When a new baby is on the way, there is typically a lot of excitement and attention from friends and family in the countdown to the much-anticipated day of birth.

Then the big day comes, and new parents can suddenly find themselves navigating countless new responsibilities and a rollercoaster of emotions. It can be challenging to know what feelings are normal and when it’s time to ask for help.

“The early days and months of parenthood are understandably overwhelming, especially during times of isolation that many have faced recently during the pandemic,” said Betsy Laughter, MSW, education specialist, WakeMed Birth & Family Education. “Without the help of family or friends and neighbors, those sleepless nights can really take a toll over time.”

Laughter wants new parents and their circle of support to know that’s a fairly normal feeling and to be alert to any concerning signs of peripartum (the period of time shortly before, during and after delivery) and postpartum depression, anxiety and mood disorders. “It’s not fun to talk about or to think you might personally experience mild or severe depression during such a special time, but the reality is that you don’t necessarily have control over some of the changes to your body and mind.”

A Sea of Change

New mothers’ bodies have already been through a lot physically, and then they experience a wide array of physical postpartum changes, including big hormonal swings that directly affect their mood and mindset.

“When you add in the day-to-day feeding and caretaking of a newborn, it’s a lot,” said Laughter. Caring for a baby through those early developmental stages can be absolutely amazing, but just when you get into a new routine your baby’s sleep patterns or feeding needs are bound to change. “Even if you’re not a first-time parent, the waves of change just keep coming in those early months, and they can really catch you off guard at times,” said Laughter.

The best thing you can do for yourself and your baby is to be aware of the many changes to come and try to take care of yourself so you can be as strong as possible in body and mind during challenging times.

Below are five tips she offers for expectant parents.

• Build Your Circle of Support. Identify a handful of people who you know you can count on and trust to step in for you to care for your baby or to take over some daily tasks. Talk to these people in advance about the specific ways they will help you in the first days and months. Many times, that doorstep delivery or even virtual support will be more helpful than you realize. Ask yourself who can help you order groceries, take away/bring back laundry, handle outdoor chores, and most important, check in on you. Tell your circle of support that you are counting on them to make you laugh, let you cry, really listen and step in when you might not realize you need help.

• Create Your Own Nest. Pick a place in your home that you will retreat to on a regular basis to recharge. It is very important for parents to take real breaks and to rest their bodies and minds. Whether you need to sleep, eat in peace, read, talk to a friend or just listen to music without interruption, you need to plan in advance to step away, breathe and reset. If you make this a priority from the beginning during pregnancy, you are proactively taking care of yourself, which is a critical step in order to remain strong for the ongoing care of your baby.
• Learn from Others. Take the time during pregnancy to sign up for birth and parent education classes. “At WakeMed, we go over just about every topic you can think of in our classes, and you can select from a menu of options to meet your interests and needs,” said Laughter. “Our goal is to prepare you for the unknown, build your knowledge and self confidence, and provide you with trusted resources.”
• Ask for Help Anytime. If your baby is already here, and you find you don’t have a circle of support or aren’t taking breaks for yourself, it’s not too late. Reach out. People want to help. Do not tell yourself that you have to get through tough times on your own. When you combine stress, isolation, sleep deprivation and ongoing fatigue, it’s a bad recipe that can lead to serious problems, including depression. If you aren’t able to rely on family and friends for the type of support you need, there are plenty of other resources. Check out the resources listed on the next page or call 1-800-273-TALK (8255) if you and/or your spouse need immediate help.

• Join a Support Group. Sometimes you just need to surround yourself with people who understand what you’re navigating because they’re going through something similar. There are many different types of support groups to help new parents connect, and some focus on specific needs such as, breastfeeding, exercise, depression or grief. Many have gone virtual recently, which can make it even easier to join in while juggling an ever-changing routine.

Stress & Anxiety

While bringing a new baby home can and should be full of happiness, it can also be a stressful time for new parents. On top of the feeding and diaper changing, there are many anxiety-inducing factors that most parents never anticipate. If a baby has breastfeeding challenges, weight gain concerns, or other developmental or health issues that need to be monitored closely, it can all be a bit too much at times for new parents. Without the right amount of support and professional help when it’s needed, things can really feel like they’re spiraling out of control. “No matter how much a parent loves their newborn, those early days, weeks and months after having a baby are stressful,” said Laughter. “For mothers, the changes to their bodies and hormones are more than anyone ever seems to grasp before they’re actually experiencing it.”

Feeling Blue

It’s not uncommon for women to experience a mild form of depression in the first two to three days after birth that many refer to as the baby blues. A drastic change in hormones can cause women to feel anxious, upset or depressed in those early days; they might also feel angry with family members or even the baby.

The following symptoms might come and go in the first few days after delivery.

• Crying for no apparent reason
• Fears about caring for their baby
• Trouble making decisions
• Not eating or sleeping well

Approximately 80% of women may experience some symptoms of postpartum blues. It is not well understood why baby blues happen, but it is thought that a combination of factors including physical, hormonal and emotional contribute to symptoms. Postpartum baby blues typically resolve within two weeks after delivery. If a patient is experiencing ongoing or worsening symptoms beyond those initial two weeks of baby blues, it would be a reason to seek help from a medical professional. The rate of postpartum depression may be as high as affecting one in eight women.

Prolonged Postpartum Depression

For many women, professional medical help will be needed to respond to postpartum anxiety, mood disorders and depression.

“Postpartum depression might show up as what we traditionally think of as depression such as sadness or isolation behaviors, or it can show up as rage,” said Laughter. “At times, it might be something you can’t quite explain or put your finger on, but a mother will just feel or seem off – she won’t seem like herself.”

If a mother is experiencing any symptoms of depression that aren’t easily remedied with human interaction, nutritious food, fresh air or basic self care, then it is time to get professional help.

It’s important to seek help as soon as possible. A mother with prolonged depression may have troubled connecting with her baby, which can lead to developmental challenges and mental health or behavioral issues throughout the child’s lifetime. If it goes untreated, postpartum depression can last for months or years and lead to suicide or infanticide.

Call for Help at 1-800-273-TALK (8255).

---

About Dr. Elizabeth Jarvis

Dr. Jarvis joined WakeMed Physician Practices after completing her residency, medical school and a Bachelor of Science in Biology at the University of North Carolina at Chapel Hill. She graduated Phi Beta Kappa from UNC-Chapel Hill, and she was awarded the Golden Tar Heel Teaching award.

Her clinical interests include fertility, abnormal uterine bleeding, minimally invasive and robotic-assisted surgery, family planning and contraception, high risk and routine obstetrics care.

Outside of medicine, she enjoys outdoor pursuits, practicing hot yoga and spending time with her family. In 2019, she expanded her family, giving birth to a baby girl at WakeMed North where she enjoyed an excellent patient experience.