Pregnancy and Baby: Postpartum contract: Get the help you need to fight postpartum depression

Pregnancy & Baby Index: Pregnancy - Postpartum: Postpartum Depression: Postpartum contract: Get the help you need to fight postpartum depression

Postpartum contract: Get the help you need to fight postpartum depression

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Nancy & Betsy

When it comes to postpartum depression, most moms think, "Well, that won't be me." What many women don't realize is that it really might happen to them -- between one quarter and one-half of all women experience some form of a postpartum depressive illness. We have a way to help you get treatment and support if you need it.

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About postpartum depressive illnesses
Postpartum depression is very real, and is also very treatable. Many women suffer unnecessarily, because their depression is undiagnosed or they are embarassed or uncertain that they have PPD. This contract was created for you to customize and print out. Keep one for yourself, and give one to your husband, your mother, your father, your sister, or your best friend. Help them to know how to help you -- just in case you don't know how much you need it.

Of the nearly four million women who give birth each year in the United States, between one quarter and one-half of them experience the baby blues. The blues is a mild depression occurring in the first couple weeks after birth, usually disappearing within hours or days without the need for treatment. In the first weeks after birth, estrogen levels plunge by 90 percent or more - a wild hormonal fluctuation which, among other factors, can have a serious impact on a new mom's moods and emotions. Moms should not feel guilty when they don't feel as happy as they expected during this time.

During the first year after the birth of their babies, about 10% to 15% of mothers suffer from postpartum depression (PPD), a disorder that requires treatment because it can have serious consequences for not only the mother, but also the infant and the rest of the family. If caught before the depression is severe, PPD may be treated effectively with therapy. More advanced cases may require antidepressants, many of which are considered safe even while breastfeeding. Moms should not feel ashamed of being depressed because PPD is directly related to hormone imbalances and it is not something a woman can simply "snap out of." Some health care providers may dismiss a mom's concerns as the normal exhaustion experienced when taking care of a newborn. Women and their loved ones should seek support from a health care provider who will take their feelings seriously.

One or two of every thousand women suffer from postpartum psychosis (PPP). Unlike PPD, the risk for psychosis is much higher during the postpartum period than at other times of a woman's life -- up to 20 times higher in the first month after the birth of her baby. PPP is considered a medical emergency and hospitalization is generally recommended because of the risk of suicide or infanticide. Medication is required for treatment, along with an intense amount of practical support to help moms recover while still bonding well with their babies.

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Instructions: On the contract below, just edit the text in the box at the beginning and the signature box at the end. When you're done, press the "Make my contract" button at the end of the page! Print it out or save the finished contract to your hard drive. (Just made the plan and need to make changes? Use your browser's BACK button.)

Introduction: (personalize and modify the text as necessary)

Dear , Postpartum blues, depression and psychosis are real illnesses that affect an estimated 20-30 percent of women following the birth of a child. If it happens to me, I probably won't just "snap out of it" - I may need help: from you, from my doctor or midwife, from a counselor or someone else. I am giving you this contract because I may not recognize one or more of these symptoms I am experiencing, or may not want to recognize them. After the birth, please read over the risk factors and symptoms listed below. Do they sound like what I am going through? If so, please make sure I get the help and support I need, especially if I cannot help myself.

Risk Factors
I am more at risk for postpartum depression and psychosis...

If I have suffered from depression before.

If I have a family history of depression.

If I have had other hormonal problems, such as PMS.

If I'm taking certain medications.

If I had a difficult pregnancy or birth.

If my pregnancy was unplanned.

If my partner is away from home a great deal.

If I'm experiencing marital tension and/or feeling unsupported by my partner.

If I am going through a separation or divorce.

If someone close to me is ill or recently died.

If either of my parents died during my childhood or adolescence.

If I've just moved to a new home.

If I recently changed jobs, quit or was fired.

If I'm used to spending the majority of my time outside the home.

If I have been under a lot of stress.

Baby Blues
Experienced by 25-50% of women
Severity level: Low

I may not be able to sleep well.

I may cry a lot, even about little things.

I might experience mood swings.

I may seem irritable.

I may express that I feel very vulnerable or inadequate.

I may not feel like myself anymore.

I may start showing signs of baby blues 3-5 days after our baby is born. I should not feel like this for more than a couple weeks, and if I do, it may be the sign of a bigger problem for which I need help.

Postpartum Despression
Experienced by 10-15% of women
Severity level: Medium to high - seek treatment promptly

I may seem to be tired all the time.

I may not be able to sleep well.

I may cry a lot, even about little things.

I may have trouble remembering things.

I may have a hard time concentrating or seem confused.

I may express feelings of guilt or inadequacy.

I may be very irritable or hostile.

I may seem very anxious.

I may say that I can't cope.

I may not show much interest in the baby.

I may be hyper-concerned for the baby.

I may worry about harming myself - or the baby.

I may have headaches or chest pains.

I may not care about how I look.

I may not want to leave the house.

I may not feel like myself anymore.

I may stop finding enjoyment in hobbies or activities I previously loved.

I may not want to socialize and may withdraw from friends and loved ones.

I may not be interested in sex/intimacy.

I may be likely to start showing signs of depression anytime within six to twelve weeks after our baby is born, but these signs may also show up anytime in the first year.

I may feel like this for more than a year if the depression is not treated.

Postpartum Psychosis
Experienced by .1-.2% of women
Severity level: High - seek immediate treatment! Possibly life-threatening to mother and/or child

I may seem to be tired all the time.

I may not want to eat.

I may seem confused.

I may have severe mood swings.

I may feel hopeless or ashamed.

I may talk about suicide, or hurting the baby.

I may seem hyperactive or manic.

I may talk very quickly or incoherently.

I may act very suspicious of others.

I may be having delusions and hallucinations, or might hear voices (such as that of the baby).

Closing and signature lines to personalize
Thank you for your love and support! _______________________________ My signature _______________________________ Your signature

This information is not a substitute for personal medical advice, attention, diagnosis or treatment. If you have questions or concerns about your health or the health of your baby, consult with a healthcare professional. Myria Media, Inc. accepts no responsibility for damages resulting from the use of this information and make no warranty or representation, either express or implied, including but not limited to, any implied warranty of merchantability or fitness for a particular purpose. This information is provided as is, and you, its user, assume all risks when using it.

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