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Hope and Health

Your source to help with your family's health from WVU Medicine Children's

Hope & Health
Articles and Updates from WVU Medicine Children's

05/1/2024 | Elizabeth "Liz" Cohen, MSW, LICSW

Your Mental Health: Adjusting to Pregnancy and Parenting

As part of the mental health team embedded within the Department of Obstetrics and Gynecology at WVU Medicine Children’s that’s been caring for West Virginia’s women for the past 30 years, there is nothing closer to my heart than helping our new moms (and dads) make the adjustment to pregnancy and parenting.

May is recognized as Mental Health Awareness Month, an opportunity to draw attention to and spread awareness about issues that can affect mental health. We want our new families to have as much information, support, and reassurance as possible to aid in this life-changing transition.

One of the things I’ve learned over the years is that having difficulty adjusting during this time is not a character issue or character flaw. It is a very real concern with real risk factors and real solutions and treatments.

We’ve all heard about baby blues and postpartum depression, but I’d like to add postpartum anxiety to the mix.

Let’s describe these ‘common’ postpartum challenges, without judgement, embarrassment, stigma, or shame and reactions that unfortunately often accompany the disclosure of any of these by a patient. 

The Baby Blues

Baby blues are experienced by anywhere from 60-to-80 percent of new moms.


Symptoms usually start about two-to-three days after childbirth and last about 14 days.

There are really no risk factors beyond pregnancy itself. Symptoms are usually a mishmash of joy, happiness, and feelings of being overwhelmed, anxious, and fearful about how you will ever learn to take care of this very dependent little bundle. 

Nursing moms especially, but all new moms, will experience varying levels of sleep deprivation, which can negatively impact your mood as well.

Treatment is awareness and anticipation.

Know that your first two weeks postpartum have the possibility of feeling a bit rough. Enlist the aid of folks in your support network to bring over meals, watch the baby for an hour so you can nap, or fold a load of baby clothes.

Be kind to yourself. Treat yourself with the same grace and understanding you would if a friend came to you in a similar situation. Funny how we can be so much more compassionate to others than ourselves.

Postpartum Depression

Postpartum depression is a very real condition that needs to be addressed by a provider.

We see it in anywhere from 10-to-12 percent of postpartum moms. Symptoms usually start within four weeks of delivery.

If you’ve had a previous diagnosis of depression or became depressed during pregnancy, you are more at risk to develop postpartum depression. Also, any complications during the pregnancy, an unplanned pregnancy, or lack of support can increase your risk.

What can you do?

If you notice a change and “just don’t feel like yourself,” be open and honest with your provider about your mental health concerns during your pregnancy and postpartum. Discuss treatment options available to you, including medication and counseling.

Remember, medication isn’t magic. You still have to do the work to change or improve your coping skills.

Make a plan for managing postpartum and keep your six-week postpartum appointment. That appointment is your opportunity to share any postpartum concerns with your provider and your provider’s opportunity to make any adjustments or referrals as necessary.

Remember that lack of sleep can have a negative impact, so think about your resources for improving your sleep and use them.

Go outside and take a calming, relaxing walk. Use meditation or do deep breathing exercises. A great resource is Postpartum Support International, which has good information, education, resources, and peer support opportunities. They just opened a West Virginia Chapter, so there may even be local opportunities in the future.

Another really good resource is the book This Isn’t What I Expected, Overcoming Postpartum Depression by Karen Kleiman and Valerie Raskin.

If your situation ever includes thoughts about hurting yourself or the baby, that is the time to contact your provider immediately or get yourself to a local emergency department.

Postpartum Anxiety

Postpartum anxiety is more recently being recognized as a postpartum condition. It is seen in six-to-10 percent of our pregnant and postpartum women.

Putting women more at risk of experiencing postpartum anxiety is a history of anxiety, a complicated or unplanned pregnancy, and lack of social or family supports.

The constant worry and dread that something bad might happen, intrusive thoughts, and panic can cause significant disruptions and diminished enjoyment of your postpartum course.

Like postpartum depression, postpartum anxiety can be treated with medication and therapy, but you must tell your provider that you are suffering with these symptoms.

If you know you have a risk factor, talk to your provider in advance of delivery so you can develop a plan together. Anticipation and planning are key to maximizing your postpartum success!

What to Take Away

  • Postpartum conditions are NOT characters flaws.
  • This is nothing to feel guilt, shame, or embarrassment about.
  • Treat yourself with grace and kindness.
  • Identify and use your supports and line them up before delivery.
  • Catch up on sleep whenever you can and get outside for a walk when the weather is nice.
  • Develop an open and honest relationship with your OB provider so you are comfortable sharing whatever information needs to be shared.
  • Remember, educate yourself, be aware, and anticipate and discuss options with your provider.
  • Most of all, enjoy your baby and take lots of pictures!

If you are struggling with mental health as an expecting or new mom, call the Maternal-Fetal Medicine and Mental Health team at 304-598-4878.

About the Author

Elizabeth R. Cohen, MSW, LICSW, is a West Virginia licensed, independent, clinical social worker. She received her master’s degree in social work from Howard University in Washington, D.C., in 1988. Liz has coordinated the Mental Health and Wellness Division of the Department of Obstetrics and Gynecology at WVU Medicine since 1994. In this outpatient setting, her clinical practice addresses a wide range of issues that affect women and their mental health, including infertility, depression, post-partum mood disorders, pregnancy loss and bereavement, teen pregnancy, intimate partner violence, anxiety disorders, and high-risk pregnancies. Liz is also an instructor at the WVU School of Medicine, lecturing medical students on postpartum mood disorders, bereavement, and how to counsel patients with bad pregnancy outcomes. Administratively, she chairs the OB/GYN Department’s Wellness Committee, is a member of the Clinical Competence Committee, and serves on the School of Medicine Admissions Committee.

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