Written by Anna Ribeiro, LMSW
Pregnancy and postpartum can be a whirlwind of joy, gratitude, fear, confusion, and hope. During pregnancy, so much time is spent trying to figure out how to care for your growing baby. This is only intensified after the baby is born. During this phase, we give so much care to our growing babies–as we should–but that same level of care is not extended to mothers and their mental health. Looking back on my own journey into motherhood, these are the things I wish someone would have taken the time to tell me, so that I could have better cared for myself.
- It’s not just postpartum, and it’s not just depression.
There are six different types of Perinatal Mood and Anxiety Disorders (PMAD’s): Depression, anxiety, bipolar, obsessive compulsive disorder, PTSD and psychosis. These disorders can occur any time during pregnancy or up to one year postpartum.
- Anyone can be affected by a perinatal mood or anxiety disorder–no one is immune.
Moreover, it can happen with any pregnancy, even if it didn’t happen in your first, second, etc. The symptoms of a maternal mental health condition can present differently from one person to the next, or can appear differently even in the same person from one pregnancy to another.
- If you are suffering–you are not alone, and it is not your fault.
PMAD’s effect:
- 1 in 7 moms during the first 3 months postpartum
- 1 in 5 moms during the first 12 months postpartum
- 1 in 3 women of color
- 1 in 10 dads
- There are several risk factors that can increase one’s chance of suffering from a maternal mental health condition.
A personal or family history of depression, anxiety, OCD, bipolar or trauma before children or with a previous pregnancy can increase the risk of experiencing a maternal mental health condition.
Life stressor risk factors include lack of support, financial stress, and recent stressors (such as job loss, divorce, death of a loved one, health emergency or accident).
Other risk factors include: previous history of miscarriage or stillbirth, unplanned/unwanted pregnancy, high risk pregnancy, traumatic delivery, parent of multiples, NICU baby, breastfeeding complications, and age (under 20, over 40).
Women of color and women living in poverty experience PMAD’s at a rate 2-3 times higher than white women. Lack of access to affordable healthcare, logistic barriers to obtaining help, and cultural and racial biases in the healthcare system all contribute to these disparities.
- Only 40% of cases are diagnosed, and only 60% of those seek treatment, according to Postpartum Support International.
These numbers vary–some say only 15% to 25% of women suffering receive treatment. It can feel impossible to seek help. It can feel like weakness, when in fact it takes incredible strength.
- Perinatal mood and anxiety disorders are temporary and treatable with help and support.
Organizations such as Postpartum Support International (PSI) aim to support women struggling with maternal mental health conditions. With online support groups, provider directories, loss and grief resources, and more, this is a good place to start to find help. Their message is simple but powerful: “You are not alone, you are not to blame, and with help you will be well.”
All of these facts are widely available with some research. However, they are not widely distributed to pregnant and postpartum women or their families. During a “normal” pregnancy and delivery in the United States, a mother can expect 10-15 prenatal visits. Comparatively, after delivery there are only 1-2 postpartum checkups. Although this is a very common time for PMAD’s to occur, they are rarely discussed at the postpartum visits. In my case they were not mentioned by my provider, and I was too scared to bring up the thoughts and feelings I had been experiencing. These prenatal and especially postpartum visits could be an opportunity for education, screening, and intervention. However this opportunity is missed. As it is, we are left to educate ourselves, and educate others.
Ultimately what I wish I had been told is this: the very best thing you can do for your baby is to care for yourself. Your baby deserves a happy, healthy parent, and there is help available so you can become that person.
Postpartum Support International Helpline:
Call 1-800-944-4773 (4PPD)
#1 En Espanol or #2 English
Text in English: 800-944-4773
Text en Español: 971-203-7773
Suicide Prevention Hotline: 1-800-273-8255