Perinatal Mental Health: A Guide for Doulas and Birth Professionals
By Jenny Peters, VP of Clinical Operations at FamilyWell with experience supporting families as an educator, postpartum doula, and Perinatal Behavioral Health Coach.
Perinatal mental health is an escalating issue in the United States and globally. In fact, one out of five birthing parents will suffer from a mental health condition while pregnant or after childbirth, according to the American Psychiatric Association. What’s more, 75 percent do not receive treatment and are left to navigate their circumstances alone.
After the birth of my first baby, I felt a deep connection to these experiences of new and expecting parents, and I knew I wanted to dedicate my career to supporting them. I began my journey as a Certified Postpartum Doula, providing hands-on care and guidance during those early, challenging weeks.
However, as I worked closely with families, I quickly realized the immense need for emotional support that often went beyond what I could offer as a doula. This insight motivated me to expand my skill set, leading me to pursue additional education and certifications in perinatal mental health.
Once I combined my doula experience with perinatal mental health coaching skills and tools, I was able to offer more holistic support, and confidently address the emotional challenges my clients so often faced through pregnancy and the first year postpartum.
Mental health struggles are the leading cause of U.S. maternal mortality rates, but most of these deaths are preventable. This is where perinatal mental health care comes in, alongside the care of doulas and other birth professionals.
I believe so strongly in empowering doulas and birth professionals with perinatal mental health knowledge and expertise so that they can effectively support the mental health of pregnant and birthing parents—and be an important part of solving the maternal mental health crisis.
Here’s what you need to know about perinatal mental health and how you can help.
What Is Perinatal Mental Health?
Perinatal mental health refers to the psychological wellness and emotional stability of a birthing person. Becoming a parent can be challenging and emotional. Around 70 - 80 percent of new parents will have mood fluctuations or intense emotions after childbirth.
This is a normal response to the hormonal changes that occur post-labor, and these mood swings often resolve on their own. However, without the right support to navigate these emotional challenges, symptoms may worsen.
When depression, anxiety, chronic fatigue, despair, irritability, numbness, or other related feelings persist, those suffering might experience panic attacks, inconsistent eating habits, sleep disturbances, intrusive thoughts, or self harm. They may also struggle with lack of motivation to bond with their child, perform daily activities, or tend to their own self-care.
If birthing individuals go without support, this can even be fatal. In fact, mothers are at a higher risk for suicide after birth, than during pregnancy, with the greatest risk occurring between 6-weeks and 1-year postpartum.
Risk Factors for Perinatal Mental Health Conditions
These mental health concerns can manifest for a number of reasons. While each case is unique, the American Psychological Association outlines some of the most common risk factors that contribute to perinatal mental health issues, either during or after a pregnancy:
Hormone fluctuations or imbalances after childbirth
Personal history of anxiety or depression
Predisposition to mental illness in the family
Stress of becoming a parent and caring for a newborn
Fear of being incompetent or unqualified as a parent
An infant with special needs (medical issues, premature birth, etc.)
An infant who cries often or eats and sleeps irregularly
Feeling isolated or lacking social connection and support
Financial strain or employment insecurities
Other emotional stressors (death or conflict in the family, etc.)
Racial Disparities in Perinatal Mental Health
Black mothers are twice as likely as white mothers to experience mental health conditions, but half as likely to receive care. The Policy Center for Maternal Mental Health further explains:
A risk factor for maternal mental health disorders for black women is “chronic stress from racism, rather than race”—an important distinction.
Adverse health and mental health outcomes for Black women are increased from “chronic stress and higher levels of lifetime exposure to trauma.”
Black women experience “discrimination, racism, and inequities in the maternity care system,” which significantly increases their risk for maternal mental health disorders.
Common Perinatal Mental Health Conditions
Perinatal Mood and Anxiety Disorders (PMADs) is an umbrella term that refers to a range of mental health disorders parents can experience during and after pregnancy, adoption, or loss. Postpartum Depression and the “Baby Blues” are widely discussed, but it’s important to know about other PMADs that parents commonly experience during pregnancy and postpartum.
The Importance of Perinatal Mental Health Care
Proper perinatal mental health care is critical to supporting birthing and new parents during what can be a challenging time in life because it is both prevalent and dangerous. Here are some important data points to consider:
It is estimated that more than 600,000 birthing parents in the U.S. deal with perinatal mental health issues each year. Those in marginalized communities or low income households are especially vulnerable—and the ramifications could impact both the parent’s well-being and the child’s normal development. (The Policy Center for Maternal Mental Health)
More than 50 percent of birth-related fatalities occur up to one year following the delivery. Therefore, it’s crucial that all new parents can access mental health treatment during and after pregnancy. (Centers for Disease Control and Prevention)
Birth Trauma and Perinatal Mental Health
Birth trauma can have a significant impact on perinatal mental health. This term refers to complications or interactions in childbirth that cause emotional distress or overwhelm for a birthing parent—and it is not uncommon.
One in three birthing parents feel their delivery was traumatic, and one in five dealt with mistreatment in pregnancy or childbirth. (Maternal Mental Health Leadership Alliance)
As many as 44 percent of deliveries result in trauma, causing issues such as panic attacks, anxiety, depression, insomnia, or even suicidal thoughts. (Women and Birth Journal)
These experiences can harm the birthing person’s mental health and relationship with others, including their newborn. While these symptoms can be short-term, it’s not unusual for the post-traumatic effects to lead to chronic mental health struggles, further elevating the risk of dangerous conditions.
Making a Difference: What Can Be Done
Both medical practitioners and birthing professionals can help improve perinatal mental health outcomes and offer resources to those who are suffering. For example, comprehensive mental health screenings during pregnancy and the postpartum period will promote both early detection and successful intervention of perinatal anxiety, depression, and other mental health conditions.
In our certification program, we train doulas and other birth professionals how to administer these evidence-based mental health screenings, including EPDS, GAD-7, and PHQ-9.
But your support can go far beyond screening – you can play a role in providing ongoing emotional support to pregnant and new parents by expanding your perinatal mental health skills and expertise.
How to Expand Your Skills with the Perinatal Behavioral Health Certification Program
Our Perinatal Behavioral Health Certification Program is one way to equip yourself with the skills to be an anchor for parents as they navigate the emotional challenges of this monumental life transition.
This self-paced online certification course will teach you the practical techniques and trauma-informed coaching skills to support parents with the normal daily challenges and complex mental health issues that they might encounter. Some examples include:
Emotional Check-Ins: Planned sessions to regularly monitor mental well-being and address emerging concerns.
Coping Strategies: CBT-driven techniques and tools to manage stress, anxiety, and other emotional challenges.
Practical Advice: Guidance on handling daily stressors, from managing sleep deprivation to navigating the demands of breastfeeding.
Resource Connection: Information on additional support services and resources, such as lactation consultants or support groups.
Screenings: Evidence-based perinatal mental health screenings, including EPDS, GAD-7, and PHQ-9.
You’ll learn from diverse expert instructors — who are some of the top U.S. voices in maternal care. The course takes place through 15 teaching modules and 10 hours of interactive Zoom mentorship sessions.
Becoming certified in Perinatal Behavioral Health also sets your practice apart, showcasing your unique and much-needed expertise in mental health. Not only is this an opportunity to change the lives of new or soon-to-be parents, it’s also a rewarding career path that will help you connect and unite with others in the birthing community from all backgrounds.
Learn more about what it means to be a Perinatal Behavioral Health Coach:
How Perinatal Behavioral Health Coaches Change the Lives of New and Expecting Parents
A Day in the Life of a Perinatal Behavioral Health Coach: Cierra Murphy-Higgs
A Day in the Life of a Perinatal Behavioral Health Coach: Danielle McClellan
Perinatal Mental Health Matters—and You Can Help
As miraculous as childbirth and parenthood are, these experiences can also be difficult — your support could feel like a beacon of hope to someone in a mental health crisis. If you’re passionate about making a difference for both new and expecting parents, consider how you can bring more mental health awareness into your current practice and expand your skills even further.
