The Most Common Childbirth Complication Isn’t What You Think

Depression is the most common childbirth complication, but it’s often unexpected. Psychologist Hannah Cassedy explains the warning signs and how to reach out for help.


Can you name the #1 childbirth complication?

It’s not placenta or umbilical cord problems. It’s not the dreaded tearing either. The most common childbirth complication is perinatal depression: depression that develops during pregnancy or after delivery.

One in seven new mothers experience postpartum depression

Fifteen percent of women experience postpartum depression in the first 3 months after childbirth: that’s 1 in 7 mothers. This very common complication is still sometimes talked about with hushed voices and the fear of raised eyebrows. Since it’s so common, however, many women find that once they start talking about their struggle with postpartum depression, they learn that they are not alone and that help is available to them.


Symptoms of postpartum depression

Symptoms of postpartum depression vary for everyone, but they can include intense sadness, big mood swings, losing interest in things that you usually care about, changes to your appetite, sleep disturbance (aside from getting up with the baby), intense feelings of anger or agitation, feelings of hopelessness or shame, and possibly thoughts about harming yourself or someone else. With postpartum depression (as opposed to the milder “baby blues”), these symptoms tend to get worse over time if they’re not treated.


Highest risk factors

You might be wondering if you’re at risk for postpartum depression. Mothers with a history of depression or anxiety have a higher risk; so do those under a lot of stress, such as military families, teen mothers, or those with limited support at home. Mothers who are particularly sensitive to hormonal changes, such as those with really intense PMS, are also somewhat more likely to develop postpartum depression. But no one is immune from it. Being highly educated doesn’t reduce your risk; having an all-natural birth doesn’t reduce your risk; having a generally nice life doesn’t reduce your risk.


Treatments for postpartum depression

The good news is that we know how to treat postpartum depression. The most effective treatment is a combination of therapy and medication. However, medications aren’t appropriate for everyone, so the first step is to consult with your doctor. You’ll notice that your OB or midwife may ask you questions about sadness and stress in your postpartum visit. Take these questions seriously and answer them honestly. If you’d like to find resources on your own, I recommend Postpartum Support International as a starting point.

As a psychologist who treats postpartum depression and anxiety, I can assure you that reaching out for help is the first step toward recovery. Not only is it good for you, but it’s also good for your baby. You can think of it as being a role model: by reaching out for help, you’re showing your baby what to do when faced with a challenge. Instead of keeping your head down and hoping it will pass, you’re showing your baby that you can be proactive and thoughtful about working through uncomfortable feelings and unexpected problems as they arise.

Dr. Hannah Cassedy is a Dallas-based clinical psychologist. She treats women and men struggling with depression, anxiety, and major life changes, such as pregnancy, postpartum, and the transition to parenthood.


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