Dosen : DR. Tambunan, M.

Hum

PAPER
POSTPARTUM BABY BLUES

Arranged by :

Shafira Nur Alhikma

P00312017040

MINISTRY OF HEALTH, REPUBLIC OF INDONESIA

POLYTECHNIC OF HEALTH, KEMENKES KENDARI

D-IV Midwifery PRODI

IN 2020
 TABLE OF CONTENTS

TABLE OF CONTENTS…………………………………………………………ii
CHAPTER I PRELIMINARY
1.1 Background.......................................................................................................1
1.2 Problem formulation...........................................................................................2
1.3 Purpose of writing..............................................................................................3
CHAPTER II DISCUSSION
2.1 Definition of post partum baby blues................................................................4
2.2 Etiology of post partum blues baby blues depression.........................................6
2.3 Classification of blues syndrome........................................................................7
2.4 Management of post partum blues baby blues depression..................................8
2.5 Prevention of post partum blues........................................................................9
CHAPTER III CLOSING
3.1 Conclusions......................................................................................................11
3.2 Suggestions......................................................................................................12
REFERENCES
 CHAPTER I

PRELIMINARY

1.1 Background
Pregnancy is a dramatic episode of the biological condition,
psychological changes and adaptations of a woman who has experienced
it. Most women consider that pregnancy is a natural event that must be
passed but some women consider it a special event that will determine the
next life. Complex physical and emotional changes require adaptation to
lifestyle adjustments to the pregnancy process that occurs. Conflicts
between the desire for procreation, the pride that arises from social cultural
norms and the problems in pregnancy itself can trigger various
psychological reactions, ranging from mild emotional reactions to severe
mental disorders.

Complex physical and emotional changes require adaptation to

lifestyle adjustments to the pregnancy process that occurs. Conflicts
between the desire for procreation, the pride that arises from social cultural
norms and the problems in pregnancy itself can trigger various
psychological reactions, ranging from mild emotional reactions to severe
mental disorders.

The puerperium is a period in which the body adjusts both

physically and psychologically to the process of giving birth which is
approximately 6 weeks. In addition, the understanding of the puerperium
is the period of labor to begin with the recovery of tools and limbs related
 to pregnancy / childbirth (Ahmad Ramli, 1989). From the two meanings
above, the group concluded that the childbirth period is the period from
the completion of labor until the recovery of uterine and limb kits and
psychosocial related to pregnancy / childbirth for 6 weeks. In the process
of adaptation during the postpartum period there are three methods which
include "immediate puerperineum" ie the first 24 hours after giving birth,
"early puerperineum" ie after 24 hours to 1 week, and "late puerperineum"
that is after one week to 6 weeks postpartum.

One of the causes of depression from biological factors is

postpartum depression. Iskandar (2007) explains that postpartum
depression occurs because of a lack of support for the adjustments needed
by women in facing their new activities and roles as mothers after giving
birth. Postpartum depression is a psychological problem after childbirth
such as the emergence of anxiety, feeling lability and depression in the
mother.

Hormonal changes and changes in the lives of mothers after

childbirth can also be considered triggers of this depression. It is estimated
that about 50-70% of women give birth to early symptoms of postpartum
depression, however these symptoms can disappear slowly due to the
process of adaptation and proper family support.

1.2 Problem formulation

1. What is meant by post partum blues baby blues depression?
2. What are the causes of post partum blues baby blues depression?
3. What are the post partum blues baby blues depression classifications?
4. How is the management of post partum blues baby blues depression?
5. How to prevent post partum blues baby blues depression?
1.3 Purpose of writing
1. To know the meaning of post partum blues baby blues depression
2. To find out the etiology of post partum blues baby blues depression
3. To know the classification of post partum blues baby blues depression
4. To find out the management of post partum blues baby blues
depression
5. To find out the prevention of post partum blues baby blues depression
 CHAPTER II

DISCUSSION

2.1 Definition of post partum baby blues

Post partum is the period after childbirth can also be called the
puerperium (puerperium), which is the period after childbirth that is
needed to recover the uterus that lasts 6 weeks. Post partum is a period of
6 weeks from the baby's birth until the reproductive organs return to
normality before becoming pregnant (Bobak, 2010).

So it can be concluded that the postpartum or post partum period is

the period after the birth of the baby pervagina and ends after the uterine
uterus returned to normal without complications.

Baby Blues Syndrome is the stress or stress experienced by a

woman after giving birth because she thinks that the presence of a baby
will interfere with or damage things in her life such as career, beauty /
appearance and routine activities that are considered important in her life.
Baby blue syndrome sufferers are mostly among career women, artists,
models and modern women, but this syndrome does not rule out the
possibility of attacking young women (early marriage) and all women after
childbirth. Changes in negative attitudes with poorly controlled emotional
conditions such as frequent anger, quickly offended, and away from
newborns, insomnia and often cry often. If this is not immediately dealt
with a negative impact on mental health sufferers. This syndrome
generally occurs in the first 14 days after giving birth, and tends to get
worse around the third day or four after delivery.

Hadi (2004), stated simply that depression is a painful experience,

a feeling of hopelessness.
 Lewellyn-Jones (1994), states that women who are diagnosed
clinically in the postpartum period experience depression in the first 3
months after giving birth. Women who suffer from postpartum depression
are those who socially and emotionally feel alienated or easily tense in
every event of their lives.

Post-partum blues (PPB) or often also called maternity blues or

baby blues is defined as a mild affective disorder syndrome that often
appears in the first week after delivery or during the taking-in phase, tends
to worsen on the third to fifth day and lasts in the range 14 days or two
weeks postpartum.

Baby blues are situations in which a mother experiences feelings of

discomfort (sadness or moodiness) / mood disorders after childbirth, which
are related to her relationship with the baby, or even with herself.

Post partum blues is depression that occurs after childbirth (post

partum). Mothers who have just given birth are usually expected to feel
very happy after giving birth. But because of the large hormonal changes
during childbirth and the challenges of caring for babies, around two-
thirds of women feel sad. About 10 to 15% suffer from clinical depression.
And about 1 in 1000 becomes so depressed that they need to be
hospitalized for their safety and the safety of their babies.

This post-partum blues is categorized as a mild mental disorder

syndrome, therefore it is often ignored so that it is not diagnosed and not
treated as it should, eventually it can become a problem that is difficult,
unpleasant and can make feelings uncomfortable for women who
experience it, and sometimes even this disorder can develop into a more
severe condition namely depression and post-saline psychosis, which has a
worse impact, especially in matters of marital relations with her husband
and child development, because stress and the attitude of an insincere
 mother constantly can make babies grow into children who cry easily, tend
to be fussy, anxious, moody and easily hurt.

2.2 Etiology of post partum blues baby blues depression

The etiology or exact cause of postpartum blues is unknown.
However, many factors are thought to contribute to the occurrence of
postpartum blues, including:

1. Hormonal factors associated with changes in estrogen, progesterone,

prolactin and estradiol levels. Decreased estrogen levels after
childbirth is very influential in postpartum emotional disorders
because estrogen has the effect of suppressing the activity of the
enzyme monoamine oxidase, a brain enzyme that works to activate
adrenaline and serotonin which play a role in mood changes and
depressive events.
2. Demographic factors namely age and parity.
3. Mother's psychosocial background, such as; level of education, marital
status, unwanted pregnancy, history of previous psychiatric disorders,
socioeconomic and adequacy of social support from the environment
(husband, family and friends).
4. Fear of losing the baby or disappointed with the baby.
However, there are some opinions that say that Post partum blues is
not related to hormonal changes, biochemical or nutritional
deficiencies. Between 8% and 12% of women cannot adjust their
parental roles and become so depressed that they seek doctor's help. In
other words, women are more likely to develop post partum
depression if they are socially and emotionally isolated and have just
experienced a life-threatening event.
5. Mother is not ready to face labor
6. Physical discomfort experienced by women causes disturbances in
maternal psychology such as swelling in the breast that causes pain or
stitches that have not healed
 7. Marital dysfunction or inability to build relationships with others, feel
isolated
8. Medical problems in pregnancy (PIH, diabetes mellitus, thyroid
dysfunction)
9. Experience in the process of childbirth and pregnancy that is traumatic
(such as cesaria section, and epistomy)
10. birth of a child with a disability / disease
11. A history of depression, mental illness and alcoholism (people who
have a background in mental disorders and have been psychologically
troubled before becoming pregnant, are at high risk of experiencing
post partum blues. The risk is biased 2-3 times more than those who
do not have the background of the problem. Even women who are not
at risk, if there is a problem at the time of delivery, can increase the
incidence of the United Nations.Mothers who give birth by surgery
because of pregnancy poisoning such as preeclampsia, can be at risk
of UN.
12. Personal character (self-esteem, immaturity)
13. Stress in the family, for example: Economic factors deteriorate,
problems with the husband, problems with in-laws. stress experienced
by women themselves such as breastfeeding does not come out,
frustrated because the baby does not want to sleep, stress seeing the
baby sick, feeling bored with life lived.

2.3 Classification of blues syndrome

a. Mild: post partum blues or often maternity blues or new mothers'
syndrome is defined as a disorder of the effects that often appear in
the first week after childbirth marked by symptoms: symptoms of
depression or sad reaction (dysporia), often crying, irritable, anxiety,
feeling lability.
b. Severe: major depression is known as non-psychotic depression
syndrome in pregnancy but generally occurs within a few weeks to
 months after birth. Symptoms of major depression: changes in mood,
disturbance in sleep patterns, mental changes and libido, can also
appear phobias, fears, self or baby hurt, severe depression will have a
high risk for women or families who have experienced psychiatric
disorders or have experiencing premenstrual syndrome. The
possibility of recurrence in subsequent pregnancies.

Management of major depression: family support and the

environment, psychological therapy from psychiatrists and psychologists,
collaboration with doctors for anti-depressants (giving depressants need to
be considered in pregnant and breastfeeding women), patients with
attempted suicide should not be left alone at home, if needed do treatment
in the hospital, not recommended for rooming or care to join with her
baby.

2.4 Management of post partum blues baby blues depression

Post-partum blues or post-copy mental disorders are often
overlooked and not handled properly. Many mothers who 'struggle' on
their own in a few moments after giving birth. They feel there is
something wrong but they themselves do not really know what is
happening.

The handling of post-copy mental disorders in principle is no

different from the handling of mental disorders at other moments. Mothers
who experience post-partum blues need real help. These mothers need real
help. These mothers need psychological support as well as other physical
needs that must also be met. They need the opportunity to express their
thoughts and feelings from frightening situations. They may also need
treatment and / or rest, and often will feel happy to get practical help. With
the help of friends and family, they may need to organize or reorganize
daily routine activities, or maybe eliminate some activities, adjusted to
their concept of motherhood and baby care. If necessary, help can be given
 from experts, for example from a psychologist or counselor who is
experienced in the field.

Post-partum blues can also be reduced by calm learning by taking a

deep breath and meditation, sleeping when the baby is sleeping, exercising
lightly, sincerely and sincerely with a new role as a mother, not
perfectionist in terms of caring for the baby, discussing anxiety and
communicating it, being flexible , join a group of new mothers. In
handling mothers who experience post-partum blues a holistic / holistic
approach is needed. Medical treatment, emotional counseling, practical
assistance and intellectual understanding of their experiences and
expectations may be at certain times. Broadly speaking, it can be said that
handling is needed at the level of behavior, emotional, intellectual, social
and psychological together, by involving the environment, namely:
husband, family and also close friends.

2.5 Prevention of post partum blues

1. Good self preparation

good self preparation at pregnancy is very necessary so that at

birth have good self confidence and reduce the risk of post partum
depression. Activities that can be done by mothers are reading articles
or books that are related to birth, taking prenatal classes, joining
pregnancy exercise groups. Mothers can get a lot of information
needed so that at the time of birth the mother is ready in a traumatic
event which may be surprisingly avoidable.

2. Exercise and adequate nutrition

With exercise can maintain the condition and stamina so that it

can make the state of emotion also better. Good nutrition, both food
and drink intake is very important in the post partum period. Try to
get a balance between these two things.
3. Mental support and the environment

mental support is very necessary in the post partum period.

This support is not only from the husband but from family, friends and
the environment. If you want to tell your emotions, express emotions
and life changes experienced to someone you can trust to be a good
fan. Post partum mothers must have faith that the environment will be
supportive and always ready to help if experiencing difficulties. This
will make the mother feel better and reduce the risk of post partum
depression.

4. Express what was received

Post partum mothers do not bury their own feelings. If you

have a problem, you should immediately discuss it with your closest
friends. Health workers can help mothers to express feelings and
mothers to be more comfortable.

5. Looking for information about post partum depression

The information about post partum depression that we can

provide will be beneficial to mothers - triggering factors so that they
can anticipate or seek help if they need the condition. You also have to
improve this situation by compiling the sdar against this condition and
will get help to move it. Gathering with people who have experienced
postpartum depression can help get information about changes and
real things that are experienced.

6. Avoiding drastic life changes

that is, a drastic change in life after birth will affect the
emotional of the mother so as much as possible should be avoided
such as moving jobs, moving to a new home. Live with fairness like
before giving birth
7. Do housework

such as cooking, cleaning the house, caring for plants and

other household chores that can help forget the emotional upheavals
that arise in the post partum period. When the mother's condition is
still unstable, it can be acted on by doing household chores. You can
ask for support from family and the environment, even if you have a
housemaid, you can do the activity.
 CHAPTER III

CLOSING

3.1 Conclusions
Baby Blues Syndrome is the pressure or stress experienced by a
woman after childbirth because sufferers assume that the presence of a
baby will interfere with or damage things in her life such as career,
beauty / appearance and routine activities that are considered important in
her life. Patients with baby blue syndrome are mostly among career
women, artists, models and modern women, but this syndrome does not
rule out the possibility of attacking young women (early marriage) and all
women after childbirth. Changes in negative attitudes with emotional
conditions that are less controlled, such as frequent anger, quickly
offended, and away from newborns, insomnia and often cry often. If this is
not immediately dealt with a negative impact on mental health sufferers.
This syndrome generally occurs within the first 14 days after giving birth,
and tends to get worse around the third or fourth day after delivery.

3.2 Suggestions
It is hoped that this paper can increase students' knowledge in
providing Nursing services as well as providing their needs in daily life.
And for health practitioners to be able to improve health services in the
field of nursing so as to maximize us to provide health education in the
treatment of postpartum blues depression.
 REFERENCES

Bobak, Lowdermilk, Jensen. (2004). Textbook: Nursing Maternity 4th edition.

Jakarta: EGC.

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Askep Postpartum Blues. http://agussutionopathy.blogspot.com/2008/05/bab-i-t
overview-pustaka-konsep-dasar.html. accessed on 09 January 2011

Posted by zietraelmart in Postpartum Blues. 2008. Tags: Midwifery

Psychology.http:
//zietraelmart.multiply.com/journal/item/8/POST_PARTUM_BLUES. accessed
on 09 January 2011

Marilyn E. Doenges, 1999, Nursing Care Plans, Careers Translator I Made,

Jakarta: EGC.