For many expecting parents, an approaching due date is time to feather the nest. We complete our registry, set up a nursery, and make sure we have all the baby gear we are going to need.
When my first daughter was born, I was caught off guard – floored – by two surprises. One, I knew I would love her, but I didn’t know I would be IN LOVE with her.
Second, the postpartum stage was harder than I expected. Much harder.
I had dreamy moments of nursing in the glider and cuddling her in a carrier. But there were a lot of challenges I never even dreamed of. Breastfeeding was much harder than I expected, yet I felt strongly, almost rigidly, that it had to be 100% of her nourishment. Having things not go as expected is one of the most common risk factors for postpartum mental illness. And as we know, birth and babies rarely stick to the textbook.
The “baby blues” hit 85% to 90% of new mothers, typically on day 4 postpartum, when hormones take a massive drop. This stage usually lasts about two weeks, and is considered “normal.” Even though it is “normal,” we can still make it better! In my private practice, I love to work with expecting parents during pregnancy to prepare for this postpartum stage, so that you can focus on the light and love.
I’ll talk more about how you can prepare, but first: If you are having thoughts of hurting yourself, your baby, or anyone else, DON’T WAIT – GET HELP NOW. Call your OB, your mental health provider, a local hotline, or the National Suicide Prevention Lifeline (1-800-273-8255.) If you are struggling with other strong and disturbing thoughts, such as resenting the baby or regretting having a child, don’t wait. If you find that “the blues” are hanging around past two weeks postpartum, reach out and get help. You may want to be screened for a postpartum mental illness, such as postpartum depression, anxiety, OCD, or psychosis. The Postpartum Support International Warmline provides non-emergency support in English and Spanish at 1-800-944-4773(4PPD).
Making a Postpartum Plan for Mental Wellness
The first thing to understand is that Western culture does everything WRONG to support new moms. In what I call the “reverse Cinderella” effect, a pregnant woman goes from weekly OB visits to “we’ll see in you six weeks” once the baby is out. Pregnant women are often showered with attention and help, while a new mom takes back stage to the new born.
Neither does our culture support new families. Nuclear families are isolated away from the family, friends and communities that could support them. Look at any traditional culture, and there are systems in place to nurture the new mom and the new dad. The community steps in to take over the duties of both parents, so they can focus on the newborn and bond. Don’t get me started on the lack of paid family leave in the US… but do think about how you can pull your community around you. It truly takes a village to support a new family.
Do you ever think that you “should be strong” or “shouldn’t have to ask for help”? Let it go. PLEASE ask for help. Have a friend organize a meal train. Let someone clean your house. Register for a postpartum doula instead of toys. Ask for help and be very specific. Many friends will say, “Let me know if there is anything I can do…” Take them up on it.
For more specific, practical things you can do to build your village and better survive the postpartum stage, see this short video here.
My friend Andrea Knox, LMFT, sits on the board of San Diego’s Postpartum Health Alliance with me, and recently shared her 8 S’s to consider for a postpartum plan. Read it here. For an article on 7 ways to find your circle of support when pregnant or postpartum, click here.
When Is Professional Help Needed?
So far, much of the above advice is for straightforward things we can do on our own. But when do we need to reach out to a mental health professional? Apart from serious thoughts of suicide or harming another person, which need immediate help, some mothers are unsure of what is “normal” baby blues and what is too much.
I like to say that whatever is too much for you is too much. If you are interested in a checklist of possible signs or symptoms of Postpartum Depression, try this page from the Postpartum Stress Center.
In general, the majority of “baby blues” naturally resolve after two weeks. If signs and symptoms of anxiety or depression persist after two weeks, reach out to your doctor, the Postpartum Support International Warmline (1-800-944-4773), or a mental health professional. My practice is in San Diego, where the Postpartum Health Alliance sponsors a warmline and directory of therapists who specialize in perinatal mental health. Consult this list of Postpartum Depression treatment programs and specialists on Postpartum Progress to find a provider elsewhere in the US, Canada, UK, Australia and Switzerland.
There is no harm in reaching out if you aren’t that severe. Getting support sooner is always better!
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