Maternal Mental Health: Why It Matters

Have you ever thought about postpartum care? In the first year, a baby will see his or her pediatrician six times for regular checkups, and in the second year, five times. A new mother sees her physician once at six weeks and then as needed.

In recent years, we have seen a shift in care for mothers during pregnancy and the postpartum period. The American College of Obstetricians and Gynecologists (ACOG) has been updating its standards of care regarding mental health during this time.

So, what can we do as patients to help ourselves get the best care?

One of the important things to do is to educate ourselves on which mental health symptoms are normal and which might require medical attention.

It is completely normal for new mothers (first-timers and experienced moms) to feel overwhelmed, tired, tearful, irritable and temperamental. Some call this combination of emotions the “baby blues.” These feelings can be the result of a physical shift in hormones right after the delivery of your baby. The baby blues typically arise within the first days of birth and can last for up to two to three weeks, and usually resolve with little or no intervention.

Recognizing the Symptoms of Postpartum Depression

The more commonly discussed mental health concern during pregnancy and in the postpartum period is postpartum depression (PPD). It has similar symptoms to the baby blues but typically starts after two to three weeks.

It also has other symptoms, including: low excitement about the baby, difficultly bonding, feeling burdened by tasks, and the inability to sleep when the baby sleeps. The biggest indication is trouble caring for yourself and your baby.

PPD is fairly common, and is experienced by approximately 10 percent of pregnant/postpartum women. The ACOG stresses the importance of screening for perinatal depression and recommends that OB/GYNs screen patients for the condition once during pregnancy, once at the six-week postpartum visit and throughout pregnancy if symptoms are present or if there is a history of depression and/or anxiety.

One of the main problems with screening is that many times, moms see their symptoms as normal, and that they just need to “suck it up.” Many mothers feel that because what they’re feeling may be normal, it is not worth disclosing. There is also the stigma that comes with mental health and that disclosing you are struggling can make you feel like a failure as a parent. Remember that PPD or any other mental health symptom does not mean you are a failure or a bad parent!

Now that we have educated ourselves on symptoms, what else can we do?

Coping with and Treating PPD

First, speak up! While doctors are skilled at picking up on subtle problems, they’re not mind readers. Anxiety and depression symptoms can be masked well, and often go unrecognized because in lesser forms, they may be perceived as typical. New parents, for example, often sleep less and have decreased appetite, a lack of libido, etc.

If you feel like you are struggling with anxiety or depression, share what you’re feeling with your doctor. Talk with your provider (OB/GYN or primary care physician) about your symptoms so they can determine if your feelings are simply new mom angst or something more serious.

Another important factor is to trust yourself. You know if something is off. You know what does or does not feel OK. As a new mom myself, I would cry or feel overwhelmed in the first few weeks, but at no point did I ever feel like something was wrong. If you feel this way, reach out and create a plan with your doctor.

Next, research different prenatal and postpartum options. Before pregnancy, I had never heard of pelvic floor physical therapy, perinatal mental health therapists or lactation consultants. These are providers who specialize in women’s health and are so important during and after pregnancy. Think of them as your team; the more skills you learn from them, the more prepared you’ll be to address any potential issues.

Lastly, be open to different options. There are many ways to get back to being yourself. We can sometimes be resistant to medication, therapy or peer support. But your doctor has many different resources that they can offer to you. It may not be one that you think will work for you but try to be open-minded to all of them. That said, don’t forget to always be your own advocate.