Mental disturbances and diseases after childbirth

After childbirth, from about a quarter up to nearly one half of all puerperae develop a short-lasting, mild affective distress, the so called blues. During the first months after delivery, about 10-15 % of all young mothers suffer from a longstanding depression which is so severe that they are in need of treatment. In one or two out of 1000 women even a psychotic disorder becomes manifest. These postpartal disturbances and diseases are often not diagnosed by doctors-on the one hand because the women concerned often hide their complaints due to shame and a sense guilt regarding their supposed failure as a good mother, on the other hand because these syndromes until now have not found enough attention in German-as opposed to Angloamerican medicine. Yet, these disorders-apart from the blues-are very serious ones with potentially severe consequences for the mother, the baby and possibly the whole family. Women with mental disorders in their family history and especially their own history are at an increased risk. They should be informed about this and, in certain cases, be treated preventively. Women with depressive and psychotic disorders are, especially in the postpartal time, in urgent need of treatment which, depending on type and severity of the disorder, should consist of psychotherapy, frequently also pharmacotherapy, and social care. Special needs of the postpartal period such as breast-feeding or the mother-infant relationship have to be considered which often requires close cooperation of the psychiatrist/psychotherapist, the gynaecologist and the pediatrician.