Episode description

⚠️ Content warning: This episode on postpartum care and maternal mental health includes mentions of postpartum psychosis and infanticide

In Part 2 of my conversation with birth researcher and postpartum doula Kelsey Marr, we talk PMDs — perinatal mood disorders — like postpartum depression, anxiety, and psychosis. Kelsey gives practical strategies for preventing PMD and the importance of planning, setting boundaries, and creating community so we can thrive, not just *survive*, early motherhood.

🎧 Hear Part 1: S1E7 Postpartum Care x Maternal Mental Health

Time stamps

* 02:42: Kelsey’s recommendations for planning for postpartum

* 07:22: Using your postpartum plan as a “scapegoat”

* 08:23: My personal experience of postpartum anxiety

* 10:04: Defining perinatal mood disorders (PMDs)

* 12:33: “Baby blues” versus postpartum depression (PPD)

* 15:39: Postpartum anxiety (PPA) and intrusive thoughts

* 19:59: Our culture of postpartum care and partner involvement

* 23:01: Practical tips for preventing PMDs

* 27:57: How to support postpartum parents

5 key takeaways from this episode:

Postpartum planning is essential

Start planning for postpartum early in pregnancy, like by writing down a list of boundaries and expectations and roles. This can help prevent misunderstandings and resentment.

✅ Make a “no” list during pregnancy to eliminate unnecessary stressors and set boundaries / limits.

Set boundaries and ask for help

Many new parents struggle with setting boundaries during a huge life transition (especially if they have people-pleasing tendencies!). Having a written plan to communicate needs to family and friends can help us avoid conflict and be the “scapegoat” for setting boundaries.

✅ Connect with professionals like doulas, lactation consultants, or mental health professionals before birth.

Perinatal mood disorders (PMDs) are common but complex

PMDs like postpartum depression and anxiety occur for lots of new parents, particularly if they were prone to anxiety and depression before pregnancy and childbirth. They might manifest as extreme irritability, paranoia, or negative feelings toward the baby.

PMDs don’t necessarily resolve in the first few weeks after childbirth and often require professional support, like from a mental health professional.

The role of culture and community in postpartum care

Our society — the US and Canada in particular — puts an overwhelming burden on new moms, often without adequate support systems. We need core community, as well as involvement from partners to mitigate the risk of PMDs (more so even than paid leave).

Showing up for new parents

Friends and loved ones can offer tangible help for postpartum parents like cooking meals, babysitting older kids, and doing chores (while respecting boundaries!).

✅ Sustained help beyond the initial weeks of postpartum is crucial; continue to check in on postpartum moms after the first three weeks - three months.

The guest expert

Dr. Kelsey Marr (PhD) quit her job as a birth researcher in 2023 to become a full-time doula. She helps expecting and new parents navigate pregnancy, birth, and postpartum by helping them find evidence-based information, and build their research skills and confidence to make their own best birth/postpartum choices.

* 📍 Location: Halifax, Nova Scotia, Canada

* 🆓 eBook: “Is This Normal?” Evidence-Based Guide to Your First Trimester of Pregnancy

* 👩🏼‍💻 Blog: Expecting Evidence

* 📱 Social: @collectivecarehfx

Q+A

How can we create a plan to support people postpartum to help avoid perinatal mood disorders like postpartum anxiety and depression?

KM: One of the things I love to do with my clients is to start their postpartum planning really early in pregnancy. I’m doing this myself, even though I’m only 10 weeks along. For someone with a history of anxiety or depression, we know that they’re more likely to experience a perinatal mood disorder. That’s why it’s so important to find a therapist who can support you during pregnancy and postpartum, or to talk to your current therapist about what’s coming up for you.

What do boundaries have to do with planning for postpartum?

KM: A big trigger for many people is boundaries—many of us don’t know what our boundaries are until they’re crossed.

I encourage my clients to think about things like, “Do I want visitors? What kind of help do I want with my baby?” I even have them write it down, journal about it, and share that plan with their support people—partners, family, and friends—before the baby is born. That way, those expectations are clear, and you’re not having those conversations when you’re in the fog of postpartum.

What is a perinatal mood disorder (PMD)?

KM: A a perinatal mood disorder is any sort of mood or anxiety disorder that happens during pregnancy or clinically it's defined as the first year postpartum, but we know that these things can last a lot longer.

Just that first year can feel like things like feeling intense anger or irritability, having trouble falling asleep, trouble concentrating, trouble making decisions, withdrawing, having negative feelings about the baby, lacking energy.

It's really the same sorts of symptoms that we see with depression or anxiety or psychosis, but they're specifically relating to this transition in pregnancy and postpartum.

Checklist: How to prepare for postpartum (and mitigate risk of perinatal mood disorders)

Kelsey recommends the following:

* Make sure you’re on the same page with your partner about what life will look like after baby arrives

* Build healthy habits while pregnant (sleep, movement, diet)

* Lowering lifestyle stress

* Make a “no” list of things you do not want to do when you’re a new mom

* Find your professionals before you need them badly: Physical therapist, mental health professional, postpartum doula, etc.

Thank you for checking out this episode. Leave me a comment and tell me what you think!

Upcoming episodes include:

* S1E9 People Pleasing x Libido with Lucy Rowett

* S1E10 CPTSD x Shame x Reparenting with Grace Bithell

Stay tuned!

Micah