Postpartum Mental Health
You’re having a baby! How wonderful! This is, for many families, an exciting time in their life. Bassinettes are picked out, names are decided on, and car seats are installed. Maybe you take a birthing class. You are prepared. What often gets overlooked, is that having a baby is also an incredibly fragile moment in a birthing person’s mental health and wellbeing.
There are a number of compounding reasons why this might be a critical mental health season in someone’s life. While there can be a tremendous amount of joy in having a baby, we can’t ignore the fact that this is a massive change. You’re now thrown into transition and, even when they are wanted, transition is hard. You’re having to navigate your identity and way of being in this new life as well as the responsibility for another person’s needs. Additionally, a birthing person has gone through radical body changes both hormonally and physically (I’m sure you have all seen the ways that a pregnant person’s grey matter literally decreases during pregnancy? If not, go check it out, it’s fascinating.). Furthermore, postpartum, you’re in a situation where you’re getting little sleep which impacts everything. In the time of covid (and even before, let’s be real), there’s also huge potential for isolation of new mothers. Any one of these situations can put your wellness at risk, taken together it creates an incredibly fragile situation. (This is all before we even touch on birth trauma and the impact that that can have on wellbeing).
Given the fragility, it’s important that we acknowledge what can happen during this time. There are a number of issues that can arise including postpartum depression, postpartum anxiety, and postpartum psychosis, but there are also a number of things that can come up that don’t meet criteria for a diagnosis, yet have tremendous impact. 50-85% of birthing people experience some level of mood disturbance following the birth of their child. According the Massachusetts General Hospital Center for Women’s Mental Health, before ever meeting criteria for a postpartum psychiatric disorder, the most common symptoms reported are mood lability, tearfulness, anxiety or irritability and symptoms typically peak on the fourth or fifth day after delivery and may last for a few hours or a few days, remitting spontaneously within two weeks of delivery. While, with so many birthing people experiencing this, it can almost be considered a typical part of the postpartum experience, and it may not require specific treatment, birthing parents still need support during this time.
So what is supportive? What is protective against various postpartum mental health challenges? First, check in with your postpartum friends and loved ones. Not just the baby- them. Ask how they are doing and ACTUALLY BE WILLING TO HEAR THE ANSWER. Do not brush off their experience with a half-hearted “welcome to parenthood”. Empathize with and validate their experience. There was once a quote around postpartum depression that suggested that the biggest predictor of postpartum depression was the number of hands that held the baby in the first year of life. Now, don’t just go and hold someone’s baby without asking, but do recognize that this speaks to the need for community. Offer concrete support- meals, taking care of pets, watching other children, etc, in the immediate postpartum time.
Sometimes, these common symptoms do not resolve, and sometimes they rise to the level of a diagnosable illness. What happens can you do in that situation? First, while doing all of the things listed above, work to reassure your loved one that they are NOT a bad parent. Help them to understand that they are deserving of support and connection. Offer to connect them to maternal mental health specialists (there are plenty of therapists out there who specialize specifically on postpartum depression, anxiety, and psychosis). And, as always, if the situation has become unsafe (less common but still), call 911 or go to your local emergency room.
We live in a society that is deeply unsupportive to mothers. The things listed in this blog are very real and also very challenging. If you’re interested in how you can further support postpartum maternal mental health, advocate for systemic change. Advocate for paid parental leave. Advocate for increased access to mental health care. Advocate for increased screening for the parent postpartum rather than just the six week postnatal visit. Advocate for diversified treatment teams including doctors, midwives, doulas (especially postpartum doulas), lactation consultants, and social workers as the norm to work with families during the postpartum period. This will be the most impactful thing you can do long-term to change the postpartum experience for birthing parents everywhere.