Answer by Lauren Brody, Founder and author of The Fifth Trimester, on Quora:
First and foremost, we need to erase the stigma around perinatal mood disorders. They are shockingly common (1 in 7 women nationally; 1 in 4 women for more at-risk moms living in poverty or challenging circumstances) and yet they are shockingly under-treated. New moms are often, understandably, terrified to speak up about how they’re feeling, and then the problem snowballs. We are living in a time (and a country) when women have outsized expectations of ourselves in every arena, and this can lead to real challenges as we adjust to the reality of being a parent to a newborn (exhausting, unpredictable) in a society that does a pretty terrible job of supporting new motherhood.
New York State recently enacted a maternal mental health protocol that I hope will be adopted quickly around the country. It’s very simple: They have told pediatricians how to screen for perinatal mood disorders in moms. Why pediatricians? Because for a vaginal birth, most American mothers would not have a check-up at the Ob/gyn until the 6-week mark, far far too long if you’re suffering. But they’re at the pediatrician at one week, two weeks, four weeks, and so on.
In other countries, women are screened and supported in all kinds of ways they are affected by pregnancy and birth — from these mental health disorders to pelvic floor health.
I interviewed the executive director of Postpartum Support International for my book, and she stressed to me that many cases of postpartum depression and anxiety can be treated in a handful of sessions. Getting treatment is not a huge commitment but its impact on your health, baby’s health, and your marriage or partnership can be long term.
I’d also like to take a moment to talk about intrusive thoughts — violent, scary thoughts about the baby — which I had after the birth of my first son. They are terrifying, and I can’t tell you how many women have thanked me for the information I’m about to share. This also comes from Wendy N. Davis from PSI (above): When researchers looked at what happens in the brain during these intrusive thoughts — you imagine baby’s stroller getting hit by a bus, for instance, because of some error you made — the parts of the brain that they saw “light up” (for lack of a better, scientific explanation) were not the areas that denote violence, but those that denote protection. In other words, these mothers are on hyper-protective mode. They imagine terrible things so they can spring into action to protect baby. Hearing that helped me tremendously because even though I knew I would never, ever hurt my baby, I had hated myself for even thinking the thoughts. And a mother who hates herself is not an effective mother.
One more thing to add that comes up often: What happens if you experience the onset of a perinatal mood disorder after you’ve gone back to work — after you’ve used up your FMLA? You can work with your doctor to start a conversation with your employer about “reasonable accommodations” — if you ask for that conversation, they are required by law to have it with you. And often, a reasonable accommodation is additional time away from work for treatment. It may also be a simpler temporary change of schedule that lessens the stress of your day and allows you to work. For legal questions about things like this, I recommend The Pregnancy Project at Berke-Weiss Law.