Sep 22, 2020
By Megan Kelly, PsyD
Being a mom has always had its challenges. Although fertility treatments, more expansive visions of parental responsibility sharing, and a wealth of online resources have made it easier to adjust to welcoming a baby, many women still find that the perinatal period–from pregnancy to one year postpartum–is one of the hardest times of their lives. Even for adoptive or foster parents who have not undergone the physical experience of childbirth, the perinatal period can still be a major adjustment.
It’s important to prioritize new moms’ mental well-being as much as their physical health. To better understand common issues affecting new mothers, here are four lesser-known aspects of perinatal mental health.
We’ve all seen it: social media posts of new moms and their adorable babies, perfectly coiffed and styled in matching outfits. But what we rarely see is the before or after: a fussy child, a mom’s self-doubt or tears, heaps of dirty laundry on the floor. New moms are often presented with a very narrow version of what motherhood is like instead of a more realistic portrayal of the highs and lows of the experience.
Many new moms have to contend with a mismatch in expectations: what they thought motherhood would be like, and the reality. This can be particularly tough for professional moms, and those who had babies later, who might be more accustomed to having their careers or other interests at the forefront of their identities, and who are used to measuring success by different benchmarks.
Struggling to adjust to being a mother is okay–in fact, it’s the norm. Up to 85 percent of new moms experience “baby blues”–feeling sad, moody, cranky, crying, having trouble eating, sleeping, or making decisions. It’s important for new mothers to define motherhood for themselves–not by what their own mothers did, or what they assume their peers might be doing, but by their own circumstances.
Many women fear physical complications during childbirth, but postpartum depression is just as real and common a complication of giving birth. As is often the case in mental health issues, stigma prevents us from understanding this topic better. What we do know, however, is sobering:
Some women are at greater risk for developing a perinatal mood disorder based on what else is going on in their lives. Financial stress, a recent move, lack of support from a partner, medical issues such as diabetes, or a family history of depression and anxiety are just some of the risk factors. What they all have in common, however, is the stress caused by uncertainty. New mothers want to feel secure in the decisions they’re making for their babies and their families, and when they don’t, trauma can occur.
Though these statistics may be hard to fathom or discuss, it’s important that new moms be informed on the range of feelings they might have after giving birth, and to feel comfortable asking for help.
As a society, we don’t spend a lot of time talking about the effects that miscarriage can have on a woman’s mental health–but women who miscarry are also in a perinatal cycle. As many as one in six women who lose a baby early in pregnancy will experience post-traumatic stress disorder (PTSD), with symptoms that can include nightmares, detachment from partners or parenting responsibilities, or hyper-vigilance–being overly careful in their next pregnancy because they carry a sense of self-blame for what happened.
Even mothers who don’t miscarry can feel a sense of guilt after giving birth. Trauma is often linked to one’s expectations of control and choice. When mothers don’t feel a sense of agency in their child’s birth–for example, a mother with a low-intervention birth plan who suddenly needs an emergency C-section–they may wonder if they could have done more, or if their child was negatively impacted.
While no birth or pregnancy can go entirely according to plan, the more choice women have in welcoming their child, the more empowered they will feel as they continue on their parenting journeys.
No longer are husbands expected to wait outside the delivery room for the “women’s work” to be done. Today we know that no matter the gender of a mother’s partner, supporting someone through childbirth can be both an exciting and nerve-wracking experience. What can often arise for partners is a sense of uncertainty about what their role is. In fact, 10-20 percent of partners report experiencing perinatal depression and anxiety. And the risk of perinatal mental health problems may be even greater for LGBTQ couples, who continue to face discrimination and stigma in society and sometimes even from their own families.
In men, perinatal depression and anxiety symptoms may be “masked” as anger, addiction, or withdrawal. Many men also struggle to reimagine fatherhood beyond how they were raised, especially if they were taught to value traditional masculinity over expressing emotions or participation in parenting. Even fathers who want to do better than their own fathers can struggle to understand how to do so.
Although partners of new moms may not experience the same physiological changes, they, too, could be served by early education and social support, whether via an employer or other resource.
When we consider the perinatal health of everyone involved–mom, partner, and baby–couples feel more connected, and children grow up better attached–a win for the entire family.
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DISCLAIMER: The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
ABOUT THE AUTHOR
Megan is a Clinical Quality Lead with our Blended Care Therapy program and contributes to clinical quality and training development. Prior to joining Lyra, Dr. Kelly maintained a private practice in the San Francisco Bay Area and was clinical faculty at the Stanford University School of Medicine as a member of the comprehensive Dialectical Behavior Therapy (DBT) Team. She specializes in maternal mental health, women’s mental health and trauma. She received her Doctorate of Psychology from the PGSP-Stanford PsyD Consortium.