Peripartum in pregnancy is a medical term used by doctors to highlight a time duration- before, during, or after childbirth- to define the risk of pregnancy associated comorbidities common to this time window, due to hormonal and body changes, such as peripartum cardiomyopathy and peripartum depression.
This guide walks through everything new moms need to know about peripartum, including meaning, pregnancy timeline, conditions, prevalence, treatments, and more.
The guide is divided into two main parts. The first part explains what peripartum is and covers what happens during that time period and common experiences before and after the baby’s birth. The second part consists of peripartum mental health, covering everything from why mental health changes around childbirth to the impacts on life.
What Does Peripartum Mean?
Peripartum is the time period from the 20th week of pregnancy to several weeks (4-6) after childbirth.Also known as the perinatal period, peripartum is not a disease; rather, it’s a medical term. It is used as a time marker, highlighting the period before and after childbirth, when most women experience physical and emotional changes.
Why Do Doctors Call it Peripartum?
Around childbirth or after, women often experience extreme depression and heart conditions due to shifts in pregnancy hormones, physical changes, and many other factors. To define this time period, which reflects women’s mental health, professionals use the term “peripartum”. Peripartum is a combination of two words, “peri,” which means “around,” and “partum”, meaning “birth”.
Understanding the term peripartum, the next crucial thing to know is what actually happens during this time period.
What Happens During the Peripartum Period?
1. Your Body Prepares for Birth
These are the final weeks before childbirth, and during that time, many changes occur in the body, including the cervix preparing for labor and hormonal changes. As these changes begin to happen, a few weeks before labor in some women, while in some it starts during labor, several changes can be noticed by women, making them feel uncomfortable and also impacting them mentally and emotionally. These common signs often noticed include:
- More pelvic pressure
- Braxton Hicks contractions
- Back discomfort
- Trouble sleeping
- Excitement and nervousness
2. Labor & Birth
A natural multi-stage physical process, labor and birth are actually the end of pregnancy. It includes 3 steps: opening of the cervix, birth of a child, and the delivery of the placenta.
3. Body Begins Postpartum Healing
This is the stage where the body starts healing immediately after childbirth and returning to normal conditions. The process of hormones resetting or balancing and tissues repairing can last for 6 to 8 weeks, depending on the type of delivery.
During this process, the body may experience:
- Cramping
- Perineal soreness
- Swelling
- Night sweats
- Breast changes
Emotional & Psychological Changes May Occur
After the peripartum period, the woman may experience ups and downs in mood and emotions, which is normal. However, persistent and intense emotions that feel unmanageable and interfere with functioning and care for yourself or baby are not normal and require immediate care. Emotions new mothers may experience:
- Joy
- Love
- Relief
- Anxiety
- Sadness
- Overwhelm
- Irritability
- Protectiveness
- Exhaustion
What are the Common Peripartum Experiences?
Every woman has different experiences during the peripartum time window. It might also be possible for a woman to encounter different experiences before and after childbirth. The reason is that the peripartum episode is unique to every woman, depending on two main factors: hormonal shifts and body changes (as discussed earlier). At different stages of the peripartum period, from late pregnancy to delivery, the body changes, and it affects mental and emotional health correspondingly.
The types of experiences women commonly have during this duration include:
Peripartum Blues
Peripartum or baby blues are defined as a feeling of sadness, low mood, and emotional swings.It is a mild condition, often experienced immediately after childbirth, approximately within 2 to 3 days. Peripartum blues are short-term and fade away completely within 14 days of onset. Most new mothers experience this, but it doesn’t cause any major impairment that makes it hard for them to take care of their newborn. Such a condition doesn’t require any medication or specialized treatment, and goes on its own with better sleep and other self-care techniques.
Common Signs
Here are some of the common symptoms of maternity blues:
- Feeling Sad
- Restlessness
- Trouble Sleeping
- Remains Anxious
- Mild impatience
Perinatal Depression
It’s a feeling of extreme sadness and fatigue. Perinatal depression often comes during pregnancy and/or within 1 year after the birth of a baby. This condition is chronic, and the most serious thingis that most analyses and medical studies mark peripartum or perinatal depression as very common.
According to a recently published StatPearls review by Carlson, Mughal, Azhar, and Siddiqui, the signs of depression are often noticed in 1 out of 7 women during the defined timeframe. The reasons why the majority of females near becoming a mother pass through such mood and emotional distress vary. It could be due to the stress of caring for a baby as a new mom, a history of mental disorder, or hormone changes, depending entirely on personal experiences and circumstances.
Perinatal depression is not the same as baby blues. It is far more dangerous for a mom’s and the baby’s health if it remains untreated, unlike mild maternity blues that disappear without any major setback in real life. Also, it is worth understanding that postpartum depression needs to be treated, not survived, like pushing emotions or taking medications only after a day or none. As a medical illness, it requires careful handling. Seeking a professional’s help and undergoing proven treatments can be an essential step if the first signs of postpartum depression are frequently noticed, including mood swings, crying, or symptoms listed below:
Common Signs of Peripartum Depression
- Sadness or empty feelings
- Loss of interest
- Extreme tiredness
- Trouble sleeping or sleeping too much
- Trouble caring for the baby
- Thoughts of self-harm or hurting the baby
Note: Perinatal depression is an umbrella term used to define the occurrence of depression during pregnancy and/or within 1 year. It can be noticed at different stages during this broad period.
Timeline of Perinatal Depression
- If a woman is experiencing depression during pregnancy only, it is termed as prenatal depression.
- If depression episodes are noticed after childbirth within 12 months, it’s called postpartum depression. It is very common in new mothers, and new fathers experience postpartum depression as well.
- A major depressive episode that begins during pregnancy or within 4 weeks after delivery may be specified as occurring “with peripartum onset” in the DSM-5-TR.
Perinatal Anxiety
It is one of the most common perinatal experiences. Perinatal anxiety is uncontrollable thoughts and persistent worry about the newborn. It is a condition women experience before and after giving birth to a baby.
In perinatal anxiety disorder, mothers become too anxious about the baby’s safety and feel overwhelmed due to distressing thoughts, like: Am I doing things right? I think my baby gets better without me, etc. Such unmanageable thinking patterns impair daily functioning and also affect mom-baby bonding.
According to the MGH Center for Women’s Mental Health, approximately 1 in 5, or about 20%, of pregnant women experience at least one anxiety disorder. Moreover, several studies, including the one published by Postpartum Support International, state that around 10% of men (1 in 10) are also affected by anxiety or depression during the perinatal period or after becoming a father.
Although both perinatal anxiety and depression are closely related, they are not the same. Both conditions occur during pregnancy or after the baby’s birth and are likely to co-occur in some women, but how they make an affected woman feel and act varies. Perinatal anxiety makes mothers feel nervous and worried, while perinatal depression, in contrast, causes extreme sadness and loss of mood. They also have some other differences that are discussed in our detailed guide on postpartum anxiety vs postpartum depression.
Symptoms of Perinatal Anxiety
Experiencing anxiety during pregnancy (prenatal anxiety) or after becoming a mom (postpartum anxiety) has the following symptoms, including:
- Constant worry
- Racing thoughts
- Fast heartbeat
- Dizziness
- Trouble sleeping
- Checking things repeatedly
Postpartum Psychosis
Postpartum psychosis is also a peripartum experience, but not common. It is experienced by 1 or 2 women in 1000, after childbirth. Being less common, it is still one of the most severe conditions. It results in immediate detachment from reality, causing hallucinations and delusions. It creates several challenges in living a life as a mother.
The most risky factors for mothers experiencing postpartum psychosis are ideation of self-harm and harm to the baby, highlighting the need to seek immediate help.
Common Signs of Postpartum Psychosis
- Hallucinations
- Delusions
- Sudden high mood or mania
- Severe depression or low mood
- Rapidly changing moods
Understanding peripartum: from body changes to experiences during a specific timeline; now, let’s move to the second part of this guide, which covers peripartum mental health comprehensively.
What is Peripartum Mental Health?
Peripartum mental health defines the mental and emotional state of a woman during the peripartum season, including how she thinks and feels.
What Are Common Peripartum Mental Health Symptoms?
During peripartum, a woman may experience several mental health symptoms. Below are some of the most common signs indicating mental illness. These signs may vary, depending on the peripartum experience:
Although some emotional changes can be normal during pregnancy and after childbirth or a sign of healing, persistence demonstrates the need for professional help:
- Persistent sadness or low mood
- Excessive worry or fear
- Irritability
- Mood changes
- Loss of interest
- Difficulty concentrating
- Sleep or appetite changes
- Intrusive thoughts
- Difficulty functioning
- Feelings of guilt or hopelessness
What Causes or Contributes to Peripartum Mental Health Conditions?
The reason a woman experiences sadness and low mood during the peripartum period is multifactorial. Studies identify that it is because of various factors that can be biological, physical, psychological, or environmental, or a combination of all.
Here are the possible causes:
Biological Factors
- Hormone Shifts: The mental challenges during peripartum can be due to a reduced amount of two primary hormones, especially estrogen and progesterone.
- Sleep Disturbance: During pregnancy, approximately 78% of women experience sleep challenges due to several factors, including body changes. They often struggle to fall asleep (insomnia). This can be one of the major causes of developing mental conditions.
- Thyroid Change: During pregnancy, the thyroid hormone levels fluctuate. These increases and decreases in hormone levels often result in several brain challenges. Hypothyroidism (low level) results in memory gaps and less energy, while Hyperthyroidism (high level) often results in extreme anxiety.
Psychological Factors
- Past Mental Health Challenges: If a woman suffers from mental conditions earlier or in a past pregnancy, the risk of having such a condition again becomes much higher. The recurrence rate of common prenatal mental health problems varies for every woman. However, the average ratio indicates that it’s common to experience previously experienced mental challenges in a new pregnancy.
- Emotional Stress: Being too emotional is likely to be a contributing factor in perinatal psychological challenges. For some new mothers, emotional changes after having a baby, such as high expectations to be a perfect parent, the responsibility of caring, and other factors, increase the risk of mental problems.
- Low Self-Esteem: New mothers often experience low self-esteem. For every child’s response, she blames herself and has self-doubt. For example, if a baby is crying, she thinks the baby is not receiving the right care and could be better without her. This lack of confidence raises several challenges in life, resulting in several mental health problems due to extreme parenting stress. Also, fear of doing things the wrong way makes them less connected to their babies and makes them anxious when they need to take care of their infant in front of family and friends. Emotional support and group therapy, where being around new mothers and learning from their experiences enhance self-esteem.
- Trauma During Pregnancy: Roughly 6 to 8% of mothers experience trauma when they are pregnant. This contributes to the development of one of the most severe mental health conditions, such as Post-Traumatic Stress Disorder. Experiencing such conditions is harmful to mothers and can affect babies’ development too. Common traumatic events women encounter during maternity include intimate partner violence and severe car crashes. Developing such conditions, like PTSD, is linked to panic attacks, resulting in several challenges such as shortness of breath. Finding yourself in the same situation requires immediate care, as avoiding professional help is one of the main reasons why people do not heal from their trauma.
Environmental Triggers
- Lack of Support: Support is the only thing that helps you manage life changes effectively. Life after having a baby is surprising, exciting, and overwhelming for some mothers. Receiving emotional support and assistance from your partner and the people around you encourages you and shows that you are appreciated for your care. However, a lack of support makes it challenging to cope after a life change.
- Difficult Life Conditions: Unexpected life shifts, such as money or job loss, poor housing, or living with limited resources before and after the baby, are difficult and increase the likelihood of mental health conditions.
- Relationship Challenges: Effective communication, healthy relationship boundaries, and staying connected as partners are very important during and after pregnancy. However, encountering challenges like relationship conflicts, breakups, the partner’s illness, or being away from a partner can feel harder, making mothers mentally and emotionally weak. Learning techniques for better family communication and managing relationship or divorce anxiety is crucial when encountering such situations to focus on healthy baby development.
These are some of the causes or contributing factors of peripartum mental conditions. However, mental challenges during the peripartum have a higher risk of development among women experiencing:
- Previous depression or anxiety
- Bipolar disorder
- Previous postpartum psychosis
- Significant pregnancy or childbirth complications
- Limited social support
- Major psychosocial stressors
It might be possible for a woman to face challenges with one reason or multiple, or even without knowing– which is ok. But silently experiencing such a situation or hesitating to seek help can have severe consequences, leading a person down a path where recovery feels harder.
How Does Peripartum Mental Health Affect Daily Life?
Untreated perinatal mental health issues have bad impacts on your life. Such conditions disrupt the mind, which affects overall functioning. As a mom, a woman may act well in front of others; it silently impairs their ability to fulfill daily life responsibilities and also causes barriers to adjustment to parenthood.
Here’s how a woman’s life can be interrupted by a mental disorder during the peripartum:
1. Self-Care
Being mentally distracted, a woman may not care for herself and her newborn as she should. Feelings of exhaustion, low mood, and tiredness due to depression and other mental disorders affect how she prioritizes her mental wellness and physical health. It can cause poor sleep and eating habits, impacting overall well-being. It also creates challenges for healthy physical recovery.
2. Daily Responsibilities
After becoming a new mother, a woman’s responsibilities increase, from caring for the infant to managing the home. However, undergoing mental and emotional challenges makes it much harder for moms, or in other words, 24-hour caregivers, to maintain a schedule for the baby’s care, from breastfeeding to changing diapers.
3. Adjustment to Parenthood
With a mental health disorder, the adjustment to parenthood is complex for women. Mothers often navigate challenges during the transition to parenting, which affect mom-and-baby bonding and the ability to build healthy new family dynamics.
This is how severe the peripartum mental disorder becomes when ignored. However, you don’t need to worry about this, as peripartum psychological conditions are highly treatable. So, whatever situation you are in, hope to feel like yourself again and better care for your infant; still available.
How Are Peripartum Mental Health Diagnosed?
Treatment is a path, and the diagnosis ensures appropriate selection. Before treating mental disorders, an in-depth analysis of the condition is crucial. It prevents misdiagnosis and ensures the right, well-matched treatment for the condition while assuring the safety of a woman and a baby during and after pregnancy.
Certified mental healthcare professionals use several clinically proven and reliable diagnostic approaches. These methods clarify the core triggers and highlight the level of care required. These include:
- Clinical Evaluation: Psychiatrists perform several clinical assessments to diagnose conditions. Mental health professionals utilize several regulatory processes and follow a structured evaluation to collect data needed to make an informed decision.
- Medical History: To gather valuable data about patients’ health, psychiatrists often prioritize checking medical records.
- Questionnaires: Patients are often given written tests by mental health practitioners to assess their mental, emotional, and physical wellness.
Including these and many other specialized screening and cognitive testing helps providers determine whether the actual conditions meet the diagnostic criteria, ensuring precise diagnosis.
What Are the Treatments for Peripartum?
For treating mental conditions during the peripartum period, a variety of treatment options are available. The selection of treatment for new mothers varies depending on the symptom duration, intensity, and many other factors. However, the most effective options include:
Psychotherapy
Psychotherapy is one of the best and most widely used psychiatric treatments for several mental health conditions. It is a collaborative treatment approach focused on replacing negative thoughts and emotions and building new skills. It consists of supportive sessions, each led by trained psychiatrists who help patients improve emotional regulation and enhance mood in individualized and group settings.
Psychotherapy consists of several advanced treatment approaches that work well in treating conditions during pregnancy. However, the well-known approach is:
Cognitive Behavioral Therapy (CBT)
CBT is an evidence-based, specialized treatment approach. It is one of the highly effective treatment approaches in today’s psychiatric world, supported by several clinical trials and meta-analyses. Cognitive Behavioral Therapy is a structured treatment process consisting of identifying the causes, understanding the symptoms, and achieving goals.
CBT treatment helps new mothers replace negative, distressing thoughts about themselves. Through clear, goal-oriented techniques, it helps women feel confident and encouraged about their baby care. This helps reduce anxiety and emotional distress, fostering positive attitudes and ensuring true wellness.
Medication Management
Psychiatrists also prescribe medications to patients carefully when appropriate. They make sure medications don’t cause any harm to females during pregnancy by adjusting dosage and attentively monitoring the progress. Always make sure to take medication prescribed by a certified psychiatrist and follow proper guidance or instructions.
Psychotherapy and psychiatric medication management are the two available treatment options for peripartum mental conditions like depression and anxiety. They work well in offering relief when combined; however, depending on the conditions and whether the symptoms start during pregnancy or immediately after having a baby, a psychiatrist chooses the best treatment, either individualized or combined.
Is Peripartum Mental Treatment Safe During Pregnancy or Breastfeeding?
While treatment options are available, the most concerning question among pregnant women with psychiatric illness is whether it is safe to get treatment.
Yes, peripartum mental treatment is safe when the right care is delivered and medication is supervised by a licensed psychiatrist. However, the appropriate treatment approach depends on the diagnosis and the future goals.
It is necessary to talk with a mental health care doctor immediately for guidance, as a long-delayed or untreated psychiatric condition during pregnancy can lower IQ scores and delay cognitive skill development in the baby compared to others.
How Can Brainpower Wellness Institute Help?
Brainpower Wellness Institute offers high-quality treatments for a variety of peripartum mental health conditions. Whether you are struggling with postpartum depression, anxiety, or difficulty bonding with your baby due to mental illness, we help you receive the required level of care. Our certified psychiatric-mental health nurse practitioners conduct comprehensive patient evaluations, take time to understand symptoms, and develop personalized treatment plans that fit patients’ conditions, preferences, and stage of life.
Are you looking for a peripartum mental healthcare provider in California for guidance and treatment support? We are here to help. Book your appointment by calling us at (714) 712-0711 and confirm a preferred time slot to meet with a psychiatrist. We are currently accepting new patients, and most appointments are covered by insurance. Make your move today!
