This is the commonest psychiatric condition following childbirth. It is estimated that up to 50% of women experience maternity blues.

Maternity blues is an affective psychiatric disorder that does not usually develop into frank psychiatric disorders such as puerperal psychosis and major postnatal depression.

Clinical features and presentation:

It usually presents with sudden onset of low spirits any time from the first to the tenth day after childbirth. It can also present anytime in the first one year post-partum.Common symptoms of maternity blues include tearfulness, misery,anxiety,irritability, lability of moods, sleeplessness, headache, impaired memory and negative feelings towards the baby (rare and found only in serious cases).Other symptoms include lack of satisfaction with motherhood and sense of loneliness and isolation.It must be noted that clinical features of major depressive illness is absent.

Women affected usually have a background of frequent marital and social problems.

Maternity blues usually remits spontaneously, it is considered a minor depressive illness.The cause of maternity blues is not known. Hormonal changes in pregnancy and psychological difficulties (eg bad relationship with spouse) are thought to predispose to this condition.

Management of Maternity Blues:

This does not require any intervention apart from reassuring the patient and the next of kin.

Psychological treatment is as effective as antidepressents .

Psychological treatment includes six weekly sessions of specific counseling by a trained psychotherapist. Cognitive psychotherapy is also very effective.

Social support also goes a long way in alleviating the symptoms.

Patients and their relatives should be informed of possible future recurrences in subsequent pregnancies.

It is important to note that the benign nature of the disease should not give rise to a false sense of security. The patient must be observed carefully to rule out suicidal depression and infanticidal thoughts.

References:

Textbook of Obstetrics and Gynaecology for Medical Students by Akin Agboola et al. Volume 2 ,Obstetrics.1st Edition

Page 326 and 327 ,Mild postnatal depression (the blues),Chapter 21.Psychiatric Disorders in Pregnancy and the Puerperium. Obstetrics by Ten Teachers. Seventeenth edition .Edited by Stuart Campbell and Christoph Lees.

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