If the fear of postpartum (post-childbirth) stress is one of the roadblocks in your baby decision process, then it’s important to know about the many great resources and methods available that can prevent postpartum stress and depression.
As part of my popular “Ask Merle” series, I offer this advice:
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By Merle Bombardieri, MSW, LICSW
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Q: How can I prevent postpartum stress and depression if I choose to become a mother? 🤔
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Help! The news is full of maternal mental health horror stories, especially with Lindsay Clancy’s murder trial pointing to the gaps and problems in maternal mental health. I’m worried that I could fall into one of these gaps if I choose to become a mother. What can I do to avoid postpartum stress, depression, or even psychosis?
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Merle’s answer: Postpartum stress is normal but preventable
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Some women in your shoes might find it too scary to think about potential postpartum stress and other troubles. It sounds as if you are willing to risk some discomfort, and are imagining yourself uncomfortable and unhappy in postpartum. Even though you haven’t yet decided to be a parent, you are wise to get some confidence in postpartum support, before you either commit to or rule out parenthood.
The tragedy of Lindsay Clancy and her family has brought the world’s attention to how hard it may be to get the necessary help even if asking for professional help. I can understand how these headlines make you worry about your own well-being and that of your baby and partner.
The Lindsey Clancy trial disturbs us not only because of the tragedy of her killing her three children that she loved so much, but also because it really calls our attention the inadequacy of our medical and mental health systems. Clancy lives in Boston, which has some of the best medical care in the world. Even the professionals she reached our to let her down. Sadly, her mother and husband also illustrated a lack of knowledge about her condition to immediately get her hospitalized when there were red flags, which we will talk about below.
Rest assured, you will be less worried about falling through the cracks if you understand typical postpartum mental health challenges, which include:
– Postpartum depression and anxiety, which are far more common than postpartum psychosis.
– Common red flags that signal to you and your loved ones that you need help.
– Building a support system or safety net that will catch you and restore you to well being for you and your baby.
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Advice from a Maternal Mental Health expert:
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To dive deeper into your question, I asked Maternal Mental Health expert and Doula Danielle Jernigan to contribute to this article. She offers three takeaways:
1. Before or as soon as you are pregnant, find the professionals and the postpartum mothers support group you will rely on.
2. Find experts who are trained specifically in Maternal Mental Health. The medical and mental health experts you already like and see, or who are available through your midwife or obstetric practice, may be wonderful and part of your team, but only Maternal Mental Health experts can help you prepare for or treat any of the postpartum disorders. (I am an example of a senior licensed therapist who refers any client with postpartum distress to a specialist.)
If you currently have mental health challenges, you may already have pharmacists with expertise in prescribing antidepressants or anti anxiety medications, and perhaps you also have a psychotherapist. If so, talk to them about how they will help you and coordinate your care with other medical, psych resources and support groups. They will also tell you whether you may need to switch to an alternate medication during pregnancy and nursing, if you want to do that. And because they know you, they may be able to offer some reassurance both about your ability to cope with postpartum stress and depression.
But even if you have a psychopharmacologist you trust, you should still consult a professional who specializes in Maternal Mental Health for a second opinion. They will be able to help you plan whether to adjust, replace or discontinue current anxiety or antidepressant medication during pregnancy and nursing. Keep all of your beloved professionals if you’re fortunate to have them, but you must add a Maternal Mental Health specialist to your team.
3. Talk with your Maternal Mental Health provider to help you understand the difference between needing to call 911, such as not sleeping at all, being distrustful, talking about hurting yourself or someone else. And also, yellow caution flags for which you should call and consult with a professional, such as talking about suicide with no intention of going through with it, obsessing about the baby’s safety, etc. Your professional can help you formulate this list of each type of flag.
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More resources for postpartum prevention & support:
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Your best path to understand postpartum disorders themselves and to knowing how to ask for support will come from visiting Postpartum Support International (PSI) at Postpartum.net. This website will give you an overview of the different postpartum problems that can arise from general ideas about what the “yellow” flags—signs to get help and red flags, signs to get emergency help. The organization is rich in resources, and offers a helpline to connect you to providers and support groups. PSI, its website and its podcast will give you a sense of hope and confidence to cope and enjoy well-being for you and your baby
Other key steps in preparation and prevention:
– Find an ObGYN who is compassionate and emotionally supportive as well as medically competent. Asking friends who they worked with is an excellent way to find one. Your OB will most likely do a mental health screening in your first baby visit checkup. This may include asking you about your thoughts and symptoms and taking a screening test. This practice may have a social worker on staff as well as support groups held by the clinic or elsewhere in the community.
– Get plenty of sleep. A key to reducing postpartum stress is getting enough daily deep sleep, with the help of your partner, family members or paid help such as postpartum doulas.
Again, you are wise and brave to ask this question. It’s unpleasant to think about and prepare for the worst, but it makes it more likely that you and your baby and family will flourish no matter what. Getting information about steps to finding support should ease some of your fears and make it easier to consider parenthood from a more neutral perspective. I hope this will make you feel more prepared if you decide to get pregnant.
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TBD readers, have you had similar questions and worries?
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Does something I’ve said above resonate with you about worrying about post-motherhood stress? Have you thought of some other things that could help you with preventing or relieving postpartum stress and depression? Either way, you’re welcome to reach out and let me know via any of the contact links below. I’d love to hear from you!
What other questions can I help you address? How can I help you make the right choice for you? Reach out to me via my online contact form, or in our private Facebook group The Decision Café, or on any of my social media pages: Facebook, Instagram, or Twitter/X.
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Want to learn more?
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I will be writing more about this topic and other timely baby decision considerations in my new book, expected by the end of 2026. You can preview some of these topics and techniques if you subscribe to my free, bi-monthly email newsletter. In each issue, I’ll share a sneak peek excerpt that only newsletter readers can see! So if you haven’t yet, be sure to subscribe now here.
After you’ve done that, I invite you to catch up on my previous baby decision blog posts here.
– Merle
Photo above by Mitchell Luo, Unsplash