Educationals

Breast feeding on delivery is with increased eye contact with the child and bonding months later. Maternal feelings for a new born child may normally be delayed up to three weeks, and this may need explaining to avoid rejection towards the child. For the first 3-4 weeks, a mother may feel tired, insecure and find managing the child unrewarding hard work. By three months mothers feel pangs of guilt when they have to leave the baby and join work.

Still Birth

Both mothers and fathers undergo the bereavement process following a stillbirth. The psychological effects of stillbirth and the need for counseling have been increasingly recognised. Mothers are now encouraged to see and handle stillborn babies, particularly as their imagined perception of the stillborn is usually worse than reality.

Oral Contraception

In spite of earlier concerns that oral contraception was associated with, precipitated or exacerbated severe mental illness (like depression), this is not so. There is only a mild increase in symptoms, in those with previous history of depression.

Ammenorrhoea

This can follow psychological stress and depression.

Infertility

Women with infertility problems may be subject to extreme anxiety or sadness, because of cultural belief, they are only blamed for sterility though it is unclear if this contributes to a higher rate of depressive illness.

Hysterectomy

A higher incidence of depression is found following hysterectomy which may lead to menorrhagia. If performed at an earlier age it could lead to higher prevalence of psychological problems, due to body dysmorphic ideas.

Depression in later adulthood

Involutional depression described at this stage involves :

Menopause

Ninety percent of women experience hot flushes and excessive sweating for 1-2 years after the cessation of periods, due to reduced ovarian activity causing vasomotor changes. These respond to estrogen treatment. However, in the year following menopause, up to one-third of women experience, depression, anxiety irritability. They need treatment with antidepressants and do not respond to estrogen therapy alone. The menopause may psychologically alter the woman's perception of herself.

Empty nest syndrome

When the children leave home, women experience a profound loss of purpose and identity that leads to depression.

Widowhood

About 800,000 persons are widowed each year, most of them are older and female. A third of them meet criteria for depression. These depressions respond to antidepressant medication. They benefit from self help groups or various psychosocial treatment.