Did you know that having a baby can be very stressful? This is a critical time for mental health intervention. Here are a few thoughts:
The postpartum and “perinatal” periods (essentially, during and after pregnancy) are a vulnerable period for mental health conditions
The three key postpartum mental health problems are depression (including suicidal thinking), anxiety/OCD, and psychosis (this one is rare)
Women experience many hormonal changes during pregnancy, birth, and breastfeeding that can make them vulnerable to emotional concerns
Pre-existing mental health conditions (e.g., PTSD, insomnia) could be exacerbated by the changes of pregnancy and caring for a child
There is a condition called D-MER in which intense, almost unmanageable emotions and physical sensations are experienced during breastfeeding
The other parent can also experience postpartum mental health conditions
Psychologist Dr. Nicole Pensak wrote a book called Rattled that I highly recommend to any expectant parent. In it, she explains how to set up a postpartum mental health plan, cognitive-behavioral strategies for postpartum mental health symptoms, and the research-backed benefits of “mommy brain.”
Combining her recommendations and my thoughts, here are some suggestions...
Your Postpartum Mental Health Plan
As soon as possible after pregnancy, set up an intake with a licensed mental health provider and psychiatrist.¹
o You can find professionals who are certified in perinatal mental health here.
o Even if you are against medication, it’s better to have a provider identified than to wait and realize that you need one in a crisis.
Take in the recommendations from the therapist. If they say you already have a mental health condition that needs treatment, go ahead and start therapy. It’s much easier now than it will be once your child is around! If they say there is nothing to do for now, go to the next step...
Set up a follow-up therapy appointment for as soon as reasonable after birth.¹ A good provider will be flexible with scheduling, knowing that your birth date could change.
Communicate with your psychiatrist and set up a plan for either scheduled appointments or how to connect in a crisis.¹
Get assessed for common responses to giving birth such as depression, anxiety/OCD, and psychosis. In treatment, monitor these symptoms over time.
Make an emergency plan (for example, if you experienced urges to harm yourself) with your provider that includes your partner/family members. It’s better to have this in place and then never have to use it.
Even if you are feeling great after birth, set up follow-up appointments at regular and critical times, such as one-month post-birth and after stopping breastfeeding.¹
If you are experiencing mental health symptoms, it will be difficult to schedule and follow through with appointments.¹ Have a plan in place before the birth to ensure you will be able to schedule and attend your appointments, which will be at least once-a-week.
Before the baby arrives, make a plan for optimizing your mental health in non-therapy ways as well: schedule out exercise, sleep, and activities that bring you joy.¹
Talk to your partner about whether they should receive their own mental health care during this period.
Is that enough to do? Don’t worry, you’ll have to also keep a tiny human alive, navigate changing relationships, and deal with a body that feels totally alien.
I never said it will be easy... Moms are superheroes!
Most pregnancy/post-birth providers will forget that you are a human being and only focus on the baby. This is a huge flaw in our healthcare system. Prioritizing your mental health will help you to take care of yourself during this critical time!
If you can’t find someone certified in perinatal mental health, any provider that provides quality care for depression and anxiety will likely be a good fit. I am not certified in PMH but I regularly provide CBT for depression, anxiety disorders, and OCD and would be happy to be part of your postpartum mental health plan.
If you have other thoughts on optimizing mental health during and after pregnancy, comment below!
References
Pensak, N. (2024). Rattled: How to calm new mom anxiety with the power of the postpartum brain. W. W. Norton & Co, Woodstock.
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