Caring for Your Mental Health During Postpartum

LCSW

Introduction

Becoming a parent is life changing. Parenthood has been the most overwhelming, joyful gift, and also incredibly difficult, stretching me to learn and grow in ways I didn’t think possible. Recognizing the wide range of emotions and experiences during this transformational time is vital.

Not only are parents going through a major identity shift, there’s also a big adjustment in exploring how to best use your energy and attention to care for your child(ren) while caring for yourself and nourishing your other relationships. For many, there are unexpected challenges that arise during pregnancy, birth and the postpartum time. Some of these challenges might be infertility, pregnancy loss, a hard pregnancy, or a traumatic birth experience, that stir up complex emotions, including grief, loneliness, depression and anxiety. And yet, even when things may go according to plan, still the most uncomplicated and empowering experiences can be disruptive and create mental health impacts that require additional care and support.

This blog will be a part of a series on perinatal mental health, in which we will explore common themes of the perinatal period for parents, impacts on mental health, and when extra care and assistance may be recommended. Perinatal is the time frame surrounding birth, from conception through the first year after giving birth. The postpartum, or postnatal, period includes the first year following pregnancy.

Mental Health Considerations:

According to the Maternal Mental Health Leadership Alliance (MMHLA), “mental health conditions are the most common complication of pregnancy and childbirth, affecting at least 1 in 5 mothers or childbearing people.” Non-birthing partners, including fathers, partners and adoptive parents, can also experience mood changes or mental health conditions with pregnancy and parenting. In fact, research shows that up to 10% of new fathers will experience postpartum depression or anxiety.

Perinatal Mental Health (PMH) conditions can occur during pregnancy and up to one year following pregnancy, impacting both the mother or childbearing person and non-birthing partners. PMH conditions range from baby blues, depression, anxiety disorders, and obsessive-compulsive disorder to posttraumatic stress disorder, bipolar disorder, substance use disorder, and even psychosis. Common symptoms may include overwhelming sadness, feelings of hopelessness, excessive worry and rumination, feelings of being overwhelmed, lack of interest in the baby, and extreme changes in appetite, sleep and concentration. It is common to feel sad, anxious, hopeless or irritable in the first 2 weeks postpartum, considering the dramatic hormonal swings and physical changes that come with childbirth. However, if these feelings persist or intensify beyond two weeks, it is important to discuss with your care team as extra support may be needed.

While there has been increasing attention given to the perinatal mental health experience and concerns for parents, there are still many barriers to accessing and receiving adequate support and care. Some of these barriers may include feelings of guilt and shame for needing help, the cost of care, logistical challenges, distrust of the system, and fear of judgment on parenting. Alarmingly, most individuals (75%) impacted by PMH conditions do not receive the care they need for recovery, which increases the risk of negative impacts on families. Specifically, according to MMHLA, “individuals of color and individuals who live in low income neighborhoods are more likely to experience maternal mental health conditions and less likely to be able to access care.”

The Postpartum Period:

The first 3 months following birth, also known as the Fourth Trimester, is a much-needed time of rest, recovery, and transition for parents. While every mother’s pregnancy and postpartum experience is unique, the postpartum period is often one of intense physical changes and emotional disequilibrium. It is impacted and predicted by many factors including, but not limited to, pre-existing mental health conditions, family history, socioeconomic status, race, military service, and social support.

Many bio-psycho-social factors, such as significant hormonal changes, shifts in roles and responsibilities, or heightened stress, contribute to mental health conditions in the postpartum period. Specifically, becoming a parent during the COVID-19 pandemic added an extra layer of unease, uncertainty and isolation for many parents. Even more, external factors, such as limited or unpaid parental leave, the cost of childcare, lack of provisions in the workplace, expectations on mothers in the workplace, and various systemic pressures and barriers, can increase the strain on mental health and add to feelings of overwhelm.

While there is a wide range of what’s possible, normalizing the changes and challenges that come with the postpartum period is key to getting the support needed to move forward and even experience the joy of parenthood. Below are some examples of ways to support and care for your mental health after the birth of a child.

Coping strategies and support options for the postpartum period:

Self-care:
Let’s be honest, it’s hard to imagine seeing beyond the intense sleep deprivation that is a major reality for parents of infants, especially in the first few weeks and months. While basic self-care may seem out of reach, prioritizing adequate sleep, balanced nutrition, time outside, time to recharge, and gentle movement is essential for physical and emotional recovery. Even small steps to promoting self-care, such as a daily shower or simple stretching, can have a positive impact on mood and overall well-being. Once cleared by a medical provider, regular exercise can be especially helpful in alleviating stress during this time.
Community & Social support:
They say it takes a village to raise a child. I believe it also takes a village to raise a parent! Connecting with others and leaning into your support system of family, friends, neighbors or a faith community is essential for parents and is shown to reduce feelings of isolation and increase coping during such an intense time. This support may look like encouragement or an empathetic ear, companionship, information sharing or guidance, or tangible, such as preparing meals or running errands.

Social support can also include participating in support groups or receiving care from doulas. Support groups are a common way to create connection, receive reassurance and normalize experiences. There are a wide offering of support groups through Postpartum Support International or Beyond the Baby Blues. Postpartum doula’s also provide emotional and physical support after the birthing process. Chicago Volunteer Doulas, for example, provides access to free and low-cost postpartum care and assistance up to 12 weeks postpartum, which includes support such as newborn care, baby soothing and bonding methods, breastfeeding support, caring for the baby while parent(s) sleep, or light housekeeping.
Talk Therapy:
Support from a trained mental health professional can provide a safe, non-judgmental space to talk and feel through the challenges of the postpartum period and help with symptom relief. Specifically, approaches such as interpersonal therapy can be effective in addressing grief and loss, role transitions, and relationship changes and challenges that arise postpartum. Exploring destructive thought patterns and self-talk is also beneficial in reducing feelings of distress. Mindfulness-based interventions, such as cultivating awareness, journaling and a gratitude practice, are also shown to be helpful and can also allow for further processing and foster connection with oneself.
Somatic Therapy:
Also referred to as somatic experiencing therapy, somatic therapy can be another powerful tool in your arsenal of support during your postpartum recovery journey. This type of therapy focuses on connecting your mind to your body through modalities such as dance, breathwork and meditation to learn how to regulate your nervous system and release stress, tension and trauma from the body. This approach can be helpful in processing the intense experiences that come with pregnancy, childbirth and the postpartum period.
Medication:
At times, medication is needed to support mental health conditions in the postpartum period. Whether you're taking medications for the first time or after a break, collaborating with obstetric and psychiatric providers will help determine which medications are most effective and safe.

When Immediate Help May be Needed:

If you or a family member are experiencing a crisis or emergency, please call your local emergency number or call or text the Suicide & Crisis Lifeline at 988. If you are not in crisis but life feels too heavy and immediate support is needed, the National Maternal Health Hotline can help 1-833-TLC-MAMA (1-833-852-6262). For those that need resources and referrals for maternal mental health conditions, the Postpartum Support International helpline is also available at 1-800-944-4773

Closing Thoughts:

While everyone’s postpartum and healing journey is unique, the postpartum period is a complex and sensitive time for most parents. It’s essential for parents to focus on caring for themselves so they can best care for their newborn and others. Normalizing the realities of parenthood and the postpartum experience is key for parents to feel less alone and know they are valued and it’s okay to reach out for support.

“The most difficult part of birth is the first year afterwards. It is the year of travail – when the soul of a woman must birth the mother inside her. The emotional labour pains of becoming a mother are far greater than the physical pangs of birth; these are the growing surges of your heart as it pushes out selfishness and fear and makes room for sacrifice and love. It is a private and silent birth of the soul, but it is no less holy than the event of childbirth, perhaps it is even more sacred.” – Joy Kusek

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All material provided on this website is for informational purposes only. Direct consultation of a qualified provider should be sought for any specific questions or problems. Use of this website in no way constitutes professional service or advice.