Postpartum Depression: What you need to know

KEY POINTS

  • A postpartum checkup is a medical checkup you get after having a baby to make sure you’re recovering well from labor and birth.

  • Postpartum care is important because new moms are at risk of serious and sometimes life-threatening health complications.

  • Make a postpartum care plan with your provider during pregnancy and talk to your provider about your postpartum care team.

  • Get a complete postpartum checkup no later than 12 weeks after giving birth.

  • If you had pregnancy complications or you have a chronic health condition, you may need extra postpartum checkups.

What is postpartum depression?


Postpartum depression (also called PPD) is the most common medical complication for women after having a baby. It’s strong feelings of sadness, anxiety (worry) and tiredness that last for a long time after giving birth. These feelings can make it hard for you to take care of yourself and your baby. PPD can happen any time after childbirth. It often starts within 1 to 3 weeks of having a baby.

PPD can make it hard to care for you to take care of yourself and of your baby. This is why it’s important to get treatment as soon as possible. PPD is not your fault. You didn’t do anything to cause PPD. It doesn’t make you a bad person or a bad mother.

What causes PPD?


We’re not exactly sure. It’s most likely caused by a combination of things, like:

  • Genes. Genes are parts of your body's cells that store instructions for the way your body grows and works. Genes are passed from parents to children. Depression is more common is people whose family members have depression. This is called a family history of depression.
  • Changing levels of estrogen and progesterone in your body after pregnancy. You have high levels of these hormones during pregnancy. But they can quickly go back to normal levels in the first 24 hours of giving birth.
  • Low level of thyroid hormones. The thyroid is a gland in your neck that helps your body store energy from food.

Are you at risk for PPD?


You may be at risk for PPD if:

  • You had depression or another mental health condition during pregnancy or in the past. Or someone in your family has had depression or mental health condition.
  • You’ve been physically or sexually abused or been abused by your partner (also called intimate partner violence or IPV).
  • You’re younger than 19.
  • Your pregnancy is unwanted or you have negative thoughts about being a mom.
  • You’ve had stressful events in your life
  • You have complications during pregnancy
  • You have trouble breastfeeding or caring for your baby after she’s born. Or your baby is sick or has health conditions.
  • You smoke, drink alcohol or use harmful drugs.

What are the signs and symptoms of PPD?


You may have PPD if you have five or more signs or symptoms of PPD that last longer than 2 weeks. Signs and symptoms include:

Changes in your feelings

  • Feeling depressed most of the day every day
  • Feeling shame, guilt or like a failure
  • Feeling panicked or scared a lot of the time
  • Having severe mood swings

Changes in your everyday life

  • Having little interest in things you normally like to do
  • Feeling tired all the time
  • Eating a lot more or a lot less than is normal for you
  • Gaining or losing weight
  • Having trouble sleeping or sleeping too much
  • Having trouble concentrating or making decisions

Changes in how you think about yourself or your baby

  • Having trouble bonding with your baby
  • Thinking about hurting yourself or your baby
  • Thinking about suicide (killing yourself)

If you think you have signs or symptoms of PPD, call your health care provider right away. There are things you and your provider can do to help you feel better. If you’re worried about hurting yourself or your baby, call emergency services at 911.

How is PPD treated?


Your provider screens (checks) you for PPD at your postpartum care checkups. Screening means that your provider asks you questions about your feelings and mood and your risk for PPD. If the screening shows that you may have PPD or that you’re at risk for PPD, your provider can help you get treatment.

You can get treatment for PPD from your prenatal care provider, your primary care provider or a mental health care provider. You may get treatment from one or all of these kinds of providers. Treatment can include:

  • Counseling (also called therapy). This is when you talk about your feelings and concerns with a counselor or therapist. It helps you understand your feelings, solve problems and cope with things in your everyday life.
  • Support groups. These are groups of people who meet together or go online to share their feelings and experiences about certain topics.
  • Antidepressants. These are medicines used to treat many kinds of depression, including PPD. Some are not safe to take if you’re breastfeeding. Talk to your provider to see if an antidepressant is right for you.
  • Estrogen. To help with PPD, your provider may suggest you wear an estrogen patch on your skin to replace the estrogen your body lost after pregnancy. Ask your provider if the patch is safe during breastfeeding.

Don’t start or stop taking any medicine for PPD without your provider’s OK. Take it exactly as your provider tells you to.  


Ask your provider about counseling to prevent PPD

If you’re at increased risk for PPD, certain kinds of counseling can help prevent it. Tell your provider if you have one or more of these risks:

  • You currently have signs or symptoms of depression.
  • You’ve had depression or another mental health condition in the past.
  • You’re a teenager.
  • You’re a single mom.
  • You have stresses in your life, like having low income.
  • You’ve been abused by your partner (also called intimate partner violence or IPV).

 

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