Have you got the postpartum blues?

Alice delivered her daughter, Emma, by cesarean section due to distress during labor. Emma was taken by ambulance to another hospital immediately after birth. Emma's father stayed with Alice, so Emma was without family members around her until the following day, twelve hours after being born, at which time her father went to see her. Following observation and medical examination it was determined that Emma was, in fact, fine. She was returned to her mother three days after birth.

When Alice came to see me, two months after her baby's birth, she could not relax and appeared very nervous about her ability to care for Emma. She reported that she answered Emma's every cry, sometimes crying with her for hours at a time when she could not quite or comfort her. She loved her baby very much but was having an extremely difficult postpartum adjustment since Emma, who was rarely quiet and contented, usually screamed even when held. Alice had consulted with her pediatrician, who could find no physical reason for Emma's excessive irritability and heightened sensitivity.

I observed during the session that Emma startled and cried very suddenly and very loudly at almost every change in the environment. Her cries were piercing and frantic- unlike most babies, whose cries are usually shorter and who are more easily comforted.

As we reviewed her birth experience, Emma began to wail frantically. Alice said this was her usual behavior. I pointed out that the experience of being in a strange place and in strange hands during the days after birth may have made Emma particularly needy, and that Alice was, in fact, doing a wonderful job of mothering Emma through this unusual beginning. I suggested that Alice go back to the birth and imagine what it would have felt like to have held Emma in her arms immediately after birth. After all, she had missed this, but it did not stop her from being able to hold her now and imagine what her wish could have been for herself and for her baby.

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