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postpartum blues.pptx
1. Postpartum Blues and Ayurveda
Dr. Nilofar M Shaikh BAMS, MS (AYU.)
Associate Professor & Consultant
Prasutitantra evam Streeroga department
JS Ayurveda Mahavidhyalaya
Nadiad, Gujarat, India.
Email Address: Shaikhnilofar12@gmail.com
2. Disclaimer
• I am not presenting original work or
information here. I had gathered and
reviewed the information from various
research articles , papers , internet and
Ayurveda texts .
3. • Postpartum blues, also known as baby
blues and maternity blues, is a very common but
self-limited condition that begins shortly after
childbirth and can present with a variety of
symptoms such as mood swings, irritability, and
tearfulness.
• Mothers may experience negative mood symptoms
mixed with intense periods of joy. Up to 85% of
new mothers are affected by postpartum blues,
with symptoms starting within a few days after
childbirth and lasting up to two weeks in duration.
www.marchofdimes.org. Archived from the original on 2017-02-19. Retrieved 2020-
10-29.
Introduction
4. • Symptoms of postpartum blues can vary significantly from one
individual to another, and from one pregnancy to the next.
Symptoms of postpartum blues include, but are not limited to:
• Tearfulness or crying "for no reason"
• Mood swings
• Irritability
• Anxiety
• Questioning one's ability to care for the baby
• Difficulty making choices
• Loss of appetite
• Fatigue
• Difficulty sleeping
• Difficulty concentrating
• Negative mood symptoms interspersed with positive symptoms
Seyfried LS, Marcus SM (August 2003). "Postpartum mood disorders". International Review
of Psychiatry. 15 (3): 231–42.
5. Onset
• Symptoms of postpartum blues generally
begin within a few days of childbirth and
often peak by day four or five.
Duration
• Postpartum blues may last a few days up to
two weeks. If symptoms last more than two
weeks, the individual must be evaluated for
postpartum depression.
6. Psychosocial causes
Pregnancy and postpartum are significant life events that increase
a woman's vulnerability for postpartum blues.
• Feelings commonly reported by new parents and lifestyle
changes that may contribute to developing early postpartum
mood symptoms include:
• Fatigue after labor and delivery.
• Caring for a newborn that requires 24/7 attention.
• Sleep deprivation
• Lack of support from family and friends
• Changes in home and work routines
• Financial stress, Unrealistic expectations of self
• Overwhelmed and questioning ability to care for baby
• Anger, loss, or guilt, especially for parents of premature babies.
7. Risk factors
• Most risk factors studied have not clearly and consistently
demonstrated an association with postpartum blues. These
include sociodemographic factors, such as age and marital
status, obstetric factors, such as delivery complications or low
birth weight.
• Factors most consistently shown to be predictive of
postpartum blues are personal and family history of
depression.
8. Pathophysiology
Estrogen and progesterone
• After delivery of the placenta, mothers experience an abrupt decline of gonadal
hormones, namely estrogen and progesterone.
• Major hormonal changes in the early postpartum period may trigger mood
symptoms similarly to how more minor hormonal shifts cause mood swings prior to
menstrual periods.
• Studies have not detected a consistent association between hormone concentrations
and development of postpartum mood disorders. Some investigators believe the
discrepant results may be due to variations in sensitivity to hormonal shifts across
different subgroups of women. Therefore, development of mood symptoms may be
related to a woman's sensitivity, based on genetic predisposition and psychosocial
stressors, to changes in hormones rather than absolute hormonal levels
9. Other
• The association between postpartum blues and a variety of other
biological factors, including cortisol and the HPA Axis , tryptophan,
prolactin, thyroid hormone, and others have been assessed over the
years with inconclusive results.
• Emerging research has suggested a potential association between
the gut micro biome and perinatal mood and anxiety disorders.
•
10. Criteria
• There are no standardized criteria for the
diagnosis of postpartum blues.
• Investigators have employed a variety of
diagnostic tools in prospective and
retrospective studies of postpartum blues,
including repurposing screening tools, such as
the Edinburgh Postnatal Depression
Scale (EPDS) and Beck Depression Index (BDI),
as well as developing blues-specific scales.
11. Prevention
Screening
• There are no specific screening recommendations for postpartum blues.
Nonetheless, a variety of professional organizations recommend routine
screening for depression and/or assessment of emotional well-being
during pregnancy and postpartum.
• American College of Obstetrics and Gynecology (ACOG): In 2018, ACOG
recommended universal screening for depression and anxiety using a
validated tool at least once during pregnancy or postpartum, in addition to
a full assessment of mood and well-being at the postpartum visit. This is in
addition to existing recommendations for annual depression screening in
all women.
• American Academy of Pediatrics (AAP): In 2017, the AAP recommended
universal screening of mothers for postpartum depression at the 1-, 2-, 4-,
and 6-month well child visits.
•
12. Treatment
• Postpartum blues is a self-limited condition. Signs and symptoms are
expected to resolve within two weeks of onset without any treatment.
Nevertheless, there are a number of recommendations to help relieve
symptoms, including:
• Getting enough sleep
• Taking time to relax and do activities that you enjoy
• Asking for help from family and friends
• Reaching out to other new parents
• Avoiding alcohol and other drugs that may worsen mood symptoms
• Reassurance that symptoms are very common and will resolve on their
own
• If symptoms do not resolve within two weeks or if they interfere with
functioning, individuals are encouraged to contact their healthcare
provider. Early diagnosis and treatment of more severe postpartum
psychiatric conditions, such as postpartum depression, postpartum anxiety,
and postpartum psychosis, are critical for improved outcomes in both the
parent and child.
13. Ayurveda View
• Ayurveda has described in detail about the postnatal period
and care for this period under the title Sutika Paricharya
(postnatal care).
• Prasava (labor) is a strenuous activity which causes Dhatu
Kshaya (depletion of body tissues) and there by depletion of
Bala (strength) of the woman which is the need behind
exclusive care for both women and infant after delivery.
• Paricharya is mentioned extensively in classics which includes
Ahara (diet), Aushadha (medicines) and Vihara (regimens).
15. • Vata dosha and Agni (digestive capacity) are the two key factors considered for
postnatal management.
• Vata dosha is aggravated in the pelvic region by the creation of empty space
after the expulsion of the fetus from the uterus.
• Management of vata dosha is done to prevent any possible complications and
ensure smooth recovery from distorted anatomy and physiology in the female
body.
• The digestion capacity (Agni) is deranged due to physiological changes during
pregnancy. Therefore, protection and stimulation of digestive capacity by diet and
herbs having (Deepana and Pachana ) effect is recommended.
• The nourishment therapy (Brimhana ) and rejuvenation therapy (Rasayana ) can be
useful only after proper management of vata dosha and Agni .
16. • Sutika Unmaada or Postpartum psychosis is a
psychotic condition associated with insomnia*
occurring in women who have recently delivered
a baby.
• This syndrome is often characterized by the
mother’s depression, delusions, and thoughts of
harming either her infant or herself. The ideation
of suicide and infanticide need to be carefully
monitored.
*Premvati tewari, Ayurvediya Prasutitantra evam Striroga, Part-1, Prasutitantra,
Published by Chaukhambha Orientalia, Varanasi, 2nd Edition Reprint 2009, Ch. 9,
“Sutika vigyaniya”, p 559-560.
17. • Unmāda is a very broad term comprising of various kinds of Manovikaras.
In Unmāda the impairments in the domains of Ashtavibhramas leads to
the occurrence of various clinical conditions.
• As the female may have Pitta predominant atypical features such as
Amarsha (Irritation), Krodha (Anger), Santapaschathivelam (continuous
state of anguish), Vinidra (reduced sleep) etc.
• Vata predominant atypical features like Asthane rodhanam (inappropriate
crying), asthane akrosha (inappropriate shouting), and Kapha predominant
features such as Alpacheshta (reduced psychomotor activity) and
Alpavakyatha (reduced speech).
• In the unmāda caused by the combined vitiation of all the three doşas, all
the symptoms are simultaneously manifested
18. • Postpartum blues can be treated with a variety of herbs
from the Ayurvedic medicine repertoire. These treatments
can aid in dosha balancing and psychological health.
• Ashwagandha, brahmi, and Shatavari are three of the most
popular herbal remedies for postpartum depression.
•
CHIKITSA- AYURVEDIC TREATMENT FOR POSTPARTUM
DEPRESSION
20. Therapeutic Massage
• Another Ayurveda treatment that has shown promise in the treatment of
postpartum depression is massage therapy.
• Stress and tension can be alleviated, blood flow can be increased, and
overall mental and physical health can be enhanced with a soothing full-
body massage.
• Shirodhara and Shiro Abhayanga
• Brahmi Ghrita Nasya
Yoga
• Postpartum blue can be effectively treated with the use of yoga and
meditation. These methods have been shown to have positive effects on
stress, disposition, and overall health.
Modifications in Lifestyle
• According to Ayurveda, adjusting one’s way of life can have a significant
impact on one’s health. Exercise, sufficient rest, and stress management
are all good examples. Avoiding substances like alcohol and narcotics is
also recommended, as they may amplify the negative effects of
postpartum blue.
•
21. Conclusion
• About 2–3 days after childbirth, some women begin to feel depressed, anxious,
and upset. They may feel angry with the new baby, their partners, or their other
children. They also may:
• Cry for no clear reason
• Have trouble sleeping, eating, and making choices
• Question whether they can handle caring for a baby
• These feelings, often called the baby blues, may come and go in the first few days
after childbirth.
• In Ayurveda , one can consider it as a Sutikavyapada specially sutika Unmada and
this condition can be managed with the help of Ayurveda.
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