3 things your doctor might not tell you about postpartum
Cradlewise's maternal wellness medical advisor shares what to know about protecting your mental health during the months after birth.
Content warning: Discussion of suicide ahead.
Postpartum is one of the most life-changing—and often challenging—steps in the parenting journey. It’s not called the “fourth trimester” for nothing: Your baby is still growing, changing and adapting at an amazing rate… and so are you.
It’s not uncommon for parents to feel unprepared for the mental and physical journey that is the postpartum period. It can seem like all those experts and advisors you relied on during pregnancy suddenly step back. That’s why, as a maternal wellness advocate, I want to share what your doctor might not tell you. And it starts with you, as the parent.
As a board-certified OB-GYN, startup founder, physician executive and mother, I wear many hats—but I am especially interested in centering parents in the journey of growing their families. It’s crucial to nurture not only our children, but also ourselves during this process. I’m passionate about how we can improve the overall physical and emotional health of the entire family during pregnancy, birth and postpartum.
Each family’s story is different, but if you’re preparing to bring a child into your life, here’s what I would tell a friend about safeguarding their mental health after their child arrives.
3 pieces of postpartum advice for new moms—from an OB-GYN
1. Everyone needs a postpartum plan
You hear a lot about creating a birth plan, but don’t forget about those first few weeks after baby arrives. Below are some strategies.
Start planning early
By the start of your third trimester, figure out what your support system will look like for your first month with your baby. Do you have people you can call? Are they going to stay with you or nearby for a period of time? You may decide to adjust your plan, but having some structure in place—so it isn’t just you for the first month or two—can make an enormous difference in your well-being.
Related: A postpartum plan is just as important as a birth plan. Here’s how to make one
Ask for support so you can support your child
We can shift our frame of reference away from just being centered on the baby—without the guilt of feeling selfish! I love the trend of friends and family coming together and creating meal trains, so parents don’t have to worry about cooking or preparing food for themselves. If you support, nourish and feed those parents, they will be better equipped to care for their child.
Related: Two words that can radically improve a new parent’s life: Meal trains
Anticipate your outsourcing needs
Every family will have their own challenges, but it’s important to think carefully about the ones that yours might face, whether it’s breastfeeding, recovering from a C-section birth, returning to work, or other issues. Try putting even just a little bit of thought into that because even if you don’t feel comfortable making decisions before the baby arrives, you can do some early planning. For example, you could research and create a list of postpartum doulas, lactation consultants or house cleaners in case you need additional support.
Related: 3 tips on childbirth recovery from a postpartum doula
Connect with other parents
Even if you’re stuck at home at first, it’s important to have regular outlets that make it easy for you to ask new-parent questions. Try to find something to plug into, whether it’s an in-person group or an internet forum where you feel safe asking questions. Maybe it’s an experienced mom friend who can chat by phone regularly. Setting up those channels in advance will help. In other countries, they have weekly postpartum support groups as part of your health plan. We don’t have that baked-in infrastructure in the US, so you’ll have to take the initiative to create that support yourself.
2. Sleep issues often exacerbate postpartum mental health challenges, but they are normal and treatable
The biggest thing I worry about is the risk for self-harm among not only birthing parents, but also supportive partners. We know that suicide is a significant driver for the high maternal mortality rates in the US. Here are some things to know about your mental health so you can show up not only for your family, but also yourself.
If you or someone you know is struggling with suicidal thoughts, call the National Suicide Prevention Lifeline at 1-800-273-8255 or text HOME to the Crisis Text Line at 741741.
Sleep is a major factor
Everyone knows that the postpartum period is defined by a lack of sleep. Newborns tend to sleep for up to 18 hours a day. You may get long stretches for the first week, but after that you’re pretty much on a cycle with your infant feeding every two to three hours. Going from your normal adult circadian rhythm, where you’re sleeping hopefully at least seven hours every night, to sleeping the way an infant sleeps, which is getting up every two to three hours, is a shock to the system.
If you’re breastfeeding, especially exclusively, that’s also part of the equation. Are there feelings associated with having to respond? If you have a partner, how much are they involved? So many things are wrapped up in fatigue and sleep during this time. Sleep has an impact on mood, and mood has an impact on sleep.
But help is out there. I always encourage patients to get information through local classes on newborn care and speak to a postpartum doula who can help educate them during this time when their sleep schedule is going to be unpredictable. This might also be a time that you look back at the postpartum resources list you made—do you need a postpartum doula or night nurse? Or can a friend watch your baby while you and your partner catch up on sleep? Should you outsource the dog walking?
Postpartum mood changes are normal and treatable
If you’ve given birth physically, you’re going to likely experience some feeling of the blues in the first couple of weeks of the postpartum period. Others will experience more serious and lasting perinatal depression or anxiety. If you have blues beyond the two-week mark, tell your doctor or midwife, and ask to be screened for a mood or anxiety disorder if you haven’t been already.
The goal would be to get connected with therapy and/or medication, which you may just need for a period of time. If you’re able to advocate for yourself when you notice these symptoms, you’ll understand that you’ll be able to break the cycle and feel better. The more you seek help, the more help you can access.
Related: Spotting postpartum depression can be difficult. Here’s how to enlist your partner’s help
It’s not just mothers
All parents are impacted by having a baby enter their lives, especially nowadays when there are more expectations for the non-birthing parent. As our society is evolving to shift some of the burden off birthing parents, the non-birthing parents are subject to similar stimuli and stressors that birthing parents have traditionally been.
We’re seeing peripartum mood disorders in about 10% of fathers and co-parents. They’re absolutely affected by lack of sleep, feeding schedules, and other things that put them at risk for mood disorders. All parents should be screened for these symptoms and have outlets for help.
Partners should be on the lookout
Loved ones can usually spot red flags for birthing parents. Things like, are you really able to rest? Are you having trouble falling or staying asleep? Are you eating regularly? Do you have an appetite? Are you preoccupied with things you can’t get out of your mind?
If you’re having trouble moving through the day, feel like you want to hide under a rock, or can’t interact with loved ones, those would all be warning signs for a mood issue. There are also screening tools like the Edinburgh Postpartum Depression Scale your healthcare provider can give you to get a sense of how you score.
3. Lean into technology in a way that works for your family
Technology can be a game changer for supplementing the “village” we once had.
Our villages have scattered
Most families don’t have live-in relatives for on-demand childcare, unlike other countries where there may be more multi-generational homes. Here, we’re left to our own devices—literally—so you need the devices that help you make it work.
Related: The ‘village’ is great, but the ‘parenting safety net’ is better
Technology can teach us
I fully support parents using smart cribs like Cradlewise to help encourage healthy sleep patterns. I love that you can get regular information about how your baby is doing and see the tools your little one needs to get better sleep. Using the crib as a facilitator, you learn what works and doesn’t. And the faster you learn what your child needs to sleep, the better it will be for everyone. These are not shortcuts but rather the next steps in how we parent.
Tech is our friend—we use it in every other part of our life
For example, technology is represented in our latest medical advancements—no one would ever question getting a more advanced antibiotic or the newest high-end breast pump. Whether you’re talking about technology or something else, there can be so much judgment in parenting, particularly toward women, who are often criticized for their actions. Remember to shut out the noise. It’s your family, so do what you need to do—because you’ve totally got this.
Darwin Z, Domoney J, Iles J, Bristow F, Siew J, Sethna V. Assessing the mental health of fathers, other co-parents, and Partners in the Perinatal Period: mixed methods evidence synthesis. Frontiers in psychiatry. 2021:1260. doi:10.3389/fpsyt.2020.585479
A version of this story was originally published on Cradlewise.