Postpartum Mental Health

Becoming a new parent can be an overwhelming, emotional and confusing time. Your life has changed dramatically and everything is so new. Even if you aren’t a first time parent, each pregnancy, birth and child are different. Many new parents wonder if what they are going through and feeling is normal or not.

At Pine Health, we specialize in the perinatal and postpartum period and have helped many others along their parenthood journey. Below is a list of Frequently Asked Questions (FAQs) we get around maternal mental health. If you would like more detail, or would like to talk to one of our expert practitioners, please call the clinic or book an appointment online.

Researchers have not yet outright declared a standardized timeframe for the postpartum period. However, the postpartum period most commonly addresses the 12-month period starting once the baby is born. In short, the postpartum period is most commonly considered the first year with the baby.

There is a subtle difference between the terms postnatal and postpartum, and often the terms are used interchangeably. According to the World Health Organization (WHO, 2010), postnatal usually refers the time after delivery that directly impacts the newborn baby. These could be things such as jaundice and weight fluctuations. On the other hand, the word postpartum commonly refers to things that impact the birthing mother such as, childbirth recovery and perinatal mood and anxiety disorders (PMAD). As these words are quite commonly used interchangeably it is important to use the context from the article to determine if postnatal is actually referring to the baby or the mother.

Approximately 80% of birthing mothers experience the baby blues. The baby blues usually starts 3-5 days after the baby is born and can last for up to 2 weeks. Some common symptoms of the baby blues include troubles sleeping, feeling more sad or irritable, crying for no reason, and mood swings. If these symptoms continue beyond 2 weeks of the baby being born, it might be a sign of postpartum depression.

Postpartum hormones usually last for approximately 2 weeks after the baby is born. Postpartum hormones are what commonly impact the development of the baby blues. In some cases postpartum hormones regulate within 2 weeks of delivery. However, there are times such as when breastfeeding, where postpartum hormones can fluctuate. Hormone levels are very individualized to each woman, and therefore it is hard to set a normalized timeframe. It is important to note that if you are concerned about your specific hormone levels to consult your family physician. .

One of the symptoms of the baby blues is increased crying, or crying for no reason. The baby blues is a very common experience within the postpartum period. However, prolonged bouts of intense crying might not fit within the baby blues symptomology. Feelings such as helplessness, hopelessness, and a lack of happiness and joy that lead to crying might be a sign of postpartum depression as opposed to the baby blues. Having postpartum depression does not mean you are a bad mother, or that you are weak. Seeking out additional supports will ensure you can start feeling like yourself again.

There are no definitive ways to completely prevent postpartum depression. However, there is some good news. Not all mothers will develop postpartum depression. According to the most recent data released by Statistics Canada in 2019, approximately 23% of women experience feelings consistent with postpartum depression and/or anxiety. Of that approximately 10% identified as having experienced just postpartum depression. There are some risk factors that increase the chances of developing postpartum depression.

Postpartum depression risk factors include:

• Family history, or previous experience with depression
• Poor emotional or practical support from family and friends
• Having unrealistic expectations of herself as a mother
• Complicated pregnancy, labour, or delivery
• Health complications in the newborn baby
• Protective factors for postpartum depression:
• Having a strong social support network
  • This can include anyone (spouses, partners, doulas, midwives, nurses, friends, family, etc.) that will support, respect, and advocate for the mother’s needs and wishes
• Being compassionate towards yourself as you grow and develop into the new role of a mother
• Taking intentional self-care breaks – even if they are only 5 or 10 minutes each
  • Taking small intentional breaks periodically can prevent becoming too overwhelmed
• Seeking out help and support quickly, even in pregnancy
• Educating yourself and a trusted person to recognize the signs, symptoms, and additional risk factors of postpartum depression

Yes, PPD can be serious. Postpartum depression can decrease a mother’s quality of life, impact her ability to bond with her newborn baby, and affect the family unit as a whole. If left untreated PPD can last for years. Symptoms such as feelings of helplessness and hopelessness, negative thoughts about yourself and others, and no longer enjoying things that made you happy are some of the signs of PPD. As with most depressive disorders, thoughts of suicide can also increase in mothers suffering from PPD. It is important that if you are feeling as though you might be experiencing PPD to reach out for support, as with the proper care and treatment things will improve.

Postpartum anxiety is a perinatal mood and anxiety disorder (PMAD) that can cause a mother to worry a lot about various aspects of her life, or that of her child(ren). According to the most recent data released by Statistics Canada in 2019, approximately 23% of women experience feelings consistent with postpartum depression and/or anxiety. Of that, approximately 5% identified as having just postpartum anxiety.

Signs of postpartum anxiety can include:

• Constant worry
• Feelings that something bad is going to happen
• Inability to sit still
• Changes in appetite
• Racing thoughts

Postpartum anxiety can also manifest into postpartum panic disorder, in which the anxiety and worry is so bad the mother can have panic attacks. The distinctions between what normal or excessive amounts of anxiety are is unique to each person. If the levels of worry and unhelpful feelings of fear are negatively impacting the lives of the birthing mother and/or her family, it might be a sign of postpartum anxiety.

There really is no set timeframe anxiety should or could last for. Experiencing some anxiety during the 2-week period of the baby blues would be common. However, if the anxiety is increasing in intensity or it is persisting beyond the baby blues, then it might be a sign of postpartum anxiety.

Research is beginning to emerge as to why the sound of crying increases anxiety in postpartum mothers. In one study, researchers uncovered that the hormone oxytocin changes the way in which auditory signals are processed in the brain of mice. The researchers discovered mice with greater amounts of oxytocin in their brains responded more rapidly to the cries of infant mice, compared to mice that did not have oxytocin in their brains. Oxytocin is a hormone that is commonly produced after having a baby and during breastfeeding. Based on the results from the study, it is hypothesized that mothers with greater amounts of oxytocin in their brains react more strongly to infant cries than individuals without as much oxytocin. This could explain why the sound of a baby crying increases anxiety levels.

Postpartum psychosis is a rare condition that impacts approximately 0.1-0.2% of birthing mothers. The symptoms of postpartum psychosis usually occur within the first 2 weeks after the baby is born. Postpartum psychosis is considered to be a medical emergency. If you, or someone you know is suspected of having postpartum psychosis please seek emergency medical care or call the crisis hotline for further instructions.

Signs of postpartum psychosis can include:

• Hallucinations (seeing or hearing things that are not there)
• Delusions (strange or abstract beliefs, such as being possessed)
• Thoughts of harming yourself, or baby
• Being very hyperactive
• Inability to sleep
• Paranoia or being overly suspicious
• Distrust in other people
• Difficulty communicating
• Rapid mood swings

Personal of family history of bipolar disorder, or previous psychotic episodes

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