A depressão pós-parto é um transtorno mental de alta prevalência que surge nas primeiras semanas, após o parto, e provoca alterações emocionais, cognitivas comportamentais e físicas. Mães adolescentes apresentam risco aumentado para a depressão pós-parto. Estudos mostram que a prática do aleitamento materno não se dá de forma efetiva nos casos em que a nutriz apresenta alterações emocionais. Diante do exposto, buscamos compreender quais as representações sociais sobre amamentação na perspectiva de mães adolescentes com sintomas de depressão pós-parto. Trata-se de uma pesquisa qualitativa, desenvolvida com 14 mulheres, mães de crianças com até um ano de idade e usuárias de um serviço público de saúde de Ribeirão Preto-SP. A primeira etapa consistiu na aplicação da Escala de Depressão Pós-natal de Edimburgo para rastrear as mães adolescentes que apresentavam sintomas de depressão, no puerpério. As mães que apresentavam pontuação de 12 ou mais pontos eram convidadas a continuar a participar do estudo. Para as mulheres que aceitavam ser incluídas na pesquisa, foram aplicados questionário sociodemográfico e a entrevista semiestruturada que foram gravados e transcritos na íntegra e realizados no local de escolha da participante. Para a análise dos dados, utilizamos o Método de Interpretação dos Sentidos à luz das representações sociais na perspectiva socioantropológica. Emergiram três categorias temáticas: 1) \"Ser mãe na adolescência com sintomas de depressão no pós-parto\"; 2) \"Amamentando na adolescência com sintomas de depressão no pós-parto\"; 3) \"A rede de apoio: eu e a amamentação\". A gravidez é considerada indesejada no contexto investigado, pois é vista como empecilho para se dar continuidade à vida. E isto se reflete negativamente na amamentação, visto que, há dificuldades para se desempenhar papéis maternos, nesse momento da vida. Com relação à amamentação, observamos que os conhecimentos se restringem aos aspectos nutricionais e imunológicos, sendo desconsiderados os aspectos relacionais e de construção de vínculo da prática de amamentar. Este pensamento se justifica quando fazemos um olhar para o modo como as participantes se sentem somado ao contexto cultural em que vivem, um meio que trata a amamentação como mera prática de alimentação infantil. Há a ideia de que o leite materno é fraco, sendo a mamadeira vista como uma aliada, pois além de proporcionar sensação de saciedade do bebê por mais tempo, ainda impede que ele chore e incomode principalmente no período noturno, já no período diurno evita constrangimentos por ter de amamentar em locais públicos e pode ser oferecida por outra pessoa. A mamadeira é algo que proporciona sensação de liberdade, ocasionando a independência do bebê em relação à mãe. A mulher tem como maior fonte de influência e apoio sua mãe, o parceiro ainda permanece distante à realidade da amamentação e o profissional de saúde oferece orientações pontuais, nas quais desconsideram os contextos de vida nas quais as adolescentes estão inseridas. A internet é usada para se ter conhecimento, sendo considerada veículo de forte influência. Mesmo com apoio materno, a mulher ainda permanece sozinha, com dificuldades para falar sobre sua real situação emocional e sobre suas limitações para amamentar / Postpartum depression is a mental disorder of high prevalence that arises in the first weeks after childbirth and causes emotional, cognitive, behavioral and physical changes. Adolescent mothers present an increased risk for postpartum depression. Studies show that the practice of breastfeeding does not occur effectively in cases where the mother presents emotional changes. In view of the above, we aimed to understand which are the social representations regarding breastfeeding, in the perspective of adolescent mothers with symptoms of postpartum depression. This is a qualitative research conducted with 14 women, mothers of children up to one year of age and users of a public health service in Ribeirão Preto - SP. The first phase consisted in the application of the Edinburgh Postnatal Depression Scale for screening adolescent mothers with symptoms of depression in the puerperal period. Mothers who achieved a score of 12 or more were invited to proceed participating in the research. For those who accepted to be included, socio demographic questionnaires were applied and, semi- structured interviews were conducted and recorded in a participant\'s choice location and then, fully transcribed. For the data analysis, we used the Interpretation of the Meaning Method, in accordance with the social representations in a socio anthropological approach. Three thematic categories emerged: 1) \"Being a mother in adolescence with symptoms of postpartum depression\"; 2) \"Breastfeeding in adolescence with symptoms of postpartum depression\"; 3) \"The network support: the breastfeeding and I.\" Pregnancy is considered undesirable in the context investigated, as it is seen as an impediment to give continuity to life. And this reflects negatively on breastfeeding, since there are difficulties to play maternal roles at this moment of life. Regarding breastfeeding, we observed that adolescent mother\'s knowledge is restricted to nutritional and immunological aspects, and the relational and building link aspects of breastfeeding practice are not considered. This thought is justified when observed how the participants feel in their cultural context, in which they deal with breastfeeding as a simple infant feeding practice. There is the idea that breast milk is weak, and the bottle is seen as an allied, since, as well as providing baby satiety feeling for longer, still prevents him to cry and bother, especially at night. Even during the day, the bottle avoids embarrassments when breastfeeding in public places and it can be offered by someone else. It is something that gives sense of freedom, causing the baby\'s independence from the mother. The woman has the greatest source of influence and support in her mother, while her partner remains distant to the reality of breastfeeding and the health professional provides specific guidelines in which disregards the life contexts in which the adolescents live. Internet is used in order to acquire knowledge, being considered vehicle of strong influence. Even with maternal support, the woman remains alone, struggling to talk about her real emotional situation and limitations to breastfeed. Thus, the social representations that support the breastfeeding practice, for these adolescents, bring with them the ambiguity of willing to give the best for your child - the breast milk, but also the will to be free and independent in life

O consumo de álcool durante a gestação tem sido associado na literatura científica a uma maior intensidade de sofrimento psiquiátrico durante a gestação e no pós-parto. Este estudo teve como objetivo principal verificar se o consumo de álcool em gestantes está relacionado a um aumento de sintomas depressivos e/ou ao diagnóstico de depressão no pós-parto. Para tal foi realizado um estudo prospectivo, com dois tempos de coleta de dados. Foram convidadas a participar gestantes da rede pública de saúde da cidade de Juiz de Fora/MG. Inicialmente foram entrevistadas 260 mulheres no terceiro trimestre gestacional, das quais 177 foram entrevistadas entre 15 dias a 3 meses após o parto. Para avaliação do uso de álcool durante a gestação foram utilizados os instrumentos T-ACE (Tolerance, Annoyed, Cut down, Eye opener) e AUDIT C (Alcohol Use Disorders Identification Test C), além do relato das gestantes sobre a quantidade de álcool ingerida durante toda a gestação. Para avaliação de sintomas depressivos no pós-parto foi utilizado o instrumento EPDS (Edinburgh Postnatal Depression Scale) e para o diagnóstico de Episódio Depressivo Maior foi utilizada a entrevista diagnóstica MINI (Mini International Neuropsychiatric Interview). Os resultados obtidos apontaram para um aumento de sintomas depressivos no pós-parto proporcional ao aumento do consumo de álcool durante a gestação medido pelo total do AUDIT C (Spearman Correlation, r=0,251; p<0,001) e pelo total em gramas de álcool consumido durante toda a gestação (Spearman Correlation, r=0,185; p=0,01). Além disso, foi observado uma maior prevalência de depressão pós-parto entre as mulheres que tiveram pelo menos um binge alcoólico durante a gestação (Non-parametric Chi-Square, value=88,28, p< 0,001). Os dados apresentados permitem concluir que existe um aumento de sintomatologia depressiva no pós-parto à medida que aumenta o consumo de álcool na gestação e aumento de diagnóstico para aquelas que tiveram pelo menos um binge alcoólico durante a gestação. / Alcohol consumption during pregnancy, according to the scientific literature, has been associated to a higher intensity of psychiatric problems during the gestational period as well in the postpartum period. This study aimed to verify whether alcohol consumption in pregnancy is related to an increase of depressive symptoms and/or the diagnosis of depression in the postpartum period. For this purpose a prospective study was carried out, with two phases of data collection. Pregnant women assisted by public health services of the city of Juiz de Fora /MG were invited to participate. Initially 260 women in the third gestational trimester have been interviewed. For the second phase 177 were interviewed between 15 days to three months after childbirth. To assess alcohol use during the gestational period the research instruments T-ACE (Tolerance, Annoyed, Cut down, Eye-opener) and AUDIT C (Alcohol Use Disorders Identification Test C) have been used, besides of direct reports of the pregnant women about the amount of alcohol ingested during all the gestation. To evaluate postpartum depressive symptoms the instrument EPDS (Edinburgh Postnatal Depression Scale) was used and to determine the presence of a diagnosis of Major Depressive Episode the diagnostic interview MINI (Mini International Neuropsychiatric Interview) was used. The results pointed out to an increase of postpartum depressive symptoms proportional to the increase of alcohol consumption during the gestation measured by the total score of the AUDIT C (Spearman Correlation, r=0,251; p<0,001) and by the total amount (in grams) of alcohol ingested during all the gestational period (Spearman Correlation, r=0,185; p=0,01). Further, a higher prevalence of postpartum depression was found among the pregnant women who reported at least once a binge episode during the gestational period (Nonparametric Chi-Square, value=88,28; p< 0,001). The presented data allow concluding about the occurrence of an increase of depressive symptoms in the postpartum period related to higher alcohol consumption in pregnancy as well an increase of diagnosis among those pregnant women who have had at least one binge episode during all the gestational period.

A large body of evidence has accumulated which indicates that infants of postpartum depressed mothers are at risk for negative sequelae including later psychopathology. However, methodological difficulties including discordant definitions of postpartum depression and the use of paradigms which used the mother-infant relationship to assess infant emotional expression and regulation have decreased the ability to reach a consensus regarding the nature and transmission of that risk. This study sought to address those methodological difficulties by employing an established paradigm designed to elicit emotionality in infants, the Laboratory Temperament Assessment Battery (Lab-TAB; Goldsmith & Rothbart, 1999). Participants were 30 women who met DSM-IV criteria for Major Depressive Disorder (MDD), 50 women who did not meet MDD criteria, and their 8-13 month old infants. The women were recruited from five counties within Iowa which contain both rural and urban centers. Consistent with state demographics the sample was predominantly Caucasian (76%). Mother-infant dyads were assessed approximately five months after the mother had completed a diagnostic interview. At that time six episodes from the Lab-TAB designed to elicit fear, anger, and positive affect were conducted. Emotional reactivity was coded used the AFFEX (Goldsmith & Rothbart, 1988) and composite scores were generated for each emotion. Infants of depressed mothers exhibited less intense pleasure to stimuli designed to elicit that emotion. There was also a slight, non-significant, trend for infants of depressed mothers to display more intense fear and to remain fearful longer. There was not a difference between the groups in anger expression. Emotional regulation was examined using a set of procedures set-forth by Buss and Goldsmith (1998) to determine effective regulation. These procedures involve calculating the change in affect from the coding epoch in which a "putative regulatory behavior" is displayed to the epoch immediately after the behavior. Change scores which involved no change in affect or a decrease in negative affect were considered effective regulation. Playing with clothing or an object and interacting with the stimulus were effective at regulating both fear and anger. In addition, averting gaze (disengaging with the task) was effective in regulating anger. Follow-up analysis revealed that infants of depressed mothers used gaze aversion more frequently than infants of nondepressed mothers. In addition, they were less likely to engage in social referencing (looking toward the mother) during episodes designed to elicit fear. The findings of this study are consistent with a growing body of evidence which documents the significance of considering low positive affect in examination of diagnosis and risk for depression and suggests that fear expression may be central to anxiety. Furthermore, results from the emotional regulation paradigms underscore the need for continued examination of the construct of "effective regulation." In addition, these results highlight disruptions in the mother-infant relationship which have implications for developing efficient regulatory mechanisms.

No description available.

This hermeneutic study explores the experience of well-being of eight new mothers who live in the Blue Mountains of N.S.W. The experiences were analysed to illuminate definitions, meanings and practices which create their well being. This study transcends existing notions of health and motherhood. The author argues that mothers resist the social expectations created by the 'ideology of motherhood' by; defining their well-being, redefining and resisting the notion of being the 'good mother' by creating practices to achieve their well-being. Social support is integral to this. The study is grounded in hermeneutics incorporating the Heideggerian ideas of being-in-the-world, co-constitution and the hermeneutic circle and also the Gadamerian idea of fusion of horizons. A post-structuralist feminist perspective is adopted, incorporating Foucault's ideas on power, knowledge, truth and resistance. Eight definitions of these new mothers' well-being are presented. Implications for nursing practice, education and research are discussed / Master of Nursing (Hons)

<p><p><strong>Bakgrund:</strong> 13 procent av alla kvinnor drabbas av postpartum depression (PPD) efter förlossningen. PPD påverkar inte bara modern som individ utan även barnet och resten av familjen. <strong>Syfte:</strong> Syftet med denna litteraturstudie var att belysa sjuksköterskans roll i omvårdnadsarbetet med familjer som drabbats av postpartum depression. <strong>Metod:</strong> Litteraturstudie. Databaserna Pubmed och Cinahl har använts i studien. Tre kvantitativa artiklar har använts och tolv kvalitativa. <strong>Resultat:</strong> Första mötet mellan sjuksköterskan och kvinnan med PPD har stor betydelse. Mödrarna känner sig trygga och vågar öppna sig mer om de har en bra relation med sjuksköterskan. Mödrarna anser att det är lättare att ta emot råd från en sjuksköterska de har god relation med. <strong>Diskussion/Slutsats:</strong> God kommunikation, information och kontinuitet bör förbättras i vården. Sjuksköterskorna behöver mer kunskap om PPD för att kunna ge familjerna bästa tänkbara vård. Har sjuksköterskorna god kunskap kommer även relationen med familjen att stärkas.</p></p>

Thesis (Ph. D.)--University of Rhode Island, 2005. / Typescript. Includes bibliographical references (leaves 89-99).

Postpartum depression is by definition a major depression with an onset during the first weeks after delivery. In practice, however, the term, postpartum depression is used to characterize all kinds of depressive symptoms after childbirth. The aims of this thesis were to investigate the prevalence of depressive symptoms during late pregnancy, in the puerperium and four years after delivery, and to analyze the mothers’ estimation of personal health and their children’s behavior at the age of four. Additional goals were to test the predictive power of potential associated factors of postpartum depression during pregnancy and the puerperium and finally, to elucidate possible genetic or neuropeptidergic explanatory variables behind the development of postpartum depression. A population-based sample of 1489 women was screened with the Edinburgh Postnatal Depression Scale and the prevalence of depressive symptoms was 17% in late pregnancy and 13% postpartum. Antenatal depressed mood was related to postpartum depression. In a cross-sectional study we later found that postpartum depression was associated with subsequent depressive symptoms and current health problems four years after childbirth. Four-year-old boys of postpartum depressed mothers and children of mothers with a subsequent depressive status had more behavior problems than children of non-symptomatic mothers did, according to the mothers’ opinion. The strongest associated factors for postpartum depression, in a case-control study, were sick leave during pregnancy mainly due to pregnancy complications, e.g. hyperemesis and premature contractions and a high number of visits to the antenatal care clinic. There was no association between delivery complications or complications in the perinatal period and postpartum depression. The theory that depressive symptoms in late pregnancy or postpartum are connected with CYP2D6 genotype could not be confirmed. In a rat model, we found that pregnancy and parturition influence the concentrations of neuropeptide Y, cholecystokinin, substance P and galanin in the rat brain. This result supports the hypothesis that neuropeptidergic systems in the brain influence the mood changes around childbirth. In conclusion, postpartum depression is a common feature with influence on both maternal and child well being. / Pages 26 and 57 containing illustrations are removed from the electronic version. On the day of the public defence the status of article IV was: Accepted for publication.

Motherhood is an ideal that is ostensibly valued and rewarded in American culture. It is no wonder, then, that a disease which threatens a woman’s ability to adequately fulfill her motherly duties receives a great deal of attention. My study aims to explore how ideas about postpartum depression (PPD) are presented in popular media through an examination of the messages and advice in PPD self-help books. Findings reveal that self-help authors make two significant assumptions: motherhood is a woman’s job that should bring happiness, and when mothers are not happy medical intervention in necessary. Through their gendered assumptions about parents’ roles and their insistence on a biological explanation for PPD, self-help authors prevent a healthy dialogue that examines patriarchal structures in the institutions of family and medicine. By focusing solely on the biological factors at play when women have babies, self-help authors alienate fathers, adoptive mothers, and foster parents who experience depression without biological origins. Only when PPD is discussed within the context of our social realities can we truly understand parenthood and depression.

Bakgrund: 13 procent av alla kvinnor drabbas av postpartum depression (PPD) efter förlossningen. PPD påverkar inte bara modern som individ utan även barnet och resten av familjen. Syfte: Syftet med denna litteraturstudie var att belysa sjuksköterskans roll i omvårdnadsarbetet med familjer som drabbats av postpartum depression. Metod: Litteraturstudie. Databaserna Pubmed och Cinahl har använts i studien. Tre kvantitativa artiklar har använts och tolv kvalitativa. Resultat: Första mötet mellan sjuksköterskan och kvinnan med PPD har stor betydelse. Mödrarna känner sig trygga och vågar öppna sig mer om de har en bra relation med sjuksköterskan. Mödrarna anser att det är lättare att ta emot råd från en sjuksköterska de har god relation med. Diskussion/Slutsats: God kommunikation, information och kontinuitet bör förbättras i vården. Sjuksköterskorna behöver mer kunskap om PPD för att kunna ge familjerna bästa tänkbara vård. Har sjuksköterskorna god kunskap kommer även relationen med familjen att stärkas.