Postpartum depression and perinatal mental health
Managing depression and anxiety during and after pregnancy
Expecting a new baby can leave you feeling both excited and nervous. After your baby is born, you might also feel overwhelmed. That's why it's important to watch for signs of anxiety and depression, including postpartum depression.
Knowing the signs can help you understand how you feel and find the caring support you deserve. Talk about any concerns with your OB/GYN or care provider at your prenatal and postpartum appointments.
What is perinatal mental health?
What is perinatal mental health?
Perinatal means the time during and after pregnancy. It can last from the 20th week of pregnancy through the first year after birth. During this time, changes in your or your partner’s mental health are common. Anxiety, depression, loneliness or feeling overwhelmed may affect daily life. Support and treatment can help.1
If you’re struggling, you’re not alone — and it’s not your fault. Mental health conditions are common during pregnancy and after birth. In the U.S., one in 5 people have a mental health condition during the perinatal period.1
Results from the largest study on PPD in the U.S. showed:2
- 40% of depressive episodes started after pregnancy
- 33% started during pregnancy
- 26% started before pregnancy
Maternal mental health conditions can lead to suicide or overdose. These are the leading cause of pregnancy-related death.2 However, many of these deaths are preventable. The U.S. Preventive Services Task Force (USPSTF) recommends providers screen pregnant and postpartum women for depression. The recommendation is based on evidence that counseling can help prevent perinatal depression in people with increased risk.3
What are common mental health concerns postpartum?
Postpartum mental health concerns can include more than depression. They may also include anxiety, obsessive-compulsive disorder (OCD), bipolar disorder and psychosis. Mental health conditions can look different for everyone. Read on to learn more about how to recognize some common signs.4
Postpartum depression
- Sadness, anger or worry
- Changes in sleep or appetite
- Loss of interest or hope
- Thoughts of harm
Postpartum anxiety
- Constant worry or racing thoughts
- Irritability or restlessness
- Changes in sleep or appetite
- Nausea or dizziness
Postpartum obsessive-compulsive disorder (OCD)
- Repeated, upsetting thoughts or images about the baby
- Repeated actions to ease fear, such as cleaning or checking
- Fear of being alone with the baby
- Always watching for danger
Postpartum post-traumatic stress disorder (PTSD)
- Flashbacks or nightmares
- Avoiding reminders or follow-up care
- Anxiety, panic or feeling detached
- Irritability, sleep problems or feeling on alert
Peripartum bipolar disorder
- Depression or irritability
- High mood, energy or confidence
- Fast speech, racing thoughts or little sleep
- Impulsive behavior or poor judgment
- Delusions or hallucinations in severe cases
Postpartum psychosis
- Severe restlessness or confusion
- Hopelessness
- Fast speech or extreme energy
- Seeing or hearing things that aren’t there5
What are baby blues?
A few days after giving birth, you may feel sad, worried, upset or unsure about caring for your baby. These normal feelings are called baby blues. They typically come and go during the first few days postpartum.5
You may cry, have trouble sleeping or eating, or find it hard to make decisions. Baby blues usually get better within one to 2 weeks without any treatment.5 Talk to your care provider if these feelings are strong, last more than a few days or make it hard for you to care for yourself or your baby.
What is postpartum depression (PPD)?
Welcoming a new baby can bring many emotions. Baby blues are common. They usually ease within a few days to 2 weeks. If sadness, worry or hopelessness lasts longer, you may be experiencing postpartum depression (PPD).6
What typically makes PPD different from baby blues is that it affects daily life, and it may not go away without treatment. PPD is serious, but help is available and treatment can make a difference. If daily life feels harder or you feel disconnected from your baby, you’re not alone. Talk with a health care provider for support.6
What are the symptoms of postpartum depression?
What are the symptoms of postpartum depression?
Becoming a parent can bring many emotions, and PPD can look different for everyone. If something doesn’t feel right, trust yourself. Knowing the signs can help you recognize when it may be time to ask for help.6
You may feel sad, anxious or empty. You may also feel hopeless, guilty, worthless or helpless. Some people feel more irritable, restless or tired than usual.6
PPD may make it harder to focus, make decisions or feel connected to your baby. Your sleep, appetite or weight may change. You may also have unexplained aches, headaches or stomach problems.6
Some signs need immediate support:6
- Thoughts of death, suicide or harming yourself or your baby
- Feeling unable to care for yourself or your baby
If you notice any of these signs, please talk with a health care provider. You deserve support for your mental health. A provider can listen, help identify what may be causing your symptoms and guide you toward next steps. If you may hurt yourself or your baby, call or text 988 now. Call 911 if there is immediate danger.
How long does postpartum depression typically last?
PPD can happen before or after a child’s birth. It typically occurs between a week and a month following delivery. PPD can last up to a year after your baby is born, but healing doesn’t have a deadline. Take the time you need.6
Talk to your support network about how you feel and whether your symptoms are improving. Spouses, partners, family members and friends can provide help in many ways. They can offer emotional or practical support.
If your symptoms don’t improve, you may want to ask your provider about other care options.7
Who is most at risk for postpartum depression?
Some experiences may make PPD more likely. For example, your risk may be higher if you or someone in your family has experienced depression, anxiety or premenstrual dysphoric disorder (PMDD), or if you’ve had PPD before.7
Stressful situations also play a role. This may include relationship stress, money worries or limited support. A difficult pregnancy, delivery or premature birth can also increase risk. Other risk factors include:7
- Being younger than 20 or parenting on your own
- Facing feeding challenges or caring for a baby with extra needs
Women in rural communities are 21% more likely to develop PPD compared to those living in urban areas. People living in poverty experience PPD at twice the rate of those who aren’t living in poverty.2
Women who are Black, Indigenous and people of color (BIPOC) have an increased risk for maternal mental health disorders:2
- Up to 30% of Native American and Alaskan Native women develop PPD
- Up to 40% of Black and Latina women develop PPD, twice the rate of white women
- PPD diagnoses increased 280% among Asian American and Pacific Islander women from 2010–2021
Can postpartum depression be prevented?
Postpartum depression can’t always be prevented. Knowing the warning signs and understanding your risk can help you reach out for support sooner.7
Women who have risk factors for PPD, such as a history of depression, may benefit from counseling. The USPSTF says counseling may help prevent perinatal depression in pregnant and postpartum women who have a higher risk.3 Your OB/GYN can also help you decide if you should keep taking an antidepressant while you’re pregnant.5
A few gentle steps may also help you care for yourself during this time:7
- Try to keep expectations for yourself and your baby realistic
- When you first come home, it’s okay to limit visitors and ask people you trust for help
- Rest when you can, including when your baby sleeps
- Small breaks can help, too — take a walk or spend a little time outside
- Stay connected with family and friends
- Make time for yourself when possible
Most importantly, be patient with yourself. Some days will feel easier than others, and that is okay.
How is postpartum depression diagnosed?
There is no single test for postpartum depression. At a postpartum visit, your health care provider may ask about your health history and how you’ve felt since giving birth. They may also do an exam or a lab test. Some providers screen for depression 2 or 3 weeks after birth.7
Many providers use the Edinburgh Postnatal Depression Scale during pregnancy and after birth. It has 10 questions about feelings such as sadness, anxiety and guilt. You choose the answer that best describes how you’ve felt in the last 7 days. A higher score may mean you have PPD.7
Mild postpartum depression can be hard to spot, so your answers are important. Answer openly and honestly so they can understand your thoughts and feelings. This can help them decide if your feelings are common after birth or may be signs of PPD.
If your provider sees signs of PPD, they may make suggestions for care based on how you’re feeling. Care options may include anti-anxiety or antidepressant medication, talk therapy or joining a support group.7
With the right support, you can feel better. A health care professional can listen, answer your questions and help you find a care plan that works for you. Your plan may include one or more of these options:8
- Therapy: A mental health professional can help you understand and manage your feelings. UnitedHealthcare members who identify as LGBTQ+ and allies can search for LGBTQ+ friendly providers.
- Support groups: Connecting with others who have postpartum depression can provide comfort and understanding.
- Self-care: Try to rest, eat nutritious foods, stay active and ask for help when you need it.
- Social support: Reach out to family, friends or others you trust.
- Medicine: A health care professional may prescribe an antidepressant or other treatment. Some antidepressants may be used while breastfeeding and can take several weeks to work. Talk with your provider about the benefits and risks of medicine during pregnancy or breastfeeding.
You don’t have to manage depression or other mental health concerns alone. Your provider can offer support and help you find the care that’s right for you.
If you’re a UnitedHealthcare member, there are mental health programs that may be available to you. For example, the Calm Health app offers mindfulness programs, stress management and other self-guided resources.
Your UnitedHealthcare health plan may also offer pregnancy and maternity support resources.
If you’re looking for mental health support without an insurance plan, virtual therapy may be a flexible and convenient way to get mental health care. Mind Your Health™, provided by Teladoc Health, gives you access to unlimited online therapy without insurance for one monthly fee.
Getting treatment can help you feel supported and cared for. Reaching out for help takes courage, and you don’t have to take that step alone.
Reaching out for help may feel hard, and you deserve support. You can ask someone you trust to be with you when you call a professional for help. Or you can ask them to make the call for you. A health care professional can listen, check for depression and suggest options for care. It may be time to talk to your provider, midwife or your baby’s pediatrician if:8
- Baby blues last more than 2 weeks or feel hard to manage
- Depression lasts more than 2 weeks within a year after birth
- Daily tasks feel hard
- Caring for yourself or your baby feels hard
- You think about harming yourself or your baby
If you think may hurt yourself or your baby, call or text 988 now. Call 911 if anyone is in immediate danger.
Partners or loved ones of parents who are struggling can also make a meaningful difference. Learn the signs of postpartum depression, listen without judgment and ask what support would help most. Offering practical help, encouraging treatment and giving them time for self-care can support the whole family.
Financial stress is a common concern. There are programs offered for new moms through state and federal programs and community organizations.
If you qualify for assistance, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program can help expecting and new moms get healthy food.
The WIC program also offers counseling and tips to help moms start and keep breastfeeding. WIC can help breastfeeding moms get breast pumps or other nursing items. If you have UnitedHealthcare insurance, you can check your benefits to learn your options for breast pump coverage.
Along with talking to a health care professional, these small steps may help you feel supported and get more rest:8
- Ask your partner, family or friends, or hire a postpartum doula for help
- Make time for a break, a friend or your partner
- Share how you feel with people you trust
- Rest when you can and sleep while your baby sleeps, if possible
- Connect with other parents who understand what you’re going through
- Consider a support group. Your provider can help you find one.
- When possible, wait before making major life changes. If a change can’t wait, plan for extra help.
Taking time to rest or care for yourself can help, and someone you trust may be able to lend a hand. If you or a loved one needs immediate care, help is available 24/7.
Crisis and emergency care hotlines available 24/7
If you or a loved one is in distress and need immediate care, help is available 24/7 in English and Español.
Suicide and Crisis Lifeline
Call or text 988
For emotional distress or suicidal thoughts — if you, your loved one or family member need immediate help, support is available 24/7
Emergency services
Call 911
For immediate, life-threatening needs, including medical crisis, fire, crime or natural disasters
Substance Use Helpline
Call 1-855-780-5955 TTY 711
For help with alcohol and drug concerns and care
National Domestic Violence Hotline
Call 1-800-799-SAFE (7233) or text "START" to 88788
For crisis intervention and information for victims of domestic violence and those calling on their behalf