Expecting Intensity: Normalizing the Highs and Lows of Postpartum
By Kaely Harrod, Doula and Childbirth Educator
“Is this normal?!” If there is one resounding question during the perinatal time, it is this! The newness of it all can make parents second guess everything they know about babies – and about themselves. As a parent branches into life with a newborn, normalizing their own bodily experience and the range of things they may experience with their newborn is profoundly helpful in reducing stress and anxiety.
The Postpartum Period and Mental Health
As a doula, I see lots of people’s fears and anxieties about the postpartum time during pregnancy. That’s when we are talking about their postpartum support plan, what they are anxious about, and how we can set them up with realistic expectations of what they may experience. Because those conversations are happening during pregnancy, I see a lot of parents who are nervous about postpartum mental health and want to avoid being impacted by Postpartum Mental Health Disorders.
The reality is that studies show 28% of pregnant and postpartum people will be diagnosed with a perinatal mood and anxiety disorder (PMAD). We also know that 100% of people experience hormonal changes during this time. Sometimes people suspect a PMAD when they are one day postpartum. Why does that one-day postpartum piece matter? Because your hormones are clinically “losing their minds” for the first three days postpartum. We see what’s called a postpartum hormone cliff where your heightened levels of hormones in pregnancy drop drastically in those early days and your body has to adjust to that.
These drastic hormonal changes happen on top of sleeplessness, the intense new normal of caring for a baby, and the physical impact of the pregnancy and birth itself.
Accepting Help
I hope to normalize what many new parents experience and to distinguish that from larger mental health concerns. When a parent asks me what I think they need most in the postpartum time, my response is always help. Help in whatever form you can get it. If you have people prepared to bring meals, amazing. If you have someone who can come and stay with you, perfect! If you already have an established relationship with a therapist, plan to utilize that. You don’t need a formal diagnosis to seek or accept help.
Why do I think that’s the most important part? Because everyone struggles. That’s normal. The physical and mental impact of having a baby and then caring for that baby (or babies!) is tremendous and every single one of us feels the impact. The time that impact stays varies, and our lived experiences vary, but there is a shared hardship in those early days when everyone struggles at least a little.
Postpartum is Hard
If you are approaching the birth of your child, I want you to take one thing away from this article. You will have some hard days. That doesn’t mean they will last forever. Because the early weeks are usually the hardest, I recommend having as much help as possible, including a therapy appointment. Continue meeting your basic needs (eating food, drinking water, showering, and getting sleep), and connect with people who love and support you. Those first few weeks are hard, but if we go into it with that knowledge, the hardness may not feel so overwhelming. Sleeplessness is hard. Learning a new baby’s needs and wants is also hard. Knowing that it should be hard as we branch into this chapter of parenting is helpful. This knowledge can also help us feel like we’re not doing everything wrong; there’s a learning curve for new parents.
Because we know that over a quarter of all postpartum people will be diagnosed with a PMAD, it’s important to distinguish when it’s necessary to seek further help. I want to reiterate that erring on the side of caution here is important. If you feel the need for additional help, no matter what anyone else is saying or any ‘criteria’ someone may have, seek help! Many people benefit greatly from psychotherapy, counseling, and/or medication and it’s okay to seek help even if you’re not entirely convinced you need it. If you’re wondering if what you’re experiencing may be beyond the “baby blues,” keep an eye out for a few key things:
1. The symptoms and emotions you’re feeling are getting worse, not better, especially after the first week or so postpartum.
2. Feelings of hopelessness are persistent and overwhelming.
3. Any thought of harming yourself, your baby, or others should always be taken very seriously. To get a deeper understanding of signs and symptoms, read this article about various perinatal mental health disorders: https://postpartum.net/perinatal-mental-health/.
My expectation in the early days postpartum is that a person will have intense feelings; some high and beautiful, and some low and sad. The intensity of these feelings should decrease with time. Similar to how we send people home from birth with the expectation that pain and bleeding should decrease and not increase, that same expectation should be there with mental health. It should begin to feel less unpredictable and less extreme from high to low. There’s no need to wait to get help. Asking for “too much” help is better than avoiding how you’re feeling.
You are Not Alone
So if a commercial makes you cry, or a 2 AM baby wake-up makes you question your parenting skills, or if you are less happy than you expected after delivery, you are not alone. Postpartum is a shared, shaky, hormonal time. It is one of many adventures that everyone who’s birthed a baby has walked through. It does not indicate anything about your worthiness or ability to care for yourself and your baby. You got this. It’s hard, but also such a beautiful thing to watch this little person grow.
About the Author
Kaely Harrod, Owner of Harrod Doula Services
Kaely Harrod, Owner of Harrod Doula Services, has been a doula unofficially since 2010 and officially since 2018. She’s built her business educating thousands of families and supporting hundreds in person and virtually as their birth or postpartum doula. Kaely’s work empowers and educates families to have the best, most supported birth and postpartum experiences and teaches other doulas to do the same for their clients. She works from a trauma-informed lens and focuses her work on patient-centered care to lower trauma in birth and guide families into the postpartum time with the greatest support possible.
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