May is Mental Health Awareness Month. One of the main goals of this month of awareness is to shed light on how common mental health struggles are in the general population, as well as for mothers. Since I am a mother and I work with mothers (and their children), maternal mental health is especially close to my heart. It is an ongoing mission of mine to break the cycle of stigma and shame surrounding maternal mental health struggles, by continuing to bring awareness and acceptance through education.
According to The American College of Obstetricians and Gynecologists (ACOG), perinatal mood disorders, such as anxiety and depression, are among the most common complications that occur during pregnancy, or within the first 12 months after delivery. They go on to say, “Despite the negative effects on maternal, obstetric, birth, offspring, partner, and family outcomes, perinatal mental health disorders often remain underdiagnosed, and untreated or under-treated.”
I certainly struggled with postpartum anxiety; more so with my first pregnancy. I was a new mom who’d just been pregnant and given birth during a pandemic. I also struggled with some pregnancy complications with each of my girls. Even though my anxiety was understandable given my circumstances, it still was a heavy load to carry. Luckily throughout both of my pregnancies and postpartum experiences, I had a lot of support from family, friends and wonderful healthcare professionals. However this is not the case for some moms. Unfortunately, too many moms struggle silently.
Fortunately, there is a growing amount of resources available to mothers. The problem is that most mothers don’t know where to start because they either don’t know they have a problem, or they feel too overwhelmed to seek information and help. I’ll break down some of the common mental health conditions that mothers face during pregnancy and postpartum (up to 12 months after delivery), as well as where to get started for help.
Perinatal Mental Health Conditions
Baby Blues
Having the baby blues is a common and temporary experience right after childbirth when a new mother may have “sudden mood swings, [feel] very happy, then very sad, or cry for no apparent reason.” This condition occurs in up to 85% of women within the first week after delivery, peaks three to five days after delivery, and usually resolves 10-12 days postpartum. Symptoms may include “dysphoric mood, crying, mood lability, anxiety, sleeplessness, loss of appetite, and irritability.”
The baby blues typically resolves on its own. It is recommended that the mother focus on good nutrition and sleep for herself (as much as possible) and accept help from family and friends those first two weeks while she is adjusting.
Depression
Perinatal depression is a common condition that one in seven women have experienced during pregnancy, or within a year of giving birth. These depressive episodes most often occur within the first three months postpartum. However, these episodes can begin during pregnancy, after weaning the baby (from breastfeeding) or when the menstrual cycle resumes. Risk factors include a personal or family history of depression/postpartum depression, fetal/newborn loss, lack of personal/community resources, history of substance use/addiction, complications of pregnancy, stress (relationship stress, labor/delivery, infant’s health), unplanned pregnancy, domestic violence/abusive relationship, and Adverse Childhood Experiences (ACEs).
Symptoms of depression can last for two weeks to up to a year or longer. Symptoms may include, “change[s] in appetite, sleep, energy, motivation, and concentration.” A mother may experience negative thinking including “guilt, hopelessness, helplessness, and worthlessness.” In more severe cases, she may also experience suicidal thoughts or thoughts of harming baby. Treatment options include psychotherapy and medication. Mothers are encouraged to focus on self-care (sleep, exercise, nutrition) and to seek and accept social support/help from family and friends, as well as their healthcare provider.
Anxiety
Perinatal anxiety is a common condition experienced during pregnancy, or within a year of giving birth. Anxiety most often occurs in the first six weeks postpartum. However, like depression these episodes can begin during pregnancy, after weaning the baby (from breastfeeding) or when the menstrual cycle resumes. Risk factors include a personal or family history of anxiety, major life changes, lack of support, stress (related to a difficult pregnancy/birth, or health challenges for mom/baby), prior pregnancy loss and Adverse childhood experiences (ACEs).
Symptoms of anxiety can last from weeks to months, or longer. Symptoms may include, “panic attacks, shortness of breath, rapid pulse, dizziness, chest or stomach pains, fear of detachment/doom, fear of going crazy or dying.” Others may have intrusive thoughts, fear of going out of the house, checking (OCD) behaviors, increased bodily tension, or sleep disturbance. Treatment options include psychotherapy and medication. Mothers are encouraged to focus on self-care (sleep, exercise, nutrition) and seek and accept social support/help from family and friends.
Additional possible conditions
Other perinatal mental health conditions that I did not discuss include bipolar disorder, schizophrenia, psychosis, personality disorders, post traumatic stress disorder, and obsessive-compulsive disorder. You can find more information about these conditions in the Perinatal Mental Health Toolkit listed in the resources.
If a mother suspects she is dealing with a perinatal mood disorder, she should seek help from her healthcare provider. Most mothers have access to their OB-GYN up to six weeks after giving birth. If they do not have access to a healthcare provider after that time, they can seek help from their child’s healthcare provider. The first step would be proper screening, followed by initiation of a treatment plan.
If a mother ever feels the immediate need to talk to someone and she does not have proper support in place already, she can call the National Maternal Mental Health Hotline (24/7 support) at (833) 852-6262 or the Postpartum Support International Helpline at (800) 944-4773. If a mother feels that she is in crisis, she can text 988 (24/7 support) for immediate emotional support.
Please note that if a mother ever feels that she is in imminent danger of harming herself or her child, she should seek immediate care at the closest hospital offering emergency care.
In an age where we have more general awareness than ever, as well as more information at our fingertips, it saddens me to think about how many moms are still struggling silently in this area. If you are currently pregnant or postpartum and struggling with your mental health, I hope this gives you some encouragement that you are not alone, and that there is help available.
If someone close to you is pregnant or postpartum, I hope this encourages you to check in on them and offer your support. Anxiety and depression can range from debilitating to highly functional. There are likely some women in your life who may be struggling but you won’t know it unless you ask.
All parents need to feel loved, supported and encouraged, especially in the weeks and months after becoming a new parent. I hope this month serves an opportunity for the lines of communication to open even further. As we collectively start and continue having open conversations around this important topic, true progress can be made toward awareness and acceptance, which is the first step in the healing process.
Resources:
ACOG Perinatal Mental Health Toolkit
