Perinatal & Postpartum Mental Health (7 Ways to Promote Mental Health During Pregnancy)
Perinatal & Postpartum Mental Health
(& 7 Ways to Promote Mental Health During Pregnancy)
This information is provided as general knowledge and may be used for self-improvement or education purposes but may not be used as medical advice or treatment.
Consult with your healthcare providers for your own unique health.
If you or someone you know is in crisis, immediately take action:
Go to the nearest emergency department or Call / text 988 (Free Suicide Hotline)
Pregnancy is often a major change whether planned or unplanned.
Pregnancy can be a positive experience, bring mixed emotions, upsetting feelings, and often a complex range of feelings and experiences.
If you or someone you love is experiencing difficult emotions, or are in an unsafe relationship, consult with your healthcare providers and/or mental health therapist about specific local resources. Help is out there, and you are not alone.
Pregnancy & Mental Health
Some aspects of pregnancy are well-known: morning sickness (read: all day sickness), heartburn, fatigue, mood changes, and changes to sleep.
Other pregnancy related changes may be less well-known including swelling of the nose, feet, hands, the randomness of gestational diabetes, changes in body odor, hair loss, and signs and symptoms of perinatal mood disorders.
Please note that mood changes are “common,” not “normal” (Which is my least favorite word as a therapist, but hear me out and keep reading!)
What is Perinatal and Postpartum Mental Health?
Perinatal refers to the period of time a childbearing person is pregnant through the first year post-delivery.
Postpartum refers to post-birth up to two years after delivery.
I recently attended a training through Postpartum Support International (PSI) and they shared a lovely updated description of the change in terminology about Perinatal Mood and Anxiety Disorders (PMAD):
Perinatal:
During pregnancy or postpartum period
Mood:
Depression, bipolar, psychosis
Anxiety:
Panic attacks, Generalized Anxiety Disorder [GAD], Obsessive Compulsive Disorder [OCD], Post-Traumatic Stress Disorder [PTSD]
Disorders:
Impact on daily living and/or functioning
While many people believe the risk of postpartum mental health disorders disappear after 6-8 weeks post-delivery, the increased risk period for postpartum mental health disorders persists for up to TWO years post-delivery.
Women and childbearing people experience a postpartum period even if they do not come home with a baby; and pregnancy loss can be a risk factor for grief, postpartum depression, anxiety, OCD, PTSD, and psychosis.
Men, and non-childbearing partners, are also at risk for postpartum mental health issues.
This information is relevant for couples of all orientations. Adoptive parents, and those using IVF and surrogacy, are similarly at risk for developing postpartum mental health diagnoses.
Postpartum is not just about the hormones.
PMADs often reflect the transition into a new lifestyle: there is significant change, high stress, confusion, exhaustion, poor sleep, chores, finances, a tiny new human, and visitors - oh my.
Fast Facts:
Mood changes during pregnancy or postpartum period are common:
Perinatal depression impacts 1 in 7 women
1 in 10 men experience postpartum depression
Nearly half of childbearing people do not receive treatment for PMADs (Lucas et al., 2019).
Cognitive Behavioral Therapy (CBT) is an evidence-based treatment for perinatal and postpartum mood disorders: it is treatable! (O’Brien, Gregg, & Wittkowski, 2023).
Postpartum Support International estimates over 20% of pregnant women experience postpartum depression
PMADs do not discriminate: they impact people regardless of race or socioeconomic status
Early intervention of PMADs improves the health of women and infants
Women are more likely to receive care for PMADS (and other health issues) than are men; it is likely that men experience higher rates of PMADs.
Some reasons that pregnant people and their partners do not seek help include:
- Stigma, including the misconception that men (and non-childbearing parents) are not at risk for PMADs
- Not enough time for appointments
- Feelings of shame, guilt; "I should be able to do this"
- Lack of therapists (or long waitlists)
- Financial stress
How to Prevent and Monitor for PMADs
1. Start seeing a counselor or psychologist who specializes in perinatal and postpartum populations
Build your mental health support before you "need" it; aim to establish yourself with a new therapist during early pregnancy or while trying to get pregnant.
5 Steps to Find a New Therapist
2. Monitor your sleep and signs of stress
Connection Between Sleep & Mental Health
Pregnant people and parents of young children are famously impacted by stress and experience sleep disorders; always consult with a healthcare provider if you are struggling to get restful sleep.
3. Evaluate your support system
Having a strong support system can be a protective factor against PMADs.
This may look like having a few trusted people with whom you can vent, share vulnerable thoughts and feelings with, a supportive partner, other people going through pregnancy, or folks who will help with chores and cooking post-birth.
Accepting help is not a sign of weakness!
4. Keep a list of the signs and symptoms of PMADs
Whether in your car, saved as a list in your phone, a note on your desk or refrigerator: Keep it handy for longer than you assume
(remember the 2-year period of increased risk for postpartum mood and anxiety disorders after birth)
Additionally, give this list to your partner, a few trusted family members, or friends and ask them to help you keep an eye on your mental health.
Ask them to inform you if they notice any changes.
5. Expect stress and be ready for it
Attending all of the appointments while dealing with the stress, physical changes, and potential uncertainty of pregnancy is likely to add stress!
Promote your psychological well-being by engaging in activities such as mindfulness or meaningful hobbies
45 Activities to Boost Your Well-Being
6. Join a Postpartum Support International support group
Depending where you live in Alaska you may be able to find in-person support groups in Anchorage, Fairbanks, Soldotna, or Juneau.
If you live outside of those areas or simply prefer virtual appointments, online groups are widely available (as an online therapist, I love the accessibility of virtual sessions!)
7. Make yourself (or your partner) a self-care kit
Include clay, playdough, coloring books, books for reading, essential oils, lotion, a face mask, tea, bubble bath mix, peppermints, a journal – whatever you like!
Keep this kit nearby when you’re overwhelmed and in need of an easy stress-reduction activity.
Those are 7 ways to prepare yourself for the mental health changes of pregnancy.
Just because anxiety, depression, and OCD are common does not mean anyone has to suffer.
It’s okay to feel scared, thankful, anxious, nervous, excited, optimistic, worried, and more: Pregnancy is complicated.
If you want to find new ways to cope with pregnancy or postpartum and live in Alaska, I am accepting new clients for online counseling sessions.
Read more about counseling services I offer.
About the Author:
Nicole Zegiestowsky, M.S. (she/her)
Hello! My name is Nicole and I’m a pre-licensed psychotherapist pursuing my LPC in Alaska.
I grew up in the Philly area and moved to Alaska in 2016 to finish my bachelor’s degree from Alaska Pacific University.
I earned my Master’s in Clinical Psychology from the University of Alaska, Anchorage and gained experience as a psychotherapist in community mental health, interdisciplinary primary care, and residential treatment settings.
During my free time I enjoy hiking, paddling, foraging for berries or mushrooms, and cozying up with my cat and dog.
If you think we may be a good fit together, let’s talk!
References
Postpartum Support International (PSI) Fact Sheet