When you’re pregnant, you’ll hear tons of advice about caring for your baby, but little guidance on postpartum wellbeing.
There are a million baby registries telling you how many onesies and burp cloths to buy. Postpartum mental health resources for moms are harder to find.
If you're one of the one in five new mothers who experience a postpartum mood disorder, you need to know signs, symptoms and how to get help. Better yet, you need a plan.
With help from experts, TODAY Parents created a New Mom Mental Health Checklist in downloadable and printable form.
Just like you look at a baby registry to see what you need for the baby, we hope expectant mothers and their partners, friends and relatives can use this checklist to see how to support a mom’s mental health.
This resource is for ANY pregnant person: Whether you're having your first baby or your fifth, it doesn't hurt to prepare your mental health.
"Have a mental health plan," urges Paige Bellenbaum, a social worker and founding director of the New York City-based Motherhood Center, where new and expecting moms can receive mental health support.
"Try to figure out who your providers are, even give them a call ahead of time. Know what to do, know what to look for and I always say partners need to be a part of every single step along the way."
If you feel depressed, anxious all the time, have panic attacks or bad thoughts you just can't shake — too often, it feels like you're on your own.
The good news: You are not.
Postpartum Support International helpline: 1-800-944-4773
"What's really important to say is this is really common," says Birdie Meyer, a nurse and therapist who answers calls on the Postpartum Support International helpline. "You didn't do anything wrong; you're not alone, and you are not to blame."
Meyer is the Postpartum Support International certification and education director. She says she wishes more people knew how common and, most importantly, how treatable postpartum mental health issues are.
"With the proper treatment, you WILL be well again," she says. "This really isn't going to last forever."
The new mom mental health checklist isn't everything, but it's a start. And if it makes it easier to have it saved on your phone or printed out on your fridge, you can download it right here.
What to know
Up to 80 percent of new moms experience the “baby blues,” a time when you’re extra emotional. That's normal.
The baby blues pass in about two weeks. If you experience extreme sadness after that, and it’s making it hard to take care of yourself or the baby, it could be something more.
And it's not just sadness or depression. Yes, postpartum depression affects up to one in seven new moms. But postpartum anxiety affects one in 10 new moms. There’s also postpartum OCD, PTSD, bipolar and psychosis. Symptoms can start anytime from right after birth to a year or more later, and they might not be what you expect. (See the bottom of this story for a list of symptoms and links for more information.)
What partners and friends can do
"We cannot expect new and expecting moms to throw themselves a life preserver when they are struggling. Even with mild symptoms. They can’t be the ones to save themselves," says Bellenbaum.
That's why it's so important for partners, friends and family — everyone around a new mom — to know these signs and to know how to get help.
A trusted doctor can be a good first call — even better if you talk to your doctor about potential mental health issues BEFORE the baby arrives. Not every doctor is knowledgable about postpartum mental health, though. If you don't know who to call, try the Postpartum Support International helpline: You might have to leave a message, but you'll get a response from someone in your area who understands postpartum mental health problems and can connect you with local resources. Moms can call, but also dads, friends, relatives — anyone with questions.
If you're worried about a new mom's mental health, approach the topic gently. There's so much stigma about mental illness for moms.
"A lot of women feel shame about their struggles. And so they don’t want to acknowledge it," says Dr. Rebecca Weinberg, a psychologist who oversees clinical operations for the Perinatal Depression Program at Allegheny Health Network in Pittsburgh. "Some women fear their children being taken away or being labeled a bad mother."
First, if someone may be a danger to themself or to others, call 911 or go to the emergency room. Don’t hesitate.
If you think there might be a problem but you’re not sure — ask from a place of concern and offer help, not judgment.
- DO: Try to state what you’ve observed. “I’ve noticed that you don’t seem to be sleeping, even when the baby sleeps. How are you feeling?”
- DO: Ask questions. “Tell me more about what you are most worried about?”
- DO: Offer resources. “Do you want to call this helpline together?”
- DON’T: Try to downplay their feelings, even if you’re trying to make them feel better. “Focus on the positive — you have a healthy baby!”
- DON’T: Try to impose your point of view. “Calm down, it’s not a big deal! Everything is fine.”
What to do before baby
Just like you prepare a nursery, you can prepare your mental health before a baby arrives. You can't baby-proof your mental health completely — there are risk factors outside your control. But knowing the symptoms, and knowing who to ask for help, is a good start.
Here are other things you can do:
Social media cleanse: Look at your social media feeds. Are they full of perfect-looking moms and well-behaved children in color coordinated clothes? That sounds lovely. It's also a carefully curated fantasy, and looking at those portrayals might make you feel worse about your own, unfiltered reality. Make sure your social media includes more realistic portrayals of parenthood — try Cat & Nat, I Mom So Hard, Scary Mommy and of course TODAY Parents!
Do some myth-busting: I will feel an instant, cosmic bond with my baby. Breastfeeding is easy and natural. My instincts will tell me what to do. Some of these things are true for some people, and they might be true for you. Or they might not. And that's OK! Our society has a lot of really powerful myths about motherhood, and the problem is those myths can make us feel bad about ourselves when they don't match our reality — and that can make it harder for people to recognize when they need help.
Code word for 15-minute break: With your partner, work out a code word that means “I need a break; you need to take the baby.” When one of you reaches your limit and says the code word there’s no judgment, no questions, no need to explain; just an immediate baby handover. You might think, pre-baby, that you'll never need a code word like this. Have one, just in case.
Practice TIPP: These proven “distress tolerance techniques” are used in Dialectical Behavior Therapy and they can be helpful anytime your emotions are running high, which, with a baby, is guaranteed to happen.
T = Temperature. Put your face in a bowl of ice water, or hold a cold pack to your face for 30 seconds.
I = Intense Exercise. Not always possible after giving birth, but even a short burst of intense exercise (running, jumping jacks, dancing) helps calm the body.
P = Paced breathing: Deep, slow breaths. Try five seconds in, seven seconds out.
P = Paired muscle relaxation. Breathe in, tense your muscles, make yourself aware of the tension, and then say the word “relax” in your mind while you breathe out and release.
Signs and symptoms to know
All of these symptoms come from Postpartum Support International, which is a great resource with a lot of information on its website.
General signs that something’s wrong
According to Postpartum Support International:
Are you feeling sad or depressed?
Do you feel more irritable or angry with those around you?
Are you having difficulty bonding with your baby?
Do you feel anxious or panicky?
Are you having problems with eating or sleeping?
Are you having upsetting thoughts that you can’t get out of your mind?
Do you feel as if you are “out of control” or “going crazy”?
Do you feel like you never should have become a parent?
Are you worried that you might hurt your baby or yourself?
Signs of postpartum anxiety
According to Postpartum Support International:
Constant worry
Feeling that something bad is going to happen
Racing thoughts
Disturbances of sleep and appetite (Losing weight rapidly, while it’s sometimes praised, is a sign that something is wrong. And as a new parent, your sleep is going to be messed up no matter what — but if you can’t sleep when the baby sleeps, or you can’t stop your mind from racing when you actually are tired and have an opportunity to sleep, that’s a sign something is wrong.)
Inability to sit still
Physical symptoms like dizziness, hot flashes, and nausea
Signs of postpartum depression
According to Postpartum Support International:
Feelings of anger or irritability
Lack of interest in the baby
Appetite and sleep disturbance (see above)
Crying and sadness
Feelings of guilt, shame or hopelessness
Loss of interest, joy or pleasure in things you used to enjoy
Possible thoughts of harming the baby or yourself
Signs of postpartum OCD (Obsessive-Compulsive Disorder)
According to Postpartum Support International:
Obsessions, also called intrusive thoughts, which are persistent, repetitive thoughts or mental images related to the baby. These thoughts are very upsetting and not something the woman has ever experienced before.
Compulsions, where the mom may do certain things over and over again to reduce her fears and obsessions. This may include things like needing to clean constantly, check things many times, count or reorder things.
A sense of horror about the obsessions
Fear of being left alone with the infant
Hypervigilance in protecting the infant
Moms with postpartum OCD know that their thoughts are bizarre and are very unlikely to ever act on them.
Signs of postpartum PTSD (post-traumatic stress disorder)
According to Postpartum Support International:
Intrusive re-experiencing of a past traumatic event (which may have been the childbirth itself)
Flashbacks or nightmares
Avoiding stimuli associated with the traumatic event, including thoughts, feelings, people, places and details of the event
Persistent increased arousal (irritability, difficulty sleeping, hypervigilance, exaggerated startle response)
Anxiety and panic attacks
Feeling a sense of unreality and detachment
More resources
More about postpartum depression, anxiety and psychosis
More about postpartum psychosis
How postpartum depression can start three years after birth
Postpartum Support International
