Postpartum Top 10 FAQs

How many women get postpartum depression?

Recent research has found that 15% of new moms get postpartum depression, or one in seven.  We know, however, that in women of low socioeconomic status the rate jumps to 25%.  Since approximately 4 million babies are born each year that would mean at least 600,000 women in the U.S. have PPD annually. We would argue that number is even higher, because there are 6 million clinically recognized pregnancies each year (including live births and pregnancy losses) and we know that women who’ve suffered miscarriages are also at risk of PPD. This means it’s more likely that more than 800,000 women a year get PPD.

What are the symptoms of postpartum depression?
Feeling restless or slowed down
Feeling sad most of the day
Loss of interest or pleasure in all or most things, including the baby
Extreme irritability, frustration, or anger
Feelings of hopelessness
Trouble sleeping even when the baby is sleeping
Loss of appetite or eating too much
Difficulty thinking, concentrating or making decisions
Crying for no reason
Overwhelming feelings of guilt, worthlessness or inadequacy
Scary thoughts about harming your baby
Anxiety or panic attacks
No desire to be with friends or family
Excessive worrying about your baby’s health
Suicidal thoughts or frequent thoughts of death

Why does it happen?
Postpartum psychosis is not your fault. It is not caused by anything you or your partner have thought or done. Relationship problems, stress or the baby being unwanted do not cause postpartum psychosis.
There are likely to be many factors that lead to an episode of Postpartum Psychosis. We know that genetic factors are important. You are more likely to have Postpartum Psychosis if a close relative has had it. Changes in hormone levels and disrupted sleep patterns may also be involved.

How soon after giving birth can I start postpartum exercise?
According to the American Council of Obstetricians and Gynecologists, with your doctor’s approval, you can start postpartum exercise as soon as you feel that you are ready. Start slowly- give your body time to heal. If you have diastasis recti, a separation of the abdominal muscles of more than three fingers width, do modified versions of abdominal exercises until the gap has narrowed to two fingers. If you had a C-section, wait at least six weeks before beginning abdominal exercises.

When will I get better?
It can take 6 -12 months or more to recover from postpartum psychosis. The most severe symptoms tend to last 2 to12 weeks. The vast majority of women will recover fully.
Postpartum psychosis is often followed by a period of depression, anxiety, and low social confidence. It can take time to come to terms with what has happened to you. It’s normal to feel some sadness for missing out on early motherhood. It can take time to rebuild confidence in relationships and friendships. Most women get back to feeling like their usual selves again.
Talking emotions through with family and friends can help. Seek advice about getting expert help from a psychologist, psychotherapist or counsellor. For advice on practical steps that can be taken during recovery.

Can I take medications if I am breastfeeding?
Although we cannot say that any medication is safe in breastfeeding, we can say that there is a significant body of published data that suggests that certain medications seem safer to use. These antidepressants seem to cross over minimally, if at all, into the breast milk. In addition, mothers can be taught to alter their breastfeeding schedule and add some bottle feeding to minimize exposure to the infant. By a combination of proper medication selection and other accommodations in breastfeeding, it is possible for most mothers with PPD who wish to breastfeed to do so.

How can family help?
Postpartum depression and other perinatal mood disorders affect the entire family. Family members may feel confused and worried about the mood and behavioral changes they see in the new or expectant mother. Often they recognize that a problem exists before the woman does. They can help her to identify the problem and encourage her to seek medical help. Family and friends can provide understanding, as well as emotional, social and physical support. They can provide childcare and take on daily responibilities that reduce stress. Their support will help the woman recover.

When can I have sex again after having a baby?
It is advised that you wait four to six weeks before resuming sexual intercourse. At your postpartum appointment, you can discuss options for contraception with your health care provider.

Will my depression affect my marriage?
PMD is highly stressful to the family unit, particularly when it occurs, as it often does, following a first pregnancy. For first time parents, changing the relationship from dyad (husband and wife) to a triad (husband-wife-infant) is difficult enough without the added stress of an impaired mother. Studies consistently show that a poor marriage increases the risk of postpartum depression and we can also extrapolate that poor marriages are much less capable of tolerating the stress brought on by PPD. That being said, a healthy marriage before the illness is usually able to endure the added stress and often comes out stronger when the mother recovers. When a woman suffers from PPD, it is very important to have the husband join the therapy as soon as possible. Couples who work together, in conjunction with other treatment approaches, often deal successfully with this stressful and trying event.

What do I need to tell my doctor?
Write down any symptoms you’ve had, and for how long
Write down key personal information
Make a list of all medications you are taking, and any previous mood disorders you have had
Write down questions to ask your doctor
Take a family member or friend along