Why am I struggling so much postpartum?
The postpartum period consists of the first 12 months post-birth of your baby. It can be a very exciting time, but for many, it also can also come with many challenges. Many mothers and birthing people struggle with overwhelming feelings after childbirth. This blog post will provide you with information about why you might be struggling and what resources you can turn to in Ottawa, Ontario.
1. Hormonal Shifts and Physical Recovery
There are many hormonal shifts that occur during the postpartum period. For example, estrogen and progesterone levels, which increased during pregnancy, drop abruptly after delivery (Hendrick et al., 1998). Some birthing parents may experience sadness or anxiety because of drops in estrogen and progesterone as they are associated with mood regulation. Sometimes, abnormal decreases in thyroid function can also affect postpartum mood. Prolactin levels increase in breastfeeding mothers and is known to help one cope with stress. Generally, those who are sensitive to hormone changes are more likely to experience mood fluctuations.
Common physical symptoms associated with the postpartum period include: fatigue, pain, and sleep deprivation. Postpartum fatigue (PPF) involves a decrease in one’s “capacity for physical and mental activity in the weeks to months following delivery” (Balshi & Bove, 2024, p.1). Essentially, this means that birthing parents will feel like they lack energy, are overwhelmed, and struggle to concentrate even when they have rested. Some factors which contribute to PPF include sleep disturbances or deprivation, trouble with breastfeeding, stress, and anxiety. PPF is normal and as the body adjusts and you develop a feeding pattern with your baby, it will likely improve. You may also experience pain caused by uterine cramps, C-section or perineal pain, spinal headaches, gas pain, breast engorgement, or hemorrhoids.
2. Emotional and Mental Health Factors
Baby blues can present as a weepy, low mood, anxious, sad period within the two weeks postpartum.
Postpartum depression is clinical depression during the postpartum period. It affects approximately 18% of Canadians (Gheorghe et al., 2021). and symptoms like: sleep changes, forgetfulness, loss of interest in life, emotional withdrawal, decreased communication, overwhelm, decreased self-confidence, etc. It can be experienced by those who did not give birth too.
The difference between baby blues and postpartum depression (PPD) is that the baby blues usually go away on their own within two weeks. If your symptoms last longer than two weeks, please consult your healthcare provider.
Postpartum anxiety (PPA) is clinical anxiety in the postpartum or postpartum period. It affects 13.8% of Canadians (Gheorghe et al., 2021). Some symptoms include intrusive thoughts, racing thoughts, fearful thoughts, insomnia, heart palpitations, troubling taking deep breaths, and panic attacks.
3. Pressure to “Bounce Back”
The postpartum period also may include exposure to unrealistic cultural or societal pressures and expectations. For example, you might see other Moms posting on social media and this might make you feel like you’re the only one struggling. You’re not. We also live in an age where we’re exposed to a lot of advice online and this can be overwhelming too.
You may also notice some body image struggles or societal pressure to bounce back to your pre-pregnancy body. What you see in social media is, again, not a reflection of most birthing parents’ realities. Many have access to supports or resources that others won’t have access to, like personal trainers or nannies.
All new parents experience a discrepancy between what they thought parenting would look like and what it actually is. As much as you think you can prepare, the truth is that you will not be able to anticipate everything and there will be times when you feel confused or challenged.
Sometimes it takes us longer to adjust to stress and parenthood, and this could be dependent on expectations and support we may or may not have. When it takes longer to adjust, it can lead to intense feelings of shame or failure, especially when you compare yourself to other parents. If these feelings accumulate and a parent can’t get proper support, it can negatively impact one’s mood or lead to a perinatal mood and anxiety disorder (PMAD) like PPD or PPA.
Just because you may be struggling with body image, productivity or societal pressures, doesn’t mean you’re failing. You can adjust to your new life and release some of the pressures you or others may be putting on you.
4. Lack of Support Systems
Another reason you may be struggling during the postpartum period is if you’re facing a lack of support. Whether it’s support from your partner, family, friends, or community, it can help protect you from a mental health disorder like postpartum depression. It’s important to know what your needs are, who can help, and in what area. It’s important to note that everyone won’t serve every role.
· Consider who can help you tackle things off your to-do list
· Who can help emotionally? When I need to feel good, who can I turn to? Who can I express myself honestly to? Who can hold space for me to share my birth and postpartum experiences? Can I tell my partner when I’m feeling lonely and need more quality time together?
· Finally, who can help informationally (i.e., who can help provide helpful information for whatever stage you’re at)?
It’s important to recognize that some do not have support from family, friends, or community or friends or family may not live nearby. For these individuals, it might take some effort to build their own community connections. This community could include people you haven’t spoken to in a while, co-workers, neighbours, or extended family members. This community can help you, but they’re also people you can check in on regularly when you have the capacity to do so. You never know who may be struggling silently.
When we live in an urban area, we can often feel more alone. That’s why it’s vital to think of who we can turn to for support, who we can ask for help from, and to be open to receiving it.
5. When to Seek Help & Local Ottawa Resources
Signs to talk to a healthcare provider or mental health professional:
- If you have baby blues for more than two weeks
- If you have thoughts about harming yourself or your baby
- Persistent heavy bleeding, fever, or other concerning symptoms
- PPA warning signs: excessive and consistent worry about baby, racing heart, shortness of breath, intrusive thoughts, irritability, panic attacks, loss of appetite.
- PPD warning signs: forgetfulness, crying spells, negative thinking, feeling sad or hopeless, emotional withdrawal, overwhelm, decreased self-confidence, feeling guilty or worthless, suicidal thoughts
Local Ottawa Resources:
- The Royal Ottawa Mental Health Care’s Birth, Parenting, and Mental Wellness page: includes peer support groups, presentations on various perinatal topics, and resources:
o https://www.theroyal.ca/birth-parenting-and-mental-wellness
- Mothercraft Ottawa:
o https://mothercraft.com/program/family-services/
- Family Services Ottawa – Beyond the Baby Blues program
o https://familyservicesottawa.org/services-and-programs/beyond-the-baby-blues/
- Doulas in Ottawa
o https://www.familydoulasofottawa.com/
o https://www.nurturedbirthottawa.com/
Struggling during the postpartum period is very common and treatable. First and foremost, you must recognize that you deserve to be cared for and supported and asking for help doesn’t make you a burden. Get familiar with your needs and boundaries and practice communicating them with those you feel comfortable with. Build a community to support you because you don’t need to do this alone.
If you require psychotherapy or counselling support, please don’t hesitate to contact me here.
References:
Balshi, A. & Bove, R. (2024). When fatigue postpartum is also prodromal. Women’s Health, 20, 17455057241309495. https://doi.org/10.1177/17455057241309495
Barbu, R.M., Gavrilescu, C., Cojocaru, E., Popescu, R.I., Ababei, D., & Bild, W. (2020). Hormonal effects of estrogen and progesterone in postpartum depression. Bulletin of Integrative Psychology, 3(89), 87-84. http://dx.doi.org/10.36219/BPI.2020.3.10
Canadian Perinatal Mental Health Trainings. (2025, February). Foundations of Perinatal Mental Health [PowerPoint presentation].
Gheorghe, M., Varin, M., Wong, S.L., Baker, M., Grywacheski, V., & Orpana, H. (2021). Symptoms of postpartum anxiety and depression among women in Canada: Findings from a national cross-sectional survey. Canadian Journal of Public Health, 112, 244-252. https://doi.org/10.17269/s41997-020-00420-4
Hendrick, V., Altshuler, L.L., & Suri, R. (1998). Hormonal changes in the postpartum and implications for postpartum depression. Psychosomatics,39(2), 93-101. https://doi.org/10.1016/S0033-3182(98)71355-6
Keefe, R.H., Brownstein-Evans, C., & Rouland-Polmanteer, R.S. (2018). The challenges of idealized mothering: Marginalized mothers living with postpartum. Journal of Women and Social Work, 33(2), 221-235. https://doi.org/10.1177/0886109917747634
Negron, R., Martin, A., Almog, M., Balbierz, A., & Howell, E.A. (2014). Social support during the postpartum period: Mothers’ views on needs, expectations, and mobilization of support. Maternal Child Health, 17(4), 616-623. https://doi.org/10.1007/s10995-012-1037-4.0
Schiller, C.E., Meltzer-Brody, S., & Rubinow, D.R. (2014). The role of reproductive hormones in postpartum depression. CNS Spectrums, 20(1), 48-59. https://doi.org/10.1017/S1092852914000480
Sundström-Poromaa, I., Comasco, E., Sumner, R., & Luders, E. (2020). Progesterone – Friend or foe? Frontiers in Neuroendocrinology, 59 (100856). https://doi.org/10.1016/j.yfrne.2020.100856
Torner, L. (2016). Actions of prolactin in the brain: From physiological adaptations to stress and neurogenesis to psychopathology. Frontiers in Endocrinology, 7. https://doi.org/10.3389/fendo.2016.00025
