gave birth to her first child seven years ago through a

very complicated emergency caesarean section

: "I was in bed for two months recovering. I didn't know what was wrong with me, or what it was postpartum depression. I was physically unwell, I

cried

suddenly, I rejected the child at times, I felt guilty because I saw myself as incapable of taking care of him...", she narrates.

Later he learned that he had suffered a depression, which lasted approximately three months.

She passed it 'bareback', helped by her partner, her family and her friends: "I also found help from the

midwife

and other mothers I met in the breastfeeding groups."

Precisely,

Carla Quintana

, midwife and founder of Maternify, a pregnancy and postpartum care services company, believes that midwives are underused: "In other countries we are the main figure in pregnancy and postpartum and throughout the fertile life of a woman. Our main function is the information and identification of the symptoms of a possible depression in order to refer to the appropriate professional".

Quintana insists: "We can identify postpartum depression

early

and thus, when you go to the psychologist, the treatment will be more successful. It is not normal for a woman to feel totally overwhelmed at five months. We are the filter in a situation in which that times matter."

88% of women ask for more psychological help

Shutterstock

There are no very precise data on how many women suffer from postpartum depression, because it is a very invisible disease.

It is estimated that between

15% and 30%

of women who give birth suffer from it and that it affects especially

adolescent

mothers, mothers of premature babies and mothers who live in urban areas.

Better mental health care for women during pregnancy and after it would be the best 'medicine', although

Irene Aterido

, a sexologist, menstrual health expert and Intimina adviser, maintains: "Society is very interested in pregnancy , but very little by the mother (and her partner, if she has one) in the

puerperium

Support from the family, from the environment, and the

validation of feelings

of ambiguity, anguish, and confusion in the face of the new role are essential to prevent clinical depression ".

This 'disinterest' translates, according to a study carried out by Marternify for which they have asked almost 1,500 women, in that up to

88% ask for more psychological help during maternity

, but especially during the first days at home.

Specifically, 40% detail that difficulties in terms of

breastfeeding

are one of the main challenges they must face, and the advice and support of a professional "is essential".

The

World Health Organization

published last March new guidelines (60 recommendations) on the urgency of providing care to women and their babies in the first six weeks after birth.

Among them, it urged determining "

screening

for postpartum depression and anxiety in the mother, with referral services and treatment if necessary."

How to prevent postpartum depression

The

Edinburgh test

is a screening tool for health workers, although Esther Ramírez Matos believes that a good clinical interview is enough for a specialized professional that includes questions not only about the woman's feelings, but also about her diet, rest, etc.

Ramírez calls for more resources in Health and more training for professionals: "There is more awareness about perinatal health, but it is still lacking. It is important that the

women themselves and their families

know how to detect the signs and ask for help, and training psychologists is essential , midwives, Primary Care doctors, etc. because there are emotional states that are already in the pregnancy and if they are not treated in time, then it is worse".

Ana Kovacs

, also a perinatal psychologist, adds: "Information is power, although today we live immersed in a kind of "infoxication" that causes dizziness and anxiety. And we see that on many occasions this prevents mothers and fathers from deciding and acting before the birth of a child with a certain calm and tranquility".

And faced with feelings of guilt and shame for feeling overwhelmed, she says: "Motherhood can

overwhelm

us . So seeking help, support and company is a sign of strength

According to the criteria of The Trust Project

Know more

  • Maternity

  • Psychology