Now What: Navigating Your Postpartum Mental Health After Your 6-Week Check-Up
For so many women and birthgivers, the 6-week postpartum check-up is the last contact they have with their OB/GYN or midwife. This visit is vital- your doctor or midwife will make sure you are healing properly, check any stitches, talk to you about birth control, and ideally, screen you for postpartum depression. But then what?
What Happens After Your 6-Week Postpartum Visit?
At our practice, so many of our patients come to us after this appointment. They were “cleared” by their doctor, but they don’t feel like themselves. Whether they are struggling with mood or anxiety concerns, having trouble navigating breastfeeding, or experiencing pain, these women were not prepared for the road ahead. Even when everything goes well, the postpartum period is a time of enormous transition and change. Postpartum women and birthgivers deserve so much more care, attention, and education about their mental and physical health. A pelvic exam, a quick mental health screening, and a discussion of birth control are not enough.
While there are so many things to expect during the postpartum period, this Maternal Mental Health Month, I wanted to share some of the most common concerns that we work with as a practice in the hopes of helping pregnant patients and those newly postpartum better prepare for the road ahead.
What to Expect Postpartum: Common Concerns and Mental Health Challenges
1. Postpartum Anxiety
Most people have heard of postpartum depression (PPD). In fact, women are typically screened for PPD during pregnancy and at their 6-week “clearance” appointment. But most birth givers and not told about perinatal anxiety disorders. 1 in 5 postpartum women will develop a clinical anxiety disorder (PPA), but don’t get “flagged” by their doctor because they don't have symptoms of depression. Symptoms of anxiety, such as panic attacks, sleep disturbance, racing thoughts, and worry, are so common during the postpartum period, and yet so many women have never been told that these symptoms are just as significant as depression, and therefore don’t get treated.
2. Intrusive Thoughts After Birth
Studies suggest that somewhere between 70-100% of postpartum people and their partners experience distressing intrusive thoughts. These thoughts frequently involve thoughts of something bad happening to their baby, such as accidentally dropping or hurting it. These thoughts are ego dystonic, meaning they don’t feel good and typically scare people or feel shameful. Most postpartum people are too afraid to seek support for their intrusive thoughts because they are worried about how they will be received. Will someone think they want to hurt their baby? Will someone think they are a terrible mother? Given the frequency and normalcy of intrusive thoughts postpartum, we are failing postpartum families when they are not educated and prepared.
3. Sleep Deprivation and Mental Health
While it feels fairly obvious that sleep deprivation is a typical part of the postpartum period, new parents are often surprised by how intense it is. Furthermore, messaging about how to feed their baby, such as concerns about building a breastfeeding relationship, can send the message that getting quality sleep is not as important as a baby's needs. The problem is that sleep deprivation is a huge risk factor for mental health concerns, and depending on the person, can trigger significant mental health problems. Helping postpartum families navigate the complicated dance around sleep is vital to everyone’s mental health.
4. Feeling Touched Out
Feeling “touched out” refers to the experience of sensory overload or overwhelm that can happen when a person is touched, climbed on, or needed physically at great frequency. This is a very common feeling for postpartum people, especially those who are breastfeeding/chestfeeding. The feeling that your body is not your own, or that you don’t want anyone else to touch you at the end of the day, is quite common but can be distressing if you don’t know what it is, or how to explain is to other people.
5. Disinterest in Sex After Baby
While you may have been “cleared” for sex at your six-week visit, most postpartum people are not ready for sex yet. Between hormonal shifts that reduce arousal and sex drive, exhaustion, feeling “touched out”, and a shifting identity, it's very common to not feel ready for sex after you are cleared. It’s not a sign of something wrong with you or your relationship.
You Deserve More Than a 6-Week Clearance
While the examples above reflect just a few common but often unanticipated postpartum experiences, there are an infinite number of mental, physical, and relational shifts that happen postpartum that birthgivers are not prepared for. Stay tuned for our next post on the dream referral list that I give all my postpartum patients, so their mental and physical needs are cared for beyond their 6-week check.
