Lifestyle Choices

Birthmarks

It would be logical if all birthmarks were present at birth. This is not always the case. Some marks appear in the first few days of life but others can be delayed by months or years. In these cases it is thought that the fault resides in the skin from birth but only reveals itself when some other factor acts as a trigger. An example of this is the unusual problem called Becker’s nevus. It has the appearance, usually on the shoulder, of a large light brown patch, often with some coarse dark hair in it. It is first seen at puberty and is triggered by rising hormone levels. Salmon patches or stork bites derive their name from the old fable about babies being delivered down the chimney by a friendly stork whose beak has clasped the human bundle by the nape of the neck. These marks are seen in about a quarter of the population. Sometimes they are thought to have appeared in adult life but it is only that some new hair style or hair disease has revealed a patch that has really been present since birth. (more…)

Stress during labour

Childbirth can be a time of intimacy, excitement, wonder and openness. It can also be a time of fear and pain, sometimes in a place that is forbidding and lacking in warmth. There may be all kinds of left-over feelings, which are usually repressed. First of all, the birth hurts you — it is quite natural for some women to be angry about this. Secondly, you may resent the way your delivery was handled. Unfortunately, the case history above is not an isolated example. I have heard of so many similar and worse cases that it sometimes makes me feel ashamed of my profession as a doctor. The resentment is usually related to lack of consultation on decisions. Medical interventions are sometimes carried out (for instance, routine episiotomies, injections to speed up the birth of the placenta) without any explanation of side-effects. If the side-effects occur, the natural reaction is anger, but this is often repressed, with the explanation that the doctor knows what is best. It is this attitude of the patient handing over authority to the doctor and the doctor taking assumed authority over another’s life that may lead to later feelings of resentment. Some women have told me they felt like a nonentity, going through a process that was designed by the hospital to maximize speed and efficiency. Others have told me that it felt like being taken over by machines and fingers. The residue of resentment may go very deep and is usually repressed, with a resultant depression of spirits in general. (more…)

Depression is very common in a mother after the birth of her child. Some mothers notice depression only at this time and at no other time in their lives. The reasons why depression is so much more common soon after giving birth are bothcomplex and conjectural, but can be conveniently divided into two groups: physical stress and emotional/psychological stress. Depression after childbirth generally takes one of three forms: maternity blues, postnatal depression, or post-natal psychosis.

These usually start two or three days after birth. You may quite suddenly get weepy and irritable, and then just as suddenly, you are out of them. They are very common and do not usually lead on to any longer-lasting depression.

This occurs after about 10 per cent of births. It may start soon after birth or it may start after an initial few weeks of happiness and high spirits. It is a common experience to feel more emotionally vulnerable for four to six weeks after giving birth —you feel more open and sensitive to everything. This period of greater openness is often remembered with pleasure, but sometimes, after four to six weeks, the physical and emotional demands of looking after a child twenty-four hours a day begin to get a mother down, and you may feel grey and exhausted for many months or even a year or more. A minority of mothers will go into a more severe depressive process which occasionally lasts years. (more…)