What is Maternal Mental Health?

Whether it be natural, IVF, adoption, or any other means of becoming a parent, mothers can expect not only their lifestyles to change but also their bodies and hormones. This experience will be different for everyone, but one thing that is more common than most realize is the toll motherhood (or the journey to it) takes on one’s mental health.

According to Mental Health America, most maternal mental health disorders occur in what is referred to as the “perinatal period.” This includes the prenatal period (before conception), gestation period (while pregnant), and the postpartum period (the first year after the baby is born).

In a study done from 2017 through 2019 of new or expecting mothers, 74% scored positive or moderate to severe for a mental health condition.

Breaking Down Perinatal or Postpartum Mood and Anxiety Disorders:

Breaking Down Perinatal or Postpartum Mood and Anxiety Disorders:

A focus for mental health practitioners when working with soon-to-be moms or new moms is diagnosing and treating perinatal mood disorders. These are often referred to as PMAD (Perinatal/Postpartum Mood and Anxiety Disorders).

Though depression is the most talked about disorder when discussing maternal mental health, some others you may experience include: anxiety disorders, panic disorder, obsessive-compulsive disorder, birth-related PTSD, bipolar disorder, and/or postpartum psychosis.

Postpartum Depression

In the immediate days following childbirth, mothers may experience a phenomenon called “the baby blues” due to aggressive hormonal fluctuations. In fact, 80% of new mothers report experiencing these mood swings – roughly around days 3 to 5 post-delivery, which subside within a few weeks. However, if a birthing person continues to experience these high-level emotions for an extended period of time, they may be diagnosed with postpartum depression.

The symptoms of PPD are similar to clinical depression but may also include specific fears or ruminating thoughts surrounding the child’s well-being. PPD may also include intrusive thoughts of purposely or accidentally harming the baby. According to Postpartum Support International, 10-20% of new moms are diagnosed with PPD. (Note: Depression during pregnancy can occur as well – this is called Antepartum Depression)

Postpartum Depression

In the immediate days following childbirth, mothers may experience a phenomenon called “the baby blues” due to aggressive hormonal fluctuations. In fact, 80% of new mothers report experiencing these mood swings – roughly around days 3 to 5 post-delivery, which subside within a few weeks. However, if a birthing person continues to experience these high-level emotions for an extended period of time, they may be diagnosed with postpartum depression.

The symptoms of PPD are similar to clinical depression but may also include specific fears or ruminating thoughts surrounding the child’s well-being. PPD may also include intrusive thoughts of purposely or accidentally harming the baby. According to Postpartum Support International, 10-20% of new moms are diagnosed with PPD. (Note: Depression during pregnancy can occur as well – this is called Antepartum Depression)

Perinatal Anxiety

Perinatal Anxiety
Perinatal Anxiety

Though postpartum anxiety doesn’t attract as much attention from society, a growing number of women are being diagnosed. In fact, an estimated 10% of pregnant women and 15% of new moms are experiencing it. Symptoms include constant worry, a feeling of impending doom, racing thoughts, sleep and/or appetite disturbances, and inability to sit still. Additional physical symptoms may include hot flashes, heart palpitations, and nausea. These are all symptoms of anxiety.

Postpartum Obsessive-Compulsive Disorder

Arguably one of the most misunderstood diagnoses in the PMAD world, PP-OCD is anxiety that manifests as repetitive, intrusive images and/or thoughts that may be alarming and unprompted. Different from psychosis, these images and thoughts are not delusional in nature and have a very low risk of being acted upon. These thoughts/images often leave a sense of horror and unrest due to the misalignment with one’s morals and character. Engaging in compulsions may be a birthing person’s attempt to reduce the fear and anxiety involved with PP-OCD.

Birth-Related Post-Traumatic Stress Disorder

Birth-Related Post-Traumatic Stress Disorder

Whether you experienced or witnessed an event that involved actual or perceived danger to yourself or others, you may be at risk for developing postpartum PTSD. Scenarios in which this is most common include: the baby being admitted to NICU, unplanned C-sections, prolapsed cords, use of vacuum extractors or forceps during delivery, postpartum hemorrhaging, unexpected hysterectomy, severe preeclampsia/eclampsia, perineal traumas (such as 3rd or 4th-degree tears), feeling powerless due to poor communication or lack of support from your care team or partner, or those with a history of sexual trauma.

Symptoms of postpartum PTSD may include: flashbacks, nightmares, intrusive re-experiencing, avoidance of stimuli associated with the event (such as thoughts, feelings, places, or people), increased and persistent arousal (such as irritability, difficulty sleeping, and heightened startle response), and feelings of detachment and/or numbness. If this sounds like you, you are not alone – an estimated 30% of women experience some symptoms of PTSD after childbirth. Early and consistent treatment can be highly effective in restoring your quality of life.

Bipolar Mood Disorder

This disorder has two sides – often known as the “highs and lows,” though clinically defined as depression and mania (or hypomania in more mild cases). Criteria for this diagnosis is that symptoms last longer than four days. A postpartum depressive episode resembles clinical depression: low mood, increased tearfulness, appetite/sleep changes, anhedonia, lack of motivation, fatigue, etc. The manic episodes may be harder to identify, as they vary for each person and case. For some people, “manic” is when they feel their best. They have more energy; they take up new hobbies or interests and may experience hypersexuality or impulsive spending. However, mania is not the baseline and is not long-lasting. Some people don’t sleep for days during a manic episode; they may be easily agitated, have an inflated ego, speak very quickly, or may even experience hallucinations or delusions. These signs and symptoms are more profound and more severe than just the average moodiness that is expected with postpartum. For many, pregnancy or postpartum might be the first time they become aware of the bipolar mood cycles.

Postpartum Psychosis

For decades, we have not hesitated to include reminders about the 1 in 1,000 risk of developing a blood clot in the postpartum period. And yet, we fail to inform new parents about the 1 to 2 in 1,000 risk of developing postpartum psychosis. This is a jarring statistic, considering what’s at stake – the lives of mothers and their children. Of that number, 4% of those cases involve infanticide, according to Postpartum Support International.

Symptoms of postpartum psychosis often start within the first two weeks after birth and can include hallucinations, paranoia, delirium, and delusions. The appearance of these symptoms is a medical emergency that requires immediate care via interventions, treatments, and assessments. It is important for loved ones to take any unusual behavior during the postpartum period seriously, as this may be the only outward sign that the mother is struggling.

Risk Factors for PMAD:

  • Personal/family history of depression, anxiety, or postpartum mood disorders
  • Premenstrual Dysphoric Disorder
  • Financial stress
  • Marital stress
  • Complications with pregnancy, birth, and/or breastfeeding
  • Inadequate support in caring for the new baby
  • Major recent life events outside of childbirth (loss, move, job loss)
  • Mothers of multiples
  • If the baby had a NICU stay
  • Mothers who have gone through infertility treatments
  • Women with any form of diabetes (including gestational)
  • Women who have a thyroid imbalance

Risk Factors for PMAD:

  • Personal/family history of depression, anxiety, or postpartum mood disorders
  • Premenstrual Dysphoric Disorder
  • Financial stress
  • Marital stress
  • Complications with pregnancy, birth, and/or breastfeeding
  • Inadequate support in caring for the new baby
  • Major recent life events outside of childbirth (loss, move, job loss)
  • Mothers of multiples
  • If the baby had a NICU stay
  • Mothers who have gone through infertility treatments
  • Women with any form of diabetes (including gestational)
  • Women who have a thyroid imbalance

Prevention for PMAD:

  • Practice healthy habits (eating healthy, getting enough sleep, staying active)
  • Make a plan for pregnancy and postpartum stage
  • Identify people to whom you can talk openly and honestly
  • Use stress management techniques such as mindfulness or grounding skills
  • Seek professional help, especially if you have several risk factors (listed above).

Treatment for PMAD:

  • Medication management
  • Psychotherapy
  • Inpatient care
  • Support groups / Socialization
  • Exercise and good nutrition
  • Decrease in caffeine intake

Treatment for PMAD:

  • Medication management
  • Psychotherapy
  • Inpatient care
  • Support groups / Socialization
  • Exercise and good nutrition
  • Decrease in caffeine intake

Additional Resources

Healthy Start Coalition of Pasco County:
https://healthystartcoalitionpasco.org/
6623 US Highway 19 New Port Richey, FL 34642
(P): 727-841-7888

Family Resource Guide:
PDF Guide

Florida BH IMPACT: (Improving Maternal & Pediatric Access, Care and Treatment for Behavioral Health)
https://flbhimpact.org/
(P): 1-833-951-0296

Oasis Pregnancy Care Center:
https://oasispregnancycenter.org/
Tampa Office – 813-978-9737
Land O’ Lakes – 813-406-4965
Wesley Chapel – 813-618-5037
Dade City – 352-534-5003

Teen Parent Program / Pasco Co. Schools (Cyesis):
PDF Resource
Learning Design Coach for DJJ and Cyesis Programs, Office for Student Support Programs & Services:
Stacia M. Clowes, MPH, CPH
sclowes@pasco.k12.fl.us
(P): 813-825-4461

Breastfeeding Support / La Leche League:
Central & West Pasco Leaders
Vanessa: 813-788-7965
Amanda: 813-501-3150
http://lllsunshinestate.org/pasco/

Breastfeeding Support / FL Department of Health
Breastfeeding Support Line:
(P): 727-484-3760
Breastfeeding Classes:
(P): 1-877-942-2229

BabyCycle Diaper Bank:
https://babycyclefl.org/
6511 43rd St #1811 Pinellas Park, FL 33781
(P): 727-256-3708

Better Together:
https://bettertogetherus.org/
(P): 239.470.2733
info@bettertogetherus.org
Family Care Coordinator:
Lisa Perry (813-337-7640)

Women Infants and Children (WIC):
Florida Dept. of Health in Pasco County
https://pasco.flhealth.gov/
(P): 727-861-5250

Citations:

[1] A report from the California Task Force on the Status of Maternal Mental Health Care. https://www.2020mom.org/ca-task-force-recommendations[2] Proprietary data from MHAScreening.org (2017-2019)[3] Mental Health America, Inc. (2023). Pregnancy and Postpartum Disorders. Mental Health America. https://mhanational.org/conditions/pregnancy-and-postpartum-disorders[4] Postpartum Support International. (2023). Learn More – Perinatal Mental Health Disorders. PSI. https://www.postpartum.net/learn-more/

Our Location

Our office is conveniently located in Hunting Creek Pointe office park, just a half-mile from the Little Road/Hwy. 54 intersection in Trinity and within 10 miles of Odessa, New Port Richey, Port Richey, Palm Harbor, East Lake, Tarpon Springs, Bayonet Point, and Hudson.

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