Provider Practice Essentials registered nurse continuing education

Postpartum State of Mind: What most people don’t talk about

Kelsey Bates, ARNP

Welcoming a new baby into the world is one of the most remarkable life happenings that occurs. Each pregnancy and delivery has its own unique story. Many parents, especially first-time parents, have many different emotions about the arrival of their new tiny human and it can be extremely overwhelming.

When expecting a new baby there is so much excitement. From getting the nursery ready, picking out a name, and celebrating with family and friends at a baby shower. Everyone remembers the first time a parent gets to hold that little bundle of joy in their arms. Once the baby arrives and the exhaustion sets in after one to two days, the next couple of weeks to few weeks can be really rough on new parents, especially momma.

Adjusting to Change

One of the best analogies I’ve heard to describe having a newborn at home, especially for first-time parents is, “it feels like I had been thrown into an ice-cold pool of water with no ladder or steps to climb out. “It feels like a shock to my system.” There is truly no way to prepare for the lack of sleep that comes along with having a newborn. Sure, people tell you “get plenty of rest before baby gets here” or “say goodbye to sleeping in.” Until an individual experiences the reality of having a newborn, one truly can’t understand the pure exhaustion that goes along with it.

Sleep Deprivation

That being said, if more individuals were to share the rough patches of having a newborn along with all the joys, of course, I think more new parents wouldn’t be so shocked as what’s to come when they bring their new baby home. What many people don’t talk about with having a newborn is how the exhaustion can take a hard hit to one’s mental state. We all know that without sleep it’s difficult to function. But the exhaustion of having a newborn is its own state of exhaustion, especially for mom.

Social Media Judgement

Not only is she dealing with sleep loss but her hormones are on a crazy roller coaster. Many people never talk about this part of it, in the age of social media everyone talks about and posts pictures of how grand things are. They don’t talk about or show the challenging times. Same thing with the marketing industry. Advertisements for various baby items always show the parents smiling, clean clothes (no spit up marks), hair and make-up done. Television isn’t any better, most movies and television shows make having a newborn look fairly easy. I would beg to differ that is not realistic, whatsoever.

This leaves quite a few new parents, who don’t know any different, thinking they are having a really hard time with their newborn while all the other parents make it look like a cake walk. This is a big part of why many new parents struggle so much, in addition to sleep loss and hormones, they haven’t been prepared for the true reality.

Reaching Out for Help

It can also be hard for new parents to reach out for help if they think they are the only ones struggling with a newborn or feeling the way they do. It can leave them feeling “different” or “something is wrong with me.” When, if that new momma only knew the majority of new parents have struggles and very similar feelings, she probably wouldn’t be so hard on herself.

Health care providers that work with pregnant patients, first time parents for sure, need to make sure to let them in on this reality beforehand. We also shouldn’t just assume that the new expecting parents already know how challenging it can be having a newborn. Let them know that they will very likely be extremely exhausted for the first few weeks due to lack of sleep and that this is totally normal. Educate them about the different feelings and thoughts they may experience.

Screening for Depression

All pregnant patients should be screened during pregnancy and after for the potential of depression utilizing the PHQ-9 or the Edinburgh Postnatal Depression Scale. Encourage them to take a parenting course that also covers what to expect after baby arrives. AND reassuring them that 99% of people only post the happy, good times on social media. Maybe even encourage the patient to take a break from social media for 2-3 weeks after bringing baby home, since those are the toughest weeks, in general, with a newborn.

Langan and Goodbred (2016), discuss the prevalence of peripartum depression being 5-7% and the prevalence of baby blues being 80%. Telling a first-time expecting mom these statistics could ease her mind in knowing that she isn’t the only one having a rough time. It’s important that we educate patients and make sure they have a general understanding of baby blues and postpartum depression.

As with anything in life, knowing what to expect going into something new can make the experience quite a bit easier for an individual.


Langan, R. C., & Goodbred, A. J. (2016). Identification and management of peripartum depression. American Family Physician, 93(10), 852-858.

Learn more about postpartum depression and other pregnancy related problems in our clinical toolkit!

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