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Pregnancy and Postpartum Support for New Moms

There is no one right way to experience new motherhood. Many women experience challenges, doubt and emotional highs and lows during this transition. Who am I as a mother? Why am I having such a hard time? Other women are naturals as new moms. I used to be so confident. When will I feel like myself again? Our culture celebrates motherhood yet doesn't prepare women for this profound life change. It is essential to feel supported during this time. I am here to help - nurturing new moms and moms-to-be is the heart of my psychotherapy practice. 

Mothering a newborn is not always easy or what we expected; there are many unanticipated changes that occur. The first few months can be filled with complex, changing feelings: joy, confusion, sadness, delight, overwhelm, frustration, hope, guilt, disappointment, loneliness and ambivalence. The myth of this being a time filled with happiness, natural bonding and innate maternal instinct may increase anxiety and depression. 

It is also helpful to focus on the process of becoming a mother. Women may experience identity shifts, attachment concerns, loss of independence, relationship adjustments, isolation, confusion regarding the return to work, and grief for the loss of the previous life mixed with hope for what's to come. While navigating this profound life transition, there is a need to feel safe and not judged as a new mom. It is also essential to take care of yourself.

New Mom Self-Care 

  • Know that what you are feeling is very common for expectant or new moms.
  • Talk to your partner, friends or family about what you are going through. 
  • Utilize support systems for emotional support or help with infant care.
  • Be kind to yourself. Caregiving is hard work. You will start to feel more confident.
  • Expect complex feelings around this life change. It may take some time to feel like yourself again.
  • Make sure that you have some periods of downtime for yourself.
  • Challenge negative/critical or unsupportive thoughts.
  • Make sleep a priority. Get help for night shifts and discuss sleep concerns with your doctor.
  • Get outside. Take a daily walk in nature during pregnancy and later with your baby.
  • Join a support group to normalize feelings and connect with other expectant or new moms.

Understanding Pregnancy and Postpartum Challenges

If you are having difficulty adjusting to pregnancy or new motherhood, or you have not been feeling like yourself, please talk about it. Maternal mental health challenges may surface at any time - from pregnancy through the first few years after birth. Please be aware that transitioning to the new identity of parent can be especially challenging after infertility, previous pregnancy loss or birth trauma. Pregnancy and postpartum emotional changes can affect the entire family, and it can be helpful to understand the spectrum of possible concerns. If you or a family member notice any of the mood or anxiety changes described below, seek additional support.

Pregnancy mental health concerns include increased depressive or anxiety symptoms, ambivalence or reduced interest in becoming a mother, extreme anxiety or fears regarding the developing baby's health or possible miscarriage, lack of attachment to the pregnancy or feeling overwhelmed by this life change. Factors that may contribute to pregnancy concerns include previous infertility, pregnancy loss or birth trauma, prenatal testing results, partner relationship difficulties and lack of social support. Pregnancy may be a challenging time for women with a history of depression, anxiety, bipolar or OCD.

Baby blues are emotional or distressing feelings that naturally arise post-birth. Symptoms may include some feelings of anxiety or depression, a rise in moodiness and emotionality, tearfulness, feelings of frustration or disappointment and sleep concerns. Please know that the baby blues are experienced by the majority (80%) of new moms, appearing a few days after birth and resolving after a few weeks.

Postpartum depression is experienced by roughly 20% of new moms and ranges from mild to severe. Symptoms cause more distress than the baby blues, and include severe feelings of depression, increased mood swings, sadness, crying, strong feelings of shame and guilt, loss of interest in activities, feeling numb, difficulty concentrating, feeling overwhelmed, critical thoughts of being an inefficient mother and disconnection to the baby. Loss of sleep plays a role, along with isolation during maternity leave. 

Postpartum anxiety happens when severe anxious thoughts become difficult to control. Many new moms are naturally in their heads a lot, but increased general anxiety around motherhood and infant care can become problematic. Often moms report thinking nonstop, not being able to turn off thoughts, an inability to relax and irritability. Look for perfectionist traits and trying to do everything 'right' (when there is no right or perfect way to care for a new baby). Also look for anxious thoughts, especially around infant health, sleep or feeding, and a never ending to-do list. Racing thoughts may impact mom's sleep.

Postpartum panic disorder occurs when extreme fear and anxiety manifest somatically through panic attacks. Symptoms may include chest pain, heart palpitations, feeling faint, tingling, sweating, shaking and feeling out of control. Anxiety may increase as you begin to fear having more panic attacks.

Postpartum obsessive-compulsive disorder occurs as obsessive, intrusive thoughts completely take over. Symptoms include obsessive worry for the baby’s health, care or hygiene, or irrational fears around you or others causing harm to the baby. Many women create compulsive behaviors or rituals to compensate for intense thoughts.

Postpartum PTSD is often related to traumatic birth. Symptoms can include nightmares, flashbacks of birth or past trauma, feeling unsafe, avoidance, hypervigilance and a sense of unreality / out of one's body.

Postpartum bipolar disorder can manifest in women with a history of bipolar or major depressive disorder, and may also appear for the first time after childbirth. It typically presents initially with severe depressive symptoms. Manic symptoms include elevated mood, euphoria, decreased need for sleep, rapid speech and grandiose thought patterns.

Postpartum psychosis is the most severe postpartum concern and occurs rarely. Safety is an urgent concern. Symptoms include confusion, hallucinations, delusional thinking, odd speech patterns, paranoia, severe insomnia and extreme irritability. Psychotic symptoms have a rapid onset and require immediate medical attention.

Post-adoption depression affects up to 25% of adoptive parents. Symptoms may include depressed mood, increased anxiety, sleep or eating concerns, irritability, unrealistic expectations of motherhood, attachment concerns, self-doubt about parenting, lack of support, fear that the child will be taken away and feelings of disappointment, inadequacy or guilt. Mood concerns can be heightened by legal or societal stressors and previous infertility.

Get Support

I am passionate about supporting new moms and moms-to-be on their journey to parenthood. I welcome individuals and couples who may need support during this transition. I have experience supporting new moms and completed professional training in the assessment and treatment of perinatal / postpartum mood and anxiety disorders. Please contact me for an initial consultation.

Resources

Postpartum Support International

Postpartum Progress Support Groups

California Maternal Mental Health Collaborative

The Other Postpartum Problem: Anxiety

Where Postpartum Depression Meets Adoption

Books:

Becoming a Calm Mom: How to Manage Stress & Enjoy the First Year of Motherhood, Deborah Roth Ledley PhD

This Isn’t What I Expected: Overcoming Postpartum Depression, Karen Kleiman, MSW and Valerie Raskin, MD

Dropping the Baby and Other Scary Thoughts: Breaking the Cycle of Unwanted Thoughts in Motherhood, Karen Kleiman, MSW and Amy Wenzel, PhD

The Journey to Parenthood: Myths, Reality and What Really Matters, Diana Lynn Barnes PsyD, Leigh G. Balber

Breathing with Baby, Nicole Bookman, MA

The Post-Adoption Blues: Overcoming the Unforeseen Challenges of Adoption, Karen Foli PhD, John Thompson MD

Finding Calm for the Expectant Mom: Tools for Reducing Stress, Anxiety, and Mood Swings During Your Pregnancy, Alice Domar PhD and Sheila Curry Oakes

Mindful Motherhood: Practical Tools for Staying Sane During Pregnancy and Your Child's First Year, Cassandra Vieten PhD

The Pregnancy and Postpartum Anxiety Workbook: Practical Skills to Help Overcome Anxiety, Worry, Panic Attacks, Obsessions, and Compulsions, Kevin Gyoerkoe, PsyD, Pamela Wiegartz, PhD, Laura Miller, MD