Kathleen M. Pike, PhD

A Baby is Born

I have a new grandson! It is thrilling. His chubby cheeks make us swoon. He is strong and healthy. His arrival also means significant changes in everyday routines, sleepless nights, and new identities for my son and daughter-in-law, the new parents.

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The joy of a new baby is indescribable, and being a parent is hugely rewarding, but it is also hard work. Recognizing this and saying it aloud can be challenging, given all the joy and the unwritten code that makes parents feel guilty for not feeling jubilant 24/7. But staying silent does not make the stress or challenges go away. Saying aloud that the new bundle of joy is also a lot of work is key to protecting and promoting new parents’ mental health.

1. Universal and Cultural. No society treats the birth of a child with indifference. A new baby is a momentous event in any culture, but cultures differ regarding how new parents are treated and expectations regarding roles and responsibilities. Cultures vary widely in the type and amount of information shared about childbirth and parenting and expectations for partners during pregnancy, labor and delivery, and parenting. Individuals from different cultural backgrounds are likely to have distinct ideas about all these aspects of parenting that they will only discover when their assumptions are put to the test in the act of parenting. Talking about cultural differences is essential to managing expectations and stress for new parents.

2. Postpartum Depression. Approximately 6.5% to 20% of women experience postpartum depression around the world. Postpartum depression is characterized by a major depressive episode during any phase of pregnancy or within four weeks of delivery. Significant risk factors for postpartum depression include a history of depression and anxiety, history of interpersonal violence and abuse, complications during pregnancy, and a lack of social support. Postpartum depression occurs more commonly in adolescent females, mothers who deliver premature infants, and women living in urban areas. Like major depression, psychotherapy is recommended for women with mild to moderate peripartum depression, while a combination of therapy and antidepressant drugs is recommended for women with moderate to severe depression. The good news is that it is highly treatable, with better outcomes associated with early identification – another reason not to shy away from these issues but rather attend to symptoms early.

3. Postpartum Depression in Men. Postpartum depression is most often reported in mothers; however, some data indicate that postpartum depression can also occur among new fathers. As is the case for mothers, postpartum depression among fathers encompasses an episode of major depressive disorder that occurs soon after the birth of a child. Among fathers, common symptoms of postpartum depression include irritability, restricted emotions, and low mood. Risk factors include a history of depression in either parent, poverty, and hormonal changes. Because postpartum depression is less common among men, it is also commonly overlooked.

4. Marital Stress. Many couples report that a baby’s arrival strengthens their bond and appreciation for one another. At the same time, as much as the arrival of a baby is joyful for most couples, a baby’s arrival is also associated with more stress. Couples often report more conflict and less spontaneity and freedom after babies arrive. Because there are so many things to do and think about all at once in caring for this new life, partners have less time to think about each other’s needs – let alone their own needs. Proactive strategies to make time for one’s own needs, attend to each other’s needs, ease stress, and combat sleep deprivation are key to protecting and promoting mental health.

5. Paid Parental Leave. I will have to refrain from going on a rant here, but I just have to put on the table that I find it outrageous that the United States is counted among only seven member countries of the United Nations that do not require employers to provide paid time off for new parents. Of those seven, which also includes, Papua New Guinea, the Marshall Islands, Micronesia, Nauru, Palau, and Tonga, the US is the only high-income country. The irony is that a large body of rigorous research demonstrates that paid parental leave policies benefit mothers, fathers, and infants. The data are strong for improved maternal mental health. In one study, for example, paid family leave was associated with decreased psychological distress among parents. In another, paid leave reduced symptoms of depression among mothers with infants by nearly 30%.

The arrival of a new baby is life-changing for parents. The joy and rewards are impossible to capture in words. Yet, like all major life events, becoming a parent is not a unidimensional experience, and making room to recognize and attend to potential stresses and risks is key to protecting mental health for mom, dad, and child alike. Next up is discovering what it means to be a grandparent, beginning with figuring out what my “grandmother name” will be!

Picture of Kathleen M. Pike, PhD

Kathleen M. Pike, PhD

Kathleen M. Pike, PhD is Professor of Psychology and Director of the Global Mental Health WHO Collaborating Centre at Columbia University.

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