The True Birth Experience: Looking at Maternal Mental Health and the Real Issues That New Moms May Face
Jessica Heiman Freilich, Psy.D.
Having a baby is one of the most life changing transitions one can experience. Change often comes with a mix of emotions. Following the birth of a child people often feel joy, love, overwhelmed, doubt, a sense of loss, and fear just to name a few. While we often hear about how wonderful and joyous having a baby is, people rarely talk about the difficult feelings that accompany bringing a new life into this world. Many women report that the reality of becoming a mother is inconsistent with how they believe it will be. Being open about the possible challenges and experiences is essential to decreasing shame and feelings of isolation in new parents. Understanding the difference between feelings associated with adjusting to motherhood versus more serious symptoms is essential in ensuring those who need help the most receive the support they require.
Up to eighty-five percent of women experience the “Baby Blues” following delivery. The Baby Blues typically appear a few days postpartum and consist of sadness, mood swings, irritability, crying, and anxiety. The Baby Blues, however, is not the same as postpartum depression. The symptoms will resolve on their own within three weeks and are thought to occur due to extreme hormonal fluctuations at the time of birth and fatigue. A woman will feel much relief after the symptoms resolve, but it is important to understand that the adjustment to parenthood continues with many ups and downs. When one is feeling angry, overwhelmed, and missing their “old life,” they are not alone, but women often tend to feel guilty and ashamed about these feelings. They feel that feeling this way cannot be compatible with loving their baby. However, these feelings are completely normal when one considers the major transition having a baby truly is.
On the other hand, some women find that feelings of persistent sadness and anxiety do not resolve after a few weeks. In this case, Perinatal Mood and Anxiety Disorders (PMADs), often referred to as postpartum depression, may be present. Symptoms include difficulty bonding with baby, inability to sleep even when the baby is sleeping, intense sadness and crying, hopelessness and helplessness, anxiety, loss of interest, joy, and/or pleasure, and a sense of worthlessness. Many women will also experience intense anxiety that may include flashbacks due to a traumatic birth, intrusive and scary thoughts surrounding something bad happening to their baby, or even thoughts of possibly inflicting harm onto one’s baby themselves.
Unfortunately, women are often afraid to disclose such intrusive or scary thoughts due to fears of judgement and being seen as an unfit mother. It is important to note that when one is bothered by thoughts of harming their baby, the probability of acting on them is extremely unlikely. As we are fostering more awareness regarding how common and treatable these symptoms are, more and more women are being encouraged to talk about what they are experiencing so they know they are not alone, and they can get help.
Perinatal Mood and Anxiety Disorders are treatable. Risk factors that may place women at risk for PMADs include a personal or family history of depression and anxiety, current life changes and/or stressors, lack of social support, financial distress, marital difficulties, a traumatic pregnancy or birth experience, and infant temperament.
One important risk factor that is not commonly talked about is a past history of trauma, especially physical and/or sexual abuse in childhood. Pregnancy, child birth, and new motherhood happen to be a time of intense vulnerability and powerlessness. It is common for traumatic memories to be recollected and triggered which often accompanies intense feelings and distress. Therefore, it is beneficial for those with a trauma history, especially one that involves sexual and physical abuse, to establish a relationship with a therapist during pregnancy to ensure support. In fact, the U.S. Preventative Task Force recently issued new recommendations indicating pregnant and postpartum women at risk of experiencing a PMAD seek counseling. As the mental health issues women face in the perinatal period are being talked about more and normalized, more women will hopefully receive the help they need which will serve to benefit them, their baby, and the rest of their family. For more information on PMADs and a more in-depth description of the different disorders, visit the Postpartum Support International (PSI) website.
Postpartum Support International www.postpartum.net
Seleni Institute www.seleni.org
Kleiman, Karen (2017) The Art of Holding in Therapy: An Essential Intervention for Postpartum Depression and Anxiety
Simkin, P & Klaus, P. (2004) When Survivors Give Birth: Understanding and Healing the Effects
of Early Sexual Abuse on Childbearing Women