The Progressive Stages Of Postpartum Depression

Postpartum depression is one of the most common complications of childbearing with an estimated prevalence of 19.2% in the first three months after delivery (1). Depressive episodes (major and mild) may be experienced by approximately half of women during the first postpartum year (1). Characterized by depressed mood, loss of pleasure or interest in daily activities, feelings of worthlessness and guilt, irritability, sleep and eating disturbances (2), its etiology is multi-faceted and complex (3;4).

Borra, C., Iacovou, M., & Sevilla, A. (2015). New Evidence on Breastfeeding and Postpartum Depression: The Importance of Understanding Women 's Intentions. Maternal & Child Health Journal, 19(4), 897-907. doi:10.1007/s10995-014-1591-z

The postpartum period is about going through change and transition from a woman to a new mother. This is a time where mothers restore muscle tone and connective tissue in the body after the birth of the baby. Although there is a dramatic change during the postpartum period, women’s body is nonetheless not fully stored to pre-pregnant physiology until about 6 months post-delivery (Osailan, 6). At this time, women need to receive special health and social support to prevent problems such as postpartum depression. During this period, culture plays a major role in the way a woman perceives and prepares for her birthing experience. In fact, the notions of birth and postnatal care vary considerably with cultural beliefs and traditional practices. Each culture has its own values, beliefs and practices related to pregnancy and birth (Osailan,1). In the United States, after a short hospital stay, moms and babies are sent home because it is expected for mothers to heal within 42 days after giving birth. Whereas in other societies like Mexico, the postpartum recovery is active long enough until the new mother is fully healed (Brenhouse). In the article, “Why Are America’s Postpartum Practices So Rough on New Mothers?” by Hilary Brenhouse, the author states, “With these rituals comes an acknowledgment, familial and federal, that the woman needs relief more at this time than at any other—especially if she has a career to return to—and that it takes weeks, sometimes months, to properly

Often the time after birth is a filled with joy and happiness due to the arrival of a new baby. However, for some mothers the birth of a baby leads to some complicated feelings that are unexpected. Up to 85% of postpartum woman experience a mild depression called “baby blues” (Lowdermilk, Perry, Cashion, & Alden, 2012). Though baby blues is hard on these mothers, another form of depression, postpartum depression, can be even more debilitating to postpartum woman. Postpartum depression affects about 15% (Lowdermilk et al., 2012) of postpartum woman. This disorder is not only distressing to the mother but to the whole family unit. This is why it is important for the nurse to not only recognize the signs and symptoms of a mother with postpartum depression, but also hopefully provide preventative care for the benefit of everyone involved.

The Center for Disease Control estimates that 1 in 20 people suffer from depression (2014). Although widely recognized and somewhat easy to diagnose, depression is an ignored and almost hidden, disease. In women, the statistics are especially grim for those who are pregnant or were recently pregnant. A great number of women suffer from postpartum depression; an illness which is often overlooked, misdiagnosed and untreated. Postpartum depression (PPD) has been defined as an emotional disorder that occurs in an estimated 10-15% of all women after childbirth (Liberto, 2010). Postpartum depression not only impacts the mother, but can cause long-term psychological challenges for the baby and create emotional turmoil for all family members.

Postpartum Depression also referred to as “the baby blues” is depression that is suffered by a mother following the birth of her child that typically arises from the combination of hormonal changes and fatigue, as well as the psychological adjustment to becoming a mother. Most mothers will feel depressed or anxious after the birth of their child, however it turns into postpartum depression when is lasts longer than two weeks, and if treatment is not sought after a month, it could continue to worsen severely.

In order to fully understand the narrator’s condition, it is essential to fully understand who she is, what her context is, and the mental disorder she is suffering from. Through her secret diary, we learn about the narrator’s experiences as a newlywed suffering from Postpartum Depression and the unhelpful advice of her husband John, who doubles as her doctor. The mental disorder the narrator is dealing with is called Postpartum Depression; a mental illness affecting 1 in 7 women in the United States alone, causing symptoms such as anxiety, excessive crying, changes in appetite, harmful or “scary thoughts,” and many more of the unusual actions portrayed by the narrator in her journal (“Postpartum Depression”). These symptoms are evident

The oppression by John on the narrator reveals the problems Gilman had in her life. Dr. Wier Mitchell, Gilman's doctor who put her on the rest cure, is represented in the book by John (Greene 1). This short story is an attempt to show other people what women had to deal with at the time rest cures were prescribed. The combination of seclusion, not being able to write, and subordination by John cause the narrator's mental condition to slowly become unstable over time. The narrator's condition is described as, "Temporary nervous depression-- a slight hysterical tendency” (Scott 200). Gilman is making an attempt to warn other women of the dangers of these types of treatments (Snodgrass 1). Psychosis, or slight hysterical tendencies in this case, have many symptoms such as delusions, depressions, and hallucinations ("Psychosis" 1). All of these symptoms can be seen in the narrator and are all caused by large events in general ("Psychosis" 1). The large event in this case is the birth of her child. Carmine Esposito says that at the time that the story takes place, hysteria was considered a women's disease and that this hysteria calls for a rest cure, which does not cure anything (1). We now realize that a good cure would have been spending more time with her baby (Esposito

In the United States, as well as many other countries and cultures, postpartum depression is prevalent, but many times overlooked or not diagnosed. Postpartum depression is a “mood disorder that occurs with alarming frequency with documented prevalence of 10% to 15% during the first 3 months after delivery” (Horowitz, et. al, 2013, p. 287). Throughout hospitals, nurses are being educated about postpartum depression, which allows them to educate patients on what postpartum depression is and how to recognize the signs. If unrecognized and left untreated, women are at an increased risk of future depressive episodes and functional impairment (Katon et. al, 2014). There are many initiatives in place to increase the amount of screening and education that is occurring for postpartum depression.

The narrators husband plays a big role in the worsening of her depression. Her husband, a physician, assures her that her “temporary nervous depression” (71) will be cured if she stays at the colonial mansion to rest. He discourages her from writing, leaving the house, or anything that would stimulate her too much. Her husband rooms her in the nursery, despite the narrator insisting on being in a different bedroom.

The overview of this article is postpartum depression in rural Unites States communities. Researchers search to find the causes and effects of postpartum depression in rural US communities. There are many reasons this is a problem because it not only effects women but it effects children, the family unit as a whole, communities and many other areas as well. There are people that move to rural areas because the cost of living can be cheaper and a family that is trying to save money could view rural home life as a way to save money. There can be a downside though this becomes the lack of quality healthcare, poor education opportunities, distance is typically too far for many to be able to see quality services this all aides in the problems with Postpartum Depression. Nurses are the frontline in spotting postpartum depression and there needs to be more screening for this major problem.

This paper give a in depth description of five different articles, all with the main subject being postpartum depression. The first three description are of experiments that have been carried out on postpartum depression, in the explanation of these journals the purpose, hypothesis, procedures, participants, results and limitations will be discussed. The last two articles will review and summarized in detail the information article. In this paper, there will be in depth description on ways to treat postpartum depression, ways to predicts the probability an individual will develop postpartum.

According to authors Susan Dowd Stone and Alexis E. Menken postpartum depression can start during pregnancy which is called perinatal disorder (2008). During pregnancy, women can suffer through mood disorders which are a leading cause of postpartum depression. Women who are screened and diagnosed for depression are most likely to have postpartum depression. Doctors know to keep a close watch on these women who are found positive for depression. After giving birth, the woman will develop postpartum depression; this can lead to postpartum psychosis when women do not receive the help that they need. There are women known to have killed their children due to having postpartum depression or

"Mitchell's patients lost much of themselves as people" (53).  Gilman herself, after sinking into a deep depression, was sent to Mitchell in Philadelphia for his rest cure.  After a month of treatment Mitchell concluded that there was nothing wrong with her and sent her home with these instructions: "Live as domestic a life as possible.  Have your child with you at all times.  Lie down an hour after each meal.  Have but two hours of intellectual life a day.  And never touch pen, brush or pencil as long as you live." (Gilman, Autobiography 62).  Gilman followed these instructions for several months until she came extremely close to losing her mind.  Says Gilman of this time: "I made a rag baby, hung it on the doorknob and played with it.  I would crawl into remote closets and under beds to hide from the grinding pressure of that profound distress." (63).  It is exactly this situation that lead Charlotte Perkins Gilman to write her eerily accurate tale of one woman's forced regression into insanity.

Jane is the narrator who suffers from postpartum depression, she recently had a child, but cannot take care of it due to the fact that she is sick. Her husband John controls her life and tells her what she can and can’t do. Her sister in law cleans the house they rented for over the summer and Mary is the one who takes care of the child. As the narrator loses touch with the outer world, she comes to a greater understanding of the inner reality of her life. She starts to go insane being in the room she is in the whole time and she can’t do nothing about because her husband is controlling what she has to do. Living in today’s world she can go to therapy and also go to marriage counselling or couples’ therapy to get help with her marriage.