Postpartum Anxiety: What You Need to Know

Thanks to a recent push in research and legislation as well as celebrities like Brooke Shields, Hayden Panettiere, Adele and Chrissy Teigen openly sharing their personal accounts, postpartum depression is receiving much more attention than ever before.

Considering that approximately 600,000 women each year in the United States experience postpartum depression, this awareness is long overdue. Pregnant women are educating themselves about it and arming themselves with tools necessary to cope with any depressive symptoms that may arise.

However, more common than postpartum depression is its not so distant cousin, postpartum anxiety. In the United States, a little less than 700,000 women struggle with postpartum anxiety every year. What’s worse, is because it is so infrequently discussed, most women who suffer through it are surprised by the experience, unprepared for how to handle it and often misdiagnosed (or not diagnosed at all) for months.

This anxiety can disrupt the mother-child bond as well as impact a mother’s ability to care for her child if the anxiety is severe. Additionally, the stress that anxiety puts on her body can negatively affect her milk supply.

Here’s what you need to know about postpartum anxiety…

Anxiety lies on a spectrum. Most new mothers, especially first-time mothers, are prone to experiencing some anxiety. Worries about whether their baby will be safe, if the baby is eating enough, sleeping enough and if she’s doing a good enough job as a mother are all normal responses to new motherhood. A low level of anxiety, especially in the early days, is an adaptive feature for mothers to stay alert to their baby’s safety. Postpartum anxiety becomes problematic when it consumes every second of every day. For example, anxiety prevents you from sleeping or making a decision or driving anywhere with your baby for fear something will happen.

There are various forms of postpartum anxiety disorders. Not all postpartum anxiety is considered an anxiety disorder. Typically the difference between anxiety and when it is considered an anxiety disorder lies in symptom duration (how long the symptoms persist) as well as symptom severity (how much they impair your daily functioning). Examples of postpartum anxiety disorders include postpartum obsessive- compulsive disorder (OCD), postpartum panic disorder or postpartum generalized anxiety disorder (GAD). The official diagnosis is given by a licensed mental health professional. If you are concerned, I recommend visiting a mental health provider for assessment.

Postpartum anxiety does not mean you’re crazy or paranoid. Anxiety is very real. It is not something you are making up, nor does it say anything about your ability to be a mother or how well you are coping. Between the significant hormonal shifts that occur after childbirth and the sleep deprivation, added responsibilities and physical healing after delivery, there are many triggers for you to develop anxiety.

Some women are at higher risk for postpartum anxiety than others. Women who experienced a traumatic pregnancy (such as a high-risk pregnancy), a traumatic birth or who brought home a baby after a miscarriage, ectopic pregnancy or stillbirth are more likely to experience postpartum anxiety and postpartum anxiety disorders. Additionally, if you have a history of anxiety or depression you are more likely to experience postpartum anxiety.

What are the symptoms of postpartum anxiety?

Since anxiety lies on a spectrum, most women at some point or another in their postpartum experience will notice that they feel many, if not all of, the following symptoms:

Feeling dread or like something bad will happen
Constant worry
Racing thoughts
Sleep or appetite disturbances
Restlessness
Dizziness, hot flashes, nausea, stomach pain, shortness of breath

If these symptoms are impairing your ability to care for your baby, to go about your daily routine or affecting your ability to rest, please contact a mental health professional who specializes in postpartum anxiety.

If you’re not sure whether a call to a mental health provider is warranted, I recommend trying a self-reflective exercise. Hand your baby off to a trusted caregiver for 5 minutes. Find a quiet place to lie down or sit. Take several deep breaths and relax your body as best as you can. Ask yourself, “Would I benefit from some extra support?” Be honest with yourself.

If you have trouble with doing this exercise or if you realize that you really could benefit from some extra support, that is your clue to find a provider as soon as possible.

A note about high-risk pregnancies…

Many women who experience a high-risk pregnancy, traumatic pregnancy, traumatic delivery and/or NICU stay are faced with anxiety postpartum. In my professional experience, this anxiety typically presents itself between 6-12 weeks after your baby comes home. This anxiety is not a new condition you are facing. It is simply your body’s signal that it’s time to heal from the trauma you have experienced.

The good news…

Though anxiety is the most common complication of childbirth, it is one of the most treatable postpartum conditions. With the right support, you can go back to feeling like yourself again.

Frequently Asked Questions

What are your qualifications?

I am a double board certified ObGyn and Maternal-Fetal Medicine Specialist. I have worked at a large academic center in academic medicine as a clinician, educator and researcher since 2004.  I am currently a tenured Professor and actively manage patients with high-risk pregnancies.

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