There is no single cause for the emotional difficulties many women experience after giving birth. However, experts suspect that rapid postpartum changes in levels of the female hormones estrogen and progesterone may have a powerful effect on women’s postpartum mental health.
- Progesterone and estrogen are secreted by the ovaries and placenta, allowing the uterus to receive and maintain a fertilized egg. Levels of these hormones increase 10-fold during pregnancy. If levels of these hormones are too low, a miscarriage may occur.
- After childbirth, progesterone levels drop dramatically, reaching pre-pregnant levels about 72 hours after delivery. Experts suspect that this dramatic shift in female hormones may play a major role in depression after childbirth.
- During pregnancy, levels of endorphins, which are naturally secreted chemicals that make us feel good, also increase. Endorphin levels drop sharply after pregnancy, which also adds to the risk of depression.
Postpartum refers to the period immediately after childbirth. Symptoms of depression that occur during this period are known as postpartum depression. Other symptoms of mood disorder such as sleeplessness, irritability and anxiety, also can occur.
In addition to these physiological changes, other factors that may contribute to postpartum depression include:
- Difficult pregnancy and/or delivery
- Problematic or troubled marriage or intimate relationship
- Baby with a high level of needs
- Sense of loss at not being pregnant anymore
The importance of getting enough sleep cannot be overstated. Many experts believe a disruption in a new mother’s sleep patterns can contribute significantly to depression. Napping during the day, while the baby naps, is a good way to catch up on sleep that may be interrupted repeatedly during the night.
Women who are suffering from postpartum blues, depression, or psychosis are not at fault. They are not bad or incompetent mothers, and have done nothing wrong.
There is no one cause identified for PND, but a number of possible factors have been put forward to explain why mothers become depressed in this way
- The shock of becoming a mother - Some women are not prepared for the physical shock of childbirth, the new responsibilities associated with a new baby (feeding, bathing, changing nappies etc.), the fact that it is a 24 hour-a-day job. She feels that she is losing her freedom and when she does go out, she has to change where she goes to take into account buggies, feeds, changing rooms etc. The mother may have had to give up her job aswell.
- Cultural differences - Mothers don’t enjoy high status in Western cultures, some mothers resent that. Too much is expected of mothers, they are expected to know how to deal with everything, but they may not have support or help from friends or family who have had children before.
- Life changes & Stress - A mother is more likely to become depressed if some other stressful event has occurred e.g. the death of a family member.Moving house, changing jobs becoming unemployed (mother or partner) are all stressful events which can cause a loss of self esteem. A mother also needs someone to talk to and confide in.
- Childhood Experiences - Unresolved losses or griefs from the mothers childhood may surface again after after the shock of giving birth.
- Hormones - Some doctors believe PND is caused by the changes in hormone levels in the mothers body after giving birth. A lack of the hormone progestrone is thought by some to be a cause of PND.
Revision date: June 20, 2011
Last revised: by Sebastian Scheller, MD, ScD