Maternal Mental Health
Perinatal Mood and Anxiety Disorders (PMADs) is the umbrella term for mood and anxiety disorders that occur during pregnancy or up to one year postpartum.
These terms encompass women (and men) who experience postpartum post-traumatic stress disorder, depression, postpartum anxiety, postpartum OCD, postpartum blues, postpartum post-traumatic stress disorder and postpartum psychosis.
As with every group, COVID-19 has likely exacerbated the stress, anxiety, and depressive symptoms associated with perinatal mental health.
When possible, encourage moms to have a Postpartum Plan for what she and her support system can do to help create a supportive environment for after the birth. A postpartum plan is a plan that includes a set of steps that a mother identifies before the baby is born to set her up for success for the time after.
This can include:
- Scheduled sleep or "naps". If the mother has prior children or is postpartum this would be when an alternate caregiver is available.
- Appropriate nutrition/meal plans that can be made simply and without additional stress.
- Drinking plenty of water for hydration.
- Scheduled calls/video chats from support systems (family, friends, church, etc.)
- Short walks around the neighborhood (with appropriate social distance) for increased physical activity and Vitamin D exposure.
- Doing things that help her feel more "normal" such as taking a bath, and watching her favorite TV show
Depression After Pregnancy
Many new mothers experience what is known as “the baby blues”. With “the baby blues”, new mothers may have mood swings; feel sad, anxious or overwhelmed; have crying spells; lose their appetite; or have trouble sleeping. These symptoms do not tend to be severe, do not need treatment and generally do not last more than two weeks.
The symptoms of postpartum depression (PPD), however, last longer and are more severe. PPD can be disabling for a new mother. PPD is a type of major depression that affects about 1 in 8 new mothers within the first year after childbirth. PPD can have a negative impact on a new mother’s health and her ability to care for her infant.
Signs of PPD
Some symptoms of PPD may mean that a mother is experiencing something more serious than “the baby blues.” Multiple symptoms that don’t go away or thoughts of suicide may mean that the mother could need an evaluation by a health care provider or mental health professional. A new mother may experience extreme changes in depressed mood, loss of interest in all/or most of activities, changes in appetite, changes in sleep habits, excessive guilt and/or worry, impaired concentration, recurrent thoughts of death or suicidal ideation for up to two weeks. While it is a serious condition, PPD can be treated successfully with medication and counseling.
Perinatal Anxiety - a range of anxiety disorders, including generalized anxiety; slightly less common than "baby blues" or PPD; impacts a reported 10% of new parents increasing and disruptive fears and worries (that make daily life much more difficult). Symptoms include difficulty concentrating and focusing, restless sleep, panic attacks, irritability, muscle tension, upset stomach, increased heart rate, tightness in the chest.
Postpartum Obsessive-Compulsive Disorder - Intrusive repetitive thoughts that are scary and do not make sense to the mother. 3-5% of new moms (and fathers) reported postpartum OCD symptoms at two weeks postpartum. Symptoms include guilt and shame over parenting decisions; frightening obsessions related to harm befalling the infant; hyper-vigilance in protecting the infant fear of being left alone with the infant; may or may not include compulsions (i.e., needing to clean constantly, count objects, check on things repeatedly, or reorder things.
Postpartum Psychosis - sudden onset of psychotic symptoms following childbirth; much more rare (0.1% of mothers) and often more acute in symptomology; requires immediate psychiatric evaluation and medical attention. Symptoms include hallucinations (see someone else's face instead of your baby's), delusions (feeling as though your baby is possessed or "evil", confusion/disorientation about your reality, waxing and waning (there are periods of "normalcy" in between psychotic symptoms).
Are You Okay Mom? (English) - Educational one-sheet and symptom checklist
Are You Okay Mom? (Spanish) - educativo de una hoja y lista de verificación de síntomas
Maternal Mental Health Matters (English) - Educational booklet with information and resources for moms and providers.
Maternal Mental Health Matters (Spanish) - folleto educativo con información y recursos para mamás y proveedores
Postpartum Support International (PSI)
National hotline 1-800-944-4PPD (4773)
Resources available from the Postpartum Support International (PSI)
PSI offers five different online support groups led by PSI facilitators, often who have personal experiences with these topics.
- Perinatal (Prenatal and Postpartum) Mood Support Group, Pregnancy Mood Support Group, NICU parents, Military moms, and Pregnancy & Infant Loss.
- The link for registration for those groups is here: https://www.postpartum.net/get-help/psi-online-support-meetings
PSI Phone Chat sessions
Alesha Lilly, Ph.D
Director, Behavioral Health Program
OSDH/Child Guidance Service
1000 NE 10th Street
Oklahoma City, OK 73117-1299
Phone: (405) 271-4477, E-mail: Alesha Lilly
James Craig, MSW, LCSW
Public Health Social Work Coordinator
OSDH/Maternal and Child Health Service
1000 NE 10th Street
Oklahoma City, OK 73117-1299
Phone: (405) 271-9444 ext. 56931, E-mail: James Craig