Emotional Challenges After Giving Birth

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If you are a new patient seeking prenatal care, please call 310-794-7274. If you are an established patient and need to reach labor and delivery, call 310-825-9111 for Westwood or 424-259-9250 for Santa Monica.

If you have any symptoms of “baby blues” or postpartum depression, please call your obstetrician or certified nurse midwife. Trust your instincts. If you have a concern about your well-being or the well-being of your baby, please call your provider.

The birth of your baby is an exciting time that brings with it many emotions. These emotions, along with other factors, can lead to challenges.

Before you go home from the hospital, you will complete a questionnaire called the Edinburgh Postnatal Depression Scale. This is a self-assessment scale for postpartum depression. You will complete the same questionnaire at your 6-week follow-up appointment with your obstetric provider. The questionnaire asks about your feelings over the past 7 days. You can complete it at any time. If your score adds up to 13 or higher, please contact your mental health, obstetric or primary care provider.

Baby Blues vs. Postpartum Depression

Most women experience “baby blues” after giving birth. This is because of body changes and stressors. Some women develop postpartum depression, which is major depression due to hormonal and psychological factors. Postpartum depression sometimes develops during pregnancy. Fathers and non-birthing parents can also develop postpartum depression.

Both the baby blues and postpartum depression are common, and there is no reason to feel shame or guilt for having symptoms. A person can also have both the baby blues and postpartum depression.

 Baby BluesPostpartum Depression
Timeframe• Usually starts 3 – 5 days after childbirth and can last up to 2 – 3 weeks.
• You might notice symptoms for a few minutes or hours each day with periods of happiness and pleasure in between.
• Usually starts 1 – 3 months after childbirth but can begin at any time during the first year.
• Usually starts gradually, but can also happen quickly.
• Sometimes starts around the time of weaning off breastfeeding or the first menstrual period after childbirth.
• You will notice symptoms most of the day, more days than not.
Symptoms• Sadness 
• Crying 
• Weepiness 
• Irritability 
• Frustration 
• Moodiness 
• Worry 
• Anxiety 
• Trouble concentrating 
• Forgetfulness
In addition to symptoms of baby blues, individuals have: 
• Feelings of overwhelm and the inability to cope 
• Sadness that doesn’t go away 
• Fear that you can’t take care of your baby 
• Feeling inadequate and guilty 
• Trouble concentrating or making decisions 
• Lack of interest in things you used to enjoy 
• Changes in appetite with weight gain or loss 
• Sleep problems: too little or too much 
• Trouble sleeping, even when you are exhausted and your baby is sleeping 
• Excessive worry about your baby or no feelings at all 
• Thoughts of harming yourself or your baby 
• Feelings of hopelessness, with no belief life will ever get better 
• Irrational thinking; seeing or hearing things that are not there
Risk factors• History of premenstrual syndrome (PMS)• History of severe premenstrual syndrome (PMS), premenstrual dysphoric disorder or postpartum depression 
• Personal or family history of depression or anxiety 
• Stopping psychiatric medications 
• Mood changes while taking birth control pills or fertility medications
Causes• Rapid hormonal changes 
• Physical and emotional stress of pregnancy and delivery 
• Trouble with breastfeeding 
• Transition from hospital to home 
• Physical discomforts 
• Emotional letdown after pregnancy and birth 
• Anxiety about increased responsibility 
• Chronic sleep deprivation and fatigue
In addition to factors that cause baby blues: 
• Lack of support, social isolation 
• Prior perinatal loss 
• History of abuse or neglect of the mother 
• Disappointment over the common myth of the postpartum period being an exhilarating time for all mothers 
• Mother or baby with medical problems 
• Conflict in the relationship with partner or spouse 
• Colicky or fussy baby 
• Financial stressors
What do I do?• Get support: Ask for help and talk to someone you trust.
• Rest and sleep whenever possible. 
• Eat a balanced diet: Avoid caffeine, alcohol and foods high in fat or sugar.
• Go outside, take a walk and enjoy the sunshine.
• Postpartum depression is treatable. If not treated, it can lead to long-term depression.
• Talk to your doctor if you have symptoms of depression.
• A combination of therapy and antidepressant medications is often the most effective treatment.

If you are feeling “down” most of the time or “not your usual self,” professional help is available. If you have thoughts of harming yourself or your baby, please contact your doctor immediately or go to the emergency department.

Resources:

Maternal Outpatient Mental Health Services (MOMS) Clinic at UCLA Health 
The MOMS Clinic provides assessments by an experienced reproductive psychiatrist to women who may be suffering from perinatal mood disorders, anxiety or psychosis after childbirth.

UCLA Perinatal Intensive Outpatient Program 
310-825-4138

Women’s Life Clinic 
310-825-9989

LA County Mental Health Clinic Access Line 
(Medi-Cal insurance) 
800-854-7771

LA County Perinatal Mental Health Task Force 
Provides information for women and their families on postpartum depression and anxiety. maternalmentalhealthla.org 
Caring Support: Call 211

Postpartum Support International: Call 800-944-4773

National Women’s Health Information Center

Medline Plus

Behavioral health resources through private insurance: 
Phone number usually found on the back of your insurance card.

Edinburgh Postnatal Depression Scale

As an expecting or postpartum mom, we would like to know how you are feeling. Please check the answers that most closely reflect how you have felt in the past 7 days — not just how you feel today. See the Edinburgh Postnatal Depression Scale. The number next to your answer is the score for that question. Add your scores for each response. TOTAL SCORE: If your score is 13 or greater, or you answered question 10 with any answer other than “Never,” contact your health care provider.