Vital Signs: Don’t forget the new mom; help is available for perinatal misery

When a woman is pregnant, so much attention is on the new baby. Is it a boy or a girl? When is the baby shower? When is the due date? Family and friends will ask, “Are you ready for the baby to be here?” Baby, baby, baby — but what about Mom?

New mothers have more responsibilities, have to respond to their new babies around the clock, and must adjust to changes in their relationships with partners, friends and families. Add this to the physical recovery after giving birth, and you understand why most mothers remember this as one of the most wonderful, difficult and tiring life stages to endure. It is no wonder that some mothers struggle with these changes.

Mothers are often warned about “baby blues” — the feelings of exhaustion, anxiety, unexplained crying and mood swings that usually happen within the first two weeks after the baby is born. According to the American Academy of Pediatrics, baby blues are common — affecting about 50% to 80% of all moms — and relate to a major decrease in hormonal activity after delivery. Baby blues usually resolves on its own, but if it does not, it may be because a mother is experiencing perinatal mood and anxiety disorders.

What used to be known as postpartum depression is now recognized as perinatal mood and anxiety disorders, (PMADs). This term describes a range of symptoms that more fully capture what many mothers experience. According to the American Academy of Pediatrics, PMADs include depression, anxiety, obsessive-compulsive disorder and psychosis (one or two cases per 1,000 women).

About 20% of new mothers will experience PMADs in the first year after baby is born. It can be months until a mother has symptoms. Some PMAD symptoms include feeling overwhelmed or irritable; having sleep disturbances or anxiety; and feeling distant from one’s baby, friends and family.

Although there is no single cause for PMADs, it is important to remember that PMADs do not happen because of something a mother has or hasn’t done. Some factors that the American Academy of Pediatrics has linked to PMADs include:

» Hormone changes after childbirth

» Personal or family history of mood and/or anxiety disorders

» Stress related to going back to work or school, lack of free time, sleep issues, relationship problems and/or lack of support

» History of trauma

» History of significant reproductive health issues

» Psychological factors, including unrealistic expectations, perfectionist tendencies and difficulty with transitions.

Normally, PMADs are associated with the birth mother; however, any new parent may experience these feelings. Family members and friends can play an important role in helping their loved ones get help for PMADs.

How you or someone you know can get help for PMADs:

» Make an appointment with your doctor. Almost half of PMAD cases go undiagnosed because many women feel reluctant to talk about how they feel. Your doctor may refer you to a local therapist or prescribe medication to help.

» Surround yourself with a support system for help. Family, friends and other new parents can be a major source of support.

» Attend a local support group. Visit the Postpartum Support Virginia website ( to find a local support group in your area.

» Out of the Blues – Charlottesville support group meets first and third Mondays of every month from 7:00 to 8:30 p.m. and second and fourth Thursday of every month from 10:30 a.m. to noon. Learn more at

» Call the “Moms on Call Program” support phone line or visit

» Visit the Thomas Jefferson Health District’s website ( for information about pregnancy and parenting resources.

» Search for other resources. For example, the Improving Pregnancy Outcomes Workgroup, a local coalition that is open to the public, shares resources and discusses challenges and solutions surrounding pregnancy and birth outcomes.