Navigating the Emotional Journey of Pregnancy & Postpartum

Let this be a sounding alarm for all new or soon-to-be parents trying to make sense of all the changes that having a baby brings.

Did you know that there is a 1 in 5 chance as a mother, 1 in 10 chance as a father, and 3x higher than standing average chance as a nonbinary parent that you will develop a perinatal mood and anxiety disorder within your baby's first year of life? This is not said to scare you, or to say that your fate it set it stone. It's not. But often we take our physical health, wellness, and conditions seriously, and here at Candlelit Care, we believe your mental health deserves, no, beckons for the same high regard. And sometimes building that awareness to hold our mental health at a higher regard comes with some introductory education. Ready?

Well first off, let me just remind you that you are not alone if managing through early parenthood is feeling overwhelming. There is so much that you’re navigating mentally, physically, and emotionally when you’re pregnant or postpartum. From the moment you’ve discovered that you are expecting to delivery or perhaps coming home with your new baby, your body and mind will have gone on an emotional rollercoaster and I'll be honest, it's a LOT.

Additional note: when I reference women in this blog and future articles, it's because the current research, data, and participating parties identified themselves as women in those studies. Unfortunately, research on mental health complications within the parenting LGBTQIA+ community is limited to a mere 1 study. Yeesh. That said, according to current evidence, maternal mental health is a major challenge that affects pregnant and postpartum women globally. In the United States, there are six types of perinatal conditions according to the American College of Obstetricians and Gynecologists (Nov 2021) that have been identified and acknowledged.

Postpartum Depression (PPD): Postpartum depression is one of the most common PMADs and affects approximately 15% of new mothers. Symptoms may include persistent sadness, feelings of worthlessness, changes in appetite, and difficulty bonding with the baby. In black women, PPD may manifest differently due to cultural, social, and systemic factors.

Postpartum Anxiety: Postpartum anxiety involves excessive worry, fear, or nervousness that can interfere with daily activities. It may manifest as constant worrying about the baby's health or well-being. Black women may experience heightened anxiety due to stressors such as racism, discrimination, or unequal access to healthcare.

Postpartum Post-Traumatic Stress Disorder (PTSD): Postpartum PTSD can develop after a traumatic childbirth experience. Symptoms may include intrusive memories, flashbacks, and severe anxiety related to the childbirth trauma. Black women may be at a higher risk of traumatic birth experiences due to disparities in healthcare quality and maternal mortality rates.

Postpartum OCD: Postpartum OCD consists of intrusive or obsessive thoughts, compulsions, or images related to the harm or injury of a child. It is worth noting that for parents experiencing OCD, the intrusive thoughts are paired with compulsions that help to rid of the thought, temporarily ease the anxiety, or tolerate the obsession. This can cause great discomfort and shame for the person experiencing it.

Postpartum Psychosis: Postpartum psychosis is a rare but severe PMAD that involves hallucinations, delusions, and extreme confusion. Prompt medical intervention is essential, as it can pose significant risks to both the mother and the baby. Always dial 911 or emergency services in your country if you are experiencing hallucinations, delusions, thoughts of harm for yourself or your baby, or lack of touch with reality.

Bipolar Mood Disorders: Bipolar disorders are characterized by a vacillation between highs and lows with symptoms resembling extreme anxiety one minute and depression the next. Bipolar I has a greater degree of mania (high or anxious mood), whereas bipolar II is characterized by longer periods of hypomania (low mood).

What is the cause of PMADs?

Perinatal Mood and Anxiety Disorders (PMADs) are caused by a variation of biological, psychological, and environmental factors. Hormonal fluctuations, genetic predispositions, and neurotransmitter imbalances can play a significant role in the onset of PMADs. Additionally, the demands of pregnancy, childbirth, and new motherhood, coupled with sleep deprivation and altered lifestyle, can trigger stress and anxiety. Socioeconomic disparities, racial stress, and a lack of social support also contribute to the development and exacerbation of PMADs, emphasizing the need for a comprehensive approach to addressing these mental health challenges.

Ways to Cope with PMADS

1. Create a Postpartum Plan

Before you conceive, it could be useful to put a plan in place that details who will be there to help you, who can offer you feedback, and what your boundaries are for home visits, meal training, etc. during pregnancy and after birth. Many women put a lot of effort into a birth plan, but a postpartum plan is just as important to a healthy recovery, if not more important. It can be helpful to remember that you are never going to be in labor as long as you’re doing to be postpartum, why not give that one the effort it deserves?

Some examples can be found here: https://postpartumva.org/wp-content/uploads/2020/11/PSVA_PostpartumPlan_090820.pdf

2. Have a Mental Health Consultation Before You Need it

One of the greatest risk factors for developing a PMAD are preexisting mental health concerns. Women who have experienced depression or anxiety prior to pregnancy are more likely to experience a PMAD. Prior to conceiving, consult your provider (like your doctor, therapist/counselor or midwife) about risk factors and discuss options for identifying and treating any potential maternal mental health issues.

3. Exercise

Focusing on exercising can help regulate your hormones and neurotransmitters. Exploring these coping skills can help boost your energy and happiness, and help regulate your sleep. The addition of music, movement, community, and hobbies that interest you can combine well with this strategy as well. That said, one of my favorite quotes from an educator at Postpartum Support International was "some of us cannot just 5k our anxiety or depression away!" - this can be a mood boosting strategy, but sometimes you may need more.

4. Nutrition

It goes without saying that good nutrition will help your body recover (think muscles, tissues, hormonal regulation, accounting for potential blood loss, lack of sleep, etc) after giving birth. In many cultures around the world, during the first 30-40 days, it is recommended to prioritize healthy fats (omega 3’s, seeds, nuts, fish oils, dairy or dairy free butters, coconut oil, and more) for healing tissue, milk production (if you are choosing to feed baby with your body), and hormonal regulation.

In addition, warming comfort foods, nutrient dense broths and stews, and healthy sources of carbohydrates for quick energy and proteins for muscle repair and more sustained energy. Remember that if you’re breastfeeding, an additional 400-500 calories/day are recommended (but coffee doesn’t count)!

4. Befriend Self-Compassion

Data has shown that embracing mindfulness-based self-compassion is a coping mechanism that reduces the risk of experiencing postpartum depression or other PMADs. Because becoming a parent is one of the biggest stressors, embracing an attitude of compassion and grace toward oneself is helpful. Through this, you’ll find yourself more able to forgive yourself for mom guilt and other negative feelings related to motherhood.

5. Accept & Offer Peer Support

Accessing support from your peer group during pregnancy and in the postpartum phase has been shown to reduce symptoms related to postpartum anxiety. There are groups you can join through online FB groups, or in your local community.

6. Designate a Partner or Trusted Friend to Give You Honest Feedback

Because the time period after giving birth can be blurry at best, many women struggle to see their own emotional struggles. During early pregnancy, request that an honest person in your life give you feedback if they see that you seem distressed or are “not acting like yourself.” These observations can be crucial to timely intervention.

7. Employ Relaxation Techniques Early & Often

Due to the emotional and physical toll pregnancy and birth can take on the mind and body, it’s important to find daily ways to engage in relaxation. Whether it’s meditation, yoga, cuddling with a pet, journaling, or drinking a cup of tea.

8. Do a Daily Self Check-In

Make time to check in with yourself at least once a day. Ask yourself the simple question, “What do I need right now?” If your answers are out of character, negative, or scary, be honest with yourself and share what you notice with someone close to you or your provider.

9. As Much as Possible, Prioritize Sleep Hygiene

While sleeping is difficult with a newborn, mental health challenges can be exacerbated by not having proper rest. Sleep is actually one of the most protective actions you can prioritize to lower your risk of PMADs and depression postpartum. As much as possible, sleep when you have windows of time when you can safely do so. When you have help with the baby is likely the best opportunity for this. Consider an early bedtime between 6-8pm for this temporary season of life if you are managing sleep with a newborn as a solo parent. If partnered, try to set up a "staggered sleep" schedule with your partner, co-parent, grandparents, or caregivers. Remember, caring for your baby and healing your body IS WORK.

10. Self Care (not just a shower)

Everyone is talking about it, we all need more of it - it's self care! That said, yes, a shower or trip to the grocery store alone are nice treats, but I'd challenge if they are sustainable methods of long term self-care. Some additional ideas might include...

- Going for a walk with a friend (with or without baby) who truly gets you

- Coming back into an old hobby or picking a new one

- Joining a support group for like-minded or identifying parents

- Getting your hair or nails done

- Taking a class that inspires you

- Spending time outside

- Treating yourself to your favorite bev or snack

- Doing a childcare trade with fellow parents you trust to get some much needed time solo or with your partner

...to name a few. But no matter what you do, make it your own, make it regular, and be sure to connect with your Candlelit Care coach to help you set SMART Goals along the way. ;)