What is Perinatal & Postpartum Distress?

For some women, the transition to motherhood is not the blissful joy that was dreamed and fantasized. Beginning as early as the third trimester of pregnancy, and going through the first year of her new child’s life, about 14% of women experience perinatal distress. “Perinatal” is the time during pregnancy and after birth, including postpartum.

Perinatal distress is the umbrella term that captures all:

  • Postpartum depression
  • Postpartum anxiety
  • Postpartum OCD
  • Postpartum PTSD
  • Postpartum psychosis
  • Symptoms and distress that occur during pregnancy

Perinatal distress can be very alarming and unsettling for women. Many women have no prior knowledge to the negative symptoms experienced during motherhood. The symptoms are confusing and alarming.

What does it feel like?

It can feel hopeless, disconnected, and like a failure. You can feel irritable, frustrated, and angry. You may feel like such a disappointment when you compare yourself to all the other “perfect” and “happy” moms that you encounter at the park, mom’s groups, or on social media. Your heart may race with anxiety, and constant fears of needing to protect your baby at all times. You may believe that you need to maintain perfection in cleanliness so that no germ is ever introduced to your baby. Sometimes the pregnancy or the birthing experience was so traumatic that you avoid all reminders of that time, maybe even avoiding the baby.

Your personal disappointment can be so profound that you are silenced. Silenced from telling your husband, your family, your friends, and your doctor. You don’t want others to know that motherhood hurts and that you’re struggling.

How does it happen?

Bringing a baby into the world brings with it the intersection of so many familial beliefs and values, hormonal fluctuations, identity transitions, career changes, financial obligations, social and cultural expectations, and sleep deprivation; as well as the urgency to figure parenting out quickly since there is a brand new life in which you are supposed to nourish, securely attach to, and keep alive; and in a society that is much more individualistic, and lives further away from potential grandparent or family support; all while making it appear seamless and pretty.

Good grief!

So many changes and transitions and expectations, all at once.

Will it happen to me?

There are predispositions that increase a woman’s likelihood to experience perinatal distress.

Predisposition Checklist

  • Are you more sensitive to hormonal changes during your period or premenstrual syndrome (PMS)?
  • Do you have a family history of perinatal distress or postpartum depression?
  • Do you have a personal history of depression, anxiety, OCD, bipolar disorder, psychosis, abuse, or trauma?
  • Do you tend toward being a perfectionist?
  • Do you have a tendency to worry, obsess, or ruminate?
  • Do you have limited family or friends who will support you?
  • Is your marriage or relationship already strained?
  • Was your pregnancy difficult, unexpected, or undesired?
  • Are there other big stressors like a job change, recent move, financial stress, major loss, or illness?

What can I do?

Recruit help! Find your people who will support you through this time. Consider asking for help from family, friends, your church, mom groups, neighbors, co-workers, support groups, or people with whom you need to rekindle your friendship.

Hire help! Consider hiring or asking others for the gift of hired help for cleaning, grocery shopping, cooking, childcare, animal care, or car detailing.

Ask! Specifically, ask for what you need. This is not selfish. Most people are more than willing to help if you can somehow muster the words to say what you need.

Get connected with a counselor. If you know that you have a previous mental health diagnosis, then it is very wise to start early in establishing care with a counselor. Starting counseling early can get healthy life skills in place before you are depleted and exhausted.

Consult with your doctor. Share your concerns and explore if there are any other medical reasons affecting your functioning (like a thyroid imbalance), as well as interventions or recommendations.

Drink water! Stay as hydrated as you can. Water helps with brain functioning and mental clarity, breastfeeding, fighting off illnesses, and many other physical needs.

Sleep! Aim to get at least 6 consecutive and uninterrupted hours of sleep. Sleep is restorative, helps with brain functioning and mental clarity, assists with memory, and significantly impacts your mood.

Laugh or smile. Laughter helps produce positive hormones in your body and decreases the negative stress hormones.

Remind yourself – this is a phase, I’m doing the best I can, it’s ok that I don’t know, it’s ok to ask for help, breathe, slow down, I’ll feel like myself again.

There is hope!


The steadfast love of the Lord never ceases; his mercies never come to an end; they are new every morning; great is your faithfulness. Lamentations 3:22-23 (ESV)

Next Steps:

  1. If you are struggling with Perinatal Distress or Postpartum Depression, reach out for help. Connect with a counselor here: 
    Counselor Referral
  2. For Further Reading

    “This Isn’t What I Expected” and “Dropping the Baby: And Other Scary Thoughts.” by Karen Kleiman

    Blog: www.postpartumprogress.com

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