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• W1569233004 abstract "Introduction Childbirth is one of the most complicated events in human experience in terms of biological, psychological, and social perspectives. Childbirth is viewed by society as a joyful event. However the real experiences of mothers are often more complex than this idealized image. Instead of the expected fulfilment and tranquility, many women struggle with new sets of demands and expectations, loss of order and routine, feelings of being 'trapped', and having to endure sleepless nights. The transition in their role to the parenthood may also involve changes in relationships with their partners, career decisions, and social isolation. Other challenges may involve financial distress and housing problems (especially when a pregnancy is unplanned). The stresses and emotional upheaval in vulnerable women may predispose them to psychiatric morbidity. Most reports regarding psychiatric disturbances in the postpartum period fall into 3 groups--postpartum blues, postpartum depression, and postpartum psychosis. Some of the disturbances are part of what may be termed general psychiatric disorders, but some may be closely related to the reproductive process. Apart from the postpartum psychosis, other non-psychotic disorders are commonly subsumed under the rubric of antenatal and postnatal depression. There are dangers of grouping diverse disorders under a single heading.' Some studies show that anxiety disorders may be more common than depression.' Anxiety disorders in pregnancy and childbirth have a specific focal content, for which specific interventions may be indicated.' The focus of antenatal anxiety could be: fear of foetal abnormality, fear of foetal loss (especially after previous reproductive difficulties and losses),' fear of stillbirth, fear of childbirth, and fear of inadequacy as a mother. The focus of postnatal anxiety could be: fear of the newborn, based on the awesome responsibility of care'; some mothers develop infant-focused anxiety, or obsessive impulses and thoughts, with phobias about the baby.' Fear of cot death could result in exhausting nocturnal vigilance.' Moreover, many mothers are excessively troubled about the health and safety of their children. One in 10 women suffer from postnatal depression (PND) without psychotic features. (10) Prevalence rates vary depending on the population studied, the method of assessment, and the length of the postpartum period under evaluation. A striking feature of PND is that it impacts both mother and infant. Its effects include cognitive and social difficulties, difficulty in attachment and infant development. All such adverse effects may persist even after resolution of maternal symptoms. Postnatal depression also affects relationship with the partner, and appears to exacerbate problems that existed before the pregnancy, since a poor marital relationship has been described to be a risk factor for PND. (12) Relatively little attention has been given to the relationship between anxiety disorders and childbirth. The 2 conditions frequently co-exist. (13) It is highly likely that many women who report depression in the postpartum period also experience clinically significant levels of anxiety. Recent studies suggest that postpartum anxiety disorders are underestimated and are more common than depression. (14-18) A prospective study demonstrated that nearly 20% of postpartum women reporting dysphoria also experience panic and / or obsessive compulsive symptoms. Anxiety appears to be a common experience in women who are 4 to 6 months postpartum. There could be a biological basis for some postpartum anxiety. Me Ivor and colleagues (20) studied the growth hormone response to apomorphine (a test of D2 receptor sensitivity) in 14 puerperal women with a history of depression. The greatest increase in receptor sensitivity was found in the 3 women who developed postpartum anxiety disorders. Women exhibit increased levels of cortisol during pregnancy and at the beginning of the postpartum period. …" @default.
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• W1569233004 date "2009-09-01" @default.
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• W1569233004 title "Symptoms of Anxiety and Depression in the Perinatal Period: Referrals to the Comprehensive Child Development Service in a Hong Kong Regional Hospital" @default.
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