Motherhood is a huge identity shift
Mothers experience a range of postpartum feelings, from mild anxiety to serious depression.
Understanding the differences between baby blues, postpartum anxiety, and postpartum depression will help you get the support you need
Take the time to do "emotional nesting" as you prepare for baby

What Does "Postpartum" Really Mean?

Visiting Contributors

Dr. Juli Fraga is a San Francisco-based psychologist specializing in women’s health, including perinatal mood concerns, postpartum depression, and anxiety.  She is a freelance writer, blogger, and a mother.  Find her on Twitter @dr_fraga.

After the birth of your baby, several new words enter your motherhood vocabulary, and one that you will hear repeatedly is “postpartum.” But, what does this term actually mean, and how is it related to postpartum depression?  

POSTPARTUM 101

Postpartum:  Following the birth of your baby, you enter the postpartum period, which is the first year after childbirth. During this time, your body is healing from childbirth and your hormones are recalibrating. This bodily transition may result in skin, hair, health, and mood changes. 

Postpartum Depression (PPD):  Approximately 17% of women suffer from postpartum depression. Yet, many of these women are never properly screened and diagnosed, and as a result, do not receive the therapeutic support that they need. The postpartum period is a particularly sensitive time as biological changes, identity transformations, and lifestyle adjustments are all underway. As a result, many women with mild to slightly moderate symptoms of postpartum depression may ignore their symptoms, because they assume these symptoms are a “normal” response to the stress that accompanies new motherhood. While 90% of women experience the baby blues after the birth of their babies, it’s important to understand the difference between the more normal blues and a postpartum mood concern.

Baby Blues: Women who are experiencing the baby blues often feel overwhelmed, sad/tearful, and slightly anxious and irritable. While uncomfortable, the baby blues are a normal response to the hormonal fluctuations that occur immediately after giving birth. The blues typically last between 10-14 days. After this time, if they are not improving or they are becoming worse, a postpartum mood screening is recommended. Obstetricians, pediatricians and perinatal psychotherapists, as well as some midwives can screen for postpartum depression. 

THE FACTS ABOUT PPD

What causes postpartum depression? Does it go away on its own? What are the recommended treatments? These are all valid questions when trying to understand PPD.

Several variables are correlated with perinatal depression: Hormonal fluctuations, life-stressors, and previous personal or family history of depression. Postpartum depression can occur anytime during the first year (the postpartum period) following the birth or adoption of a baby. 

While the term “postpartum depression” is often used as a catchall to describe women who are feeling emotionally distressed during motherhood, it’s important to know that there are several maternal mental health concerns that may arise during the postpartum period. 

Postpartum Anxiety: Postpartum anxiety is also a common maternal mental health concern that may arise anytime during the first year following childbirth. Postpartum anxiety symptoms include: extreme worries and fears about the baby, intrusive thoughts about the baby’s safety, feelings of overwhelm and, in some instances, shortness of breath and feelings of panic. 

Postpartum Depression: Women with PPD may experience feelings of sadness, hopelessness, irritability, guilt, lack of interest in the baby, and sleep and appetite changes. In rare instances, women may have thoughts about hurting themselves or the baby. If this occurs, it is very serious and requires immediate medical attention from a physician or psychiatrist. While scary, PPD is treatable and the sooner a woman receives treatment, the better her outcome for recovery. 

Postpartum Psychosis: Postpartum psychosis is very rare. It occurs in only .1% of births, however it is very serious. Symptoms generally emerge within 1-2 weeks after giving birth and include: delusions, hallucinations, paranoia, and lack of contact with reality. Postpartum psychosis requires immediate medical attention, psychotropic medication and oftentimes hospitalization.

TREATMENT

Generally speaking, psychotherapy with a perinatal psychotherapist, group support and sometimes anti-depressant or anti-anxiety medication are the recommended treatments for perinatal mood concerns.  Several forms of psychotherapy are effective for treating PPD. The most common are Cognitive-Behavioral Therapy and Interpersonal Process Therapy. Cognitive-Behavioral Therapy teaches specific behavioral tools that can help manage symptoms of depression/anxiety. Interpersonal Process Therapy examines the client’s interpersonal relationships and utilizes the therapeutic relationship as an avenue for processing relationship concerns and alleviating interpersonal distress. Many women respond well to a brief course of psychotherapy (8-10 sessions). 

A MATERNAL MAP

“Can postpartum depression be prevented?” “Is there anything I can do during pregnancy to prevent PPD?” Women often ask these questions and wonder how to prevent PPD.

During pregnancy, it is often difficult to see beyond the birth of the baby. As a result, nesting often focuses on preparing the baby’s room, attending birthing or newborn care classes, and purchasing baby items. But motherhood is a huge identity change and women learn to mother largely from the ways they were mothered.  

Taking the time for emotional nesting during pregnancy can provide some insight about how you are likely to approach new motherhood. Begin by asking yourself some simple questions, such as “What is one thing I wanted from my parents that I did not receive?” “How will this impact me as a mother?” “What is it like for me to feel out-of-control? “How might this affect me during motherhood?” By outlining your emotional map, you can become intimate with the range of feelings that accompany new parenthood.

It’s also helpful to set-up a lot of support, such as enlisting friends and family members to provide meals during the postpartum period, or help with household tasks such as laundry and grocery shopping. Also, be gentle with yourself. Extend yourself the same compassion you will extend to your newly born baby. Becoming a mother is one of the most profound events we undergo and this identity shift is bound to stir up a range of emotions. Educating yourself about postpartum mood concerns is one way to advocate for your emotional wellbeing during this time. Remember, you are not alone and you are not to blame. Help is available. 

For more resources:
Postpartum Progress 
Postpartum Support International 

Photos: Laura Kudritzki Photography
Hair & Makeup: Pretty Parlor

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