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El Camino Hospital Pregnancy and Postpartum Resiliency Circle

Is it Baby Blues or Postpartum Depression?

By: Barb Dehn, RN, MS, NP


Having a new baby to care for is an emotional experience.

Add to that the lack of sleep, feeding every 2 to 3 hours round the clock, a hormonal roller coaster….oh, yes and your body’s recovery from childbirth, plus your partner and family and, well, you get the idea. It’s easy to feel overwhelmed with all of the changes.

Mild mood changes are absolutely normal and expected for the first few weeks after giving birth. Every mom goes through a period of adjustment as her old way of life adapts to her baby’s needs, unique temperament, personality, as well as the baby’s sleep cycles, feeding challenges and all the other aspects of their care.  

What every mom needs

All moms need support when a new baby arrives. Many times, moms who are feeling overwhelmed need to:

  • Know that they aren’t alone
  • Be encouraged to get more sleep
  • Have other trusted caregivers help out by caring for the baby
  • Be given permission not to be perfect
  • Let go of pressures to keep up appearances

Comparing Your Experience to others on Social Media

Most new moms I’ve worked with over the years find motherhood much more challenging than they ever expected. This is what they tell me in the privacy of the exam room at 2, 4 and 6 weeks after giving birth. And because there can be a lot of shame involved when things are slightly less than perfect, it’s the rare mom who is comfortable posting anything but perfect photos and commentary on social media.

This sets everyone up for a false sense of inadequacy. You might be covered in spit up, be dragging around on only 2.5 hours of sleep, without a shower in days, hair in a ponytail and happen to glance at a friend’s photos and become instantly dejected, “Look at Emily, she’s lost all her baby weight, the breastfeeding is a breeze, her baby isn’t puking all over her and I bet she takes a shower every day.”

The truth

While adjusting to motherhood can be a breeze for a few lucky new moms (with full time help and a stylist on call), the vast majority of new moms need about 3-6 months to figure out how to care for their baby and themselves and, yes, get a shower every day.

If your pregnancy, birth and/or breastfeeding experiences are not what you expected or your baby has a health challenge, the feelings of being overwhelmed can become amplified.

Many new moms must also contend with managing complex relationships with well-meaning extended family members or be asked to conform to cultural traditions that may not resonate with their current situation. These can also add more stress to an already challenging situation.

Recognizing Postpartum Depression

There has been so much about postpartum depression in the news lately. Many new moms and their families wonder where the line between the normal “baby blues” ends and postpartum depression begins.

The following are examples of what may happen with more severe mood changes, and/or those that last more than 2 to 3 weeks. Anytime you are concerned about yourself or someone you love, do reach out to a health care provider.

Call your OB or Pediatric provider if you are:

  • Feeling out of control
  • Feeling sad and crying often
  • Unable to sleep even when you are exhausted
  • Having increased anxiety, worry or panic attacks
  • Unable to care for yourself or the baby
  • Having recurring thoughts or obsessive behaviors
  • Feeling hopeless, guilty or ashamed
  • Having disturbing thoughts about harming yourself or your baby

When in Doubt, Reach Out Safe and effective treatment options

Postpartum depression can be safely treated through one-on-one or group counseling, safe medications, or a combination of both. There are a variety of classes, support groups and treatments available no matter where you live.

You can find more resources through Postpartum Support International.

For moms who live in the San Francisco Bay Area, the Maternal Outreach Mood Services (MOMS) program at El Camino Health's Scrivner Center for Mental Health & Addiction Services is a resource I count on for my patients. This specialized program provides education, counseling and medical evaluation for expectant and new mothers.

Disclosure: Barbara Dehn RN, MS, NP is a practicing Nurse Practitioner and health expert, known as Nurse Barb. She is locally based and works with El Camino Health to share health information with the community.

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