Most mothers feel joy and excitement after having a baby, but almost all mothers also feel exhausted, sleep-deprived and overwhelmed by the responsibilities of caring for a newborn. They may experience other unsettling emotions, such as sadness or anxiety. Approximately 8 of every 10 mothers have these feelings in a mild form called baby blues (also referred to as postpartum blues or maternity blues). Some experts believe that baby blues are caused by hormonal changes after pregnancy; others think these emotions occur as mothers adjust to the reality of life with a newborn. Baby blues usually begin 2 or 3 days after delivery, last for a few days, and go away without any treatment.

On the other hand, about 1 of every 10 women develops postpartum depression, a more severe form of the baby blues that often starts several days to weeks after childbirth, lasts longer than the blues, and often requires treatment. Mothers with postpartum depression feel intense sadness, anxiety, fear or despair and these feelings may steadily worsen. In some cases, a mother's thoughts become unrealistic and there may be physical symptoms, too, like sleeplessness or too much sleep, or a marked decrease or increase in appetite. Postpartum depression is a serious illness that interferes with a mother's ability to care for herself and her child.

To see whether you may have symptoms that suggest postpartum depression, answer the following questions:

• Are you having trouble falling asleep?
• Are you waking up early and are unable to fall back to sleep?
• Are you sleeping (or do you want to sleep) most of the time, even when the baby is awake?
• Has your appetite changed (eating either too much or not enough)?
• Do you feel anxious?
• Do you feel worthless or insecure?
• Do you feel sad?
• Do you cry for no apparent reason?
• Do you feel angry, with your new baby, your partner or your other children?
• Have you lost interest in things that used to bring you pleasure?
• Do you feel like a failure as a mother?
• Do you feel as though you do not love your baby as much as you should?
• Are you having difficulty concentrating?
• Are you having a hard time making decisions?
• Are you afraid that you might hurt your baby?
• Are you afraid to be left alone in the house with your baby?
• Have you thought about hurting yourself?

Most mothers will answer yes to at least some of the questions above during the first week or two after childbirth. But call your doctor immediately if:

• You are worried that you may harm yourself or your baby
• Any of these symptoms makes it hard for you to care for your baby
• You have any of these symptoms for more than two weeks
• You start to have these symptoms one to two months after childbirth
• You have any other concerns

Remember that caring for a newborn is demanding and exhausting, both physically and emotionally. Do not hesitate to contact your obstetrician, your baby's doctor or the nursery where your baby was born to discuss your concerns. It is essential to your health and the health of your baby that you get the help you need.

Last updated May 29, 2011

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