The subjects in Records's study described how their past abuse experiences affected their thoughts and view of their labor, delivery, and postpartum experiences (Records pp). Records revealed that "all of the subjects felt that the combined recall of trauma events and the labor and delivery experience provided the foundation for the PPD...perceived negative labor and delivery experience as the basis for their PPD" (Records pp).
In the May 01, 2002 issue of OB GYN News, Erik L. Goldman cites Dr. Diana Dell's press briefing sponsored by the American College of Obstetricians and Gynecologists. According to Dell, women are under tremendous pressure to "make perfect babies and to be perfect mothers and perfect wives...and she's got huge expectations about what it will be like," and reality is less like a Gerber baby food commercial and more like Marine boot camp than most new mothers expect (Goldman pp). Being a new mother means that there is an incessant demand, the woman must obey every order, and there is "no rest, no mercy and no concern" for her feelings (Goldman pp). Yet this does not mean that false expectations cause postpartum depression, however in a woman with a history of depression or other risk factors, the "discord between longstanding expectations and the realities of early parenthood can trigger episodes of depression which can sometimes tailspin very quickly" (Goldman pp). Dell estimates that up to 70% of all pregnant women experience some symptoms of depression during their pregnancy or in the postpartum periods, but only 10-16% of them meet the criteria for major depression (Goldman pp). Up to 20% will have an episode of major depression before the end of the first year, and the numbers are even higher, up to 25%, for first time adolescent mothers (Goldman pp). Dell advised being especially concerned about women with bipolar disorder or schizophrenia, and although psychosis is very rare among the general female population, it has a prevalence of 25-35% among women with these conditions (Goldman pp).
In the April 15, 1999 issue of American Family Physician, C. Neill Epperson reports that postpartum major depression, PMD, occurs in approximately 10% of childbearing women, and may begin anywhere from 24 hours to several months after delivery. Epperson cautions that before a definitive diagnosis of PMD is made,...
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