Source: Interview with Timothy Kremer, M.D., OB/GYN on the medical staff at Texas Health Harris Methodist Hospital Fort Worth
Bringing home a new baby changes everything. Your sleep, your schedule, your body and your emotions all shift at once. That is why maternal mental health deserves just as much attention as diapers and feeding schedules in the weeks after giving birth.
"Virtually everybody" experiences some emotional ups and downs after delivery, says Timothy Kremer, M.D. an OB/GYN on the medical staff at Texas Health Harris Methodist Hospital Fort Worth. The key is knowing what is normal, what is not, and when to ask for help.
Baby Blues: Normal and Expected
Most new moms feel weepy, tired or moody in the first days after giving birth. These feelings are often called the baby blues, and they are caused by real, physical changes in the body.
The baby blues have a clear physical cause, Dr. Kremer explains. After delivery, hormone levels shift quickly. Those changes affect mood.
In other words, the baby blues are not something you did wrong. They are not something you caused or could have prevented. They are a natural response to the hormonal changes of childbirth, and for most moms, they fade on their own within a couple of weeks.
When It's More Than the Blues: Postpartum Depression
Sometimes those normal changes grow stronger and turn into something more serious called postpartum depression. Unlike the baby blues, postpartum depression does not fade on its own and can make daily life feel impossible.
Signs of postpartum depression can include:
- Crying often, sometimes out of nowhere. One patient told Dr. Kremer, "I'm doing okay, I'm tired, but I'm just crying all the time."
- Scary thoughts that will not go away. Doctors call these intrusive thoughts. They are unwanted, upsetting thoughts that keep running through your mind. Many moms describe being terrified something will happen to their baby, to the point they cannot sleep or focus.
- No energy or interest in anything. Barely wanting to get out of bed or care for yourself is a major warning sign.
Dr. Kremer says intrusive thoughts are the symptom moms are most afraid to mention. Some worry that if they admit to scary thoughts, someone will take their baby away. He wants moms to know that having distressing thoughts is not the same as wanting to act on them, and doctors understand the difference. Speaking up is how you get better.
Family members can help by watching for these signs, too. A spouse, partner, mother or friend is often the first to notice that a new mom is struggling.
Postpartum Anxiety
Worry after birth is normal. Postpartum anxiety is worry that will not turn off. It can show up as racing thoughts, constant fear about the baby's safety, or trouble sleeping even when the baby sleeps. Like postpartum depression, it is common, treatable and nothing to be ashamed of.
If you had anxiety or depression during pregnancy, your risk of postpartum depression is higher. That is one reason your care team screens you throughout pregnancy, before you leave the hospital and again at your follow-up visits after giving birth.
Dr. Kremer says his team screens every patient because just asking "How are you feeling?" is not enough. "Not every patient that is struggling is going to bring that forward," he says.
Treatment Works, and It's Better Than Ever
If you are diagnosed with postpartum depression, you have options. Counseling helps many moms. For some, medication is the right choice.
There is now an FDA-approved medication made just for postpartum depression. It is a two-week pill taken at home, and it works on the hormone changes that cause the condition. Dr. Kremer says many of his patients notice a difference within days. "They come back three weeks later and say, 'I'm kind of reset and back into a normal space.'"
For moms who are unsure about taking a long-term antidepressant, a short-term option can make it easier to say yes to treatment.
Tips for the Weeks After Giving Birth
Before his patients leave the hospital, Dr. Kremer shares a few key reminders:
1. You are not released into the wild. Your care does not end at delivery. You will have follow-up visits with your obstetrician or midwife, and your baby will see the pediatrician. Your care team is still your team.
2. Make sleep a priority. Losing sleep makes mood problems worse. Make a plan with your partner or family so you can rest. "If you're not in your best state of mind, you're not going to provide the best care for your newborn," Dr. Kremer says.
3. Lean on your support system. Many new moms feel they have to do everything themselves. Don't. Let your spouse, family and friends help, especially in those first couple of months.
4. Reach out early and often. Use MyChart to message your care team with questions between visits. If something feels off a week after delivery, do not wait for your scheduled appointment. Your doctor can bring you in sooner.
Where to Find Support
Beyond your doctor's office, help is available:
- Lactation consultants. These breastfeeding experts can help when nursing is not going well. Trouble with breastfeeding can leave moms feeling like they have failed, which can feed depression.
- Counseling services. Your doctor can connect you with a mental health professional.
- Postpartum Support International. This group offers a helpline that connects moms with mental health services in their own communities.
- Special support groups. There are resources just for families facing pregnancy loss and other hard situations.
You've Got This, and You've Got Help
Recovery after giving birth takes time, in your body and your emotions. Go easy on yourself. Some hard days are normal. Struggling every day is not, and it can be treated.
If you are a new mom who is not feeling like yourself, tell someone. Tell your doctor, your partner or a friend. Asking for help is not a weakness. It is one of the best things you can do for yourself and your baby.
Need a physician for you or your growing family? Call 1-877-THR-WELL or visit TexasHealth.org to find care near you.