Postpartum Dönemde Psikolojik Değişiklikler ve Uyum
Özet
Annelik, anne-bebek ilişkisinin gelişimini de içeren önemli bir psikolojik değişim dönemidir. Doğumu takip eden zaman olarak tanımlanan doğum sonrası (postpartum) dönem, yalnızca fiziksel bir değişim dönemi değil, aynı zamanda kadınların anne olarak yeni rollerine uyum sağlarken duygusal ve psikolojik düzenlemeler yaşadıkları bir dönemdir. Bu bölümün temel amacı doğum sonu dönemdeki psikolojik değişiklikleri ve uyumu ele almaktır. Bu kapsamda öncelikli olarak gebelik sonrasında meydana gelen ve psikolojik sağlıkla ilişkili olan beyin yapısındaki değişiklikler, doğum sonrası dönemdeki hormonal adaptasyonlar, duygusal, bilişsel, psikolojik değişimler, bu dönemde başarılı müdahalelerin önemi ve etkileri tartışılacaktır.
Motherhood is a period of significant psychological changes, including the development of the mother-infant relationship. The perinatal period can be a challenging period for women as well as a pleasant one. The postpartum period, defined as the time following the birth, is a critical stage in a woman's life that requires attention and care due to the significant physiological and psychological changes that occur during this period. The postpartum period is not only a period of physical recovery, but also a time of emotional and psychological adjustment as women adapt to their new role as mothers. The main aim of this chapter is to address psychological changes and adaptation in postpartum period. In this regard, first, the changes in brain structure that occur after pregnancy that are related to psychological health, hormonal adaptations in the postpartum period, emotional, cognitive and psychological changes will be emphasized. Then, the importance and effects of successful interventions in this period will be discussed.
Referanslar
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Barba-Müller E, Craddock S, Carmona S, Hoekzema E. Brain plasticity in pregnancy and the postpartum period: Links to maternal caregiving and mental health. Archives Women’s Mental Health. 2019; 22(2):289–299. doi: org/10.1007/s00737-018-0889-z.
Aleknavičiūtė J, Evans T, Aribas E, Vries M, Steegers E, Ikram M, Kushner S. Long-term association of pregnancy and maternal brain structure: The Rotterdam study. European Journal of Epidemiology. 2022; 37(3):271–281. doi: org/10.1007/s10654-021-00812-6.
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Ainsworth MDS, Blehar MC, Waters E, & Wall S. Patterns of Attachment: A Psychological Study of the Strange Situation. Mahwah, NJ: Erlbaum; 1978.
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Referanslar
Bornstein MH. Parenting infants. In: Bornstein MH, editor. Handbook of parenting. Mahwah, NJ: Erlbaum; 2002. p. 3–43.
Barba-Müller E, Craddock S, Carmona S, Hoekzema E. Brain plasticity in pregnancy and the postpartum period: Links to maternal caregiving and mental health. Archives Women’s Mental Health. 2019; 22(2):289–299. doi: org/10.1007/s00737-018-0889-z.
Aleknavičiūtė J, Evans T, Aribas E, Vries M, Steegers E, Ikram M, Kushner S. Long-term association of pregnancy and maternal brain structure: The Rotterdam study. European Journal of Epidemiology. 2022; 37(3):271–281. doi: org/10.1007/s10654-021-00812-6.
Hillerer K, Jacobs V, Fischer T, Aigner L. The maternal brain: An organ with peripartal plasticity. Neural Plasticity. 2014;1–20. doi: org/10.1155/2014/574159.
Hoekzema E, Barba-Müller E, Pozzobon C, Picado M, Lucco F, García-García D, Vilarroya Ó. Pregnancy leads to long-lasting changes in human brain structure. Nature Neuroscience. 2016; 20(2):287–296. doi: org/10.1038/nn.4458.
Kim P, Leckman JF, Mayes LC, Feldman R, Wang X, Swain JE. The plasticity of human maternal brain: Longitudinal changes in brain anatomy during the early postpartum period. Behavioral Neuroscience. 2010; 124(5):695–700. doi: org/10.1037/a0020884.
Swain JE, Lorberbaum JP, Kose S, Strathearn L. Brain basis of early parent-infant interactions: Psychology, physiology, and in vivo functional neuroimaging studies. Journal of Child Psychology and Psychiatry. 2007; 48(3-4):262–287. doi: org/10.1111/j.1469-7610.2007.01731.x.
Lange AM, Barth C, Kaufmann T, Anatürk M, Suri S, Ebmeier KP, Westlye LT. The maternal brain: Region-specific patterns of brain aging are traceable decades after childbirth. Human Brain Mapping. 2020; 41(18):4718–4729. doi: org/10.1002/hbm.25152.
Kim P. Human maternal brain plasticity: Adaptation to parenting. New Directions in Child and Adolescent Development. 2016; 153:47–58. doi: org/10.1002/cad.20168.
Oancea M, Strilciuc Ș, Borza DB, Ciortea R, Diculescu D, Mihu D. Neurobiological and behavioral underpinnings of perinatal mood and anxiety disorders (PMADs): A selective narrative review. Jorunal of Clinical Medicine. 2024; 13(7):2088. doi: org/10.3390/jcm13072088.
Rajhans P, Goin-Kochel RP, Strathearn L, Kim S. It takes two! Exploring sex differences in parenting neurobiology and behaviour. Journal of Neuroendocrinology. 2019;31(9). doi:10.1111/jne.12721.
Feldman R, & Bakermans-Kranenburg MJ. Oxytocin: a parenting hormone. Current Opinion in Psychology. 2017;15:13–18. doi: org/10.1016/j.copsyc.2017.02.011.
Strathearn L. Maternal neglect: Oxytocin, dopamine and the neurobiology of attachment. Journal of Neuroendocrinology. 2011;23(11):1054-1065. doi: org/10.1111/j.1365-2826.2011.02228.x.
Walter MH, Abele H, & Plappert CF. The role of oxytocin and the effect of stress during childbirth: Neurobiological basics and implications for mother and child. Frontiers in Endocrinology. 2021;12. doi: org/10.3389/fendo.2021.742236.
Modak A, Ronghe V, & Gomase KP. The psychological benefits of breastfeeding: Fostering maternal well-being and child development. Cureus. 2023;15(10) doi: org/10.7759/cureus.46730.
Larsen CM, & Grattan DR. Prolactin-induced mitogenesis in the subventricular zone of the maternal brain during early pregnancy is essential for normal postpartum behavioral responses in the mother. Endocrinology. 2010;151(8):3805-3814. doi: org/10.1210/en.2009-1385.
Glynn L, Davis E, Sandman C, & Goldberg W. Gestational hormone profiles predict human maternal behavior at 1-year postpartum. Hormones and Behavior. 2016;85:19-25. doi: org/10.1016/j.yhbeh.2016.07.002.
Bridges RS. Neuroendocrine regulation of maternal behavior. Frontiers in Neuroendocrinology. 2015; 36:178-196. doi: org/10.1016/j.yfrne.2014.11.007.
Bos P. The endocrinology of human caregiving and its intergenerational transmission. Development and Psychopathology. 2017;29(3):971-999. doi: org/10.1017/s0954579416000973.
Dubber S, Reck C, Müller M, & Gawlik S. Postpartum bonding: The role of perinatal depression, anxiety, and maternal-fetal bonding during pregnancy. Archives of Women's Mental Health. 2015;18(2):187–195. doi: org/10.1007/s00737-014-0445-4.
Bowlby J. Attachment. Attachment and loss: Vol. 1. Loss. New York, NY: Basic Books; 1969.
Bowlby J. Attachment, communication, and the therapeutic process. In A Secure Base: Parent-Child Attachment and Healthy Human Development (pp. 137-157). New York, NY: Basic Books; 1988.
Ainsworth MDS, Blehar MC, Waters E, & Wall S. Patterns of Attachment: A Psychological Study of the Strange Situation. Mahwah, NJ: Erlbaum; 1978.
Sümer N. Ana babalık ve bağlanma In: Sayıl M & Yagmurlu B. (Ed.). Ana babalık: Kuram ve araştırma. İstanbul: Koç Üniversitesi Yayınları; 2012. p. 169-190.
Hairston IS, Handelzalts JE, Assis C, Kovo M. Postpartum bonding difficulties and adult attachment styles: The mediating role of postpartum depression and childbirth-related PTSD. Infant Mental Health Jorunal. 2018;39(2):198-208. doi:10.1002/imhj.21695.
Mercer R. Becoming a mother versus maternal role attainment. Journal of Nursing Scholarship. 2004; 36(3):226–232. doi.org/10.1111/j.1547-5069.2004.04042.x.
Shorey S, Ng E, Downe S. Cultural competence and experiences of maternity health care providers on care for migrant women: a qualitative meta‐synthesis. Birth. 2021; 48(4):458–469. doi.org/10.1111/birt.12581.
Mercer R, Walker L. A review of nursing interventions to foster becoming a mother. Journal of Obstetric, Gynecologic & Neonatal Nursing. 2006; 35(5):568–582. doi.org/10.1111/j.1552-6909.2006.00080.x.
Shin H, Park Y, Kim MJ. Predictors of maternal sensitivity during the early postpartum period. Journal of Advance Nursing. 2006; 55(4):425–434. doi.org/10.1111/j.1365-2648.2006.03943.x.
Nordahl D, Rognmo K, Bohne A, Landsem IP, Moe V, Wang CEA, Høifødt RS. Adult attachment style and maternal-infant bonding: the indirect path of parenting stress. BMC Psychology. 2020; 8(1). doi:10.1186/s40359-020-00424-2.
Ahmad A. Postpartum depression: A comprehensive review. International Journal of Clinical Images and Medical Reviews 2022; 2(3). doi.org/10.55920/ijcimr.2022.02.001071.
Radoš NS, Tadinac M, Herman R. Anxiety during pregnancy and postpartum: course, predictors and comorbidity with postpartum depression. Acta Clinica Croatica. 2018; 57(1):39–51. doi.org/10.20471/acc.2017.56.04.05.
Ayers S, Eagle AL, Waring H. The effects of childbirth-related post-traumatic stress disorder on women and their relationships: A qualitative study. Psychology, Health & Medicine. 2006; 11(4):389–398. doi.org/10.1080/13548500600708497.
O'Hara MW. Postpartum depression: What we know. Journal of Clinical Psycholology. 2009; 65(12):1258–1269. doi.org/10.1002/jclp.20644.
O'Hara MW, McCabe JE. Postpartum depression: Current status and future directions. Annual Reviews of Clinical Psychology. 2013; 9:379–407. doi.org/10.1146/annurev-clinpsy-050212-185612.
Sharma V, Mazmanian D. The DSM-5 peripartum specifier: prospects and pitfalls. Archieves of Womens Mental Health. 2014; 17:171–173.
Om Suryawanshi I, Pajai S. A comprehensive review on postpartum depression. Cureus. 2022; 14(12). doi.org/10.7759/cureus.32420.
World Health Organization. The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. Vol 1. World Health Organization; 1992.
Vliegen N, Casalin S, Luyten P. The course of postpartum depression: a review of longitudinal studies. Harvard Review of Psychiatry. 2014; 22:1–22. doi.org/10.1097/HRP.0000000000000013.
Özcan NK, Boyacıoğlu NE, Dinç H. Postpartum depression prevalence and risk factors in Turkey: a systematic review and meta-analysis. Archieves of Psychiatric Nursing. 2017; 31(4):420–428.
Zheng J, Sun K, Aili S, Yang X, Gao L. Predictors of postpartum depression among Chinese mothers and fathers in the early postnatal period: A cross-sectional study. Midwifery. 2022; 105:103233.
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