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Maternal mental health is one of the most important health conditions of pregnancy, but often takes a back seat to the baby’s needs. As new moms we talk so much about our new babies in detail— from what they eat to how they sleep and cry and poop. But we rarely talk about how WE are feeling. We don’t ask new moms often enough— how are you?
Giving birth is an emotional time for new moms. As such, we’re frequently told that experiencing a rollercoaster of emotions during and after pregnancy is ‘normal,’ but it rarely feels ‘normal.’ And it turns out, it’s impossible to even define what’s normal, only what’s normal for you.
“I wish I had been prepared to understand that the window for postpartum mental health challenges doesn’t fit neatly into a few weeks or months after birth.”
Tory Fairies, new mom in San Francisco
The gist of postpartum mental health
The postpartum period can be confusing, challenging, and scary— supporting maternal mental health is critical to supporting healthy babies. The more we talk about mental health post-pregnancy, the more we can normalize that there are a boat-load of new feelings we’re all feeling. Some larger than others. But no matter the size, these feelings ARE normal, it’s the honest, raw conversation that needs to be.
How common are maternal mental health issues?
Individual stories about mental and emotional challenges are often assumed to be the minority experience, but the data shows otherwise:
- Baby Blues: 80% of all new mothers experience a brief but noticeable wave of sadness within few days or a few weeks after giving birth, known as the baby blues.
- Mental Health: Half of all new mothers experience regret, shame, guilt or anger, mostly due to unexpected complications and lack of support.
- PPD: Nearly 1 in 7 experience postpartum depression & 50% of PPD cases in new moms go undiagnosed.
- Postpartum anxiety: More than 15% of pregnant and postpartum women are affected by anxiety and related disorders.
Understanding the challenges of postpartum depression
Jane Van Dis, OBGYN and medical advisor for Bobbie, believes more openness around maternal mental health is needed to ensure women receive appropriate support. “When someone asks me what the #1 complication of pregnancy is, I say, maternal depression, anxiety and mood disorders.”
How is it, though, that something that affects so many women is often unscreened, untreated and ignored? There are multiple factors:
- Stigma: There is the fear that society equates mental health problems with bad parenting. Only 10% of men and women get the care they need.
- Societal norms: Focus on the baby often means a new mother’s health conditions are ignored by herself, her family, and her support network.
- Lack of follow up: Up to 40% of women don’t go to their postpartum check up.
Supporting moms also benefits their babies
The American College of Obstetricians and Gynecologists recommends that postpartum care should be an ongoing process. Many experts believe that women should be screened at least once during prenatal and postnatal care. These screenings are now the law in California. When we discuss maternal mental health we often focus solely on postpartum depression but anxiety and psychosis are also essential to diagnose and treat.
Q&A with Jennifer Bronsnick, LCSW, from The Mindful Family
We sat down with Jennifer Bronsnick, a Certified Mental Health Integrative Medicine Practitioner to discuss postpartum depression, maternal self care and what we can do going forward.
Maternal mental health does not always fall into neat categories of black and white diagnoses, but rather shades of grey. What advice do you have for those new moms who feel something is just a little off?
Jennifer: If you don’t feel good, tell somebody. Let someone know, your best friend, your doctor, or call Postpartum Support International (free hot-line 1-800-944-4773). Struggling is an inevitable part of new parenthood but suffering is different. Don’t suffer. If you’re crying all the time, feel worthless, feel your baby would be better off without you— these are dangerous thoughts and require help. If it’s longer than two weeks, it might be a bigger issue.
Postpartum depression often gets a lot of attention but postpartum anxiety can be a real challenge for many parents. Can you explain symptoms and treatment options?
Jennifer: The symptoms could be feeling worried, nauseous, panic, not wanting to leave the house, or persistent scary thoughts. My approach is cognitive behavior, exposure therapy (getting active), psycho-education (why it exists and how the brain works), because I find that once you understand why your body is reacting in the way it is, it’s easier to accept and move forward. There is not just one form of treatment, everyone is unique.
There are so many types of therapists and therapy these days (even text!), how can someone find what’s right for them?
Jennifer: Psychology Today is a great website and many therapists list their practices there. Do an advanced search of where you can find a therapist that takes your insurance and has a particular specialty.
Self-care tips for new moms:
- Dig in: Look at the subtle factors for good health.
- Me time: Be intentional about finding ways to take care of yourself.
- Talk: Find a professional to share your symptoms.
- Nutrition: Take a magnesium supplement and make sure you’re eating well.
- Peers: Build a support network, whether it’s online or in-person.
Resources from Jennifer Bronsnick:
Baby Blues After Pregnancy, March of Dimes
Perinatal anxiety disorder prevalence and incidence,Journal of Affective Disorders
Optimizing Postpartum Care, American College of Obstetricians and Gynecologists
Screening for Perinatal Depression, American College of Obstetricians and Gynecologists
Obstetric hospitalists can screen for postpartum depression, MDedge ObGyn
Motherhood Is Hard to Get Wrong. So Why Do So Many Moms Feel So Bad About Themselves?
Suicide risk among perinatal women who report thoughts of self-harm on depression screens
Depression Among Women, Center for Disease Control & Prevention
Postpartum Support International