What is Postpartum Mental Health Care?
At Magee-Womens Behavioral Health Services, we treat any behavioral or mental health problem a woman may have in her lifetime. This includes mental health issues you may develop during conception, pregnancy, and the postpartum period.
Pregnancy and childbirth can trigger hormonal changes that can increase your risk of mental health issues. Many women also experience postpartum memory loss or brain fog — the so-called "mommy brain" — after giving birth. This can get in the way of caring for yourself and your baby.
Our ob-gyns and mental health experts can screen and treat mental health issues before, during, and after pregnancy.
What conditions do we treat?
It's common to feel sad, tired, or worried after giving birth. About 80% of new parents have these "baby blues" symptoms, according to the March of Dimes. Baby blues symptoms often start two to three days after you give birth and typically go away within two weeks.
For some new moms, these feelings can last longer and feel more intense, pointing to mental health problems. Postpartum mental disorders are mental health conditions that can affect people after giving birth.
Pregnancy and postpartum mental health issues we treat at Magee-Womens include:
- Postpartum depression — This medical condition affects 15% of women. It often starts one to three weeks after giving birth, with symptoms of depression lasting longer than two weeks.
- Postpartum-related psychosis — This rare, severe form of depression affects about one or two in 1,000 people who give birth. Symptoms usually start in the first two weeks after giving birth. Women with bipolar disorder or schizoaffective disorder are more at risk of postpartum-related psychosis.
- Trauma from past events or labor and delivery — Nearly 40% of parents with babies in the neonatal intensive care unit (NICU) experience post-traumatic stress disorder, according to the March of Dimes. Some 25% of NICU-baby parents experience it up to a year after their baby's birth.
- Perinatal loss and grief — Dealing with grief after a stillbirth or infant loss.
What Postpartum Mental Health Care Services Does UPMC Magee-Womens Offer?
Postpartum mental health care can begin long before you give birth. Behavioral and mental health services offered through UPMC Magee-Womens and UPMC Western Behavioral Health can safeguard your mental health before, during, and after pregnancy.
Behavioral and mental health care services
These include:
- Pre-conception assessment and counseling — If you're thinking about starting a family but have concerns about your mental health, we can help identify and treat any mental health issues.
- Psychiatric assessments — We perform assessments in outpatient and inpatient settings and the emergency department.
- Screening for perinatal depression and anxiety — Your obstetrician will screen you for behavioral and mental health issues at each appointment during and after pregnancy. During each well-baby visit from birth until 24 months, your baby's pediatrician will also screen you for behavioral and mental health issues, including depression.
- Help with medication management during and after pregnancy — Our experts can review your medicines and create a plan for your pregnancy and postpartum.
- Counseling and psychotherapy — You can get one-on-one talk therapy in person or virtually. We also offer a special outpatient treatment program for new and expectant mothers.
- Team support in the NICU — Our neonatal doctors, nurses, development specialists, and social workers work together to provide extensive services that support families.
- Brexanolone — This is a treatment for postpartum depression given as an infusion. Contact your doctor about a referral or email brexanolone@upmc.edu.
- Mother-baby intensive outpatient program (NEST IOP) — Women who are pregnant or up to 12 months postpartum receive about nine hours of intensive outpatient treatment in this program. NEST-IOP helps you handle depression and anxiety around childbearing.
Postpartum care services
Postpartum Care Services are part of Obstetric Services at UPMC Magee-Womens.
After delivering your baby, your postpartum care begins in one of Magee's postpartum units, where you and your baby will spend the rest of your hospital stay. Postpartum care includes several services that can ease the challenges of caring for your newborn and protect your mental health.
These include:
Breastfeeding support
It's common for new mothers to have challenges breastfeeding. It may be hard to get your infant to breastfeed. Or your expectations of breastfeeding may not match reality.
When either happens, breastfeeding can have a negative impact on maternal mental health. It may increase your risk of anxiety, depression, or other mental health conditions. That's according to a systematic review published in the Journal of Women's Health.
Certified experts from Magee's Lactation Center can support your breastfeeding journey during your postpartum recovery in the hospital and at home.
Magee Postpartum Pelvic Floor Healing Clinic
Some 25% of women in the United States have pelvic floor disorders (PFD), according to Voices for PFD. Your pelvic floor provides support for your vagina, bladder, uterus, and rectum. PFD can cause vaginal pressure and pain and bladder or bowel problems, such as leakage of urine, feces, or gas.
Carrying and having a baby can weaken or strain your pelvic floor. Having PFD is linked to postpartum mental health problems, according to a systematic review in the Journal of Reproductive and Infant Psychology.
Experts at the Magee Postpartum Pelvic Flood Healing Clinic care for women who have healing issues, pain, or pelvic floor problems within a year of giving birth. A pelvic floor physical therapist will tailor a care plan focused on healing your pelvic floor after childbirth.
Postpartum depression resources
During postpartum care at UPMC Magee-Womens, our experts provide mental health resources for you and your family.
Treatment for Postpartum Depression
Postpartum depression and other serious mental health issues don't go away on their own. The longer you wait to get treatment, the more difficult it can be to treat. If you are struggling with mental health issues postpartum, you need treatment.
UPMC's experts can help you decide what treatment options are right for you. First-line treatment for PPD typically includes a combination of antidepressant medication and talk therapy.
Treatment for postpartum mental health issues can include:
- Antidepressants, including postpartum anxiety medication — Medication can help manage your symptoms. If you are breastfeeding, your doctor can help you choose a medication that's safe to take while breastfeeding.
- Counseling or talk therapy — This includes cognitive behavioral therapy or interpersonal therapy.
- Transcranial magnetic stimulation (TMS) — If your symptoms don't respond to medication and talk therapy, your doctor may recommend TMS. It involves using magnetic waves to stimulate nerve cells that are underactive in people with depression.
- Electroconvulsive therapy (ECT) — People with severe PPD may not get better with medications and talk therapy alone. ECT is often used to treat people with postpartum psychosis.
- Brexanolone infusions — Brexanolone can help people with severe PPD who don't want to do ECT. A doctor or nurse will administer this FDA-approved treatment, which you take through an IV for 60 hours over 2.5 days. Brexanolone may not be safe to take while pregnant or breastfeeding.
- Zuranolone — is the first oral medication approved to treat PPD. It can harm a fetus, so you should not take it while pregnant and use extra birth control measures while on it.
- Support groups — Meeting with others who have PPD can help you feel less alone.
- Self-care — Eating right and getting enough sleep can help improve PPD symptoms.
Why Choose UPMC Magee-Womens for Postpartum Mental Health Care?
Your first days and weeks as a parent are hard enough. That's why we make postpartum mental health care easy.
UPMC provides:
- Easy to access care — You can access behavioral and mental health care, including treatment for anxiety and depression, right in your ob-gyn's office.
- A spectrum of services — We also provide consultations, help manage medications, and offer mother and baby programs.
- Cohesive care — From screenings to referrals to visits, every provider you see has access to your medical record and knows your medical history.
When To Call Your Doctor For Postpartum Mental Health Issues
All too often, new mothers are too ashamed or embarrassed to speak up about what they are thinking or feeling. But there's no shame in having postpartum mental health issues. Getting the mental health help you need can help you take care of yourself and your baby better.
Signs of postpartum depression
Protecting your mental health postpartum starts with recognizing the symptoms of mental health issues and getting help. Call your doctor if you have any of the following symptoms for more than two weeks.
These may be signs of postpartum depression or other mental health issues:
- Extreme or unusual crying or sadness.
- Feeling depressed most of the day.
- Feeling angry or moody.
- Feeling hopeless.
- Feeling guilt, shame, worthless, or like a failure.
- Feeling tired all the time.
- Gaining or losing more than 5% of your body weight over one month.
- Severe mood swings.
- Difficulty concentrating or making decisions.
- Having trouble bonding with your baby.
- Loss of interest or pleasure in things you once enjoyed.
- Sleeping or eating more or less than usual.
- Withdrawing from friends and family.
Signs of postpartum psychosis
Call your doctor or provider right away if you have any of the following symptoms:
- Feeling hopeless, restless, upset, or very confused.
- Hearing or seeing things that aren't there.
- Paranoia, you worry you can't trust other people, or you think other people want to hurt you.
- Rapid mood swings.
- Trouble sleeping, even when you're exhausted.
Risk factors for postpartum depression
Some women are more at risk for postpartum depression and other postpartum mental health issues than others.
Your risk of PPD is much higher if you are a minority or person of color. According to a study published in Health Affairs, PPD affects:
- 22% of pregnant people who identify American Indian or Alaska Native.
- 19% of pregnant people who identify as Asian or Pacific Islander.
- 18% of pregnant people who identify as Black.
- 11% of pregnant people who identity as White.
Risk factors include:
- Being under the age of 20.
- Depression before or during pregnancy.
- Difficulty breastfeeding.
- Experienced or experiencing domestic violence.
- Experienced abuse or adversity as a child.
- Family history of depression.
- Little or no support from your spouse, partner, family, or friends.
- Problems with a previous pregnancy or birth.
- Relationship struggles, money problems, or experience other stressful life events.
- A traumatic or difficult birth, including having a baby born prematurely or with special health care needs.
- Unplanned pregnancy.
What to do in a postpartum mental health care emergency
People with postpartum depression and postpartum psychosis may have thoughts of hurting themselves, their baby, or someone else. If you have thoughts of suicide or of hurting your baby, yourself, or someone else, call 911 or call or text 988 Suicide & Crisis Lifeline.
Last reviewed by a UPMC medical professional on 2024-09-05.
