Relationships
Mamas on Bedrest: Sign of Post Partum Depression in New Dads
May 31st, 2010Post partum depression in dads is not always easy to spot. Where a new mama may be sad, weepy or withdrawn, a new dad suffering with post partum depression is more likely to be angry, hostile, aggressive or, in some cases aloof and withdrawn spending lots of time away from home and family.
What causes post partum depression in men? Well, the causes are the same as in women; sleep deprivation, 
adjustment to the unending needs of the newborn, the stress on the marital relationship and withdrawal (albeit temporary) from friends and activities once enjoyed. The birth of a new baby ushers in a time of major transition and change for the entire family. If the pregnancy had complications, the issues are further compounded.
Until very recently, no one really considered the impact a new baby had on dads. The focus has always been on mama and baby, their health and their needs. But a recent study shows that new dads are just as overwhelmed as new mamas once a baby is born and it is essential to the well being of the family in general, and to the emotional and behavioral development of the baby in particular, that any depression in dad be addressed.
In the May 19, 2010 Journal of the American Medical Association, James F. Paulson, PhD, a pediatric psychologist and professor at East Virginia Medical School in Norfolk, VA reports data from a review of 43 research studies in which just over 28,000 men were evaluated for post partum depression. Paulson and his colleagues found that 10.4% of new fathers experienced post partum depression, a number that is more than double the 4.8% rate of depression in men in the general population. Paulson also found that post partum depression in new dads peaked from 3-6 months post partum at about 25%.
The numbers were a alarming to Paulson and others who have begun to look at post partum depression in men. Previously post partum depression was thought to only occur in new mothers and the assumption was that it was due primarily to the fluctuation of hormones. More recently researchers have noted that women with a personal history or even a family history of depression are at increased risk of developing post partum depression. This new data indicates that men with a personal or family history of depression are also at increased risk of developing post partum depression. In addition, if a man’s wife is depressed post partum, he is also more likely to become depressed. Paulson and other experts are unsure if mama’s post partum depression sparks dad’s post partum derpession or vice versa. But one thing is clear, if either spouse develops post partum depression, it puts the other spouse at increased risk.
Paulson’s data is sounding alarms throughout the medical community. Clinicians and family members must be on the alert to the signs and symptoms of post partum depression in new fathers.
- Sadness
- Depressed Mood
- Loss of interest in formerly pleasurable activities
- Fatigue
- Sleep abnormalities
- Weight loss or gain
- Appetite changes
- Feelings of hopelessness
- Irritability
- Aggression
- Withdrawal from the family, extended time away from home and the family
The last three symptoms are very specific to men. When these symptoms are noted, it is very important to encourage a man to seek help from either his primary care physician or a mental health care provider because depression, and post partum depression in particular, are highly treatable. It is very important that dads receive treatment to avoid social, emotional, behavioral and developmental problems in their children as they grow up. It has already been shown that children raised by a depressed mother are at increased risk of these problems, but the emotional well being of dads can have just as strong an impact. Susan Nolen-Hoeksema, a depression expert and psychology professor at Yale University who wasn’t involved in the current study adds,
“Men’s postpartum depression may manifest differently than women’s,” said Dr. Nolen-Hoeksema. “In general, depressed men are more likely to exhibit hostility and even aggression, whereas women who are depressed tend to become sad. You have to worry not only about the general atmosphere it [the father's depression] creates, but also about potential abuse,” said Dr. Nolen-Hoeksema.
Getting a new dad to get help is key. “Men are extraordinarily less likely to seek mental health services [than women],” Paulson noted. “If we can get a man in to see his family doctor or even a mental health provider, that’s a really major step.”
Paulson also notes that educating couples that post partum depression is a possibility-in both mother and father- after the baby is born is essential. “Just letting parents know that they’re at higher risk of depression, what they need to look for and what they can do about it, could help.”
As with a new mother, if the signs and symptoms of depression become evident in a new father, strongly encourage him to get medical attention. If he hesitates, further encourage him by letting him know that his emotional well being can and will have long term effects on his children.
Resources:
www.postpartummen.com. This website is run by Will Courtenay, PhD, a psychologist in Oakland, Calif.
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The Impact of Mama’s Bed Rest on Extended Family Members
May 27th, 2010
Last week I had the pleasure of interviewing Robin Elise Weiss, a well known childbirth educator, doula, lactation consultant, Pregnancy and Childbirth guide for About.com and now I am happy to say, a friend. While we chatted away, Robin commented on the fact that when mama is on bed rest it is very hard on the extended families because while they are concerned about the baby, their thoughts are often with the mama (who is daughter or sister, etc..) and/or the father ( son/brother).
Her comments stopped me cold. I had 2 high risk pregnancies and never once did I even think about what how my pregnancies were affecting my parents, my in-laws, my sisters or my husband’s siblings. I have to admit that I was so wrapped up in my own fears and what my body was either doing or not doing that I frequently called my family and verbally purged. I gave no thought to the fact that I may have increased their anxiety gazillion fold.
I remember when I was pregnant with my daughter, my first successful albeit most complicated pregnancy, my father in-law would call me every day. He was so sweet, he’d call and ask me how I was feeling and how the baby was doing. And those days that followed an event, like after I had spotted and had some cramping, he was even more sweet and soothing.
In light of Robin’s comments, I am now taking a look at things from his perspective. My husband and I married late. I was 35 and my husband was 36. My husband is the oldest child in his family and even now, 10 years into our marriage, neither of his siblings is married (although his brother has a little girl). His parents had all but given up the notion of being grandparents. When we married, they were hopeful, but completely tactful and did not push. After my first miscarriage and the realization that I would need surgery and potentially “assistance” getting pregnant and carrying to term, they were completely supportive. So when I became pregnant naturally 3 weeks after my surgery, they were overjoyed. Then the “fun” began.
I began getting sick at 6 weeks and stayed nauseated throughout the pregnancy. About 4 months into the pregnancy I spotted and had some mild cramping we thought that I was miscarrying. My OB watched me carefully, contemplated bed rest and we were all relieved when my high level ultrasound revealed a very healthy little girl at 20 weeks. The pregnancy continued to be a roller coaster. I had lots of what I called “rumbling” beginning at about 7 months. I now realize was probably having either Braxton Hicks or preterm labor. I went into labor at 36 weeks and 6 days and when my OB’s partner noted that I was dilating 1-2 cm an hour, we went ahead and had the c-section. My daughter had breathing problems initially and stayed 10 days in the NICU, but after that, all was well. My inlaws came to see their new grand baby just days after I got home.
I never censored my conversations with my father-in-law. If I was feeling lousy, I told him that I was feeling lousy. When we had the spotting and cramping scare, I talked with him about how scared I was. I never stopped to think about how scared I may have been making him feel. My father in-law was so excited to be a grandpa and he adored my daughter. He would just smile and laugh whenever he saw her which wasn’t that often because he lived out of state. I am so filled with sadness now, because he died just one year after her birth and he never saw my son who is the spitting image of him.
Robin’s statement is an excellent reminder that a high risk pregnancy has far reaching effects-beyond the pregnant woman, her spouse or partner and the baby. My father-in-law was a huge source of support for me while I was managing my difficult pregnancy, and while he was concerned about the baby, his main concern was for me first and then my husband, his son. He so wanted to reassure us that it was going to be okay, yet who gave him that assurance? I don’t know of many resources for families and friends of mamas on bed rest. Those of us who work in the field are often called upon to answer questions. But to my knowledge information is sparse at best.
I would like to think that if I had the situation to do over I would have been more cognizant of my father-in-laws feeling, but probably not. When you are a high risk pregnant mama or a mama on bed rest you have about all you can handle just managing yourself and your pregnancy. So from whom did my in-laws receive support? From family and friends and a strong church community. Today there are websites and a vast array of information resources. In my next post, I will provide many of those websites and resources.
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When Love Hurts: Domestic Abuse in Pregnancy
February 23rd, 2010
Pregnancy is a time when a couple should be savoring their time together while eagerly anticipating the arrival of their new little one. Sadly for some couples, pregnancy becomes a time of increased stress and ends in abuse-both physical and emotional.
Reasons for Domestic Abuse During Pregnancy
The most common reason for abuse during pregnancy is that it is a continuation of pre-pregnancy abuse. Women who are abused prior to pregnancy are at increased risk of being abused during the pregnancy. Domestic abuse during pregnancy is also the result of:
- Stress related to the pregnancy-especially if the pregnancy was unintended.
- Financial concerns regarding the pregnancy, delivery and subsequent addition to the family
- Change in the partner’s relationship, especially insecurity and/or jealousy of the father regarding mother’s divided time and increased attention to the baby.
How Common is Domestic Abuse in Pregnancy?
The March of Dimes and other resources state rates of domestic abuse during pregnancy reach as high as 25% of all pregnancies. Abuse of pregnant women occurs in all ages, races and ethnic groups and in all socioeconomic levels.
What is Considered Abuse?
The abuse can range from name calling, verbal insults and controlling/isolating behavior to pushing, hitting, punching, kicking or choking. While emotional abuse is extremely stressful, physical abuse can be extremely harmful-even deadly to mother and baby. If you are unsure if you are in an abusive relationship, ask yourself the following questions:
- Does my partner always put me down and make me feel bad about myself?
- Has my partner caused harm or pain to my body?
- Does my partner threaten me, the baby, my other children or himself?
- Does my partner blame me for his actions? Does he tell me it’s my own fault he hit me?
- Is my partner becoming more violent as time goes on?
- Has my partner promised never to hurt me again, but still does?
If you answered “yes” to any of these questions, you are in an abusive relationship and need to get help-if not for yourself, then do it for your baby.
Effects on Mother and Baby
Abuse certainly has detrimental effects to both mother and baby. For mother, the increased and persistent stress can cause her to withdraw. She may begin missing prenatal appointments and thus not getting much needed care for herself and her baby. She may not eat well or sleep well and is at increased risk of depression. If the abuser is controlling, she may have lost contact with family, friends and loved ones. Isolation is an integral part of abuse as it keeps women from seeking and obtaining help. It also helps hide the physical signs of abuse-if there are any.
If mother has any sort of chronic disease, these will likely get worse and can cause complications for both mom and baby. Mother may not be taking necessary medications or getting necessary treatments so her overall physical health is compromised. Hence the energy and nutrients she has to give to her baby are also compromised.
The added stress is no better. When mom is stressed, so is baby. Additional stress has been linked to preterm labor, miscarriage and even still birth.
Physical abuse is quite possibly the most dangerous form of abuse. In addition to the overall physical injuries a pregnant woman may sustain, physical blows to a pregnant woman’s belly can result in placental damage or abruption, vaginal bleeding, injury to the fetus, preterm labor or even miscarriage.
What To Do
First and foremost, if a pregnant woman (or any woman) is at risk for domestic abuse, she needs to get help.
Start by speaking with your obstetrician or midwife (if you can speak with them alone). Health care providers often have access to resources or people on their staff can help you get help.
Contact your local police department if you feel you are in immediate danger.
Find a safe place to stay where you can get help. This may be with a good friend, neighbor or family member. You may be able to get help from your church or other civic organizations. If woman’s shelters are available in your area, contact them to see if they can assist you.
Gather some of your things, especially important documents such as bank account numbers, credit card information, prescriptions, etc…Have a bag ready and easily accessible in the event you have to leave abruptly. You may even want to have them somewhere outside your home (at a friend’s home for example) in the event that you have to flee unexpectedly.
Domestic abuse during pregnancy is more common than many of us realize. However, it is not normal and need not be tolerated. Help is available from the resources below.
National Council of Child Abuse and Family Violence
http://www.nccafv.org
Alliance for Children and Families
http://www.alliance1.org
Stop Abuse for Everyone
http://www.safe4all.org/resource-list/
National Domestic Violence Hotline (800) 799-SAFE (7233)
http://www.ndvh.org
This post was compiled using data from The March of Dimes, Cyberparent.com and Women’s Healthcare topics.com
