Disclaimer: This is general medical information and not specific medical advice. It does not and should not replace diagnosis or treatment by your healthcare provider. If you are seeking personal recommendations, advice, and/or treatment, please consult your physician. If you have an emergency, you should contact 911 or go to the nearest Emergency Room.This article was originally published on Romper by Jessica Wakeman. Our founder Dr. Shirazian was interviewed for this piece.
July 20, 2019 - Motherhood brings many emotions, adjustments, and physical changes that go deeper than what’s visible on the outside. There are so many ways for new moms to be struggling on the inside — all too often without anyone else realizing what’s going on.
It’s common for new moms to feel isolated, anxious and depressed, and experts who spoke to Romper say that all new parents feel overwhelmed at times. But it’s important to know that help is all around you, and asking for help sooner rather than later is the best course of action.
Here are some common ways that new moms struggle and what to do:
If you’re feeling anxious or depressed, talk to your doctor.
Our society is discussing postpartum depression (i.e., depression after the baby is born) with more openness. But that’s not the whole picture: Moms can begin to feel depressed during pregnancy, and they can feel postpartum or prenatal anxiety as well — together, a set of conditions referred to as “perinatal mood and anxiety disorders” (PMADs).
“Anxiety is a big one that doesn't necessarily get talked about,” says Rebecca Weinberg, M.D., director of clinical operations for the perinatal depression program at the Allegheny Health Network in Pittsburgh, Pennsylvania. She even suggests the rates of anxiety could be “probably higher” than rates of postpartum depression.
I think it's a wonder that every mother is not experiencing depression or anxiety.
Indeed, a study published in August 2016 by the Journal of Affective Disorders found that anxiety and related disorders affected 15 percent of pregnant and postnatal women. Anecdotally, certified postpartum doula Ann Grauer of Wisconsin says that in the past five years of her 30-year-plus career, she’s seen “the anxiety level [go] off the charts.”
Society doesn’t make it easy for new moms. Given “the fact that we expect you to have your baby and then just automatically know what to do with them all the way through, I think it's a wonder that every mother is not experiencing depression or anxiety,” says Grauer.
But aren’t all new parents a little fretful? Some fear and uncertainty is to be expected. Clinical anxiety, however, is when those fears gallop out of control and you are consumed with “intrusive thoughts or worries,” says Weinberg.
Two clinical criteria for anxiety are that it impedes daily function, and it causes a lot of distress. For example, clinical anxiety may cause a mom to panic that her child will stop breathing, so she is “staying up all night watching the baby” and not getting much-needed sleep, Weinberg explains. It can also take the form of “intrusive thoughts,” like visions of falling down the stairs while holding the baby, to the point a mother starts avoiding the stairs, she adds.
An estimated 91 percent of new mothers will experience intrusive thoughts, Karen Kleiman, M.S.W., L.C.S.W., author of Good Moms Have Scary Thoughts, tells Romper by email. “These thoughts are common and do not necessarily indicate that treatment or intervention is necessary, unless they are accompanied by significant distress or interfere with functioning.” Importantly, "these thoughts are not associated with an increased risk of actions taken or harm to infants."
Cognitive behavioral therapy (CBT) or medication can help with perinatal anxiety and depression, says Weinberg, and they should be discussed with your doctor.
If you feel emotionally overwhelmed, ask for help.
Experts agree that even new moms who don’t have a clinical diagnosis of anxiety should expect to feel overwhelmed at times. New parenthood is overwhelming. It helps if you don't pile more pressure on yourself to do everything and to do it “perfectly” (whatever that means).
Easier said than done, though, right? A whopping 90 percent of moms say they feel judged, and 46 percent of moms feel judged “all the time” or “nearly all the time,” according to the 2016 National Parent Survey by Zero To Three, a nonprofit focused on improving the lives of infants. These moms reported feeling most judged by strangers. (Yes, strangers.)
Is it terribly surprising that moms feel this pressure? “Women think they have to do everything themselves,” says Dr. Taraneh Shirazian, M.D., gynecologic surgeon at NYU Langone in New York City and the founder of Mommy Matters. That couldn’t be further from the truth.
As Grauer put it, “Nobody is supposed to do this on their own.”
Letting someone else care for your child is not a dereliction of your mommy duties; it’s practicing self-care. “You are not being the best you can for yourself and your infant if you don't give yourself leeway to get a little bit of extra rest or sleep, or change of clothes, or walk outside,” Shirazian explains.
Yes, you’re a mom now, But you’re also a human being, and you need to do what you need to feel like one.
If you feel isolated, put a community in place around you.
Isolation is something that women don’t expect to feel from motherhood, says Weinberg. Sure, there’s a curtailed social life, and potentially a scaled-back career. But society heaps additional pressure and responsibility on mothers: According to the Pew Research Center, 53 percent of Americans believe that (breastfeeding aside) moms do a better job than dads at caring for a new baby.
That’s why it’s never too early — or too late, for that matter — to secure consistent, reliable support when you’re a new parent. “It is so true that it takes a village,” says Shirazian. “It's best that everyone understand that from the get-go.”
Unfortunately, 57 percent of moms say they aren’t getting the support they need (compared with 34 percent of dads), according to the National Parent Survey. With affordable childcare unreachable for many, it’s crucial to build a support network of friends, family, neighbors, co-workers — whoever it is can provide assistance and an occasional break.
One option for support and assistance is hiring a postpartum doula for both the parents and the baby. Grauer compares it to having a “private, one-on-one [newborn care class] right inside your home.” In addition to assisting with bathing the baby and helping prepare meals, postpartum doulas “are trained in understanding what the emotions of becoming a new parent are like and how to move through them,” said Grauer. Postpartum doulas can be available through public-health initiatives, or paid for through health savings accounts, and some insurance covers home visits for new moms.
Even though [social media] does have the ability to build community, it can also can create fear and isolation.
Mom groups, either online or locally, can also provide social support. Look for kind, nonjudgmental folks, and for an online group, ideally find one with moderators who enforce community standards and are sticklers for sharing vetted, medically accurate information.
“Choose who you listen to carefully,” advises Grauer. “Having people around you who are truly in it for you — and not for their own agenda — is a really big deal.”
If you’re comparing yourself to others, edit your social media accounts (and only take advice from trusted sources).
A 24/7 internet connection means you can find the answer to any question at any moment. Yet Shirazian believes there is an “overload” on both information and social media that can cause moms to struggle even more.
“Both those things — ironically, actually — often give people less education and more isolation,” she says. “Even though [social media] does have the ability to build community, it can also can create fear and isolation, and not teach people the correct things.”
Additionally, Grauer advises against “only following people who post perfection,” and suggests following people who post more realistic depictions of parenthood (and life in general).
It sounds obvious, but it bears repeating: Having millions of followers or fans does not make someone an expert. On anything.
The (real) experts Romper spoke with stress that lay people, like celebrities and “influencers,” are not qualified to dole out medical advice. With so much information “coming at us so fast and heavy,” says Grauer, it can be tricky “to differentiate what's a good source, what's not a great source, [and] what’s someone's opinion.”
Instead, Shirazian recommends trusted medical sources like the American College of Obstetricians and Gynecologists or American Academy of Pediatrics, says Shirazian, explaining “all of those platforms vet information before they post it, so it will be accurate.”
It's [the] biggest trauma a woman can go through in the course of her lifetime.
You’ll also want to manage your news consumption, especially when it comes to scary stories like fires, diseases, and car crashes.
“We might suggest [new moms] don't watch the news or limit the amount of time online,” says Weinberg. Disengaging from panic-inducing Google searches can also help, she adds, especially if they “not actually that productive [and] just create a lot of worry.”
What does help? A relationship with a pediatrician whom you can easily call, send a picture, and ask a lot of questions, says Shirazian.
Ultimately, as a new parent, you need to take care of yourself as much as you take care of your baby.
“People don't think of pregnancy and recovery [this way] but it's [the] biggest trauma a woman can go through in the course of her lifetime,” says Shirazian.
“You need to give yourself as much leeway as you've ever needed to give yourself — that you will ever need to give yourself — in your entire life.”
If you or someone you know is experiencing depression or anxiety during pregnancy, or in the postpartum period, contact the Postpartum Health Alliance warmline at (888) 724-7240, or Postpartum Support International at (800) 944-4773. If you are thinking of harming yourself or your baby, get help right away by calling the National Suicide Prevention Lifeline at 1-800-273-8255, or dialing 911. For more resources, you can visit Postpartum Support International.