Many new moms experience the “baby blues” after childbirth. Whether your birth was easy and uncomplicated or difficult and stressful, most moms will feel a bit sad, exhausted, or overly worried in those first few days after giving birth. And that is completely normal. It can happen after your first or even your fourth baby; there are no rules for the baby blues.

As midwife Cassie Kurtz said, “Your hormones just jumped off a cliff.” It’s like PMS times a thousand. It’s completely normal to feel a little low. Not to mention the fact that you’re not sleeping much, and your life as you know it has been completely upended by a new little being who is completely dependent upon you.

We chatted with Cassie in our podcast episode, From Pregnancy to Beyond, to gain a little more insight on how to distinguish between normal feelings of exhaustion after giving birth and something more serious, like postpartum depression. 

What is postpartum depression? 

Postpartum depression is defined as depression that occurs after having a baby. Postpartum depression lasts longer than the typical baby blues, “which commonly include mood swings, crying spells, anxiety, and difficulty sleeping. Baby blues typically begin within the first two to three days after delivery and may last for up to two weeks,” according to the Mayo Clinic. 

Postpartum depression (PPD) is a more severe form and can include symptoms of depression like feeling sad or anxious, loss of interest, lack of energy, and feelings of hopelessness. But PPD can also include symptoms like: 

• Crying more often than usual.
• Feelings of anger.
• Withdrawing from loved ones.
• Feeling numb or disconnected from your baby.
• Worrying that you will hurt the baby.
• Feeling guilty about not being a good mom or doubting your ability to care for the baby.
• Intense irritability and anger
• Fear that you're not a good mother
• Hopelessness
• Feelings of worthlessness, shame, guilt, or inadequacy
• Diminished ability to think clearly, concentrate or make decisions
• Restlessness
• Severe anxiety and panic attacks
• Thoughts of harming yourself or your baby
• Recurrent thoughts of death or suicide

Who is at risk?

Anyone is at risk; even new dads can get postpartum depression. It’s estimated that 1 in 8 women will experience postpartum depression, and these numbers can vary by state and can be as high as 1 in 5. Additionally, estimates of the number of women affected will differ by age and race/ethnicity. 

Risk factors for postpartum depression

• Stressful life events 
• Problems in your relationship with your spouse/partner
• Low social support.
• Financial problems
• Previous history of depression.
• Family history of depression.
• Difficulty getting pregnant.
• Being a mom to multiples, like twins or triplets.
• Being a teen mom, or if the pregnancy was unplanned/unwanted
• Your baby has health problems or special needs
• Preterm (before 37 weeks) delivery.
• Pregnancy and birth complications.
• Having a baby who has been hospitalized.

What to do if you think you have postpartum depression

Talk to someone—especially your healthcare provider. Even if you think it’s just the baby blues, if these feelings persist for over a couple of days, it’s important to let your healthcare provider know.  “We, as providers and midwives especially, are here for you and want to do your follow-up care. We have time to talk to you, and we want to do that. We want to make life better for you. It's not your fault that you feel that way, your hormones just jumped off a cliff, and that's normal. [We want to get] them the help that they need, whether that be a medication for a little while just to get their hormones balanced, their serotonin balanced, or even just some therapy,” Kurtz says.