By Jen Wittes

While writing a recent article about The 4th Trimester for Minnesota Parent, I picked the brain of Krista Post, a local expert on postpartum mental health.  I first met Krista at our monthly Welcome Baby Care meeting last spring.  She had so much insightful information about postpartum mood disorders and facilitated a discussion with our doulas that we often revisit in our daily work.  There are a couple of wisdom nuggets that I offer my clients repeatedly, and they come straight from this meeting we had with Krista.

Here’s an exerpt from our recent Q&A:

What do you find to be universally true of postpartum women in America?

New moms in America have very high and, I think, unrealistic expectations of themselves.  We think we have to do it all, and we feel guilty and inadequate when we can’t.  It’s hard for us to ask for help, and to accept it when it’s offered.

What is the most important thing a woman can do for herself in the 4th trimester, after baby comes home?

Slow down.  Think of yourself as needing to be “swaddled” too; in the cocoon.  Your body is recovering, your emotions are fragile, your energy is depleted.  It’s all about making a postpartum care plan—before you have the baby!  This includes getting help and support, and more help and support.  Of all the times in our lives when we might need—and deserve—more support, this is one of them!

A wonderful doctor I know from Korea talks about her culture’s tradition of “lying in.”  This is a period of 90 days where women get to stay in their jammies and rest in bed.  The aunties, sisters, grandmothers, and neighbor ladies bring her restorative soups, and of course, her baby when it’s time to nurse.  She is expected to rest and get her strength back, NOT stress herself out by thinking she can cook dinner, do the laundry, and go back to work ASAP.  Can we get this tradition here too, please?! 

What do you consider the number one factor contributing to most cases of postpartum depression?

That would be impossible to generalize.  There isn’t one main factor, but there are many “risk factors.”  They include:

1. Past experience with mental health issues or sudden appearance of such symptoms during pregnancy.
2. Being sensitive to hormonal fluctuations; challenges with PMS and PMDD.
3. Traumatic birth, which can happen even when things go as expected.  Unexpected interventions, however, are more likely to cause emotional problems later.
4. Environmental factors such as not being in a stable or harmonious relationship, financial problems, and coming from difficult family and childhood situations.
5. Although all women are vulnerable to postpartum depression and anxiety, younger women, women of color, woman in rural or poor urban settings suffer the most.

Why do you think Americans are reluctant to focus on the postpartum period with the same intensity reserved for pregnancy and childbirth?

On a personal level, it may be about that “happily ever after” story we’ve told ourselves.  On a socio-political level, it would mean that as a nation we would have to take the average family’s struggle more seriously.  We would have to figure out how parents could have adequate income and time away for maternity and paternity leave, affordable childcare, insurance coverage for both birth and postpartum doulas, and other basic needs that only a minority of people in this country have and take for granted.

Krista Post is a licensed psychologist practicing in St. Louis Park, specializing in postpartum mental health.  She helps men and women adjust to their new roles as parents, and works with couples to build emotional harmony into their relationships and expanding families.

She is also the director of Pregnancy & Postpartum Support Minnesota, an organization that Welcome Baby Care refers to and utilizes often.  If you or someone you know is coping with postpartum mood disorders, please check out the resources at PPSM, or call Krista directly at (612) 296-3800.