The gentlebirth.org website is provided courtesy of
Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA

Notes from a Talk on Postpartum Depression

One note: I expect the information below about supplementing with
formula will probably be very controversial for some doulas.
Obviously, feel free not to advocate it to your clients, as there are
so many other ways of helping! The purpose of this post is just to
raise awareness of the PPD issue.



"Baby blues" is not the same as PPD. It is characterized by mood
swings and irritability up to 2-3 weeks postpartum and resolves on its
own.

Signs of PPD may include:
Crying
Anxiety
Apathy towards the baby
Changes in appetite
Fatigue or difficulty sleeping
Anger
Feelings of isolation, lack of enjoyment
Feeling "not like herself"
Mom can also be in denial about the issue

These are the ways a friend (doula) can help:
Don't assume that everything is OK based on appearance- instead ASK!
Just as with suicide thoughts, PPD cannot be "triggered" by a
question. (ex: "Having a new baby can be rough; how are you doing?")
Just be present with the mom, listen to her
Help her set up a support network, such as help with meals and childcare
Offer to watch the baby for a bit, to take the burden off (help her
find postpartum doula services)
Be a source of information and referrals
Be honest and open
Go over baby's schedule and make sure mom is getting enough sleep (at
least 5hrs/night). Fatigue makes everything worse!
If baby is breastfeeding exclusively - discuss alternative ways of
feeding (ex: pumping some while supplementing with rest with formula;
that allows dad/someone else to feed the baby at night and have mom
get the allotted sleep time).
Educate the husband
Helpful language: "I'm here for you," "This is treatable and
temporary," "You can do this," "This is common" vs "This is normal"

Things that are not helpful:
Making mom feel guilty
Not offering resources to deal with PPD
Closed-ended advice such as "just try to relax" or "exercise more"

Mothers' PPD can have negative effects on language/cognitive
development of the children. They vocalize less, cry more, have
attachment difficulties and lower activity levels. The mothers tend to
be more critical of babies. These effects can be long-term, if
untreated, with children later exhibiting ADD.

Some things you can do if you suspect suicidal tendencies:
ASK! Put the question out there. Again, it will not promote the idea.
"Do you feel like hurting yourself?"  
Give out the crisis hotline number
If you notice mom is acting "happier" do not assume she is "out of the
woods." Do not cut off your support. Recovery takes time.