Pregnancy and Postpartum Counseling

Did you know that postpartum mood and anxiety disorders (PMADS) are the number one most common complication of childbirth? Studies show that 1 in 5 women will experience these significant mood shifts after giving birth. What many women don’t realize is that symptoms can show up anytime during pregnancy and up to one year after giving birth. When we think of PMADS, we often think of postpartum depression and have an image of a women holding a newborn baby and feeling sad. This is only one small example of what PMADS look like.  The following are other ways PMADS can present:


between 60% and 80% of women experience what professionals describe as the “Baby Blues,” or feelings of exhaustion, irritation, and sadness after having given birth. These symptoms typically begin anywhere from one to three days post-delivery and may last between two and fourteen days.


Postpartum depression is only routinely screened by healthcare providers in the US in the first month or two after delivery but it can present at any time in the first year after giving birth. There are many ways this diagnosis can present, and a woman does not need to have all of these symptoms to be experiencing PPD. A few common symptoms are :

  • anger/irritability/’mommy rage’
  • sadness or numbness to emotions
  • excessive guilt and shame
  • lack of interest in the baby or other things
  • changing in eating and sleeping patterns
  • thoughts of hopelessness
  • thoughts of harming the baby or self

Remember, every case of postpartum depression is different.


Sometimes called the ‘hidden disorder’ because it is more likely to go undiagnosed and noticed by women, even though it is likely more common than postpartum depression. Studies show that about half the women who have postpartum depression also have postpartum anxiety. A few common symptoms are:

  • excessive worry about babies well-being or other things.
  • Feelings of dread
  • Racing thoughts
  • Lack of concentration
  • Changes in eating and sleeping patterns
  • Physical symptoms such as dizziness, hot flashes racing hear, and nausea.
  • Intrusive thoughts: scary and unwanted images of accidents/harm/etc.

Like postpartum depression, symptoms can onset up to a year after giving birth and in many cases, during pregnancy. Additionally many women experience these symptoms onset around the time of weaning from breastfeeding.


The benchmark for this disorder is having repetitive, upsetting and unwanted thoughts or mental images (obsessions), and sometimes they need to do certain things over and over (compulsions) to reduce the anxiety caused by those thoughts. This is often mistaken for postpartum anxiety or missed altogether due to  being written off as  “normal” worry in the postpartum period. Additionally, those struggling might not always be forthcoming with providers due to shame or fear of others reactions or your baby getting taken away. The truth is that if you’re alarmed by thoughts of harming your baby, that’s a pretty reliable indicator that you won’t do it. You may be experiencing Postpartum OCD if you encounter any of the following symptoms within twelve months of giving birth:

  • Obsessions, also called intrusive thoughts, which are persistent, repetitive thoughts or mental images regarding harm to the baby.
  • Compulsions, -doing certain things over and over again to try to reduce fears and obsessions. This may include things like needing to clean constantly, checking things many times, counting or reordering things.
  • A sense of horror about these obsessions
  • Fear of being left alone with the infant
  • Hypervigilance in protecting the infant


Postpartum psychosis is rather rare, affecting only 0.1-0.2% of all births. However, it is a serious disorder and requires immediate medical attention. Symptoms include:

  • Delusions or strange beliefs that feel real
  • Hallucinations (seeing or hearing things that aren’t there)
  • Feeling confused
  • Feeling disconnected from reality
  • Decreased need for sleep
  • Paranoia and suspiciousness

While acts of harm to oneself or the baby are uncommon, women suffering from postpartum psychosis may do things they might not otherwise do given their altered state. Therefore, seeking urgent attention from professionals is paramount to keeping you and your baby safe. 


P-PTSD is often caused by a traumatic or frightening childbirth real or perceived — during pregnancy, labor, delivery, or postpartum.

Pregnancy examples: severe morning sickness, fertility treatments, history of miscarriage, serious pregnancy complications.

trauma during childbirth examples:  long and painful labor, cord prolapse, severe tear, hemorrhage, emergency c-section, unusually fast labor, unplanned labor outside of hospital.

Postpartum trauma examples: Premature baby, lack of support during labor,  baby needing to go to the NICU, infant health trauma, breastfeeding difficulties, stillborn or child loss.

Symptoms include:

  • Flashbacks of the trauma
  • Nightmares
  • Need to avoid triggers related to the trauma

*learn more about trauma treatment at Steadfast Counseling HERE

Every disorder listed here is both TEMPORARY and TREATABLE.

Steadfast Counseling is committed to helping you reclaim your life and experience joy in motherhood.

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