When preparing for the postpartum period, you may initially focus on the baby:  what do you need to stock the nursery with? What will your approach to baby sleep and feeding be? How do you diaper and swaddle? You might also be thinking about your physical healing – loading up on maxi pads, belly binders, and a sitz bath. Yet one critical piece is so often left out of the equation: your postpartum mental health.

It’s estimated that 80% of women experience the “Baby Blues,” or feelings of exhaustion, irritation, and sadness after giving birth that typically last for about two weeks. But one in five pregnancies in the U.S. will result in a perinatal mood and anxiety disorder (PMAD), also known as postpartum depression. Due to the stigma that surrounds maternal mental health in this country, and the romanticized version of motherhood we are conditioned to expect, most PMAD cases go undiagnosed and untreated. The pandemic only exacerbated maternal mental health issues. 

PMADs include anxiety, depression, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and psychosis. What many people don’t know is that only 50% of diagnoses actually happen during the postpartum period – the other 50% of all diagnoses originate during pregnancy.

Here are some common PMAD symptoms you’ll want to look out for:

Low mood, sadness, diminished pleasure, hopelessness, not enjoying the things you used to enjoy, constant worry, catastrophizing, jumping to conclusions, difficulty making decisions, inability to sleep when the baby is sleeping or being cared for, loss of appetite, scary and intrusive thoughts of harm coming to the baby, not feeling connected to the baby, feeling incredibly irritable and overwhelmed, and thoughts of wanting to escape. 

So how can you better plan for your mental health in the postpartum?

Know the facts 

• Women who have a previous history of depression/anxiety (personal or familial) are at a much greater risk of developing a PMAD in the perinatal period.
• Women who have experienced a PMAD previously have a 50-75% chance of a repeat.
• Stressful life events and circumstances can contribute to a PMAD (finances, relationships, physical/sexual abuse, substance use, recent or unresolved loss, etc.).
• An unplanned or unwanted pregnancy, traumatic birth, or NICU experience can contribute to the development of a PMAD.

Familiarize yourself AND your support team with PMAD symptoms

• The Motherhood Center has descriptions of each PMAD diagnosis to give you a better sense of what symptoms look like. 
• Postpartum Support International also has a great PMAD symptom fact sheet. 

Research PMAD treatment options in your community:

• Familiarize yourself with mental health providers near you that clinically treat pregnant and postpartum women. This includes psychologists and social workers, as well as reproductive psychiatrists who specialize in medication that is safe and effective to take during pregnancy and the postpartum period. 
• If you are in the Tri-State Area, The Motherhood Center specializes in treating new and expecting mothers with PMADs. We offer support groups, individual therapy, medication management, and a Day Program for women that are having a difficult time caring for themselves and/or their baby. 
• If you are outside of the Tri-State area, Postpartum Support International has Coordinators located in every City and State and Country that can help connect you to PMAD treatment providers close to you.

The great news about PMADs is that they are totally treatable! Women can feel so much better with support groups, therapy and/or medication. And the sooner a new or expecting mom seeks help, the sooner she can get back to feeling like herself again, and enjoy the pregnancy and postpartum period just as she was meant to.