Mood Disorders in the Puerperium and the Role of the Midwife: Study on Improvement of Midwives’ Knowledge About Post-Natal Depression After an Educational Intervention

Family, not only in terms of cohabitation of two adults, but in term of intragenerational symbiosys, is formed with the birth of a child (Musek, 1995). Pregnancy and birth are one of the major transitions in the life of a family members; they can promote family’s evolution (Nastran Ule, 1993) however if they represent adaptational stress that family members are unable to cope with, can have harmful effect, resulting in the mental crisis of individuals (Zavrl, 1999); especially the mother. Being a mother nowadays is harder that ever before. Parenthood must be squeezed in the rifts between the strata of social life policy, economy, industry, trade ect. and parenthood is considered of low value in comparison with those cathegories. Child represents some sort of private luxury. Women, often professionally engaged, therefore expect the task of motherhood in a strategic spirit – they carefully plan the pregnancy, are determined to deal with the motherhood succesfully and to return as soon as possible into the ‘normal state’, this is life as before the pregnancy (Kitzinger, 1994; Gatrell, 2005). As they became aware that parenthood is a life style and that child affect all aspects of their life that is going to change forever, they can be surprised, or even feel traped. This feelings, beside the newborn care that can be stressful because of repetitive and monotonous everyday activities, can provoke in women feelings of loss – loss of professional identity, previous lifestyle, autonomy ect. (Mauthner, 1999; Beck C.T., 1995a). Because of high (and sometimes unrealistic) expectations that they developed in pregnancy for themselves as mothers, they can suffer the feelings of guilt and inadequacy because they failed to become ‘perfect mother’ and have ‘innapropriate’ feelings towards the child. They must realize that the perfect mother does not exist (Kitzinger, 1994); it is just an arteficial product of the society, created by the ilusions of the media with the reminders of praised traditional role of women. Self-esteem and self-confidence are exposed to severe stress during postpartum. A lot of women pass this transition unharmed, but some of them can not cope mentally with all the changes; they can respond with feelings of dissapointment, anger, guilt or even depression. It is ironic that family, social institution, primary constructed for reproduction, is at most at strike just with the birth of the child (Welburn, 1980).