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#1 Childbirth Complication

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by Elise Bowerman

With all the information we have - including technology at our fingertips - there is still no universal screening for the #1 complication in childbirth: perinatal mood or anxiety disorder (PMAD) - including anxiety, depression, obsessive-compulsive disorder or psychosis. This affects at least 20% of women.

(However, there is universal screening for the 18% of women who have gestational diabetes.)

Postpartum depression and/or anxiety (PPD/A) is normal in the first year after giving birth. It’s normal!

But, do we really FEEL like it’s normal?! Not a bit.

Clearing Up the Shame

Unfortunately, there is a stigma about depression and anxiety. It has to do with a lack of understanding on everyone’s part (researchers, doctors, men and women.) Plus, the media shows us horrific examples of women who did not receive the care they needed to be nurturing mothers to their children, like the 1995 headline of Susan Vaughan who drowned her two young sons by rolling her car into a lake.

Cases like this story encompass the rare development of postpartum psychosis. When this information is not shared through media outlets it leaves the public to believe depression is the reason a mother would commit such heinous acts.

It is absolutely gut wrenching, but something we have to face when mental health care isn’t being prioritized or treated. There are many mothers who are highly functioning with depression and/or anxiety. If they dealt with a mood disorder prior to having children, then they are more likely to experience a perinatal mood disorder or have exacerbating symptoms.

Postpartum has often been referred to the first 6-12 weeks after giving birth. Nowadays, it's generally accepted that "postpartum" is the first year of baby's birth. 

Personally, I feel postpartum is forever. Once we become a mother the life we once identified ourselves with is over. We lead a new life, have new priorities and even a new body. This is something we have to acknowledge and explore as age.

Medically Speaking - On the Physical Level

Medically speaking, anatomically, everything may seem okay and the doctor/midwife may clear mom to slowly return to her usual activities. But a woman has to get used to this new body. Her body is no longer “hers” as she just created new life! Adjusting to the changes that occur may be quite a process. Our modern culture places heavy pressure on women who have birthed to look and behave like they did before; yet, they are no longer that woman! They are now mothers – women who have a fresh perspective on what it means to be alive. 

Until a split second ago – when her baby was just in her belly – the body and mind was doing everything to keep baby alive. About nine months have been spent adjusting to this way of life. Now, baby is outside of her body, and it’s up to her to keep baby alive. This throws her hormones for a loop!

Estrogen, progesterone and endorphins are shifting dramatically. Her body is readjusting to the new demands as a mother with a baby earth-side. Mentally and emotionally women are on a roller coaster ride.

While her body and hormones are adjusting, there’s another factor to consider. Her state of mind.

Women’s emotional health is most at risk during pregnancy and postpartum. She’s vulnerable to the pressures others place on her, to her own ideals, and to the lack of care most women get in the United States.

She’s sleep deprived on a regular basis. (One of the most powerful torture tactics used.) This causes her to not be able to think clearly… like at all.

While she’s caring for her baby, herself, and family… Her mind may still be processing the birth. The way many women are treated in birth (especially if they are birthing in a hospital) is close to a robot.

She may have been plugged in with needles for devices to track her vitality or giving her medications, with another device following baby’s heartbeat, confining her to the bed, where nurses and doctors place expectations on her to get baby out in a certain amount of time.

Perhaps the birth didn’t go as she imagined. It’s important for her to feel empowered, confident, and trusting of her primal instincts to birth baby. If she doesn’t, she will have a difficult time being an empowered and confident mother.

If left untreated children of mother's with postpartum depression are at a greater risk for behavorial problems: sleeping and eating difficulties, temper tantrums, and hyperactivity. Some may have verbal language delays, as well. An untreated mother has a greater chance of experiencing major depression episodes in the future.

PMAD Stats

Researchers are at the early phases of understanding and gathering information about perinatal mood disorders. These statistics will change as data will likely reveal these numbers to be much higher than what's been previously reported.

  • Over 3 million people are diagnosed with postpartum depression (PPD) each year in the U.S.
  • 1 in 5 mothers reportedly experience PPD or Anxiety.
  • African American and Latina women are at higher risk for PMAD than white women.
  • 10% of fathers experience PPD.
  • Adoptive parents can experience depression and anxiety, too!

You Don’t Have to Survive This Alone

… because you are not alone!

1 to 10 Scale

Envision a scale of 1 – 10.
1 = cannot get out of bed, barely getting by during the day, 10 = extremely lively, happy, and productive.

Notice how you may be on a regular basis (each day may shift slightly.) For instance, you may find yourself between a 3-6 and that’s how you roll. Observe the feelings you have, and how they may impact your day. When you are at a 3, what would help give you a boost of energy or make you feel more complete? Do you think you can take care of yourself AND your baby AND any other family members or commitments you may have when you are at a 3?

If you feel you would like some help to alleviate the pressures, then you know, you will benefit from someone helping you with ______________________ (fill in the blank) when you are at a 3.

Using this scale to your advantage can be the difference of not knowing you are in depression or anxiety, and knowing. Learning yourself now will only benefit you later.

Mom Groups

Find local support now –  groups like prenatal or postnatal yoga, babywearing groups, pregnancy workout classes, preparing for birth and caring for a newborn classes, lactation groups, moms of preschoolers groups, healthy living moms groups, etc. You can join many mom groups before baby arrives, too! 

Professional Support

Consider speaking with a professional counselor, or licensed psychotherapist who works with women in their childbearing years. You’d be amazed how many of us have sought professional mental health care before/after having our babies!

Hire a babysitter, nanny or postpartum doula. You can be home while they're there to hold baby, make a meal, finish laundry, etc. Put your feet up, enjoy your home for a couple hours!

Nutrition also plays a major role in how humans feel - mentally and physically. Seek nutritional advice from someone well-versed in how food and plant-based remedies can nurture our body systems to greater balance.

Mindfulness or meditation practices with an experienced practitioner will also help the emotional and physical bodies. What we say to ourselves (even just in our thoughts) creates our external reality. Observing and sometimes re-formatting our thought patterns may create space to accept moving through this phase of womanhood with a little more gentleness.

Online Resources

  • -> Articles -> 'P' for Postpartum

What Others Can Do

If you know, or are supporting, a someone who is pregnant or has given birth within the last year or so - you have an important role in their life. Here are few ideas to truly be there for this new mother. Simple is key:

  • Nurture her with nutritious meals, snacks and tons of water. (Research meals for women who have recently given birth and/or breastfeeding, if applicable.)
    • Meal Trains are a great opportunity to get extra help, too.
  • Ask mom how she's feeling. Do not shrug off her feelings, or tell her how not to feel. Listen.
  • Give mom a break. (i.e. babysit - do not ask mom for anything. Let mom take a long shower, sleep/nap, eat in peace, visit with friends, get her hair done, watch TV, etc.)
  • Keep mom company. Simply having adult conversations and sharing the same room can help in a big way. It will make her feel more human; rather than a 24/7 caregiver.
  • Encourage mom to connect with other new moms, like postnatal yoga classes.