Maternal Mental Health: What You Should Know and How You Can Help

For expectant mothers, caring for mental health is just as vital as physical health – and it begins even before the baby is born. From pregnancy planning through the postpartum period, mental wellness plays a critical role in not only a mother’s health but her baby’s as well. With the right knowledge, proactive care planning, and strong support from loved ones, women can reduce their risk of postpartum depression and nurture their mental health throughout the perinatal journey.

Understanding Maternal Mental Health and Postpartum Depression

The Perinatal Mental Health Timeline

Women can help prevent postpartum depression by fostering mental wellness throughout their pregnancy – and before they conceive.

“We talk a lot about improving physical health before conception,” said Alexis Totaro, MSN, RN, WHNP-c, CARN-AP, VP of Operations Behavioral Health Services and Administrator/Chief Nurse Executive at Christian Health, who is also a board-certified women’s health advanced practice provider and certified perinatal maternal mental health provider. “But mental health should be part of that preparation, too.”

The perinatal period is the timeframe beginning before conception – during pregnancy planning – and extending through postpartum. Just as you would begin preparing for your pregnancy by taking vitamins, quitting smoking, or eating more protein, you should be prioritizing your mental wellness as well. The beginning of that process includes something called preconceptual counseling.

What Is Preconceptual Counseling?

Preconceptual counseling is a health care visit where your provider will assess your health, identify risks, and create a plan to promote a healthy pregnancy, which may include education, vaccinations, medication management, and lifestyle changes like nutrition and exercise.

If you are in treatment for any mental health issues, preconceptual counseling is an especially important opportunity to discuss them openly with your provider. This includes reviewing your current medications, exploring any other treatment options, and making necessary adjustments well before pregnancy begins. Proactively planning for your mental well-being helps ensure continuity of care, reduces unnecessary stress, and supports your emotional health throughout pregnancy and the postpartum period.

The Medication Misconception

One of the most common myths surrounding pregnancy is that expecting mothers must immediately stop taking antidepressants or other mental health medications to have a safe pregnancy.

“That’s often not true,” said Alexis. “In fact, newer studies show that untreated depression during pregnancy can have more adverse effects on the fetus than most medications.”

Research increasingly shows that untreated anxiety and depression during pregnancy are linked to higher risks of preterm birth, low birth weight, difficulty bonding after delivery, and postpartum depression. When a mother is struggling mentally, it can affect sleep, nutrition, and overall well-being, which are all critical for healthy fetal development.

Plus, women are better able to care for themselves, attend prenatal appointments, prepare emotionally for birth and parenthood, and have a smoother transition into the postpartum period when they are in good mental health.

However, every pregnancy is different, and all medical decisions should be made under the guidance of a medical provider to ensure the safest and most effective treatment plan that prioritizes both maternal and fetal health.

Recognizing the Signs of Postpartum Depression

Postpartum depression (PPD) is a mood disorder that occurs after childbirth, characterized by severe sadness, anxiety, and hopelessness that interfere with daily life and the mother’s ability to care for the baby, potentially starting up to a year after birth. Even women without a history of mental health challenges can experience PPD. And while the postpartum period can be difficult for anyone, PPD goes beyond typical exhaustion and normal adjustment to the new responsibility of being a mother.

Common warning signs include:

• Changes in mood, including sadness or emotional flatness
• Trouble sleeping or sleeping excessively
• Poor self-care or hygiene
• Appetite changes
• Difficulty bonding with the baby

Signs of postpartum are not always obvious. “Sometimes women are just going through the motions, such as feeding and changing the baby, but doing it robotically, without real joy or connection,” Alexis said. “That’s a red flag.”

As a loved one of a postpartum mother, it’s important to pay attention to any subtle changes and intervene early. “You know your loved one,” said Alexis. “The sooner you help them get screened and get help, the better.”

The Power of Support

How Loved Ones Can Help

Having a healthy support system is vital to handle the new pressures of motherhood, even for those who aren’t struggling with postpartum depression. As a loved one of a new mom, providing a helping hand and listening ear can significantly reduce feelings of isolation, ease stress, and if she’s dealing with PDD, help her recover more easily.

You can support a new mom by:

• Ensuring she gets rest, attends doctor’s appointments, and takes her prescribed medications
• Temporarily caring for the baby if needed
• Providing support with daily tasks, such as preparing meals, helping with household chores, or running errands
• Listening without judgment, validating her feelings, and reassuring her that she is not alone and help is available

Simply checking in regularly and offering consistent encouragement can make it easier for a new mother to speak up when something doesn’t feel right.

Knowing What to Say – And What Not to Say

Offering support can also mean saying the right things and avoiding the wrong ones. Many people have trouble understanding how new mothers can be unhappy during what should be an exciting time. Mothers who had difficulty conceiving and went through fertility treatments especially get dismissed when dealing with PDD, because their loved ones often have the misconception that they should be grateful for their baby, not depressed.

“Postpartum depression is a chemical process that’s out of someone’s control,” said Alexis. “Causing them to feel guilt and shame will only make their recovery harder.”

Things not to say include:

• “This is normal; it’ll pass.”
• “You wanted this baby so badly. How can you be depressed?”
• “Did you think motherhood would be easy?”
• “Snap out of it.”
• “You just need to sleep/eat/exercise more.”

Things you should say include:

• “I’m here for you.”
• “You’re not alone.”
• “This isn’t your fault.”
• “We can get you help.”

When to Seek Professional Help

Loved ones play a critical role in recognizing the early warning signs of postpartum depression and helping a new mother get the care she needs. “Supporting a new mom isn’t only about bringing food or babysitting,” Alexis said. “It’s about truly seeing her, asking how she’s doing, and stepping in early when something doesn’t feel right.”

If a new mom is exhibiting signs of postpartum depression that persist for more than two weeks, professional treatment may be necessary. A mental health screening will help determine the best plan of care, which may include counseling, medication, or a combination of both. In the event of any thought of self-harm or harming the baby, immediate emergency help is vital.

Compassionate Support at LiveWell Counseling

If you or someone you know needs mental health support before, during, or after a pregnancy, we can help. At LiveWell Counseling, our highly qualified mental health providers have a diverse range of expertise, including maternal mental health. From your first appointment, you’ll receive personalized, compassionate care in a gentle, comforting environment. To learn more about how LiveWell can help you or a loved one, please call (201) 848-5800 or visit ChristianHealthNJ.info/LiveWell.