Emotional Changes During Pregnancy and BeyondApril C. Sanchez, M.D.
Congratulations on your first pregnancy! Everyone experiences different emotions as they go through pregnancy. The initial reaction to a positive pregnancy test varies from joy and excitement to indifference, disappointment, anger, and/or fear. Obviously, this depends to some extent on whether it was a planned pregnancy. Throughout the pregnancy, it is common to have more extreme emotions and many women will cry much more easily than in the non-pregnant state. I believe this is due in part to the hormonal changes in your body and in part to physical factors such as fatigue, nausea, and a constantly changing body. While some crying spells are normal, you should alert your doctor if you feel the crying is uncontrollable or if feelings of sadness are overwhelming.
Emotional changes are also common in the postpartum state. About 40% of women will experience an initial indifference when holding their baby for the first time. This is more often seen after a painful labor experience or after using certain drugs during labor. This resolves within a matter of a day or so, and the new mother then forms a bond with the baby. Up to 50% of women have some postpartum "blues". Characteristically, these women experience fatigue, tearfulness, difficulty concentrating, and depressed mood. There are no risk factors for the "blues" and resolution usually takes about a week to ten days. A small percentage of women will experience a major depressive disorder in the postpartum period. This is when feelings of depression or loss of interest are present daily for at least two weeks. The depression is accompanied by appetite changes, insomnia, fatigue, feelings or worthlessness, thoughts of death, and/or rejection of the infant. Less severe depression may respond to psychotherapy; however, medication is usually necessary for a period of at least six months.
The main thing to keep in mind as you go through your pregnancy and beyond is that while some mood fluctuations are normal, anything which seems extreme to you should be discussed with your doctor.
April C. Sanchez, M.D.
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