When the ‘baby blues’ become more serious, it is time to seek help

March 30, 2023
four medial providers standing together over a bassinet in the birthing center
Birthing Center Clinical Supervisor Leigh Copsey, RN, and staff Marla Casella, RN, IBCLC, Linda Taylor, RN, and Jessica Whitaker, LNA take care of a newborn in Memorial Hospital’s Family Birthing Center.
More than three million births are recorded in the United States each year. Each birth often includes excited – and sometimes tired – new parents eager to move on from months of pregnancy to raising their new child.

With all the activity surrounding pregnancy, birth, and bringing a new baby home, many new moms experience the “baby blues.” For some, the ‘baby blues’ progress to postpartum depression.

The American College of Obstetricians and Gynecologists notes that post-partum depression is linked to several factors including changes in hormones, extreme emotions, fatigue, and stress from actual or perceived lack of support. They also note that women with a history of depression, including a previous post-partum incidence, are at increased risk.

New moms who are struggling should reach out to a provider, a partner, a family member, a friend, or any resource able to help says Melissa Kanter, a psychiatric mental health nurse practitioner at Memorial Hospital. Not everyone experiences the baby blues or postpartum depression, but if it does occur, she encourages moms and partners to know where they can go for help and “don’t be afraid to ask.”

The baby blues “usually go away in about a week or two” according to Dr. Marni Madnick, an OB/GYN in Memorial Hospital’s Women’s Health practice, as the new mom and the rest of the family adjust to the new baby in the household. When these feelings linger or evolve into “sadness, crying, lack of interest in favorite activities, irritation, frustration, anxiety, neglect of baby or self-harm”, Dr. Madnick and her colleagues say it is time to seek help.

The biggest barrier to seeking help, Dr. Madnick says, is personal. “Even if everything goes perfectly well [during pregnancy and delivery] there is often a pressure for this to be an amazing experience. But they’re not getting any sleep or their baby is crying all the time or they’re not breast feeding well or they’re partner’s not helping.”

“A lot of women feel embarrassed or ashamed when they feel that way because they think they’re supposed to feel really happy and when they don’t, they bury it. And that makes it worse.”

Conversations about pregnancy-related issues, including emotional health issues, are important. “We talk to patients about what to expect during their labor and delivery, especially with first-time moms. And we discuss what to expect post-partum,” Dr. Madnick adds.

Clinical departments at Memorial Hospital involved in working with new moms on their emotional health include the OB/GYNs (obstetricians and gynecologists) and midwives in Women’s Health, the specially trained team of nurses in the birthing center, pediatricians and the behavioral health team. The Memorial team uses all encounters during and immediately after pregnancy as opportunities to assess and screen for any issues that may have an impact during and after the pregnancy. If concerns are identified recommendations may include additional observation, medication or referral to behavioral health specialists.

Birthing Center Clinical Supervisor Leigh Copsey, RN, uses the time patients spend in in Memorial’s Birthing Center for their labor and recovery to “ask our questions and use our screening tools.”

“We ask some uncomfortable questions. ‘Are you having a hard time sleeping? Are you not eating enough? Eating too much? Are you feeling down or depressed? Are you feeling hopeless?’ We give people the opportunity to reach out if they are struggling.”

While postpartum depression usually starts from one to three weeks post childbirth, the American College of Obstetricians and Gynecologists writes the condition can often appear up to one year after childbirth. Copsey adds it is important for new moms and their families to be aware of changes in mood or behavior. At Memorial, a typical post-childbirth follow-up plan includes a phone call from a Birthing Center nurse 48 hours after discharge, a scheduled OB/GYN visit within two weeks and an additional visit with their OB/GYN at six weeks. Pediatricians also ask how the new mom is doing during new baby visits in the weeks following birth.

Copsey also notes the support groups at the hospital and in the community where new moms can get support. “We have Childbirth Classes and a New Moms class at the hospital and encourage all moms, especially first-time moms, to take those classes.”
The important role the other parent plays in helping a partner through the baby blues and postpartum depression should not be overlooked, Copsey acknowledged. “Babies bring a lot of changes to the family and there’s a lot to do. Sometimes, it can be a bit too much for either parent.” Either parent is encouraged to call the birthing center if they are anxious or have concerns about their partner.

“Sometimes a parent does not want to admit they are struggling. We often say to the other parent, ‘If you notice something and they don’t want to admit it you can call us.’ We try to encourage that so they [the other parent] pay attention and try to be helpful and take that burden away.”

Copsey added there is a push in health care to focus on post-partum issues and, as part of the MaineHealth system, Memorial has “been on the cutting edge of what’s recommended and have a lot of people weighing in on what we should be doing and how we should be screening people.”

Parents and families are encouraged to call their OB provider or the Birthing Center any time for questions, guidance or emergency help. The Birthing Center is available 24 hours a day. 603-356-5461 ext 2146

Where to find help for postpartum depression

Here are some additional resources for information on postpartum depression:

In any time of need, your OB or primary care provider can be a resource. You may also call the Memorial Hospital Birthing Center at 603-356-5461 for information on where to turn. Register for Childbirth Classes or the New Moms Support Group at Memorial Hospital by calling 603-356-5461.

If there is an immediate concern, call 911.


About Memorial Hospital
Memorial Hospital is a not-for-profit 25-bed Critical Access Hospital located in North Conway, NH, and is a member of the MaineHealth family. Its hospital services include a 24-hour emergency department, surgery center, clinical laboratory, heart health & wellness programs, imaging services, cardiopulmonary care, family birthing center, oncology, chemotherapy and infusion services. Practices include primary care and family medicine, diabetes care, behavioral health, women's health, podiatry, orthopedics and physical therapy. Memorial Hospital is also home to The Merriman House nursing home, which provides senior care services in a comfortable, home-like setting. For more information, visit memorialhospitalnh.org  or call 603-356-5461.