Postpartum depression: hormonal or social causes?

In the postpartum period, thousands of women experience a state of sadness and discouragement that, depending on the period in which it manifests itself and its intensity, is considered a mild disorder or a form of depression that, in the rarest cases, can be transformed in a risky psychotic state for the life of the woman and that of the newborn.

According to estimates, in Italy every year about 70% of women who carry out a pregnancy suffers from a mild and transient mood disorder - known as baby blues -, while between 8% and 15% suffer from depression postpartum and 1% post-partum psychosis .

When hormones seem to be the only culprits

Most of the literature on the subject states that the causes of this type of disorder are not entirely clear, but the tendency is to attribute it to hormonal changes, an undoubtedly important aspect, especially with regard to the transient baby blues syndrome experienced in the days following the birth. However, when the problem is prolonged and intensified, biologizing explanations are not enough.

On the website of the Ministry of Health it is stated that " the woman feels sad for no reason, irritable, easy to cry, not up to the commitments that await her. Furthermore, a recurring feeling among new mothers, who have to face this problem, is shame mixed with guilt ”.

But do women really feel sad "for no reason" after giving birth? A vision of this type, in addition to bringing to mind the sexist stereotypes related to the "irrationality" of the female gender, obscures the factors that can be decisive in the onset of the problem.

Dealing with post-natal depression with yoga

The social factors of postpartum depression

If we try to remember or imagine what happens in a woman's life from the moment of childbirth, various elements emerge that contribute to causing this type of depression.

In the first place, childbirth, a source of anxiety and fear, is an extremely medicalized moment in life, the modalities of which have been progressively removed from women's freedom of decision-making.

Above all , prenatal hospitalization and cesarean delivery can be traumatic experiences, so much so that they are recognized as risk factors in the "adverse reproductive aspects" category, together with the unwanted pregnancy, nulliparous or primiparous, spontaneous or induced abortion, previous mortality and coincident medical problems (Cognitive investigation "To be born safe", 2012: 97).

After giving birth, a woman's lifestyle can undergo profound transformations , complicit in the precariousness of the world of work, the system of maternity leave and the lack of a solid welfare state . In our country, moreover, the task of caring for others and the home environment still falls on women, placing us in last place in Europe as regards gender equality in the use of time (Istat data).

In addition to this division of roles that already exists in the life of a childless couple, there is an increase in the amount of domestic work carried out by women with the arrival of a child. Thus, the time to devote to professional projects, to interpersonal relationships, to well-being and to one's own person, diminishes and, with it, self-esteem.

At the same time, husbands and companions continue to do the paid work they had before becoming a father, reducing the time they could devote to the paternal role.

If the situation experienced by new mothers is similar to the one described above - and in Italy in most cases - it seems out of place to say that new mothers are sad "for no reason" and attribute to hormonal imbalances any causal relationship with post depression -partum.

We should start to think, instead, that this problem depends to a large extent on the conditions in which the woman finds herself in the puerperium period, which are determined not only by personal choices, but also and above all by the social system and the type of differential social mandate assigned to the two genders that make it difficult to reconcile family and professional life .

Where are the solutions

The causes and risk factors of postpartum depression do not reduce to the hormonal aspect, but have deeper roots that include the characteristics of the current medical system and gender roles .

Therefore the solutions must not be sought only in curative medicine which, through pharmacological treatments, can generate a series of negative consequences such as the interruption of breastfeeding, but rather in the reduction of the vulnerability of women to this type of depression .

The ways to follow must be situated both in the field of health policies, through the promotion of a demedicalized, active and sweet birth; both in the field of equality policies that give impetus to shared parenting through paternity leave, flexible working hours, the creation of nests in the workplace, the possibility of working from home, the strengthening of family support networks and professional.