Postpartum anxiety (PPA) can complicate the transition to parenthood. Below you’ll find information about PPA and practical coping strategies and resources for those experiencing this condition.

PPA is a mental health condition that can occur after childbirth. People with PPA may experience constant feelings of worry, overwhelm, and panic. These feelings of anxiety are usually related to the health and safety of the baby. But people with PPA may experience other fears like worrying about being a “bad” parent, or the transition of returning to work/school. It is important for new parents and health professionals to be aware of the signs and symptoms of PPA so new parents can receive effective care.

Understanding PPA

It is estimated that 17.1% of people who give birth will experience PPA. About 11% of the partners of people who give birth will also experience PPA. Certain risk factors may make it more likely for someone to develop PPA:

  • Prior to the birth: People with a prior history of generalized anxiety disorder, post-traumatic stress disorder, abuse, barriers to educational opportunities and a lack of social support are at a higher risk for developing PPA.
  • During the birth: People who have a preterm birth and/or a negative experience of the delivery are more likely to experience PPA.
  • After the birth: People who have low partner support, a negative experience of the first week postpartum, or experience the infant’s crying as excessive are more at risk for PPA. Poor health habits and a low sense of self-efficacy after the birth can also increase a parent’s risk for developing PPA.

Additionally, new parents may experience anxiety when it comes to breastfeeding/chestfeeding. They may be concerned about proper latching, whether the baby is getting enough milk, or if the parent is producing enough milk. Some new parents who breastfeed/chestfeed can experience dysphoric milk ejection reflex (D-MER). D-MER occurs when the parent has abrupt feelings of anxiety, depression, anger, homesickness, or paranoia as they begin breastfeeding/chestfeeding. This can contribute to PPA, making anxious feelings more intense.

What are the symptoms of PPA?

While many symptoms of PPA are similar to generalized anxiety disorder (GAD), there are some important differences. When experiencing PPA, anxiety symptoms are usually related to the baby’s safety, fears of not being a good enough parent, financial stressors, increase in responsibilities, or relationship challenges as a result of the birth.

Some of the symptoms of PPA include:

  • Physical symptoms: Disrupted sleep, increased heart rate or heart palpitations, nausea or stomach aches, feeling short of breath, loss of appetite, trouble sitting still, muscle tension
  • Emotional symptoms: Inability to relax, racing thoughts (especially about worst-case scenarios), obsessing over things that are unlikely to happen, difficulty concentrating, forgetfulness, irritability, feeling on edge or fearful
  • Behavioral symptoms: Avoiding certain activities, people, or places, being overly cautious about situations that aren’t dangerous, attempting to control things, checking things over and over again

While PPA affects the person who gave birth, it also impacts the child. PPA can negatively affect the parent-child bond, feeding practices, infant temperament, and the social-emotional development of the infant.

“The first night I brought him home, the anxiety started. I was checking on him over and over. Then I started reading things online, trying to figure out ‘is it normal that he’s doing x?’ I had so many baby monitors all over the house, more than we needed. I feared that my son wasn’t connecting to me and that my husband knew what he was doing and I didn’t. But I didn’t want PPA to make it so hard for me to enjoy motherhood. Getting family support, going to therapy, and joining a support group online helped me enjoy being a parent.”

— Jennifer, Texas

How is PPA different from PPD?

Recognizing both the differences and similarities between PPA and postpartum depression (PPD) can be helpful in developing self-awareness and seeking out a treatment option that will work best for you.

While PPA centers around overwhelming feelings of worry about the baby’s safety or a parent’s ability to care for their baby, PPD has more to do with constant feelings of sadness, hopelessness, and a lack of interest in daily activities.

For example, someone with PPA may feel the need to control everything baby-related and believe they are the only caregiver who will hold or feed the baby the “right” way.

On the other hand, someone with PPD may feel like they are not able to stop crying, feel exhausted all the time, and have thoughts of harming themselves or the baby.

Sometimes it can be hard to separate PPA and PPD symptoms from one another. Many people may experience both of these types of symptoms at the same time. In this case, it is important to talk to your health care provider as soon as possible to receive the proper care and support.

Managing PPA

PPA may feel so overwhelming that it can be hard to know where to start when looking for treatment options. Here are a few things you can do to help manage PPA during this challenging time:

Routines

Creating healthy routines can be a helpful way to reduce anxiety and overwhelm. They can make life feel more predictable and manageable. Set realistic goals for yourself that are easily achievable so you feel a sense of positive momentum. For example, one small routine you could try adding to your day is taking one deep breath before getting out of bed in the morning.

Sleep

Getting enough sleep helps our brains rest. But getting sleep when you have a new baby can be a challenge. Finding ways to improve your quality of sleep with PPA can help you feel calmer and allow you to recognize your anxious thoughts when they arise. If you have a partner or someone else in your life willing to support you, you can try taking turns during night feeding or asking them to watch the baby while you take a nap. You could also try napping while your baby is napping. Allowing someone else to watch your baby or sleeping while your baby is sleeping might be challenging if you are experiencing PPA. You might be anxious about what could happen to the baby while you aren’t there. But doing your best to trust others and lean on their support can ensure that you get the rest you need to feel healthy and balanced.

Nutrition

Healthy nutrition supports your mental health, reducing anxiety and depression symptoms. Breastfeeding/chestfeeding also burns calories, so it is especially important that new parents who are breastfeeding/chestfeeding get adequate nutrition. It can be hard to find time to cook healthy meals when you are a new parent, but do your best to take turns cooking with people in your support system and/or find nutritious take-out options. You can also try setting aside time if someone else is watching your baby to do some simple meal prepping for the week. This can reduce anxiety since you won’t have to think as much about cooking every time you’re hungry. Some days, a comfort food like pizza might be just what you need. You don’t need to feel guilty on the days when indulging in these foods provide you some relief.

Physical activity

Making time to move when you are able is a great way to manage the symptoms of PPA. Physical activity decreases stress, tension, anxiety, and depression. It also stimulates feel-good hormones and burns off stress hormones. It may be challenging to find time for physical activity with a newborn. But taking your baby for a walk in their stroller, going to a baby yoga class, or even finding time to do some stretching while they are napping could offer some ways to integrate movement into the time you are caring for your baby.

Support systems

Find ways to involve your partner (if you have one) and your family in caring for your baby so you can get some much needed rest. It may be hard to let go of control, but if you can practice letting go a little bit at a time, you will be able to have more time to recharge so you can be a calm, present parent to your baby. Joining online or in-person support groups for new parents can also make you feel less alone. You can even find some of these groups on social media platforms where you can connect more casually with other people going through something similar. Do the best you can to recognize when you need support and ask for help when you need it.

Therapy

Working with a therapist can be a helpful way to process your feelings and come up with ways to help you manage your stress and worries about your baby. Your therapist can also help you develop skills like asking for help and setting boundaries, which may be helpful as a new parent. Research suggests that cognitive behavioral therapy (CBT) is an effective therapeutic method for treating PPA, and many providers are trained in this specialty.

Medication

Some people may find that medication helps them manage their PPA symptoms and allows them to enjoy being a parent again. It is important to talk with your doctor and/or psychiatrist about medication options that would best suit your needs and any potential side effects or impacts on breastfeeding/chestfeeding they may have.

Mindfulness

Studies show that developing a mindfulness practice can be beneficial for the treatment of PPA. Mindfulness comes in many shapes and forms. While some people may love a 30-minute meditation session each morning, others may find that unrealistic to fit into their schedule. Even taking a moment to pause before eating a meal and taking your time to savor your food is a mindfulness practice. Find what works for you and see if you can incorporate these practices into your days.

Culturally-based practices

Rooted in intergenerational knowledge and ancestral history, these traditional practices are often used in BIPOC communities as a way of healing. Some people with PPA may find comfort in these practices, such as joining a prayer circle. Another culturally based practice that might be of interest could be energy healing methods such as smudging or reiki. Incorporating your cultural identity into your healing process can be an affirming and supportive experience.

The National Maternal Mental Health Hotline – 1-833-TLC-MAMA – is a free and confidential space for pregnant women and new moms to get the emotional and mental health support they need. Trained counselors are available 24/7 by phone and text in English, Spanish, and translation services in over 60 languages.

Experiencing a mental health condition after giving birth can be extremely challenging. In addition to caring for a new baby, you may also be juggling many other responsibilities. It may be difficult to find time to take care of yourself. Do your best to engage in the wellness practices that support you, reach out for help, and offer yourself compassion as you navigate this complex time.

Mental Health America resources

Anxiety

Postpartum depression

Postpartum depression information and support

What is postpartum depression?

Perinatal mental health

Maternal depression—Making a difference through community action: A planning guide

Take a mental health test

If you or a friend are struggling with your mental health, take an anonymous, free, and private mental health test. It only takes a few minutes, and after you are finished, you will be given information about the next steps you can take based on the results.

Take a screen

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat 988lifeline.org. You can also reach Crisis Text Line by texting HOME to 741741.