Question: My wife just came home from the hospital after delivering our first child. She seems overwhelmed. What can I do to help?

Answer: Your desire to be of assistance is commendable. She will need all the help she can get as she tries to adjust to the physical and emotional changes of the postpartum period.

I'll share some things I think will be of value as you go about trying to help, but this is not a comprehensive list. If you are a good listener, your wife will tell you what her needs are.

The most significant thing you will notice is your wife's fatigue. She will simply not have the same energy levels as before. Fatigue is a result of the physical exertion of delivery, anemia from delivery-related blood loss and the stress of dealing with the complex emotions associated with childbirth.

Medical problems, such as hypothyroidism and depression, are also more common in the postpartum period and can be a cause for fatigue as well.

It will be great if you can make yourself available to perform household tasks and assist with the care of the baby while your wife gets back on her feet. If she is nursing the baby, her sleep will be interrupted every few hours for feedings. Therefore, she will not rest as comfortably or as much as she is used to.

I recommend you try to take care of as many things as possible around the house, such as meal preparation, cleaning chores and outside errands, so she can concentrate on taking care of just herself and the baby.

Your wife will have a fair amount of pain during the next week or two. This is due to "afterpains" as the uterus contracts and shrinks to its former size. Afterpains are usually strongest when a woman breastfeeds, although they are not as severe with the first baby as with the second.

She may also have pain associated with an episiotomy or other areas that were sutured by the doctor following delivery. Make sure she has adequate pain relievers and takes them regularly. Sometimes women feel as if they shouldn't take any medication, especially if they are breastfeeding. The medications that her doctor prescribes will be safe, however, so she shouldn't worry about that.

You should be on the watch for any medical complications. These include fever, excessive bleeding, pain that is not relieved with medication, or fainting. If any of these things occur notify your wife's doctor.

It's normal following delivery for a woman to experience a psychological reaction known as the postpartum blues. Signs of this are a low mood, weeping, restlessness, confusion, forgetfulness, anxiety, insomnia and negative feelings toward the baby.

About 70 percent of women experience postpartum blues. You will need to be supportive and give lots of encouragement as she goes through this period. Fortunately, the symptoms are usually mild and are gone within a few weeks of delivery.

If your wife experiences significant depression to the point of not being able to function properly, she may have more than postpartum blues. She may have postpartum depression, a condition that affects about 10 percent of new mothers.

Symptoms include extreme feelings of worthlessness, a sense of failure as a mother, unusual eating or sleeping patterns (too little or too much), thoughts of suicide, a fear of leaving the baby alone or severe confusion.

Women are more vulnerable to postpartum depression if there is a family history of depression, if they have been depressed in the past (such as following a previous delivery), if there is a lack of support with child care, if marital discord is present, if financial problems exist, if pregnancy complications occurred, if the baby is having medical problems or if the pregnancy is unwanted.

Postpartum depression is fairly common and easily treated, so don't be shy about notifying her doctor if these symptoms occur.

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Undoubtedly, the most important thing you can do for the next week or so is be available to help. If you aren't able to be there, perhaps a sister or mother can fill in.

Your help will make your wife's recovery easier and will provide a nice foundation upon which to build your new family life.


Stephen Lamb practices OB/GYN at the Millcreek Women's Center in Salt Lake City. He is also the co-author of "Between Husband and Wife."

E-MAIL: slamb@desnews.com

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