Supporting Pregnant and Postpartum Women

by Lorna Jansen, Psy.D.

Dr. Lorna Jansen
Dr. Lorna Jansen specializes in treating children, adolescents, and families. She helps clients manage stress, deal with relationship issues, and also offers academic coaching.

In mid-December, I attended a seminar on the topic of Postpartum Depression and Related Disorders. My interest in working with women who are pregnant and new mothers stems from a long-held desire to see each child loved and cared for well. That goal has carried me through 10 years of education post high school to my current profession as a Psychologist. I love nothing more than to help a family system run more smoothly, to further a connection between a parent and child so that they can communicate more freely, to help parents see each other in the best possible light so they can work together as a team.

Having recently navigated through the pregnancy, newborn, infant phase myself, I have a new appreciation for the unique time period this is in the life of a woman. It requires a new wardrobe, new vocabulary, and an entirely new way of thinking about oneself and the world. 

The presenter at my training, Hilary Waller, MS, LPC also knows about the challenges of this phase of life. Ms. Waller spoke about her work with women at the Postpartum Stress Center in Philadelphia. That facility is one of the few of its kind and is led by Karen Kleiman, who has written about every aspect of supporting this population. During the seminar, Ms. Waller shared the knowledge and insights she’s gained from working with pregnant and postpartum moms and their families. Some of what follows was gleaned from her presentation.

The postpartum phase represents a significant shift for everyone around a new baby. First of all, this includes the mother. It is likely she will be experiencing significant hormonal changes, as well as healing from the birth. She will also have a number of emotions related to her pregnancy, labor and delivery. Often, she’ll be attempting to heal, adapt, and cope on very little sleep. She may wonder what happened to her world, or she may be contemplating how to include another little one into her existing nest. Her partner is also likely tired, worn out, and trying to meet his or her own needs with fewer resources. The baby’s extended family and friends of the parents will likely be jockeying for time to spend with him, which may or may not be given in a way that is helpful to the parents. All in all, this is a complicated time of transition.

Given the various stressors and physiological changes in play, it’s not surprising that one in seven women will suffer from a perinatal mood disorder. A perinatal mood disorder is one that occurs during pregnancy or for up to two years after delivery, clinically speaking. It includes diagnoses of depression, anxiety, OCD, panic, PTSD, bipolar, and possibly even psychosis. Due to the sleeplessness and additional stress surrounding this time, it can be difficult to understand what is normal (e.g., feeling very hormonal the first few weeks after the birth) versus what might warrant further investigation (e.g., crying most of the day and feeling hopeless months after birth). In fact, many parents experience scary thoughts, such as wondering what it would be like if they ran away and never came back, or how easy it might be to harm the child, even accidentally. Oftentimes, these thoughts do not indicate the presence of a mental disorder.

Given the vulnerable and extremely dependent nature of a newborn, it is imperative to support a mother who is struggling at this time. A therapist who is trained in this area can come alongside a woman who is pregnant or in the postpartum phase and offer her a safe place to sort through her feelings. This professional will be able to assess the mother’s overall well-being and make a plan to help her cope with the various challenges she is facing. The therapist can help the mother find practical solutions to everyday issues such as when to eat, how to get enough water to support breastfeeding, and what adequate sleep looks like with an infant. The pair can also discuss what is important to the mother as a person who has her own needs, separate from her role as a caregiver, and how she can continue to meet those.

Ideally, the mother can ask for and receive the help she needs from her support network. Her partner and other extended family members may attend therapy sessions as well, as a way of enlisting support for the mother and strengthening the relationships therein. Often, a mother with a young baby has a number of fears and concerns, many of which are normal. However, a professional can help a woman identify where her thoughts or behaviors are indicative of something more serious and ensure she gets the help she needs.

To close, the period of time when a woman is pregnant and raising a young child is unlike any other time in her life. It is sweet and important and perpetually exhausting. Regardless of whether or not the mother is having her first or sixth baby, or adopting, she is forging a new path. Never before has she been a mother to this child. And, like any transition, there is a lot to learn and she can benefit from caring and thoughtful individuals in her life.

If you or someone you love are experiencing some of the following, you may benefit from therapeutic support: feeling overwhelmed or sad most of the day, having trouble sleeping due to anxiety, experiencing panic attacks, or having the urge to self-harm. Please call our office at 215.491.1119 to make an appointment with Dr. Jansen.

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