Focusing on yourself after baby is born

Guest Post by Ellen Kolomeyer, PhD, PMH-C of Unpolished Parenthood

The fourth trimester, postpartum, the perinatal timeframe… you’ve heard so many different terms, but what do they all mean and are they all so different? Well, yes! While there is overlap among all three terms, they do refer to different periods.

If we’re being technical, the fourth trimester is the first three-ish months after a baby is born whereas postpartum applies to the entire first year after the birth of a baby. When we say perinatal mental health, however, we’re talking about wellbeing from pregnancy all the way through the first year postpartum. 

The term perinatal mental health means any parent may develop a perinatal mood and anxiety disorder at any time during pregnancy or postpartum. And any parent really does mean any parent. That’s moms, dads, adoptive parents, people who gave birth, and partners who didn’t give birth. 

Parenting Stress

Every time a baby is born, a new parent is born. Babies are born knowing exactly how to baby, yet no parent is born knowing exactly how to parent. There are so many books, classes, and resources for expecting parents, yet we can never truly prepare for what it’s like when our little ones get here with their very own temperaments, personalities, preferences, and opinions. If only they could communicate using a language in which we’re already fluent! 

When we think about it like that, it’s no surprise that new parents often feel quite overwhelmed. Many of the struggles are pervasive; every parent can relate, even if it’s not their first baby. The exhaustion of labor & delivery, physical and emotional recovery, adjusting to a whole new person entering your life, figuring out feeding, a new routine, and baby’s likes and dislikes, sleep deprivation, and major hormone shifts often results in feeling like you’re just in survival mode day after day. Fight, flight, freeze.

Sometimes, that feeling of survival mode permeates your entire life. Perinatal mood and anxiety disorders, or PMADs, can impact anyone regardless of sex, gender identity, education, income, race, and ethnicity. Welcoming a new baby is a huge adjustment and there are tons of societal pressures on parents. You’re expected to love and cherish every moment, immediately bond with baby, adjust seamlessly, find time for self-care, attend to other children and family members, manage the household, go back to work, and for this balancing act to come naturally.

The pressure is stressful and overwhelming at best but can be debilitating at worst, and difficulties that are left unresolved may continue to deteriorate parents’ mental wellbeing well past the first year postpartum.

Postpartum Depression and Postpartum Anxiety 

Research shows that postpartum depression and postpartum anxiety affect about 20% of parents. That’s 1 in 5 people, and the number one risk factor is being pregnant and having a baby. Chances are someone you know has been there or is there right now. If not treated with an appropriate, evidence-based intervention, postpartum depression and anxiety can last much longer than the first year postpartum.

One common myth about postpartum disorders is that they start right after baby is born. In reality, they can happen anytime during pregnancy or throughout the first year postpartum. While symptoms may look different for everyone, read on for some common symptoms to look out for.

Common Symptoms of Postpartum Depression

• Sadness,
• Frequent crying,
• Feeling ashamed, guilty, or hopeless,
• Not feeling bonded or connected to baby,
• Anger and irritability toward others,
• Not enjoying the things you used to like,
• Feeling alone, isolated, and withdrawn from people you were once close to,
• Being unable to fall or stay asleep at times when you could be sleeping,
• Changes in appetite, 
• And even thoughts of hurting yourself, your baby, or someone else.

Common Symptoms of Postpartum Anxiety 

• Constantly feeling worried about your baby (for example, about their health or safety)
• Feeling unable to control your worries and like they are always on your mind
• Finding yourself being angry, agitated, and irritable
• Often feeling restless and feel on edge
• Having trouble concentrating and focusing
• Feeling fatigued often but having trouble falling or staying asleep

Risk Factors 

Postpartum depression and other mood and anxiety disorders are a universal experience. Though expressed differently in different cultures around the world, research showed that they are seen internationally.

Mood and anxiety disorders during pregnancy and postpartum come from the intersection of your own biology, psychology, and social factors. Check out the diagram below to see the different variables that create risk for postpartum depression and anxiety. 

Six ways to promote your wellbeing after baby is born

1. As often as possible, eat nutritious meals and snacks, and stay hydrated. You can prepare before baby gets here by freezing your favorite meals and stocking up the fridge and pantry. Carry a large water bottle even at home as a reminder to drink. Plan out who will be doing the grocery shopping (or ordering delivery) and when. 

2. Move your body any way you can. Aim for 30 minutes, 3-5 days per week and do whatever is most accessible for you. Daily exercise can reduce symptoms of depression and anxiety. Going out for some fresh air for you and baby can help you get moving, even if it’s only for a few minutes a day at first. Getting started is key. Always check with your healthcare provider before starting a new physical routine and do what feels right for your body.

3. Connect. Lack of social support is linked to decline of wellbeing in the first year postpartum. Conversely, feeling supported is one of the strongest protective factors against postpartum depression and postpartum anxiety. Aim for quality over quantity. A support network doesn’t have to be big, it just has to fill your cup. 

4. Sleep. Think of sleep like a security blanket. Getting enough is one of the best ways to protect your physical and mental wellbeing. Good sleep helps you regulate emotions and cope more effectively with stress, whereas poor sleep is linked to worsening symptoms of depression and other mood and anxiety disorders. This is another area where quality is more important than quantity. Good but short sleep is better than long but not restful sleep. 

5. Ask for and accept help. Sometimes, that alone is the hardest part of getting support. If your people are offering help, take them up on it. If you have trouble letting go of the reigns, start small. Ask someone to watch baby while you’re all in the same place so you can sleep, shower, eat, or get back into a self-care activity you enjoy. Use this time for you. 

6. Set realistic expectations and show yourself kindness and compassion. You don’t have to do it all. That early postpartum time is for resting, bonding, and nourishment for your body and soul. Go at your own pace and don’t compare to anyone else’s journey or the ideas you may have had in mind before baby got here. Give yourself permission to let go of some expectations you had of yourself and focus on feeling your best first.