Postpartum, also known as the ‘fourth trimester’ sometimes gets swept under the rug. Who has time to worry about postpartum well-being? There is a newborn baby to take care of! New parents barely have time to take a shower let alone take inventory of their own wellbeing. The obstetrician-gynecologist who delivered my first baby told my husband and me that every mom experiences postpartum to some level, whether it be baby blues or postpartum depression requiring psychosocial and psychological treatment. Whatever the severity, no mom should ever feel ashamed of their emotional well-being.
Ladies, our bodies go through a lot! Even if you feel your body hasn’t changed, it has. You may be in denial, but it did. You may feel blissful at first and then after sleep deprivation kicks in, you just feel exhausted. Each pregnancy, each delivery, and each postpartum experience is different between moms but also between your own pregnancies and postpartum experiences. One thing to remember though, you are not alone on this journey. Reach out for connections and support.
OB-GYN Appointment
3 Week
12 Week
Within the first 3 weeks postpartum, every mom should at the very least be in communication with their obstetrician-gynecologist, via phone or in person, about their emotional well-being in general and any concerns.
Following the initial contact, you should reach out for ongoing care as needed, making sure to have a comprehensive postpartum assessment by 12 weeks after your baby’s birth.
Your obstetrician-gynecologist will not only assess your physical recovery from birth but also your emotional health. Expect to discuss areas such as mood and emotions (i.e. postpartum screen, available support); infant care and feeding (i.e. feeding method and questions, pediatrician established); sexuality, contraception, and birth spacing (i.e. plan, contraceptive methods); sleep and fatigue; chronic disease and health management (i.e. women’s health screenings, vaccinations).
Pediatrician Check-up
Your relationship with your obstetrician-gynecologist should not be a single encounter after your baby’s birth, rather an ongoing process, especially throughout your baby’s first year of life. But did you know that your baby’s pediatrician will also screen you for postpartum depression at your baby’s 1, 2, 4, and 6-month appointments?
Postpartum Emotions Vary
Postpartum emotions range from mild “baby blues” to true postpartum depression that lasts longer than one to two weeks. You may feel sad, anxious, and upset. Your obstetrician-gynecologist is part of your postpartum support system and any and all emotions should be discussed with them. These feelings are common, you are not alone, and you deserve support no matter the severity. Not only do postpartum emotions vary from mild to severe but they may vary between pregnancies.
Our team is primarily comprised of moms so I’m sure you can imagine all the different postpartum experiences simply within our team.
One of our team moms expressed that with each child, her postpartum depression symptoms became more severe. I would scroll with guilt and sadness all the new moms Instagram who orchestrated beautiful newborn pictures, while I could barely get out of bed. I tried to hide my sadness because how could I possibly be sad? I was blessed with a tiny, beautiful, and perfect human. My feelings had other plans, and ignoring them only made them worse and at times, very dark. It wasn’t until I started talking about how I felt, that I actually started to see the light. Sometimes depression makes us want to cut ourselves off from the world when what we really need is connection.
As for myself, my first baby had mild colic. I recall days where I would just lie in bed crying and feeling helpless. Whereas, if I had any form of postpartum with my second child, I have no recollection of it because my life was a complete whirlwind with a 22-month-old, newborn, and a part-time job as a pediatric occupational therapist. Somehow, we all survived that year! Thirteen years later, at 40 years old, I delivered my third baby. As the months progressed, instead of feeling better, I actually felt worse.
Every situation, every pregnancy, and every postpartum experience is different, between moms and between pregnancies. However, we all have commonalities that can help bond us together to get through any challenges.
Significance of Significant Others
When I had my first child, my obstetrician-gynecologist told my husband that he was his eyes and ears. He encouraged my husband to be aware and keep on top of how I was feeling. Why is this advice so important? Because often a mom is unaware or unable to identify postpartum depression. This means that the role of a mom’s partner is critical. They may be the first person to observe postpartum depression signs and symptoms.
Common signs of postpartum depression are sad mood or mood swings, excessive crying, difficulty bonding with your baby, fatigue, lack of energy, withdrawal from friends and family, loss of appetite, overwhelming anxiety, thoughts of harming yourself or your baby. Postpartum depression may develop at any time within the first year after childbirth.
Consult a Women’s Health Physical Therapist Specializing in Pelvic Floor
I am not sure how I had two kids before I even knew this existed. But, seeing a physical therapist who specializes in pelvic floor is a must. I don’t have to tell you this, but your body just went through a massive transformation and now has to go back to pre-pregnancy life. Peeing when you laugh or sneeze does not have to be your future! Seeing a physical therapist who specializes specifically in the pelvic floor not only carves time out for yourself but also helps you to find aspects of your body again that have been impacted, such as your core stabilizers that weaken with pregnancy (American Physical Therapy Association).
Although this blog is not specifically about Paternal Postpartum Depression, we did want to note that it is a real thing. Some doctors are even starting to speak with dads at appointments about it now. If the father of your child appears irritable, depressed, or demonstrates a decreased emotional presence outside of his norm, he may be experiencing Paternal PPD.
As Postpartum concerns continue to be on the rise and more publicized, moms and dads are becoming more candid about their experiences on social media and normalizing postpartum emotions. If you are struggling with any form of postpartum emotions there is no shame in this battle and finding the right professional is important for both you and your baby’s well-being. You don’t have to suffer alone. Reach out.
The best place to start is to speak with your primary care doctor, obstetrician-gynecologist, or your baby’s pediatrician. Postpartum depression is treatable, typically with therapy, medication, or a combination of both. Postpartum Support International (see link below), an organization which offers support, education, online groups, text and hotline support, as well as referrals for specialists trained in postpartum issues. There are free support groups, in person and online, available.
We would love to hear from you about your experiences. Please email us at thenurturenotebook@gmail.com with your story.
Love Your Nurture Notetakers,
Tracy Walters, MA, LPC
Kim Bandi, OTR/L, Founder of The Nurture Notebook
Jaime Sinift-Heimer M.S. CCC-SLP/L
https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/05/optimizing-postpartum-care
https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/11/screening-for-perinatal-depression
https://www.acog.org/womens-health/faqs/a-partners-guide-to-pregnancy
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6659987/
https://www.webmd.com/depression/postpartum-depression/news/20080506/men-also-get-postpartum-depression
https://www.healthychildren.org/English/ages-stages/prenatal/delivery-beyond/Pages/Dads-Can-Get-Postpartum-Depression-Too.aspx
https://www.apta.org/news/2018/07/11/ob-gyn-group-embraces-fourth-trimester-concept-acknowledges-role-of-physical-therapy-in-postpartum-care
