May is maternal mental health awareness month. This topic is both professionally and personally relevant to my own life, as it is for many of the clients I work with and many mothers, mothers to be, or mothers in waiting.
There is still a narrative in our society that motherhood is magical, natural, and the most amazing time of one’s life. The story told to us is instant connection and instant happiness, but the reality for as many as 1 in 5, is that it is difficult, a mix of emotions, and a lot of guilt and shame. This becomes compounded by a lack of support families have.
I’m sharing because the reality of motherhood needs to be talked about. This is for the women out there struggling to understand why this isn’t the magical experience we are told it is supposed to be.
What Is Maternal Mental Health?
Mental health conditions occurring while trying to conceive, during pregnancy, and in the postpartum period (up to 1–2 years after birth)
- These are different from other mental health conditions because of the vulnerable time and unique changes that occur simultaneously— hormonal shifts, identity changes, sleep deprivation, social pressure, and lack of the village.
- It can also affect fathers and non-birthing parents
The Full Spectrum of Conditions
- Baby blues — Common, affecting 80% of parents, short-lived, lasting no more than 2 weeks postpartum, dissipating on its own, and distinct from clinical conditions
- Postpartum depression (PPD) — Occurs in 1-5 mothers and 1-10 fathers. Sadness and/or irritability, lack of interest in the baby, sleep and appetite changes, episodes of crying, loss of interest in joyful activities, potential thoughts of harm to self or baby.
- Perinatal anxiety — Equally as common as PPD, often combined with PPD. Near constant worry that is difficult to manage, on edge/unable to relax, irritable, racing thoughts, believing something bad is going to happen.
- Postpartum OCD — Repetitive, unwanted, intrusive thoughts (obsessions) and irrational, excessive urges to do certain actions (compulsions). These obsessions and compulsions often center around the health and safety of the pregnancy and/or baby
- Postpartum PTSD — Pregnancy complications, unplanned C-sections, use of devices to deliver the baby, baby going to NICU, feelings of powerlessness and/or lack of support and reassurance during the delivery, severe physical complications or injury related to pregnancy or childbirth.
- Postpartum Bipolar Disorder — 50% of women who are first diagnosed are done so in the postpartum period. Elevated mood followed by depressive episodes, grandiosity, irritability, impulsive behaviors, potential hallucinations/delusions, decreased need for sleep, poor judgement, and rapid speech.
- Postpartum psychosis — Rare but serious, occurring in 1 to 2 per 100 births; seeing or hearing things others don’t, rapid mood swings, paranoia, decreased need for sleep, delusions-strange beliefs. Requires immediate treatment.
- National Maternal Mental Health Hotline: 1-833-943-5746
Who Is Most at Risk?
- Those who have a history of depression, anxiety, bipolar or trauma
- Lack of social support
- Experiencing a difficult or traumatic birth experience
- Having a baby in the NICU, experienced a miscarriage or infant loss, or pregnancy complications
- Financial stress, relationship strain
- Marginalized communities are disproportionately affected due to systemic barriers, racism, and healthcare inequity
Why So Many Women Suffer in Silence
- Stigma: fear of being seen as a “bad mother” or CPS being called because of intrusive thoughts.
- Pressure to feel grateful and happy
- Dismissal by healthcare providers who still don’t understand or know what to look for in pregnant and new parents
- Lack of universal screening- because of the lack of information many practices still don’t screen at the recommended intervals
- Cultural and language barriers can prevent some women from asking for help.
How to Recognize the Signs
- In yourself: persistent sadness, rage, numbness, intrusive thoughts, inability to bond with baby, panic attacks, inability or difficulty caring for self or baby, thoughts of self harm or harm to baby.
- In someone you love: withdrawal, not eating/sleeping, expressions of hopelessness, saying things like “everyone would be better off without me”
- Be aware of how you and your partner may be feeling and coping with this change. If you just don’t feel like yourself it’s ok to ask questions and seek help.
How to Get Help
- Talk to your OB, midwife, or primary provider
- Postpartum Support International (PSI) helpline and provider directory
- Therapy options: CBT, IPT, and other evidence-based approaches
- Medication: There are safe options to take while trying to conceive, pregnant, and breastfeeding. If your provider tells you otherwise then they have old information. Don’t be intimidated to ask your doctor for medication interventions.
- Peer support groups — Nature’s Playhouse or Honey. Mental Health for in-person options and PSI for and online
- Here at Together We Thrive Wellness Dr. Kopp leads the team in caring for parents in this fragile stage. Dr. Kopp is also training Nicole Sifuentes to work with these families.
7. How Partners, Family & Friends Can Help
If you’re in the supporting role to a pregnant, new mom, or mom who has lost a baby; there are important ways you can support her and the family
- Believe her — don’t minimize or rationalize her feelings
- Take over tasks without being asked, cook a meal, clean the house, take their dog for a walk. If you don’t have the time yourself, send the family dinner or gift cards for meals, or pay for a cleaning service once/month.
- Help connect her to care, take the hard part off of her hands by offering to make the appointment with a mental health provider or find her support groups to attend
- Watch for warning signs and show care when expressing how you can help
- Take care of your own mental health too
8. What Needs to Change Systemically
We know that women are often overlooked in healthcare, without systemic changes women and families will continue to be the ones who suffer.
- Universal screening at all perinatal appointments
- Extending postpartum coverage beyond 6 weeks
- More social services for families and paid leave
- Addressing racial disparities in maternal care
- Investing in maternal mental health research and workforce
Recovery is possible — Motherhood is manageable. You are not alone, you are not a bad mother, and you deserve support. Together we will help you find your way back to yourself and your baby. If you know someone who could use this information: share this post on Instagram, or facebook, check on a new mom and share these resources with them, or reach out for help today
Ready to take your next step?
Here at Together We Thrive Wellness we know what it is like to go through this phase. We have therapists that understand the struggle and know how to help you get through it. Complete the Contact Form, give us a call at 248-220-7199, or email us at Hello@togetherwethrivewellnness.com
