The majority of women and men are excited about being parents. However, many cou­ples are not prepared for the many physical and emotional changes that occur after the child is born. They may also find changes in their sex lives because of the responsibility and exhaustion that often accompanies parenthood.

More Physical Changes for the Mother

Many women report painful contractions for a few days after birth. These contractions are caused by the secretion of oxytocin, which is produced when a woman breast-feeds and is responsible for the shrinking of the uterus. The uterus returns to its original size about 6 weeks postpartum: in breast-feeding women, the uterus returns to its original size quicker than in non-breast-feeding women. A bloody discharge persists for a week or so after delivery. It soon turns yellow-white and lasts for 10 days in mothers who breast-feed and up to a month or so in women who do not.

Women may experience an increase in frequency of urination, which can be painful if an episiotomy was performed or natural tearing occurred. Women may be advised to take sitz baths, in which the vagina and perineum are soaked in warm water to reduce the pain and to quicken the healing process. Until the cervix returns to its closed posi­tion, full baths are generally not advised.

Postpartum Psychological Changes

Although the majority of women feel excitement after the birth of a baby, many also feel exhausted. Minor sadness is a common complication of childbearing (Howard et al., 2005). However, for some, it is a very difficult time with endless crying spells, and anx­iety. In severe cases, this is referred to as postpartum depression. Physical exhaustion, physiological changes, and an increased responsibility of child rearing all contribute to these feelings, coupled with postpartum hormonal changes (including a sudden drop in progesterone). Partner support has been found to decrease postpartum depression (Misri et al., 2000). Men have also been found to experience some degree of postpartum de­pression after the birth of a baby. In the most severe cases, mental disturbances, called postpartum psychosis, occur; and, in rare cases, women have killed or neglected their babies after delivery.

Some ethnic and racial differences have been found in the rates of postpartum de­pression, with African American and Hispanic mothers reporting more postpartum de­pression than white mothers (Howell et al., 2005; see Figure 12.6). Although the major­ity of studies on postpartum depression have studied only heterosexual mothers, newer studies are beginning to evaluate the frequency of postpartum depression in lesbian moth­ers. Reduced social support and homophobia may put lesbian mothers more at risk for de­pression, although the planning of pregnancy and shared responsibilities may offer some protection in lesbian couples (Ross, 2005). More research is needed in this area.


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postpartum depression

A woman’s clinical depression that occurs after childbirth.

postpartum psychosis

The rare occurrence of severe, debilitating de­pression or psychotic symptoms in the mother after childbirth.



Describe the physical and emotional changes that women experience after the birth of a child.


Figure 12.6

In one study of 655 U. S. women, African American and Hispanic women more commonly reported postpartum depressive symptoms than white women. Rates of postpartum depression remained higher for both African American and Hispanic women after controlling for factors such as history of depression, social support, household management, and infant behavior.

Source: Howell et al., 2005.


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