Depression during pregnancy and following childbirth is common. Many parents — up to 80% of new mothers — experience feelings of sadness, hopelessness or unworthiness, sometimes referred to collectively as the “baby blues.” But when these symptoms intensify and persist, they can impair a mother’s ability to care for her baby and for herself.
Perinatal depression — that is, depression which affects people during and after pregnancy — is defined by its duration (lasting more than two weeks) and by its impairment to daily life functions. Perinatal depression affects up to 20% of women in the United States but may be difficult to recognize and often goes untreated.
As a medical student, I routinely meet with new parents and their newborns during their first check-up with their family doctor or pediatrician. I see them again when they bring their baby back for regular check-ups and for their follow-up visit with the obstetrician. At each of these visits, I screen parents for postpartum depression. It’s often difficult for new parents to assess their own emotional wellbeing in the wake of so much change — shifts in hormones following childbirth, lack of sleep, acute and chronic stress, and changes to daily routines. It can be intimidating or embarrassing to admit to any negative feelings around early parenthood. Many parents are reluctant to share that they feel disinterested in the baby. Others may feel overwhelmed by worry that they might hurt the baby, or feel resentment or anger toward the baby, or feel guilty about having these thoughts and feelings. Others still experience somatic symptoms like headache or body pain resulting from stress, worry or feelings of inadequacy related to their ability to parent.
Whenever we fly on an airplane, we’re accustomed to hearing the safety briefing: Secure your own oxygen mask before assisting others. Nowhere is this sentiment more relevant than in the postpartum setting — if somebody doesn’t have the oxygen they need to breathe, how can we expect them to take care of somebody else? It is no surprise, then, that untreated postpartum depression can have negative outcomes for both mothers and babies.
Postpartum depression is associated with lower rates of breastfeeding initiation, shortened duration of breastfeeding and difficulties with maternal-infant bonding, which subsequently have negative effects on infant development. As such, postpartum depression can have consequences that span across generations.
When I meet with new parents, it’s so important to stress that these symptoms are both common and treatable. Postpartum depression impacts millions of women and their families worldwide, and treatment is similar to treatment for depression outside of the peripartum setting.
Treatment generally consists of psychotherapy — which may include peer support groups, home visits or virtual support, and/or medication.
One tool I refer my patients to is the National Maternal Mental Health Hotline. Launched on Mother’s Day in 2022, the hotline provides free, confidential, 24/7 mental health support for moms and their families before, during and after pregnancy. Professional counselors provide support by call or text and are available for support in real time in both English and Spanish. Virtual support can be a critical resource for parents who live in rural areas, or who are isolated in their homes. And since pregnancy and birth of a new baby can affect the whole family, partners and family are encouraged to contact the hotline, too. In fact, ongoing research shows that postpartum depression is not limited to the childbearing parent, but affects partners and other family members, as well.
Being the parent of an infant is hard. This May, let’s honor Mother’s Day by normalizing the struggles that many new parents face and getting them the support they need to be the best parents they can be.
Rachel Pernick is a medical student at The University of Utah School of Medicine. She is completing her clinical clerkship year based in St. George.
Rachel Pernick is a medical student at The University of Utah School of Medicine. She is completing her clinical clerkship year based in St. George.
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