By Tori Lewis, Clinical Intern at Clear Path Counseling and Wellness, LLC
February 12, 2024
According to the American Journal of Obstetrics and Gynecology, postpartum depression affects roughly 14% of new mothers. Given its prevalence, most Americans are familiar with the terms “postpartum depression” and “baby blues.” Like other depressive disorders, common symptoms of postpartum depression include sadness, excessive worry, crying spells, difficulty bonding with the baby, fatigue, loss of interest in pleasurable activities, and changes in appetite. While these are accurate, there are many thoughts, feelings, and experiences that are specific to new motherhood that are less frequently known and addressed. New mothers often encounter one or more of the following.
Grief of Old Self and Life
With motherhood comes a realization that life that was once comfortable living is forever changed. With this realization comes feelings of loss of autonomy, control, identity, and independence. There may also be losses of more tangible things such as income, routine, or activities. Feelings of grief and guilt are often added to the mix. These challenges often can be addressed by recognizing that feeling happy about the birth of a child and feeling grief for all of these changes can coexist.
Feelings of Inadequacy
There is truth in the old phrase, “parenting doesn’t come with a manual”. First-time mothers and parents having an additional child may encounter self-doubt and self-criticism. Questions like: “Am I making the right choice?”, “Can I do this?”, and “What if I mess up?”, are often amplified during this time.
Feelings of inadequacy can be addressed by first recognizing that doing something for the first time is hard! Motherhood never goes exactly as planned or matches expectations with precision.
Psychoanalyst Donald Winnicott developed the “good enough mother” theory in 1953. In his research, he came to observe that children benefit from their parents failing them in manageable ways as it teaches them to live and survive in an imperfect world. By having good enough parents, children learn that their needs will be met, but the world does not revolve around them.
When adding a child to the family, relationships take time to reorganize and adapt. It may take some time to fall into a groove with those around you. In terms of partnership, there may be disagreements about parenting styles and duties, beliefs, or values. There is also a possibility that depressive symptoms may cause isolation, mood swings, irritability, difficulty connecting, and difficulty communicating emotions. A therapist can help relate symptoms of depression to relationship issues, while helping the mother not feel at fault for her symptoms.
Changes in Body Image
Recent research indicates that dissatisfaction with postpartum body image may be linked to the socially constructed concept of the “ideal body.” According to Hodgkinson, et al., these ideals include “thinness, shapely breasts, and unmarked skin.” Many women report feeling that the pregnant body gets a “free pass,” or a temporary break, from the pressures of these social norms as the pregnant body is “out of their control.” Once a woman is no longer pregnant, however, she may feel that her body is supposed to be once again “in her control.” This co-occurs with her being resubjected to unrealistic societal expectations for women’s bodies. If her body is now “within her control,” it may feel like it becomes her responsibility and her failure if it does not fit the socially constructed “ideal body.” Because of this, there is a higher pressure to reclaim her old body. Given the demands of motherhood, these postpartum body goals are often unattainable and unrealistic . The presence of these symptoms and experiences does not necessarily mean someone has a diagnosis of postpartum depression. Grief, role transitions, feelings of inadequacy, relationship difficulties, and changes in body image can be normal parts of the postpartum journey (or even the human journey).
If these thoughts, feelings, or experiences are impeding your ability to complete daily activities, causing significant distress, or last longer than two weeks, it’s recommended that you talk to your provider to discuss options. The good news is that there are several evidence-based treatments that can alleviate these symptoms. We recommend that you talk to your mental health provider or, if you need help finding one, you can reach out to us through our website.
The bottom line: postpartum depression is normal and its symptoms are treatable. Having these symptoms is not the fault of the new mother, and they do not make her a bad mother, person, or partner.
 Hodgkinson, E.L., Smith, D.M. & Wittkowski, A. Women’s experiences of their pregnancy and postpartum body image: a systematic review and meta-synthesis. BMC Pregnancy Childbirth 14, 330 (2014). https://doi.org/10.1186/1471-2393-14-330