Kim Ma­haraj, LM­SW

In a so­ci­ety such as ours, the weight of par­ent­hood falls heav­i­ly on the shoul­ders of the moth­er. The moth­er is ex­pect­ed to car­ry the re­spon­si­bil­i­ties of tak­ing care of the new­born, and of­ten has to take care of the house­hold, oth­er chil­dren and her­self, by her­self.

The fourth trimester

The post­par­tum pe­ri­od can be an es­pe­cial­ly dif­fi­cult one as you try to nav­i­gate the fourth trimester. The birth of your child it­self is such a life-chang­ing mo­ment, and one that can be filled with much joy, but al­so ex­treme anx­i­ety, wor­ry and pain.

Then the avalanche of hor­mones right af­ter birth trig­gers some­times in­tense mood swings as your body tries to come back to bal­ance af­ter build­ing up cer­tain hor­mones over the course of the preg­nan­cy.

Post­par­tum de­pres­sion (PPD)

This refers to de­pres­sion oc­cur­ring af­ter child­birth. It in­cludes sad­ness, trou­ble sleep­ing and eat­ing, low en­er­gy, dif­fi­cul­ty con­cen­trat­ing, ir­ri­tabil­i­ty, feel­ings of worth­less­ness or guilt, ex­ces­sive cry­ing, up­set­ting thoughts, with­draw­ing from the ba­by, or not bond­ing, anx­i­ety about and around the ba­by, and fear of harm­ing the ba­by. These symp­toms are con­sid­ered nor­mal with­in two weeks of birth, but if they per­sist in­to weeks and months, it would qual­i­fy as PPD.

The first month is cru­cial in pre­vent­ing the de­vel­op­ment of PPD. She has to deal with post­par­tum bleed­ing, changes in her body, and heal­ing from de­liv­ery. Sleep de­pri­va­tion could put any­one in a chal­leng­ing mood, days and weeks of not get­ting enough sleep can wear down even the most re­silient of peo­ple. Even more stress­ful is if your child is in the NICU (a nurs­ery in a hos­pi­tal that pro­vides around-the-clock care to sick or preterm ba­bies) if you have a col­icky ba­by, if you are a sin­gle mom or suf­fered from post­par­tum preeclamp­sia. There are so many more vari­ables you could men­tion that add to the stress of a new mom.

How do I know if I have post­par­tum de­pres­sion?

Some nor­mal changes af­ter preg­nan­cy can cause symp­toms sim­i­lar to those of de­pres­sion. Many moth­ers feel over­whelmed when a new ba­by comes home. But if you have any of the fol­low­ing symp­toms of de­pres­sion for more than two weeks, call your doc­tor, nurse, or mid­wife:

• Feel­ing rest­less or moody

• Feel­ing sad, hope­less, or over­whelmed

• Cry­ing a lot

• Hav­ing thoughts of hurt­ing the ba­by

• Hav­ing thoughts of hurt­ing your­self

• Not hav­ing any in­ter­est in the ba­by, not feel­ing con­nect­ed to the ba­by, or feel­ing as if your ba­by is some­one else’s ba­by.

• Hav­ing no en­er­gy or mo­ti­va­tion

• Eat­ing too lit­tle or too much

• Sleep­ing too lit­tle or too much

• Hav­ing trou­ble fo­cus­ing or mak­ing de­ci­sions

• Hav­ing mem­o­ry prob­lems

• Feel­ing worth­less, guilty, or like a bad moth­er

• Los­ing in­ter­est or plea­sure in ac­tiv­i­ties you used to en­joy

• With­draw­ing from friends and fam­i­ly

• Hav­ing headaches, aches and pains, or stom­ach prob­lems that don’t go away

Many women don’t tell any­one about their symp­toms. New moth­ers may feel em­bar­rassed, ashamed, or guilty about feel­ing de­pressed when they are sup­posed to be hap­py.

They may al­so wor­ry they will be seen as bad moth­ers. Any woman can be­come de­pressed dur­ing preg­nan­cy or af­ter hav­ing a ba­by. It doesn’t mean you are a bad mom. You and your ba­by don’t have to suf­fer. There is help. Your doc­tor can help you fig­ure out whether your symp­toms are caused by de­pres­sion or some­thing else.

Your tribe of sup­port

This is where your tribe of wom­en­folk can make a huge dif­fer­ence in your men­tal health. Hav­ing peo­ple around who can help you bear some of the many re­spon­si­bil­i­ties would do so much in al­le­vi­at­ing the stress of the post­par­tum pe­ri­od. Gath­er a sup­port team around you if you can, us­ing both in-per­son and vir­tu­al help, es­pe­cial­ly in this post-COVID world.

Do not be shy about ask­ing for help, be­cause this is where you re­al­ly need it.

Those who can as­sist in per­son could help with pro­vid­ing food, clean­ing laun­dry, and get­ting sup­plies and med­ica­tions. They can as­sist in tak­ing care of old­er chil­dren for some time dur­ing the day. If they have tak­en suf­fi­cient safe­ty mea­sures, they could as­sist with help­ing to feed and care for the ba­by or take turns feed­ing the ba­by dur­ing the night, so you could get much-need­ed rest.

His­to­ry of trau­ma

Let your OB/GYN know if you have a pre­vi­ous his­to­ry of trau­ma or mood dis­or­ders. Be open about your con­cerns and wor­ries. Know­ing your trig­gers and pain thresh­old could help your med­ical team to bet­ter as­sist you dur­ing de­liv­ery. They would al­so be bet­ter able to mon­i­tor you in post­par­tum check­ups.

Work­ing with a ther­a­pist dur­ing your preg­nan­cy to pre­pare for pos­si­ble trau­ma re­ac­tions or post­par­tum mood dis­or­ders will al­so help in min­imis­ing the pos­si­bil­i­ty of de­vel­op­ing them.

Fo­cus on self-care

The im­por­tance of fo­cus­ing on self-care and strength­en­ing cop­ing strate­gies is vi­tal in this pe­ri­od of life. Do­ing gen­tle ex­er­cis­es, rest­ing, jour­nal­ing, stretch­ing, aro­mather­a­py, watch­ing movies are some easy things you can do as you ad­just and re­cu­per­ate. Self-care is al­so mon­i­tor­ing your symp­toms and let­ting your sup­port net­work know you need help.

Prepar­ing for the worst and hop­ing for the best is a good at­ti­tude to adopt. This way, if any­thing goes wrong dur­ing de­liv­ery or af­ter birth, you would be some­what pre­pared to face it. Though noth­ing can re­al­ly pre­pare you for birth and af­ter­birth, whether it be an emer­gency c-sec­tion, mul­ti­ples, or a still­birth, go­ing through dif­fer­ent birth sce­nar­ios and af­ter­maths, and prac­tis­ing cop­ing tech­niques to deal with dif­fer­ent out­comes will be help­ful. Above all, hav­ing your tribe of trust­ed peo­ple sup­port­ing you, no mat­ter what hap­pens, is your best pre­ven­ta­tive mea­sure against post­par­tum mood dis­or­ders.