May is Maternal Mental Health Month, a time in which we focus on increasing the awareness of mental health and the well-being of mothers during pregnancy and the time period shortly after giving birth.
“The Baby Blues,” a term often used to describe intermittent periods of tearfulness, worry, irritability, fatigue, or moodiness during the first days after delivery is quite common; up to 80% of women report experiencing such symptoms as their bodies adjust after giving birth. While “The Baby Blues” often subside on their own within a few weeks after delivery, these feelings can be surprising to new mothers, especially those who have been looking forward to their baby’s arrival.
Less talked about, one in seven women experience significant symptoms of depression or anxiety during their pregnancy or in the year following delivery, and about 20% of women meet the criteria for postpartum depression. Of the women meeting the criteria for postpartum depression, approximately 66% also experience anxiety disorders (Wisner, et al, 2013; Davis, 2020). Symptoms frequently described include feeling disconnected from their loved ones, including their new baby; sadness; changes in sleep beyond what is normal with a new baby at home; crying spells; and feeling inadequate. Other symptoms include intrusive, negative thoughts; worrying excessively about their baby’s safety; feeling overwhelmed/out of control; panic attacks; and irritability. Some women have thoughts that their families would be better without them, and unfortunately, suicide is one of the top causes of maternal death.
Postpartum psychosis, a condition in which women experience delusional thoughts or hallucinations, is documented in a very small percentage of women- approximately one to two out of every 1,000 new mothers (Wisner, et al, 2013; Davis, 2020). A history of trauma, young or advanced maternal age, high levels of stress, lack of a support system, or a history of mental illness increase the likelihood of postpartum depression, anxiety, or other mental health symptoms. Difficult pregnancies, deliveries, and newborn babies are also potential risk factors.
With numbers so high, you may wonder why you have not heard more from others close to you who have struggled during the perinatal period. Statistically, most of us have had friends, a sister, a mother, neighbors, or co-workers who have suffered from some sort of emotional health challenge during pregnancy or shortly afterwards. Barriers to talking about these issues include feeling too embarrassed, ashamed, or guilty to open up about their experience. We may have endured it ourselves and not talked about it for the same reasons. Clearly, these are frequent occurrences that need to be talked about more.
The current COVID-19 pandemic is further complicating the pregnancy/delivery/new motherhood experience. This health issue is reshaping the expected experience of many new mothers and contributing to stress, sadness, and anxiety. Social distancing, the “new normal,” makes getting help from others more complicated for perinatal mothers. Expecting mothers may be sad about missing large showers or parties to celebrate the upcoming birth. Mothers may experience fear related to their upcoming delivery, wondering if those she wants to participate will be allowed to visit, or if she may even be forced to deliver without a designated birthing partner. Mothers may feel pressure to introduce their baby to friends/family, but feel uncomfortable exposing her baby to people outside of the household. Families may be facing financial difficulties as more and more individuals are laid off or furloughed. As anxiety across the world rises related to COVID-19, the same stressors we are all susceptible at this time are making the perinatal population especially vulnerable.
So, what can expecting and new mothers do?
- Remember, even when it feels like it, you are not alone! Many women experience emotional health challenges, and it does not mean that you are weak or that you are not a good mother.
- Remember that this is temporary, and with help and time, you will feel better again.
- Be open and honest with your medical providers, especially your OB/GYN, about what you are feeling. They are trained to listen, reassure you, and to refer you to someone who can help, if needed.
- Consider attending a support group for new mothers. Postpartum Support International has online groups available.
- Talk to trusted love ones and family. Tell them how you feel, and what you need from them.
- Sleep, as difficult as it can be to obtain after having a new baby, can make a huge difference. Ask your support network to watch your baby so you can get some rest.
- Engage in self-care. Go for a walk outside. Talk to your friends on the phone. Set up a virtual meeting. Eat nutritious meals. Avoid caffeine. Remember, when we take care of ourselves, we are in a better mind-space to care for those we love.
- Consider counseling and/or medication for symptoms, as recommended by your provider. Even during COVID-19, psychological and psychiatric treatment is an option. Many providers are even offering telehealth appointments so you can feel more comfortable adhering to social distancing recommendations. At UT Physicians, our mental health providers are trained to help patients experiencing mental health symptoms during pregnancy, in the year following delivery, and symptoms related to fertility difficulties and pregnancy loss.