Postpartum Blues

Postpartum depression (PPD), also called postnatal depression, is a type of clinical depression which can affect women, and less frequently men, typically after childbirth. Studies report prevalence rates among women from 5% to 25%, but methodological differences among the studies make the actual prevalence rate unclear. Among men, in particular new fathers, the incidence of postpartum depression has been estimated to be between 1% and 25.5% Postpartum depression occurs in women after they have carried a child. Symptoms include sadness, fatigue, changes in sleeping and eating patterns, reduced libido, crying episodes, anxiety, and irritability. Although a number of risk factors have been identified, the causes of PPD are not well understood. Many women recover with a treatment consisting of a support group or counseling. The Edinburgh Postnatal Depression Scale, a standardized self-reported questionnaire, may be used to identify women who have postpartum depression If the new mother scores more than 13, she is likely to develop PPD Other Name: Postpartum Depression Symptoms Symptoms of PPD can occur anytime in the first year postpartum. These include, but are not limited to, the following:

Hopelessness Low self-esteem[ Guilt A feeling of being overwhelmed Sleep and eating disturbances Inability to be comforted Exhaustion Emptiness Anhedonia Social withdrawal Low or no energy Becoming easily frustrated Feeling inadequate in taking care of the baby[ Impaired speech and writing Spells of anger towards others Increased anxiety or panic attacks Decreased sex drive

LOCHIA & TYPES OF LOCHIA In the field of the obstetrics, lochia is the vaginal discharge for the first fortnight of puerperium (after birth), containing blood, mucus, and placental tissue. Lochia discharge typically continues for 4 to 6 weeks after childbirth.[1] It is sterile for the first 2-3 days, but not so by the third or fourth day, as the uterus begins to be colonized by vaginal commensals such as nonhemolytic streptococci and E. coli.[ It progresses through three stages

Sadness

Lochia rubra (or cruenta) is the first discharge, red in color because of the large amount of blood it contains. It typically lasts no longer than 3 to 5 days after birth.
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Lochia serosa is the term for lochia that has thinned and turned brownish or pink in color. It contains serous exudate, erythrocytes, leukocytes, and cervical mucus. This stage continues until around the tenth day after delivery. Lochia serosa which persists to some weeks after birth can indicate late postpartum hemorrhaging, and should be reported to a physician. Lochia alba (or purulenta) is the name for lochia once it has turned whitish or yellowish-white. It typically lasts from the second through the third to sixth weeks after delivery. It contains fewer red blood cells and is mainly made up of leukocytes, epithelial cells, cholesterol, fat, and mucus. Continuation beyond a few weeks can indicate a genital lesion, which should be reported to a physician.

PUERPERIUM Puerperium is the six to eight week period between delivery of a baby and the return of theuterus to its normal size. This period is also sometimes known as the postpartum period. There are a number of health concerns for women during the puerperium period, along with social and psychological concerns. During this stage, a woman may be encouraged to visit the doctor several times to monitor her body's recovery from pregnancy and delivery, and her baby will also be given special medical attention as it adapts to the world outside the uterus. The puerperium period is often said to start with the successful delivery of the placenta. Immediately after delivery, a woman is examined to check for any signs of tearing or other complications, and these issues are addressed. The woman may stay in the hospital or rest in bed for several days after birth to recover from the immediate physical trauma of the delivery. In the case of a woman who has required surgery as part of the labor and delivery process, a hospital stay can last several days while the surgical site is monitored.

In general, lochia has an odor similar to that of normal menstrual fluid. Any offensive odor indicates contamination by saprophytic organisms and should be reported to a healthcare provider. Lochia that is retained within the uterus is known as lochiostasis[ or lochioschesis, and can result in lochiometra (distention of the uterus - pushing it out of shape). Lochiorrhe describes an excessive flow of lochia and can indicate infection.

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