Society paints a picture for us of motherhood in sun-washed tones: a woman’s flowing hair tickling the nose of a contentedly breast-fed child as gentle forest creatures gather around to celebrate the miracle of birth.
The truth is a little less lovely.
Our expectations around pregnancy and motherhood generally don’t include intense vulnerability, fits of depression (or rage) or a seemingly endless sense of anxiety. Yet most women experience some mood-altering fluctuation in hormones that can last for a few weeks or longer.
As a reproductive psychiatrist, I focus on the mental health implications of hormonal fluctuations during all stages of a woman’s life, from puberty to menopause. What I have found is that while most people have heard of postpartum depression, it is still widely misunderstood.
A perfect example is the phenomenon of the “baby blues.” Many people have heard the term and know that it refers to a brief period of time following birth when a woman’s hormonal changes cause her to feel overwhelmed. What many of my patients find surprising is that up to 80% of women experience the “baby blues,” and 15% will go on to develop more serious and prolonged maternal depression. One in five women experience maternal depression, which makes it the leading complication of pregnancy.
Also less known is that the physical, emotional and social demands surrounding motherhood can impact a woman’s mood well before baby arrives. Depression can occur at any time before, during or after pregnancy, and all of these periods deserve the same level of attention.
While low mood and tearfulness hits some women, others experience far more serious symptoms, including hopelessness and suicidal thinking. As many as 50% of women who have a personal history of depression will feel these symptoms roaring back during this period of their lives.
Seeking help is critical. Depression and anxiety have been associated with premature delivery, low birth weight, higher rates of C-sections and higher levels of newborn stress. A depressed mother is less likely to take care of herself and more likely to self-medicate with tobacco, cannabis or alcohol. And the effects can be long-lasting: Babies born from depressed or highly anxious mothers might experience changes to their neurochemistry that predisposes them to depression and anxiety later in life.
If you suspect that you or your partner is experiencing depression, please seek professional help. You can start by asking your obstetrician or primary care doctor to refer you to a mental health specialist.
You can also ask to be screened at your prenatal appointments and again after birth. At Hoag, for example, we have the Maternal Mental Health Program to help new and expecting mothers overcome mental health issues associated with hormonal changes before, during and after pregnancy. We screen all women who deliver at the hospital and provide assessment, consultation and linkage to services for women who require them.
When expectant mothers “plan for baby,” they generally limit those plans to decorating nurseries and interviewing potential pediatricians. Screening for postpartum depression is just as important as prenatal care for ensuring your well-being and the health of your baby.
No, motherhood is not what the fairy tales made it out to be, but that doesn’t mean you have to feel isolated or overwhelmed. Help is available.
Dr. Patricia De Marco Centeno is the medical director of the Maternal Mental Health Program at Hoag.
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