Yates trial raises inquiries of post partum

The trial of Andrea Yates, the Houston mother who was found guilty Tuesday of drowning her children last year, has renewed questions about postpartum disorders.These are a range of mental-health conditions that sometimes occur in women after they give birth. Some conditions are mild and last no more than a few days to a couple of weeks. Others are serious and require medical intervention.To be clear, Yates’ case is extreme and should not be misconstrued as typical. Doctors who treated or evaluated Yates have testified that she may have depression with psychosis and schizophrenia.Here are questions and answers about the disorders:Q. Why do postpartum disorders occur?A. Researchers do not know exactly why the disorders occur. They suspect that changes in a woman’s hormonal balance may be an important factor, but environment, such as support, also may be a factor.Q. What are the types of postpartum disorders?A. They are “baby blues,” postpartum depression and postpartum psychosis.Q. What are baby blues?A. It’s the most common and least severe of the disorders. This occurs in 50 percent to 75 percent of new mothers within a few days of delivery. They may experience one or more of the following: crying for no apparent reason, irritability, impatience, restlessness and anxiety. Symptoms usually disappear quickly.Q. How can a spouse and family members help?A. Encourage the mother to talk about her feelings. Acknowledge–do not minimize–her feelings. Be patient. Ask the mother how you can help, especially with tasks. Find ways to help her reduce stressful feelings, especially those related to caring for her baby and family.Q. What is postpartum depression, or PPD?A. It’s a condition that occurs in one in 10 new mothers within days of delivery or within or past a year. The level of severity varies. Symptoms may include fatigue, sluggishness, exhaustion, sadness, hopelessness, change in appetite, sleep difficulties, poor concentration, confusion, memory loss, uncontrollable crying, irritability, feelings of guilt, inadequacy, fear of harming the baby, lack of interest in the baby, excessive interest in the baby and lack of interest in sex.This can adversely affect the infant’s development. A mother experiencing any of these symptoms should seek professional help. Family members should encourage and support this intervention. Q. How is PPD treated?A. It may be treated with an antidepressant medication and/or counseling with a therapist trained in issues of childbirth. New mothers are encouraged to talk about their feelings with others. Socializing through support groups and friends can help in recovery. Exercise and good nutrition also can help.Antidepressant medications have no harmful effects on breast-fed infants, studies show, but not enough is known about long-term effects.Q. What are barriers to detecting these disorders?A. Barriers include the following, Dr. Neill Epperson of Yale University wrote in a published study:Most women expect an adjustment period after delivery and may not recognize that what they are experiencing is not normal.Women who recognize that something is wrong may be afraid or ashamed to admit it. They fear they are “going crazy” and that sharing these thoughts with a health professional may result in being institutionalized or separated from their baby.A woman may not know to whom to turn for help. She may not see her obstetrician/gynecologist for a long time.Some doctors may contribute to delayed detection because they may minimize a woman’s distress. Because of pressures of managed care, doctors may not have time to pay attention to mental-health issues. Q. Where can I get more information?A. You can get more information on postpartum disorders from the following:National Mental Health Association: (800) 969-6642 or http://www.nmha.org/Depression After Delivery: (800) 944-4773 or http://www.depressionafterdelivery.com/Postpartum Support International: http://www.postpartum.net/American Academy of Family Physicians: http://www.aafp.org/