Writer: Brianne Sanchez
Brittney Haskins remembers when, as a new mom, a trip to the grocery store triggered a panic attack. She tried squeezing in an extra errand after her postnatal checkup, a visit that focuses on the health and wellbeing of moms six weeks after giving birth.
“I went to Trader Joe’s afterwards and had a meltdown because I’d been away from my son,” she said.
During her appointment, Haskins had an honest conversation with her health care provider. She shared that she was struggling to sleep and eat after giving birth. Symptoms she chalked up to a normal part of parenting a newborn were exacerbated by excessive worry. She left her checkup with a diagnosis: postpartum anxiety, an often overlooked but common condition.
Maternal mental health disorders are the leading complication of childbirth, affecting one in five American women, according to the Policy Center for Maternal Mental Health. Unlike postpartum depression, which often involves feelings of sadness or disinterest, postpartum anxiety is characterized by heightened nervousness and unease that can interfere with daily life.
“I’ve heard that if you’re going to hurt yourself or your baby, you should call somebody,” Haskins said. “I was like, ‘Oh, I don’t want to hurt him. I’m obsessed with him.’”
Haskins’ experience led her to take on a volunteer leadership role with the Iowa Chapter of Postpartum Support International. PSI is the world’s leading nonprofit organization dedicated to helping those suffering from perinatal mood disorders. She also supports families professionally, as the childbirth education coordinator at Blank Children’s Hospital’s Center for Advocacy and Outreach at UnityPoint Health-Des Moines.
Haskins believes families need extra support to bridge the “chasm” between hospital discharge and their six-week screening. During that period, women’s estrogen and progesterone levels plummet, and challenges with feeding sometimes set in.
“If you are going to write a birth plan, spend 10 times the energy writing a postpartum plan,” Haskins said. She encourages couples to discuss who will wake up with the baby, wash bottles and prepare meals and how they will handle myriad other decisions and responsibilities new parents must navigate.
EARLY INTERVENTIONS
Despite advances in screenings and decreased social stigma about mood disorders, women still face numerous barriers. According to the American College of Obstetricians and Gynecologists, as many as 40% of women miss their postnatal appointment, which is a critical opportunity to connect with mental health support resources.
“We have done a wonderful job of keeping people from bleeding to death, keeping people from having strokes, from high blood pressure and infections,” said Dr. Rebecca Lundquist, psychiatrist and director of the Broadlawns UnityPoint Psychiatry Residency Program. “All the things that were a problem 100 years ago, we are doing much better on. What’s left is the iceberg of mental health and substance use issues.”
Lundquist was involved in the launch of a Massachusetts program that helps front-line providers identify and address the mental health and substance-use concerns of pregnant and postpartum patients. She is championing a similar systemic solution in Iowa to quickly connect care providers across the state with referrals for patients who need specialized help.
“Iowa is one of the few states that doesn’t have a perinatal access program,” Lundquist said.
Suicide accounts for 20% of postpartum deaths, and depression during this period is twice as common as gestational diabetes. That’s why establishing care early is important, especially for women who have a history of mental health diagnosis and are concerned about managing medications while breastfeeding.
“People fear losing their kids because they have symptoms of mental health issues,” Lundquist said. “They fear their physician is busy and won’t have time. The more we can help them to speak up, the more we can help them with these symptoms.”
PERINATAL THERAPY
Even for women who don’t have a history of mental health disorders, seeking support services before giving birth can set up space to navigate complicated feelings. Fear, shame and guilt are common but often go unspoken.
“Transitioning to parenthood is a massive life adjustment,” said Amanda Hardy, founder of Meadowlark Mental Health Clinic in central Des Moines. “There’s a lot of change, and change means loss, and that can be hard. I use a grief lens a lot with folks. I talk about mourning the loss of pre-parenthood freedom and autonomy.”
Hardy says emotional numbness can be a flag for postpartum depression, and a sense of constantly struggling uphill through day-to-day expectations. In addition to supporting patients one-on-one and through her team of licensed therapists, Hardy wrote a book to give a wider audience encouragement and tools for navigating the challenges of the postpartum period.
“Dear Mama, You Matter: Honest Talk About the Transition to Motherhood” is available in paperback and audiobook, a format that can be easier for new moms who have their hands full.
“We have to be able to talk about the hard stuff, because I think we just make it harder when we try to hide it,” Hardy said. “Admitting, ‘I don’t like this today,’ is not the same thing as ‘I don’t like my kid.’”
While clinical therapy, medication and hospital interventions play a role in improving maternal mental health, Hardy said everyone can benefit from social support.
“Whether that means you’re coming to therapy or finding a group of friends that you feel like you can be vulnerable, you need those types of spaces,” Hardy said. “If people were a pill, you would need to prescribe it. We need community, especially in parenthood.”
SOCIAL SUPPORT
For new parents living in relative isolation, the “it takes a village” proverb about childcare feels laughable. Unfortunately, a range of social issues that includes a lack of parental leave, caution over illnesses like RSV, as well as the polarizing political climate, are complicating postpartum outreach.
“I saw something online that said, ‘Sometimes a village means a therapist, daycare and DoorDash,’” Haskins said, noting moms still crave real connection in an era of social media comparison.
Haskins’ early approach involved strategically timing her walks to coincide with a neighbor she regularly saw pushing a stroller. She now coordinates online and in-person groups through PSI-Iowa, but acknowledges parents today have little bandwidth to participate.
“You don’t have to have a diagnosis to reach out for help,” Haskins said. “You can log on to a support group on a hard day and never have to log on again. Or you can be super into it and become a peer mentor.”
In 2024, “Parents Under Pressure: The U.S. Surgeon General’s Advisory on the Mental Health & Well-Being of Parents” highlighted a spike in caregiver stress, caused by a variety of factors, from financial pressure to loneliness. Leaders of local groups are trying to address this by providing free, drop-in opportunities.
“Part of our goal is to get moms to realize that their needs are important too,” said Caitlin Merritt, co-founder of TogetHER, a grassroots support network in Central Iowa.
She and co-founder Kayla O’Connor started the group after several moms they knew died by suicide last year. TogetHER hosts monthly meetups that might include educational components, workout opportunities or casual playground hangouts. The group quickly gained a social media following, but organizers would love to welcome more people to attend in-person events.
“We’re hoping moms find purpose through these connections,” Merritt said. “Whether you’re staying at home, or if you work outside of the home, you can find yourself bottled into this mom role. It’s easy to start to lose all your likes and dislikes when you are covered in food and spit-up, simply trying to navigate the day. One of our driving passions is to encourage moms to come to meetups and, through these conversations, socialization and experiences, to recognize that they’re still a whole person.”
Amy Brooks Murphy, a childbirth, postpartum and parenting educator, built a community around her continuum of services. Since launching her business in 2002, she’s seen a shift in what clients ask for.
Brooks Murphy still hosts a monthly drop-in meetup at the Clive library but says virtual groups, which emerged as a pandemic necessity, remain popular. Her one-on-one postpartum doula services expanded into empowerment consultations that cover everything from feeding babies to addressing grandparent family dynamics. Transitional baby care helps bridge the back-to-work period before infants begin a traditional daycare.
“I never like to say, ‘This gets easier,’ because that’s a lie,” she said. “It does not get easier, but it changes and it gets better. It keeps getting better, but there’s always going to be a challenge.”
For Haskins, who is now a mom of two, taking anti-anxiety medication and having forthright conversations with her health care provider, family and even support-group strangers helped her navigate postpartum challenges. Reflecting on those early weeks, she now recognizes that she was operating in crisis mode.
“I don’t think I’d taken a full breath since [my son] was born,” she said. “I didn’t realize it until finally, somebody was like, ‘You don’t actually have to live this way.’”
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