a. Possible causes of postpartum “blues” are:

• hormonal changes that occur during the postpartal period;
• the emotional stresses associated with increased responsibilities of an infant and restrictions imposed by caring for an infant;
• ego adjustment that accompanies role transition from wife and childless person to mother; and
• the discomfort, fatigue, and exhaustion that may contribute or cause the condition.

b. Common manifestations experienced by the mother are let-down feeling (for no apparent reason, so the mother thinks), irritability, tears, loss of appetite, and difficulty sleeping.

c. Associated feelings experienced by the mother, secondary to her depression are:

(1) Guilt about her unaccustomed emotional displays (does not know why she is crying and identifies, “the tears just come”).

(2) Loss of control over herself and over lack of the ability to care for herself.

(3) Feelings of failure as a mother, wife, or any other role of her involvement.

d. Nursing care responsibilities for postpartal “blues” patients.

(1) Recognize and interpret the mother’s behavior on an individual basis. Not all women act the same way during childbirth and not all women will react to childbirth in the same way. There may be underlying things influencing the mother’s behavior that may not be apparent.

(2) Allow the mother to cry as she wishes. Provide privacy for her. Let her know there is nothing wrong with her behavior. Crying may even be therapeutic.

(3) Convey to the mother that change takes time. This is the single most important concept to convey to the mother. She may not be able to do everything she wants as soon as she and her baby go home. It may take weeks or even months before she is able to make the transition to caring for her baby, her family, her home, and herself. It is okay not to accomplish everything immediately.

(4) Be understanding. Understanding and anticipatory guidance help the parents realize these feelings are a normal accompaniment to this role transition.