Around 1 in 5 birth persons have mood changes during pregnancy and after giving birth. Mood changes are the top complication during the perinatal period (the time right before and after birth). They can affect the birthing person and the whole family (partner, baby, and other children). PMADs include a wide range of mental health conditions.
Baby blues:
- Feeling sad after having a baby is very common. About 7 to 8 in 10 new parents have a mild to moderate low mood.
- The Baby Blues can last from a few days to a couple weeks.
- Symptoms often start within 2 to 3 days of giving birth. They are thought to be tied to the hormonal shifts that happen around the time of delivery.
- Symptoms can be sadness or moodiness, irritability, feeling overwhelmed, or just not feeling like yourself.
- Most often, the Baby Blues go away without treatment within 2 weeks.
Perinatal depression:
Up to 1 to 5 in 10 new parents and parents to-be (including non-birthing partners) have more intense symptoms that last longer than 2 weeks. This can be a more serious condition called perinatal depression. There are 2 types of perinatal depression:
- Antenatal depression: Happens during pregnancy.
- Postpartum depression: Can happen at any time, up to 1 year after giving birth.
- Sadness, tearfulness, or low mood on most days or for most of the day
- Not enjoying things like you used to
- Irritability or rage
- Big changes to your eating habits or sleep. You may not be able to sleep when the baby is sleeping.
- Guilt, shame, hopelessness, and doubts about your parenting skills
- Having a hard time bonding with your baby before or after birth.
- Thoughts of harming yourself or others, like the baby.
Perinatal bipolar disorder:
Bipolar disorder can happen during the perinatal period. People with bipolar disorder may have depressive and manic or hypomanic symptoms. They may feel more of the lows of depression or more of the highs of mania or hypomania. Diagnosis is based on having at least 1 episode of each.
- Elevated mood
- Racing thoughts
- Talking fast
- Impulsiveness (act without thinking) and poor judgement
- Hallucinations or delusions
Many people having a mania or hypomania episode feel like they need less sleep. Sleep disruption is common during the perinatal period and can cause an episode. About 5 in 10 women with bipolar disorder are diagnosed postpartum (after birth). The biggest risk factor for postpartum psychosis is a history of bipolar disorder.
Perinatal anxiety:
Perinatal depression is the most common word for mood changes during pregnancy or after birth. Perinatal anxiety can be as common as depression. There are many types of perinatal anxiety, like:
- Panic disorder
- Intense fears and physical symptoms or panic attacks
- Obsessive compulsive disorder
- Obsessions: Repeated, unwanted, intrusive thoughts
- Compulsions: Excessive urges to do certain actions
- Constant worry
- Racing thoughts
- Not sleeping well or eating changes (like stress eating)
- Fidgetiness, having a hard time sitting still
- Feelings of anger, irritability, or rage
- Dizziness, hot flashes, having a hard time breathing, racing heart, diarrhea, nausea
- A constant need to check things, like your baby
- Irrational fears that harm will come to your baby
Perinatal post-traumatic stress disorder (PTSD):
People who have experienced trauma (physical, sexual) may have PTSD during pregnancy or after birth. Those with pregnancy complications or a traumatic birthing experience (unplanned c-section, baby in the NICU, injury during delivery) may also have PTSD.
- Flashbacks or nightmares about the traumatic event
- Higher arousal or anxiety (irritability, exaggerated startle response, trouble sleeping, hypervigilance)
- Avoiding reminders of the event (places, people, thoughts), like delivery aftercare
- Feeling of detachment or unreality (dissociation)
Perinatal psychosis:
Perinatal psychosis, while rare, is a medical emergency. Call your doctor right away or go to the emergency department if you have any of the signs below. People with perinatal psychosis are at a higher risk of harming themselves or others (like their baby or children).
- Delusions or strange beliefs
- Hallucinations (seeing or hearing things that are not there)
- Feeling very agitated
- Hyperactivity or having more energy than usual
- Severe depression or lack of emotion
- Less need for or not able to sleep
- Paranoia and suspiciousness
- Rapid mood swings
- Having a hard time communicating
Risk factors for PMADs
Some people are at a higher risk for PMADs if they have:
- Mood issues during pregnancy (current or past)
- Personal or family history of mental health issues (especially perinatal mood disorders in female family members)
- History of infertility, miscarriage, or other perinatal losses
- Unplanned or unwanted pregnancy
- Pregnancy or childbirth complications
- Trauma
- Having a hard time breastfeeding
- Sleep loss for a long time
- Baby in the NICU
- Limited social support, including from partner
- Problems with money
- Substance use
People who are at a higher risk should find treatment or take preventive actions during pregnancy (or when trying to conceive).
PMADs can happen to anyone no matter your race, age, income, culture, or education level. People that are part of a high stress parenting group may be at a higher risk. These groups are queer or trans families, military families, teen parents, parents of multiples, single parents, parents of color, and those who have pregnancy or infant loss.
If you see any signs of PMADs, talk to your support persons, your obstetrician, or your mental health care provider. Reach out to your provider as soon as possible. Do not wait until your postpartum checkup. The sooner you get help, the sooner you will feel better.
Your UI Health Care OB/GYN provider can help you find treatment options, like medicine, psychotherapy, and so on. The Women’s Wellness and Counseling Service (WWC) is a perinatal mental health care clinic at UI Health Care. They serve people trying to conceive, pregnant persons, those who have given birth (up to 12 months after delivery), and those who have perinatal loss.
How to get help
Grief and loss:
- Compassionate Friends
- Helps families who have lost a child. Has groups in all 50 states.
- Website: www.compassionatefriends.org
- Journey of Hearts
- A website that gives comfort and support to anyone dealing with loss.
- Website: www.journeyofhearts.org
- No Foot Too Small
- An Iowa based non-profit who supports families who have lost a baby during pregnancy or infancy.
- Website: www.nofoottoosmall.org
Emergency:
- 911: Call if you are in danger for need help right away
- 988 Suicide and Crisis Lifeline: Free help any time you are having a suicidal crisis or emotional distress.
Hotlines:
- Postpartum Support International Helpline:
- Call: 800-944-4773
- Text “help” to 800-944-4773
- Free 24/7 support for parents who are struggling before or after having a baby
- National Maternal and Child Health Hotline:
- Call or text: 833-852-6868
- Chat: www.mchb.hrsa.gov
- Provides 24/7 free, confidential mental health support to pregnant people and new parents
- Your Life Iowa:
- Call: 855-581-8111
- Text: 855-895-8398
- Chat: www.yourlifeiowa.org
- Provides 24/7 free, confidential mental health support to anyone in Iowa
Find a therapist:
- Postpartum Depression Therapy Finder
- Psychology Today Directory
- Website: www.psychologytoday.com
- UI Health Care Women’s Wellness & Counseling
- Helps people during pregnancy and up to 12 months after birth
- Website: https://uihc.org/services/womens-wellness-and-counseling-service
Support for parents of multiples:
- Des Moines Mothers of Multiples
- Support for families with twins, triplets, or more
- Website: www.dmmom.com
- Multiples of America
- National support groups for families with multiples
- Website: www.multiplesofamerica.org
Specialized support groups:
- Breastfeeding and Pumping Support
- Offers breastfeeding, pumping, and mental health support groups pending insurance coverage
- Website: www.aeroflowbreastpumps.com/resources
- Postpartum Support International
- Free online groups for many communities including but not limited to:
- Moms and birthing parents
- Dads and partners
- Deaf parents
- Military families
- LGBTQ+ parents
- Asian, Black, Indigenous, and other communities
- Website: https://postpartum.net/get-help/psi-online-support-meetings
- Free online groups for many communities including but not limited to:
- Rainbow Families
- Support and resources for LGBTQ+ parents and parents-to-be
- Website: www.rainbowfamilies.org
- Young Parent Network
- Support and resources for young families in Jones and Linn counties with children ages 0-5
- Website: www.ypniowa.org
Statewide resources:
- Healthy Pregnancy Program
- Free service which provides education and support to pregnant and postpartum parents
- Contact varies by county. Find local services here: https://hhs.iowa.gov/media/12716/download?inline
- Iowa Victim Support Services
- Assistance for families impacted by homicide, domestic violence, sexual assault, stalking, child abuse, and human trafficking
- Contact varies by county. Find local services here: https://www.iowaattorneygeneral.gov/for-crime-victims