Post Date July, 30 2023
With the development of medical science and the changes in modern medical models, psychosomatic medicine has increasingly received attention from various clinical disciplines, and the psychological health care of pregnant and postpartum women has gradually attracted people's attention. Pregnancy is a significant physiological and psychological stress process for pregnant women. They undergo various psychological and physiological changes during a series of physiological processes such as pregnancy, childbirth, postpartum recovery, and breastfeeding. Once the degree and nature of certain changes exceed the limits of normal variation, they become pathological changes. Epidemiological studies show that 12 months after delivery is a high-risk period for women to develop Mental disorder in their lives. The etiology of Postpartum depression is relatively complex, generally speaking, there are biological, psychological and social factors.
1、 Biological factors In the process of pregnancy and childbirth, the endocrine environment in the body has changed greatly, especially within 24 hours after delivery, the rapid changes in hormone levels in the body are the biological basis of Postpartum depression. The levels of estrogen and Progestogen gradually increased to the peak during pregnancy, and gradually decreased to the basic level within 3-5 days after delivery. Research shows that the greater the decrease of Progestogen, the greater the possibility of postpartum depression. Of course, the relationship between hormones and Postpartum depression has not been finalized, and further research is needed to confirm it.
2、 Physical factors during labor, postpartum complications, dystocia, delayed labor, and surgical delivery are the causes of Postpartum depression that cannot be ignored. Due to the pain and discomfort caused by childbirth, pregnant women feel nervous and afraid of delayed or difficult childbirth, and their psychological preparation is insufficient. The degree of tension and fear increases, and the duration of labor lasts longer, leading to increased physical and psychological stress, thereby inducing the occurrence of postpartum depression. Secondly, pregnant women with physical diseases or disabilities are prone to postpartum depression, especially infections and fever, which have a certain impact on the promotion of postpartum depression.
3、 Psychological factors Postpartum depression is mostly seen in people who are self-centered, immature, sensitive, emotionally unstable, aggressive, stubborn, poor social skills, incompatible with others, introverted personality and other personality characteristics. Prenatal emotional instability, premenstrual tension syndrome were more likely to have postnatal depression. The puerperal women's emotion is in a fragile stage, especially in the first week after delivery, the emotional change is more obvious, and the psychology is in a serious unstable state. Because the puerperal women are not adapted to the role of the mother, Psychological stress is caused and depression and anxiety occur. The excessive anxiety and depression of the parturient can lead to a series of physiological and pathological reactions, such as the decrease of Norepinephrine secretion and the change of other endocrine hormones, which can lead to the weakening of Uterine contraction, pain sensitivity, prolonged labor process, and increased bleeding, further aggravate the anxiety and anxiety of the parturient, and become a contributing factor of Postpartum depression.
4、 The social factor support system is considered an important factor, which includes husband, family support, and personal satisfaction with marriage. Most of the patients with Postpartum depression have factors such as unfavorable support system, incompatibility between husband and wife, less concern of postpartum relatives, and poor living environment, which are risk factors for postpartum depression. Adverse delivery outcomes, such as stillbirth, stillbirth, deformed babies and maternal families' aversion to the baby's gender, are the inducing factors of Postpartum depression. Negative life events experienced by pregnant women, such as unemployment, separation of husband and wife, bereavement of relatives, and family disharmony, are important incentives for Postpartum depression. At the same time, factors such as low age, single parent, low social status, mothers with multiple children, early divorce of parents, low education, low income, and new immigrants can all increase the susceptibility of postpartum depression in pregnant women. Postpartum depression is also related to maternal age, nationality, occupation, quality of health care services during pregnancy and childbirth, postpartum breastfeeding, and the unfortunate events experienced by the growing mothers.
5、 Genetic factors are potential factors for mental disorders. The incidence rate of Postpartum depression is high among women with a family history of psychosis, especially those with a family history of depression. In addition, the past history of affective disorder and premenstrual depression can cause Postpartum depression. However, if a pregnant woman suffers from Postpartum depression and gives birth again, she has a high recurrence rate, which can be as high as 50%. For women who have had severe depression at any time in the past, the risk of postpartum depression can increase by 30% to 40%.
