Postpartum depression refers to depression that occurs during the puerperium and is a psychological disorder characterized by a series of symptoms such as depression, sadness, depression, crying, irritability, irritability, and even suicidal or infanticidal tendencies, without psychotic symptoms. In recent years, studies have shown that the incidence of postnatal depression in China is 20%, which is basically the same as that in Western countries. If left unattended, it can cause family breakup, maternal suicide or affect the upbringing and early education of children, directly threatening social stability and the implementation of the policy of eugenics. Therefore, we should fully understand the importance of mental health care during pregnancy and childbirth, pay attention to and strengthen mental health care during pregnancy and childbirth, and prevent and reduce the occurrence of postpartum depression as much as possible.
Etiological analysis The occurrence of postpartum depression is related to changes in the postpartum endocrine environment and psychosocial factors. Social factors, such as childhood hardship, poor literacy, death of a loved one, poor quality of perinatal health care, lack of family support, gender and health status of the baby, housing difficulties, poor relationship between husband and wife, and economic status of the family are all important predisposing factors; in terms of psychological factors, maladjustment to the role of motherhood, introversion, conservatism and stubbornness are good predisposing factors. Therefore, most people now believe that the main cause of this disease is social and psychological factors.
1. Psychological analysis during pregnancy and childbirth The pregnancy and childbirth period is a key period for women’s mental health care. Women have important endocrine changes at all stages of their lives, especially sex hormones. Starting from the development of gonads during puberty, which leads to an increase in sex hormones, and then decreasing through maturity to the decline of gonads, there are many large fluctuations. There are many risk periods for psychological disorders, such as premenstruation, pregnancy and childbirth, menopause, etc. Therefore, it is very important to do a good job of mental health care during these periods to prevent physical and mental diseases. It has been reported that mental shock can increase the increase of adrenocorticotropic hormone in the body during the teratogenic sensitive early pregnancy. Mental shock should be avoided during early pregnancy as it can cause congenital malformations in the fetus such as cleft lip and palate. In addition, some studies have found the same relationship between changes in blood concentrations of beta-endorphins, catecholamines, and dopamine and psychological disorders, all of which underlie the vulnerability to psychological disorders during pregnancy and delivery, and it is also believed that postpartum measurements of changes in these components can be used to predict the chance and severity of psychological disorders. When the first child is born, everything about caring for a newborn has to be learned from scratch, so the psychological pressure is great and it is easy to lose balance, and sometimes even both spouses have a psychological imbalance, which shows that the influence of social factors is also very important.
2, the psychological changes of the puerperium The psychology of the mother during the puerperium is in a fragile and unstable state. The psychological changes in the puerperium are related to the psychological state of the mother during pregnancy, her ability to bear the delivery, the environment and social factors (including the upbringing of the baby and the economic situation of the individual and the family), as well as her personality tendencies, life experiences, and the relationship between the husband and wife and family members. Therefore, maternal psychological changes are not only a personal problem of the mother, but a family-based problem as a whole. During the puerperium, especially in the 3 months after delivery, even normal pregnant women are still the most emotionally unstable. The middle of pregnancy is the most psychologically stable period, but the behavior is passive and passive, and dependence increases. In the late stages of pregnancy, the dependency decreases and the anticipation of the baby increases, as the woman realizes that the delivery has to be done by herself. After the birth and during the birth process, due to the stimulation of labor pains, a strong dependence can appear again, which is called temporary psychological degeneration. This situation improves with the end of labor, and most women feel relieved. However, dependency, passivity, depression and lack of confidence are more pronounced in women with introverted personalities, conservatism and stubbornness. Some of these women can further develop into postpartum depression and anxiety after delivery, the so-called postpartum depression signs. Maternal fatigue caused by childbirth, breastfeeding and more care for the baby, changes in lifestyle, and maternal attitudes toward sexual life and relationship with husband all have an impact on sexual life after delivery. Most women begin to have sex 3 months after delivery, but the frequency decreases significantly, and half of them can return to normal 8 months after delivery. A significant proportion of women have decreased frequency of sexual intercourse and sexual pleasure after delivery. The average frequency of sexual intercourse after childbirth is not significantly different from that before pregnancy, and social class and age have no significant effect on it. About half of them resume sexual life in 6-11 weeks after delivery, with a total average of 16.5 weeks. The later postpartum recovery was mostly associated with breastfeeding and family planning.
Mental health care focus and methods during pregnancy and childbirth 1. Health education Health education during pregnancy and childbirth is very important. The use of maternity school, regular publicity and education to pregnant women to enhance the knowledge of health care during pregnancy. Mental health care is often missing from the general education work, so this weak link should be strengthened. Health education should tell pregnant women what kind of psychological obstacles they may encounter during pregnancy and childbirth, just as maternal health education during pregnancy and childbirth should tell pregnant women the importance of taking their blood pressure regularly, so that they and their families can raise awareness to recognize abnormalities early and improve their ability to take care of themselves and correctly treat and handle the problems they find. If necessary, they should report to the doctor early for help and cooperate well with the doctor in treatment. To introduce the incidence of postpartum depression, the time of onset, the main manifestations, how to deal with it and the dangers of not treating it to mothers and their families. Many mothers or their families have told doctors that they have the disease that doctors said they have, so they get early treatment and get good results.
2.Care and encouragement Gather pregnant women in one place for prenatal education before delivery. For example, teach them how to breathe properly to relieve the bouts of pain, how to massage and exert themselves, how to cooperate with the midwife during labor, and also provide some comfort and encouragement to arouse the expectation of the mother for her future baby.
3. Intervention for those with risk factors Since we know the risk factors for various psychological disorders, we can screen out those with various risk factors for psychological disorders during pregnancy and delivery and give active intervention. Studies have found that a history of emotional abnormalities before pregnancy, surgical delivery, poor postpartum care, poor living conditions, dissatisfaction with maternal health services or certain pregnancy complications are common risk factors for postpartum depression, and when combined with non-maternal risk factors for psychological disorders, such as loss of mother at an early age, early parental divorce, and a history of mental illness in the family, people can become at high risk for postpartum depression or other psychological disorders. . Targeted education on health care is a common intervention, and other interventions such as pre-pregnancy education for husbands and family members so that they can give adequate care and help to the mother and reduce their various stresses can reduce the chance of morbidity. After receiving education and care, pregnant women can control their abnormalities if they feel they have some abnormalities. For example, one pregnant woman told her doctor that recently, whenever her husband came home late at night, she thought he was being unfaithful, but she felt that her husband would not do such a thing, so she was aware of her abnormality. Her husband understood the reason for her current state and gave more relief and tried to reduce the late return, so that the problem was gradually resolved. This shows the effectiveness and importance of timely intervention.
Summary As the level of awareness of mothers and their families increases, thus changing the human behavior from one that is not healthy to one that is beneficial. Many families probably understand the causes of the occurrence of psychological disorders and the methods of intervention when they are able to take measures at the appropriate moment. For example, some reduce the burden of maternal household chores to make life less stressful; some were more concerned about the sex of the fetus, but later repeatedly told the pregnant woman not to mind the sex of the fetus; some families comforted and encouraged the pregnant woman not to care about some economic spending for the sake of her health and the health of the next generation, which made the family more harmonious and the pregnant woman received physical and mental care. It has been proved that the number of successful deliveries has increased significantly after the education on labor and delivery. A good example of this is the decrease in the rate of cesarean deliveries since the establishment of baby-friendly hospitals and family wards. It is worth noting that every mother has physiological changes but not all have psychological disorders, so some social factors stimulation is often the main cause, should try to reduce these stimuli, such as overworked people to reduce their burden can often prevent and control the disease. Some people do not develop the disease even with the same social stimuli, which indicates that there are individual differences or environmental differences.