For years, the exhaustion, the intrusive thoughts, the numbness, and the shame that can follow pregnancy and childbirth were mostly whispered about, if they were spoken of at all. That’s changing. As CNN reported this week, women are increasingly telling their stories about maternal mental health “on the internet, at work, at home and in public,” and experts describe this moment as a long-overdue reckoning with a healthcare system that has too often left new and expectant mothers without the support they need.
The numbers behind this shift are striking. Mental health conditions affect as many as one in five women in the United States during pregnancy and in the year after birth. That is not a rare complication — it is one of the most common complications of pregnancy, more common than gestational diabetes or preeclampsia. Yet, as CNN notes, a pervasive culture of shame has allowed serious issues to go undiscussed, undetected, and untreated, leaving countless mothers to suffer quietly rather than seek help.
More Than “Baby Blues”
Part of what makes this topic so difficult to talk about is that people often conflate very different experiences under one umbrella. The mild, short-lived weepiness and mood swings many women feel in the first two weeks after delivery — often called the baby blues, according to Johns Hopkins Medicine — are extremely common and typically resolve on their own.
Postpartum depression, by contrast, is a more intense and longer-lasting mood disorder, as the Mayo Clinic explains, that can involve persistent sadness, hopelessness, difficulty bonding with the baby, changes in appetite or sleep beyond normal newborn-related exhaustion, and in some cases thoughts of harming oneself or the baby. It can begin during pregnancy or emerge anytime within the first year postpartum, and it does not resolve without support.
Depression is only part of the picture. Postpartum anxiety, described by the Cleveland Clinic, can bring relentless worry, racing thoughts, and physical symptoms like a pounding heart or shortness of breath, sometimes without the sadness typically associated with depression. And in rare but serious cases, women may develop postpartum psychosis, a medical emergency involving confusion, hallucinations, or delusions that requires immediate treatment. Clinicians now increasingly use the umbrella term perinatal mood and anxiety disorders (PMADs) to capture this full spectrum of conditions, in recognition that mental health struggles tied to pregnancy and childbirth are varied, common, and treatable.
A System Built to Miss Warning Signs
Why do so many cases go undetected? Part of the answer is structural. Historically, the six-week postpartum visit was often the only scheduled check-in after delivery — a single appointment expected to catch physical healing, mental health, infant feeding, and family planning all at once, at a moment when many mothers are too depleted to advocate for themselves. Add to that the cultural expectation that new motherhood should feel joyful, and many women internalize their struggles as personal failure rather than a medical condition deserving treatment.
This is precisely why screening matters, and why professional guidelines have evolved. The American College of Obstetricians and Gynecologists (ACOG) has established clinical guidelines directing healthcare practitioners to screen pregnant and postpartum patients for depression and anxiety using validated tools, at multiple points across pregnancy and the postpartum period rather than relying on a single visit. ACOG recommends that screening be paired with a clear pathway to follow-up care and treatment, since identifying a problem without a plan to address it does little to help patients.
What Effective Care Looks Like
Effective maternal mental health care usually blends several elements: validated screening at multiple touch points, education so patients recognize that what they’re feeling has a name and is common, and — critically — a real referral network. That can include therapy (cognitive behavioral therapy and interpersonal therapy both have strong evidence bases for perinatal depression and anxiety), medication management when appropriate, and, for higher-acuity cases, psychiatric evaluation. Practices that have mental health professionals integrated into obstetric and gynecologic care — rather than requiring patients to independently find and coordinate outside referrals — tend to see patients engage with treatment sooner and more consistently, precisely because the stigma and logistical burden of “starting over” with a new provider is removed.
Institutions such as Stanford Medicine Children’s Health have built dedicated maternal mental health programs for exactly this reason: pairing obstetric care with behavioral health support so that screening leads directly to treatment rather than a referral that a struggling new mother may never have the bandwidth to pursue on her own.
The Bigger Cultural Shift
What CNN’s reporting captures is bigger than any single statistic or guideline. It reflects a cultural shift away from the assumption that suffering silently is simply part of motherhood. Public conversations — on social media, in workplaces, among friends — are giving women language and permission to say “this isn’t right” and to ask for help. That shift matters clinically, too: patients who understand that PMADs are common, biologically rooted, and treatable are more likely to disclose symptoms honestly during screening rather than minimizing them out of fear or embarrassment.
For expectant and new mothers, the most important takeaway is this: persistent sadness, anxiety, intrusive thoughts, or feeling disconnected from your baby are not character flaws or signs of failure. They are medical symptoms with effective treatments. Bringing them up with an OB-GYN, midwife, primary care provider, or therapist — even if it doesn’t come up unprompted at a routine visit — is a reasonable and important step. The reckoning CNN describes is, at its core, a recognition that mothers deserve to be asked, heard, and treated, not just once at a single postpartum check-up, but throughout the full arc of pregnancy and the year that follows.
This article is intended for general educational purposes and is not a substitute for individualized medical advice. Anyone experiencing thoughts of self-harm or harming their baby should seek immediate help — contact the 988 Suicide & Crisis Lifeline (call or text 988) or go to the nearest emergency room.
El Camino Women’s Medical Group offers the latest Minimally Invasive Solutions for gynecologic problems. Drs. Amy Teng, Erika Balassiano, Pooja Gupta, and Vivian Wan, all members of AAGL (American Association of Gynecologic Laparoscopy), are highly trained and experienced in the field of Minimally Invasive Gynecologic Surgery. Dr. Erika Balassiano has also completed a Minimally Invasive Gynecologic Surgery Fellowship under the supervision of world-renowned Dr. Camran Nezhat. Angel Wong, PA-C, is a physician assistant who sees patients for routine and lower-acuity care.
All of our physicians are El Camino Hospital doctors and operate and deliver at the Mountain View campus.
As part of El Camino Women’s Medical Group’s commitment to comprehensive care for women, we offer in-network mental health services with world-renowned psychiatrist Dr. Rania Awaad and experienced therapist Daniya Ahmed, LMFT. For women seeking to improve their health through a healthier diet, Mariam AlAgha, MS, is an excellent nutritionist with over a decade of success helping women achieve their health goals. Her services are also in network.
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