The focus when someone has a baby is often on the pregnancy, split into three trimesters that mark distinct phases of fetal development. But Dr. Jennifer Glance, an OB-GYN, says we should also consider the postpartum period—known as the “fourth trimester.” 

The postpartum period is typically considered to extend six to eight weeks after labor and delivery. 

“But six to eight weeks is arbitrary,” Dr. Glance says. “The postpartum period actually extends to the first year of [your baby’s] life.” 

Many changes happen to mom and baby during that year—the fourth trimester—and moms can face several challenges like postpartum depression. 

Baby blues vs. postpartum depression 

Most women will have baby blues after labor and delivery due to fluctuating hormones. But some women may experience more serious postpartum depression. 

Dr. Glance says it’s important for women to monitor their emotions postpartum and reach out to someone if they’re struggling. For friends and family of new moms, it’s important to listen and watch for signs of depression, such as 

• changes in appetite
• changes in sleep
• a lack of hygiene 

However, Dr. Glance points out that it’s not always black and white. 

“Those are sometimes part of being a new parent,” she says. “You’re putting your child’s needs first. So some of the things that are normally a hallmark sign of depression can be masked in that postpartum period because there are so many life changes occurring at the same time.” 

Because of this, postpartum doctor visits are essential for a new mom’s mental and physical health. 

Importance of the postpartum visit 

According to Dr. Glance, the postpartum doctor’s visit is an opportunity for women to discuss healthcare issues outside of pregnancy and get screened for postpartum depression. Once they stop regularly seeing their OB-GYN, Dr. Glance says, they may not feel comfortable bringing up mental health struggles. 

Some women might be nervous about the screening process, but Dr. Glance ensures it’s designed to be as simple as possible. 

“They’re given a questionnaire to fill out about how they’re feeling. And then it’s scored, and the provider reviews that and asks them specific questions about it.” 

But the stigma of asking for help often keeps moms from sharing when something is wrong. 

Resources and ending the stigma 

It can be difficult for new moms to admit they’re having trouble adjusting to their new life. 

“A lot of times,” Dr. Glance says, “there’s a stigma with talking about it or admitting that you’re struggling.” 

Dr. Glance shares that multiple resources are available for moms facing postpartum depression, such as support groups, therapy, medications, and suicide prevention lines. But one of the most important resources is “the village”: support from friends, family, neighbors, and other community members is crucial. 

Dr. Glance also knows it’s important for upcoming and current doctors to understand the postpartum experience as they care for new moms. Most recently, she’s been serving as the Health Resources and Services Administration (HRSA) Grant for Rural Maternal Health for Resident Education Project Director, helping to connect a generous grant from the HRSA to support education for residents, particularly serving in rural areas. 

Postpartum depression isn’t something to be ashamed of, and speaking about it and asking for help when we need it is the first step in ending the stigma.