After Baby: Taking Care of Mom

Postpartum Mental Health

For moms and the people who love them. Please read this together before baby comes.

Having a baby changes your hormones, your sleep, and your whole life, all at once. It's normal for feelings to be big for a while. But some feelings mean you need more support, and a few mean you need help right away. This sheet helps you tell the difference.

Partners, you are often the first to notice when something is off. Keep this somewhere you can find it, like the fridge.

GREEN: This is normal (the "baby blues")

Most new moms get the baby blues. It usually starts 2 to 3 days after birth and fades on its own within about 2 weeks.

What it can look like:

•        Crying easily, sometimes for no clear reason

•        Mood swings, happy one minute and teary the next

•        Feeling cranky, worried, or overwhelmed

•        Feeling tired, even beyond the normal newborn tired

What helps:

•        Sleep when you can. Let someone else take a night feeding if possible.

•        Support. Ask for help and say yes when people offer help with meals, laundry, or older kids.

•        Eat real meals and drink plenty of water.

•        Get outside for a few minutes of fresh air and daylight.

•        Talk about how you feel with your partner or a friend.

Watch the calendar. If these feelings last longer than 2 weeks, or keep getting worse, it's time to move to the yellow section.

YELLOW: Time to get help (postpartum depression and anxiety)

Postpartum depression and anxiety are common. They affect about 1 in 7 moms. They can start during pregnancy or any time in the first year after birth. They are not your fault, and they are very treatable.

Call your doctor or midwife this week if you notice:

•        Sadness, crying, or feeling empty that lasts more than 2 weeks

•        Constant worry or racing thoughts you can't turn off

•        Feeling numb or not bonding with your baby

•        Trouble sleeping even when the baby is sleeping

•        Losing interest in things you used to enjoy

•        Panic attacks: racing heart, shortness of breath, feeling like something terrible is about to happen

•        Feeling like a bad mom, guilty, or worthless

•        Pulling away from family and friends

•        Big changes in appetite

Scary thoughts: Many moms with anxiety have sudden, unwanted thoughts of something bad happening to their baby. These thoughts are upsetting because you would never want them to happen. They are a common symptom, they are treatable, and you can talk about them without getting in trouble. Tell your doctor.

What treatment looks like: Usually counseling, support groups, medication, or a mix. Many medications are safe while breastfeeding. You don't have to just push through this.

RED: Get help right now (postpartum psychosis and other emergencies)

Postpartum psychosis is rare. It happens in about 1 or 2 of every 1,000 births. It usually starts suddenly, often in the first 2 weeks after birth. It is a medical emergency, and with fast treatment, moms do recover.

Moms with bipolar disorder, or a family history of it, have a higher risk. Tell your doctor during pregnancy if this applies to you.

Signs of postpartum psychosis:

•        Seeing or hearing things that aren't there

•        Believing things that aren't true, or that seem very strange to others

•        Feeling extremely suspicious or paranoid

•        Acting confused or not making sense

•        Not sleeping for days, or feeling like she doesn't need sleep

•        Talking very fast, acting wired, or acting very out of character

Unlike the scary thoughts in the yellow section, a mom with psychosis may not realize anything is wrong. That's why partners and family matter so much here.

Also get help right now if mom:

•        Talks about suicide or wanting to die

•        Has thoughts of hurting herself or the baby and seems like she might act on them

What to do:

1.      Call 911 or go to the nearest emergency room.

2.      Don't leave her alone, and don't leave her alone with the baby.

3.      For a mental health crisis, you can also call or text 988, the Suicide and Crisis Lifeline.

For partners

•        Check in every day. Ask "How are you really doing?" and listen.

•        Take a night feeding or an early morning shift so she can get a solid stretch of sleep.

•        Trust your gut. If she doesn't seem like herself, speak up and call her doctor with her.

•        Take care of yourself too. Dads and partners can get postpartum depression as well.

You're not alone, and you don't have to just live with this. If you're not sure which section you're in, call your doctor or the hotline and ask. We're always happy to talk with you at your visits, too.