What new mothers or pregnant women should know about postpartum depression

By: Diane Clevenger, ARNP, CNM, WHNP

Pregnancy and the birth of a baby is a joyous occasion, celebrated by family and friends. But for 1 in every 10 women in the United States, the time directly after birth can be one of the more challenging times to maintain any sort of good mental health. While many women experience the “baby blues” in the first 2-3 weeks after birth, postpartum depression is different and is often not talked about enough. There is a stigma around postpartum depression that leads too many women to suffer in silence.

What is postpartum depression?

Postpartum (or after birth) depression is generally defined as depression in the first 12 months after birth.

Many women experience the “baby blues” in the first 2-3 weeks after birth with mild symptoms like insomnia, fatigue, tearfulness, irritability, mood swings, anxiety and appetite changes. These usually resolve within 2-3 weeks postpartum.

Postpartum depression is diagnosed if these symptoms persist and/or intensify. Additional signs of postpartum depression are:

• Depressed mood most of the day
• Diminished interest or pleasure in most activities
• Fatigue or loss of energy
• Agitation or extreme irritability
• Inability to concentrate
• Feelings of worthlessness or excessive guilt

What causes postpartum depression?

There is not one definitive cause for postpartum depression, but some women may be more likely to experience this condition. Women who have a previous history of depression or postpartum depression with previous pregnancies may have a higher risk. Family history may also have an impact. Studies have shown that if one or multiple family members have a history of depression, the mother may be predisposed to postpartum depression.

How common is postpartum depression?

Postpartum depression occurs in 9-10% of women. It lasts at least a year in 30-50% of those diagnosed. This is comparable to general non-perinatal depression so early identification and treatment are extremely important in the postpartum period. You are not alone. Your provider wants you to seek care and get help to enjoy being a new mother, to be healthy and to have a healthy bonding with your babies.

How do providers test for postpartum depression?

Women receive depression screenings multiple times throughout their pregnancy and postpartum care including during pregnancy, on discharge from the hospital, two weeks after visit and six weeks after postpartum visit. These tools assist in the diagnosis as well as more intense questioning to help identify depression and provide treatment recommendations.

Postpartum depression impact on newborns

It’s important for mothers to be honest and open if they’re struggling with postpartum depression because there can be impacts on the newborn baby’s health. Postpartum depression can impact breastfeeding. Breastfeeding time may be shortened, or the woman may not reach her breastfeeding goals. There can be less bonding time, interaction, holding, physical touch, eye contact, smiles and talking to the baby. These are all important behavioral needs for a newborn.

Postpartum depression has an impact on everyone around you.

How is postpartum depression treated?

Postpartum depression is a treatable condition when recognized and with appropriate intervention. For women who experience postpartum depression, care is essentially the same as care for depression. Talking with a therapist can help manage emotions, identify and deal with personal life and relationships. Antidepressant medications can also be prescribed. Women who have been on medication previously or experienced postpartum depression with previous pregnancies may request medication more often during the pregnancy or in the immediate postpartum period.

There is also some at-home self-care to help treat postpartum depression. Here are a few tools:

• Plan for postpartum during the last trimester.
• Accept help for food preparation, running errands, doing laundry and assisting with other children during the first 2-3 weeks postpartum.
• Sleep when the baby sleeps. Lack of sleep is a real concern for developing depression.
• Do not schedule or overschedule yourself the first 2-3 weeks postpartum.
• Get mild exercise like walking.
• Eat protein, fruits and vegetables.
• Drink ample water.

Don’t feel guilty about practicing self-care. Your baby is better when you are happy and healthy.

If you are struggling with postpartum depression, we have specialists available for you. Talk with your primary care provider or find a MercyOne provider to learn about the resources near you.

About the author: Diane Clevenger, ARNP, CNM, WHNP, is dual certified as a Women’s Health Nurse Practitioner and Certified Nurse Midwife practicing at MercyOne. Diane has been with MercyOne Des Moines Midwives since the beginning of the practice in 2015. Midwives provide gynecology care in addition to all prenatal, labor and birth and postpartum care.