Returning home after childbirth throws the mother into a new and, in some ways, unexpected dimension, especially if it is the first child: a crying baby, tons of diapers to change, uninterrupted visits, a strange sense of sadness, breastfeeding from get off the ground, a couple's life to be totally reorganized. And it can happen that all this confusion can create an explosive mix, capable of losing the pleasure of the first days of this new life.
Doctor, what are the difficulties that a woman most frequently faces after childbirth?
"Immediately after giving birth the woman finds herself having to review and change her whole daily life. If during pregnancy her well-being was at the center of everything and everyone, immediately after giving birth she finds herself having to deal not only with changes body, with the exhaustion and fatigue associated with childbirth, but also the fact that only a few have asked her a simple question: 'And how are you?' Ergo: she finds herself having to rethink and having to think about her daily life in which the newcomer will be at the center. This translates into nocturnal awakenings, breasts perpetually on display, bottles and bottle warmers that occupy almost the entire kitchen counter, frequent changes of diapers and so on. Furthermore, our culture dictates that already in hospital or immediately after returning home, when a new mother just wants to have a shampoo and relax on the sofa enjoying her baby, a stressful coming and going of relatives cloud the mind of the young mother that she finds herself having to deal with the wise advice of grandmothers, mothers and aunts who, more than often help… confuse and make a new mother feel 'unsuitable and incompetent'. Summing up, the difficulties are really many and affect various spheres of a woman's life, from the intimate one to the family one to the friend one. A new mother has to slowly understand that she is the mother and she can understand her baby's needs better than anyone else. Let us remember that when a child is born a mother is born and as a beautiful song by Elisa says: 'It will be difficult to grow up / Before you become one / You who will ask all those questions / I will pretend to know more / It will be difficult / But it will be as it should be / I'll put the games away I'll try to grow up '".
What forms of postpartum depression exist?
"Postpartum depression is a fairly delicate issue to deal with and above all we must be careful when dealing with this topic because there are too many 'hearsay', the myths that often need to be dispelled, but which, passing from mouth to mouth, turn into information deemed credible and 'real'. Postpartum depression is a psychological disorder that can manifest itself in varying degrees of severity. First of all, I think it is of fundamental importance to treat the milder and more transitory forms that are defined as baby blues or maternity blues (sad mom). During this phase, which generally occurs 3-4 days after giving birth, the new mother feels sad, cries easily, anxiety, irritability, difficulty sleeping, difficulty concentrating and memory are activated. These disorders last about one to two weeks and it is an almost physiological condition, also because it is connected to the hormonal variation that occurs immediately after childbirth, and is frequent (almost 80% of women report it). In most cases it is transitory and passes by itself and the support of family members becomes essential to get out of it quickly and painlessly. The situation is different when this sadness persists, turning into a real post-partum depression. Unlike the first case, this is a disorder that affects 10% of women and occurs from the third month to the first year after childbirth. These are the most serious and most difficult to understand cases. Symptoms are generally underestimated, also because after several months of childbirth the association between symptoms and the birth event is not so immediate. In this case, the symptoms in question are those of depression: anxiety, worry, low mood with a tendency to see only the negative aspects or see the negative even where it is not there, loss of interest in things, loss of pleasure of looking after the child linked to a feeling of inadequacy with respect to taking care of him, one feels incompetent, with loss of sleep and appetite. The risk factors reported by the scientific literature are many: having suffered from anxiety and depression during pregnancy (but let us remember that the 'clinical' history of the woman is very important because each case is unique. For example, if you have experienced a miscarriage or an intrauterine death or immediately after the birth it will be almost physiological to experience the new pregnancy with anxiety), have suffered from depression and anxiety before pregnancy, familiarity with psychiatric disorders, live or have lived situation very stressful, experiencing a condition of poor family or social support, economic difficulties or precariousness, suffering from premenstrual syndrome, suffering from thyroid function disorders. The most severe case of postpartum depression, which is termed postpartum psychosis, rarely occurs. In it, the mother perceives the child as an important source of anguish, so much so that she comes to hate him and to manifest aggressive fantasies towards him. These are the cases that can lead to infanticide. Of course, I would like to underline that post-partum depression or a simple outburst of anger is not enough to lead to infanticide, but in the latter case there are important contributing causes that go beyond childbirth and that have distant origins in the life of that child. mum. When these cases occur, from the mildest to the most severe, the important thing to do is to ask for help. However, let us remember that it is difficult for a mother who has experienced that experience to recognize the difficulty. The role of husbands, companions, family members and friends is very important.
Breastfeeding: especially at the beginning it may not be easy and it could be natural to let yourself be tempted by a nice bottle of artificial milk. How to support a mom?
“Breastfeeding is a very important and very difficult chapter to deal with. There are many associations that deal with breastfeeding, but there are many messages that mothers often experience as 'imposition'. If we read the guidelines of the World Health Organization or UNICEF, they highlight the importance of breastfeeding at least the first 6 months of the baby's life, but let us remember that many mothers are effectively unable to bear the emotional and physical burden. and for this they should not be condemned. Breastfeeding must be a need and a pleasure for the baby, but also for the mother. Let us remember that breastfeeding: - strengthens and consolidates the mother / child relationship (bondig), but this happens if breastfeeding is experienced by the mother with serenity; - provides the baby with complete nutrition (nutritional benefits); - protects the newborn from infections; - it benefits the mother's health (but if the mother is mentally and physically willing). Many mothers tell me that they remember the arrival of milk rising with more pain, a few days after birth, than the contractions of labor and this is already an important moment in which the new mother is put to the test. Let us remember that, especially if it is the first birth, the breast will also have to readjust itself, expanding its tissues by welcoming the production of an element unknown until then: milk. Nor should we underestimate the moment in which, after a few hours after giving birth, family members begin to produce anxiety in the new mother when, every time the baby cries, the phrase 'he will be hungry' is pronounced. And this is the time when we often give in to formula milk. Many new mothers do not know that the few drops produced immediately after childbirth (colostrum) are a concentrate of nutritional elements that for the baby's stomachin (large when an olive at birth) is sufficient. Of course, each case is separate and this too must be emphasized. I believe that giving the necessary information to the couple, therefore to the new mother, but also to the new father, for the 'management of breastfeeding' is essential to make it enjoyable. Also in this case there are many myths, hearsay and advice. I believe that when it comes to breastfeeding, we need to listen to the needs of mother and child and accompany new mothers to find the most functional way for them. I believe it is important to give the necessary information on how to deal with milk rising, on possible positions, on natural remedies to feel less pain in the first month of the baby's life, in the importance of the possibility of involving the father by pumping the milk and using the bottles as well. aid tools, untying them from the prejudice that if the baby gets used to the bottle, he will no longer attach himself to the breast. Breast and bottle are two completely different 'tools' by nature. Many mothers tell me that babies refuse bottles even if there is mother's milk inside. Let us remember that babies initially recognize smells so it is possible that if the mother offers the bottle she will be refused because on her nose there will be a breast that is much more tempting for him; perhaps then it will be more functional for the father to propose the bottle full of mother's milk so as to be able to leave a moment of total relaxation for the mother, who will not feel guilty because her baby is equally nourished both biologically, with substances nourishing her milk, both emotionally, because the dad will offer the emotional support that is just as important. They are small nuances and small gestures that can change the way you see breastfeeding. Furthermore, I always stress that a baby is happy and peaceful if the mother is calm and happy and therefore I believe that breastfeeding should be a free choice.
Another problem could be returning to a fulfilling sex life with your partner. Again, how to support the couple?
“Sex life immediately after childbirth is a real taboo. Very often I am told that there is a decline in sexual desire and that you no longer feel what you used to be. Being still alive and sexually active when there is an exhaustion linked to the new daily life that is tyrannically managed by the children is really difficult and one must not feel 'abnormal' if the sexual life is affected by so many sudden changes. Furthermore, especially if you are breastfeeding, very often you find yourself in somewhat embarrassing situations when, in a rare passionate moment, you find yourself seeing and feeling jets of milk. Let's not forget that a woman's physique changes during and after pregnancy so if a woman no longer feels desirable it becomes difficult to let go of passion. Everything can improve and above all it is important to put aside the embarrassment by transforming the couple's life from a ballast to a resource. For example, if a new mother feels supported by her husband in managing the baby, it will be easier to feel close and cohesive and even dealing with embarrassing and incommunicable issues can become easier. Also in this case, different situations can occur and a lot depends on the proximity of the couple that you already had before pregnancy. If a couple had difficulty expressing themselves in their sex life, sex after childbirth is sure to be even more complicated. I believe that communication is fundamental, having the tools and basic knowledge is very important and I also consider it essential to contact a professional if the difficulties persist ".
Is there still repulsion to go to a psychologist?
“Generally a psychologist is synonymous with 'mad doctor'. It is undeniable that when we talk about a psychologist a series of prejudices are activated: going to the psychologist means taking long paths, it means being crazy, it is impossible to solve concrete problems just by talking, the psychologist could shape my mind and so on. Of course these are all prejudices linked to our culture, but fortunately, especially in recent years, the figure of him is increasingly linked to the concept of well-being. Another difficulty that could arise is a reticence in talking about certain intimate issues with a 'stranger'. For this I don't think there are solutions, but surely knowing these prejudices is the first step to promote taking care of one's mind and making the psychologist fear less and less. It is important to underline that the psychologist's job is to accompany the person along a path that allows them to get to have a new point of view, facilitating evolution and change through the activation of resources that that person cannot see. . The ultimate goal is the creation of psychophysical well-being, because let us remember that the famous mind-body union is real, so taking care of yourself is not only eating well or playing sports, but also taking care of the well-being of your own mind ".
What is the Georgia Association and what are its aims?
“The Georgia Association is an association that was born in 2022 whose purpose and mission is to create 'women's well-being'. Initially it was born to give support to couples with experiences of spontaneous abortion or intrauterine death or immediately after childbirth. Over the years, we have realized that there are areas that cannot be separated and that have important connections that may not be immediately visible, but which for us, who face certain issues every day, are evident. Georgia has identified 5 key areas in the life of a woman and a couple in general which are: high-risk pregnancy and abortion (which remains the mother area and point of origin), medically assisted procreation, breastfeeding, gynecological cancer and menopause . These areas - which thus presented seem disconnected - actually have a common basis: life and the couple and inevitably connects to the stages of life that a woman finds herself having to face. This does not mean that a woman must necessarily have cancer, but certainly a woman who has had, for example, cancer, if properly followed can have a pregnancy after the illness and can even breastfeed, bringing back her life cycle from one level of death to one level of life. Just as a physiological pregnancy can be experienced with anxiety and breastfeeding with difficulty if that mother has previously experienced a perinatal loss or a miscarriage. These are two examples that simplify the concept of connection between areas. This does not mean to pathologize or medicalize by force, but surely there are events that inevitably create difficulties and those same difficulties can be overcome and made resources if we know we are not alone. I always say that Georgia works by favoring access to a future dimension, by turning away from what it has been to turn it to what is possible. This does not mean forgetting the past, but it does mean finding a new meaning, a new meaning that can help you move forward, unblocking a situation that is often frightening. The pain is not overcome by pretending that it is not there, but it is certainly overcome by crossing it and, if this work is done in the company of people who have the same experience as you or professionals who know how to show you the way, it will be easier. In these cases, not feeling alone can make the journey less difficult.