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When you’re pregnant, there’s a lot of talk about birth plans, baby gear, and what labor might feel like—but far too little about what happens after. Not just the diaper changes and night feeds, but how you might feel mentally, emotionally, and physically as you navigate the early weeks and months after baby arrives.

Here’s the truth: healing after birth is not just about stitches and swaddles. It’s about your body and your brain—and for many new parents, it’s a lot more complicated than anyone warned them.

In a recent episode of Doula Talk: Postpartum, Babies, and the Battle for Sleep, I sat down with two amazing experts—Dr. Angie Maxwell, pelvic floor physical therapist and founder of Madrona PT, and Laura Meader, licensed clinical social worker and therapist at Crescent Moon Therapy—to dig into what postpartum recovery really looks like. Together, we talked about postpartum mood disorders (also called PMADs), the powerful mind-body connection, and why we all deserve better support during this huge life transition.

If you’re pregnant and planning for life after birth, this blog is your gentle guide to what’s possible, what’s common, and how to get the support you truly deserve.

What Are Postpartum Mood Disorders?

First off, let’s break down the difference between the “baby blues” and a postpartum mood disorder.

The baby blues are very common—up to 80% of birthing people experience them. They usually show up a few days after birth and might include weepiness, irritability, or mood swings. The key thing is: baby blues typically fade on their own after about two weeks.

But when those feelings last longer, feel more intense, or begin interfering with your ability to care for yourself or your baby, we may be dealing with a postpartum mood or anxiety disorder (PMAD). These include:

Postpartum depression
Postpartum anxiety
Postpartum OCD
Postpartum PTSD
Postpartum psychosis (rare, but serious)

And here’s something that doesn’t get said enough: PMADs don’t always look like sadness. They can show up as rage, panic, racing thoughts, obsessive worrying, insomnia—even physical symptoms like chest tightness, GI upset, or shortness of breath.

Why Pregnant People Should Know This Before Baby Arrives

Knowing about PMADs ahead of time is one of the most powerful things you can do. Not to scare yourself—but to prepare yourself. Because when you’re in it, it can be really hard to tell what’s normal new parent overwhelm and what’s a red flag that needs support.

Here are a few questions to reflect on (or bring up with your partner and provider):

Do you have a history of anxiety, depression, or trauma?
How do you typically cope when sleep-deprived or under stress?
What kind of support will you have postpartum—and do you feel comfortable asking for help?
What’s your plan for emotional check-ins with your partner or support team?

Just like we make birth plans, you deserve a postpartum mental health plan too.

How Pelvic Health and Mental Health Are Connected

Here’s the part many providers miss: the body holds trauma. Dr. Angie Maxwell sees it all the time in her pelvic floor physical therapy practice. A patient might come in with pain, tension, or incontinence—and Angie notices they’re holding their breath, clenching their jaw, or dissociating during their exam.

The pelvic floor isn’t just about muscles—it’s deeply emotional territory. And when you’ve experienced a challenging birth, physical trauma, or lack of support postpartum, that tension can get stuck.

That’s why holistic recovery matters so much. Angie and Laura work together to support clients not just from the neck up or the hips down—but as whole humans healing from a massive physical and emotional transformation.

Signs It Might Be Time to Reach Out

If you’re pregnant and wondering what to look for after baby comes, here are a few signs Laura suggests watching for:

Feeling like you can’t sleep, even when the baby is sleeping
Crying every day for weeks, or feeling emotionally flat
Constant worry that something bad will happen to baby
Feeling ragey or irritable most of the time
Disconnecting from yourself or your baby
Feeling “off,” like you’re watching yourself from the outside

If that sounds like a lot—it is. And also, you’re not alone. 1 in 5 birthing people experiences a postpartum mood disorder. That’s not rare. That’s common—and treatable.

What Support Actually Looks Like

Support doesn’t always mean therapy right away (though it absolutely can). It might mean:

A postpartum doula helping you get more rest
A lactation consultant easing feeding stress
A pelvic floor PT helping you reconnect with your body
A therapist helping you name your feelings and learn tools to cope
A community support group where you’re not the only one crying in leggings

Laura and Angie run a free monthly Baby Lounge in Pierce County and are launching a six-week support group for postpartum mental health. If you’re local to Washington, check it out!

Not local? You can still build your team:

Find a therapist trained in perinatal mental health via Postpartum Support International
Use the New Mom Checklist from Postpartum Progress for a non-clinical check-in and more information on depression and anxiety here: https://postpartumprogress.com/the-symptoms-of-postpartum-depression-anxiety-in-plain-mama-english
Get virtual support through programs like my First Year Support Program

You Are Not Behind. You Are Not Broken.

Here’s what I want every pregnant person to hear loud and clear:

Healing is not linear. Your six-week checkup does not mean you’re all better. There’s no deadline for feeling like yourself again. And there’s no shame in needing help.
You are allowed to take it slow. You are allowed to rest. You are allowed to say, “I’m not okay”—and be met with compassion instead of judgment.
Whether your postpartum season feels joyful, messy, or somewhere in between, you are worthy of care and support every step of the way.

Ready to prepare for postpartum on your own terms?

Grab one of my resources below to get started:

🍼 Postpartum Meal Planner Workbook & Guide
💛 Preparing for Parenthood Workbook
💤 First Year Support Program – for sleep, sanity, and support through every stage

You’re not alone, friend. And you don’t have to wait until things get really bad to get support. Let’s build your village now.

Warmly,

Doula Deb

Podcast Guests:

Angie Maxwell, PT, DPT, WCS
Madrona Physical Therapy

Dr. Angie, owner and lead physical therapist, graduated from Eastern Washington University in 2013 with her Doctorate of Physical Therapy. She is a Board-Certified Clinical Specialist in Women’s Health Physical Therapy through the American Board of Physical Therapy Specialties, making her an expert in pelvic health for all genders and ages. Angie has worked in various hospitals and large practices before starting her own.

She opened her clinic to address the community's lack of support for pelvic health, particularly post-partum care and osteoporosis treatment. She is excited to create a clinic where individuals with pelvic health issues are cared for and receive specialized treatment.

With advanced training in pelvic floor dysfunction and related movement disorders from pregnancy to menopause, Angie utilizes a trauma-informed, holistic approach to alleviate pain and movement dysfunction. She lives in Lakewood, WA, with her husband, two children, and Australian labradoodle, Roxy. Her hobbies include yoga, hiking, reading, camping, cooking, boating, and dog training.

Get in touch with Dr. Angie

Laura Meader, LICSW
Crescent Moon Therapy

Laura is a licensed clinical social worker and therapist who loves providing therapy to women in Washington. She specializes in empowering perfectionists to overcome anxiety and self-doubt and build self-esteem, so they can live more authentic, confident, and fulfilling lives. A Midwesterner by birth (and lifelong loyalty to tater tots), she is proud to call the PNW her home for the better part of the last 7 years. She completed her graduate work at the University of Chicago and has practiced clinically in the Windy City and Puget Sound with Veterans, pregnant and parenting individuals, and across broad populations in medical and private practice settings.

When she’s not working, you'll find her reading, doing her best to hydrate, and spending time chasing her three kids and the sunlight. You can learn more about her and her private practice at her website.