Pregnancy + Postpartum Adjustment

A new mom’s emotions + mental health are commonly affected by the radical shifts you face in the perinatal season, but how much and for how long varies mother to mother. Read on to learn more about what you can expect as a normal response in early motherhood, as well as signs that you might need more support and where to find it.

Becoming a parent changes everything — your body, your mind, your relationships, and your sense of self + purpose. In all the sweeping changes, it’s common to wonder, “Is what I’m feeling normal, or is something wrong?”

The answer isn’t always simple since what’s considered “normal” with your emotional + mental health in the perinatal period varies with each individual mom, depending on your unique traits and set of life circumstances. While any new or new-again mom can significantly benefit from individualized professional care + support during your perinatal season, there are also distinctions between when it’s a helpful suggestion vs. when it’s highly recommended.

Below is a general guide you can use to help recognize these differences and when it’s time to reach out for more formal support.

What’s Normal in Pregnancy + After Baby

Throughout pregnancy, into the weeks and months after birth, it’s common to experience emotional ups and downs (mood swings, weepiness, or irritability) and to feel overwhelmed by the new responsibilities of caring for an infant.

Fatigue and exhaustion, compounded by the chronic loss of sleep can also make it harder to think clearly (often called “mom brain”). Even worries + fears about the future or if your life or relationship will ever get back to “normal” can all be part of the experience.

These changes don’t have to mean something is wrong, and they definitely don’t mean you’re failing — they can just mean you’re human, going through a pretty major life transformation, and still adjusting to all the shifts.

Some of the most common emotional + mental health experiences in the perinatal season include:

  • Mood swings throughout pregnancy, and/or weepiness in the first 1–2 weeks (also called the “baby blues”).

  • Feeling overwhelmed by the responsibilities of pregnancy or caring for the baby.

  • Fatigue + mental fog from disrupted sleep.

  • Appetite + sleep changes tied to the pregnancy or baby’s schedule.

  • Needing more help than you expected.

  • Wondering who you are now, and feeling your identity shifting.

  • Feeling less connected to your partner during the adjustment.

  • Occasional worries about your baby’s or your own health and safety.

  • Occasional intrusive thoughts that are bothersome, but they easily come and go.

  • Crying more easily than usual.

When to Pay Closer Attention

However, if your sadness, anxiety, or overwhelm lasts more than a couple of weeks, if you feel like they’re getting worse, or if they make it hard to enjoy your daily life, it’s time to get support. Sometimes these mood or anxiety symptoms look like feeling detached from your baby, having constant worry, feeling a loss of pleasure in things you once enjoyed, or experiencing scary, intrusive thoughts — and these are all signs to check in with a professional.

Remember, you’re not failing — you’re going through something that’s common and treatable, and help is available.

Signs You Need Professional Support

  • Sadness, anxiety, or mood changes lasting more than 2 weeks or getting worse.

  • Feeling hopeless, trapped, or unable to cope.

  • Extreme exhaustion that makes it hard to function even when you have rest.

  • Appetite or sleep disturbances unrelated to the pregnancy or your baby’s needs.

  • Withdrawing from others or avoiding help.

  • Loss of interest or joy in things you used to enjoy.

  • Persistent relationship conflict or emotional disconnection.

  • Constant, intrusive, or panic-inducing thoughts you can’t control.

  • Thoughts of harming yourself or your baby (please seek help immediately)

These and other advanced symptoms may be indicators of a Perinatal Mood and Anxiety Disorder (PMAD), which is a common, highly treatable condition resulting from your pregnancy or postpartum adjustment. As many as 1 in 5 new moms experience a PMAD, and it can affect anyone regardless of ethnicity, background or circumstances. PMADs can also appear anytime during pregnancy or within the first year after birth. The most common PMADs include the following —

  • Postpartum Depression (PPD) – persistent sadness, hopelessness, or loss of interest in activities you once enjoyed.

  • Postpartum Anxiety (PPA) – constant worry, racing thoughts, physical tension, or restlessness.

  • Postpartum Panic Disorder – sudden episodes of intense fear, heart palpitations, or difficulty breathing.

  • Postpartum Obsessive-Compulsive Disorder (OCD) – intrusive, unwanted thoughts or mental images, often about the baby’s safety, that cause distress.

  • Postpartum Post-Traumatic Stress Disorder (PTSD) – flashbacks, nightmares, or heightened anxiety following a difficult birth or traumatic perinatal event.

  • Postpartum Bipolar Disorder – mood swings that include extreme highs (mania) and lows (depression).

  • Postpartum Psychosis** – a rare but severe and potentially life-threatening condition that requires immediate medical attention, with symptoms that can include delusions, hallucinations, extreme irritability, and manic behavior.

    **If this is you, please call your doctor or 911, or go to your nearest emergency room for immediate care.

Not all mothers experiencing adjustment difficulties will go on to have a diagnosable PMAD, but sometimes knowing the signs and symptoms to look out for can empower you to stay ahead of the possibility of one.

If you’re considering becoming or are currently pregnant, or are newly postpartum, you can also check out my guide on perinatal risk factors to assess if you could benefit from getting support before a PMAD develops.

It’s so important to remember that you are not alone — and you are not broken.

Anytime is the best time to reach out for help, and with the right support, you will feel better! Reaching out is also a sign of your strength and one of the greatest first ways to begin loving your family + yourself through the motherhood journey.

Please contact me if you think you might be experiencing a PMAD, or aren’t sure and I will help get you connected to the support you need.

Other Sources of Support

Check out some of the other reputable sources that are available to new mothers + your families, as well as some important contact info to keep on hand in case any urgent concerns arise.

Crisis + Immediate Support — 

Reach out to one of these sources if you’re experiencing thoughts of harm to yourself or your child, or if feel you otherwise feel you need immediate help from a professional.

  • 988 Suicide and Crisis Lifeline – Call or text **988** (U.S.)

  • Crisis Text Line – Text HOME to 741741 (U.S. & Canada)

Information + Resources —

Additional sources of great iperinatal, postpartum and early motherhood information

  • Postpartum Support International (PSI) — https://www.postpartum.net

    Worldwide network offering information, support groups, links to other resources, free peer support groups, and a 24/7 helpline (call or text 1-800-944-4773 – English & Spanish available).

  • The Blue Dot Project – https://www.thebluedotproject.org

    Awareness campaign dedicated to supporting and de-stigmatizing maternal mental health issues.

  • MotherToBaby — https://mothertobaby.org

    Evidence-based information about medications, exposures, and their impact during pregnancy and breastfeeding.

  • National Institute of Mental Health (NIMH) — https://www.nimh.nih.gov/health/publications/perinatal-depression

    Educational materials and research on perinatal depression and anxiety.

  • National Maternal Mental Health Hotline – Call or text 1-833-943-5746

    Free, confidential and 24/7 mental health support for mothers + their families during and after pregnancy, available in English and Spanish.