The Mental Load of Motherhood Nobody Talks About

Every year on the first Wednesday of May, the world observes World Maternal Mental Health Day — a day dedicated to raising awareness about the mental health challenges women face during pregnancy and in the postpartum period. At Inlight Psychiatry, we believe this day deserves not just acknowledgment, but urgent, sustained attention.

Becoming a mother or experiencing pregnancy loss, infertility, or a complicated birth can be one of the most emotionally demanding experiences of a person’s life. Yet it remains one of the most stigmatized areas of mental health in America.

The Numbers Are Striking

Perinatal mood and anxiety disorders (PMADs) are the most common complication of pregnancy and childbirth in the United States. They affect up to 1 in 5 women during pregnancy or in the year following birth — making them significantly more common than gestational diabetes or preterm birth, yet receiving far less clinical attention.¹

PMADs include:

• Postpartum depression (PPD) — persistent sadness, emptiness, difficulty bonding
• Postpartum anxiety — constant worry, racing thoughts, inability to rest
• Postpartum OCD — intrusive, unwanted thoughts (often about the baby’s safety)
• Postpartum PTSD — following traumatic birth experiences
• Postpartum psychosis — rare but serious; requires immediate medical care
• Perinatal depression — depression that begins during pregnancy, not after

And critically: these conditions are not limited to women. Paternal postpartum depression affects approximately 1 in 10 new fathers, yet is almost entirely unaddressed in clinical practice.²

Why So Many Women Suffer in Silence

Despite being so common, PMADs are dramatically undertreated. The reasons are layered and deeply cultural:

The “good mother” myth: There is a pervasive cultural narrative that motherhood should be joyful, instinctive, and fulfilling. When a new mother feels exhausted, detached, anxious, or resentful instead — she often assumes something is uniquely wrong with her, rather than recognizing that she is experiencing a medical condition.³

Fear of judgment: Many mothers fear that disclosing their symptoms — especially intrusive thoughts or difficulty bonding — will lead to their children being taken away or to being labeled as unfit. This fear is largely unfounded but very real.⁴

Lack of screening: While the American College of Obstetricians and Gynecologists recommends screening for perinatal depression, implementation is inconsistent. Many women are never asked about their emotional state during prenatal visits.⁵

Inadequate postpartum support: The U.S. lags significantly behind other developed nations in postpartum care. The traditional “6-week checkup” is a wholly inadequate window for identifying mental health needs that may not peak until months later.⁶

Postpartum depression is not a failure of love. It is a medical condition that responds to treatment — and no mother should face it alone.

Signs to Watch For

If you are pregnant, recently postpartum, or supporting someone who is, watch for these signs beyond the “baby blues” (which typically resolve within two weeks of birth):⁷

• Persistent sadness, crying, or emotional numbness beyond 2 weeks postpartum
• Intense anxiety, panic attacks, or a sense of dread that something terrible will happen
  Intrusive, distressing thoughts (even if you would never act on them)
• Difficulty sleeping even when the baby sleeps — not due to noise but due to a racing mind
• Feeling disconnected from your baby, your partner, or yourself
• Loss of interest in activities or relationships that previously brought joy
• Thoughts of harming yourself or feeling like your family would be better off without you

If you recognize any of these — in yourself or someone you care about — please reach out to a healthcare provider. These symptoms are treatable. You do not have to wait until you’re in crisis.

A Note on Pregnancy Loss and Infertility

Maternal mental health extends beyond birth. Miscarriage, stillbirth, pregnancy termination, and infertility are profoundly grief-laden experiences that are often minimized or expected to resolve quickly. The psychological impact — including depression, PTSD, and complicated grief — can be significant and long-lasting, and deserves the same clinical attention as any other perinatal condition.⁸
At Inlight Psychiatry, we provide compassionate psychiatric evaluation and treatment for perinatal and postpartum mood disorders in adult patients. If you or someone you love is struggling through pregnancy or the postpartum period — you deserve support. Reach out today.

References
1. Wisner, K.L. et al. (2013). Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings. JAMA Psychiatry, 70(5), 490–498. doi.org/10.1001/jamapsychiatry.2013.87
2. Paulson, J.F. & Bazemore, S.D. (2010). Prenatal and postpartum depression in fathers and its association with maternal depression. JAMA, 303(19), 1961–1969. doi.org/10.1001/jama.2010.605
3.Held, V. (2006). The Ethics of Care: Personal, Political, and Global. Oxford University Press. — cited in Choi, P. et al. (2005). Myth of motherhood and its implications. Sociology of Health & Illness, 27(2), 198–215.
4.Barkin, J.L. & Wisner, K.L. (2013). The role of maternal self-care in new motherhood. Midwifery, 29(9), 1050–1055. doi.org/10.1016/j.midw.2012.10.001
5. American College of Obstetricians and Gynecologists (ACOG). (2018). Screening for perinatal depression. Committee Opinion No. 757. acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/11/screening-for-perinatal-depression
6. Declercq, E. et al. (2014). Listening to Mothers III: Pregnancy and Birth. Childbirth Connection. — cited in postpartum care gap literature; see also: Shaw, E. et al. (2006). Systematic review of the literature on postpartum care. Birth, 33(3), 239–252.
7. American Psychological Association. (2023). Postpartum depression. apa.org/topics/postpartum-depression
8. Farren, J. et al. (2020). Posttraumatic stress, anxiety and depression following miscarriage and ectopic pregnancy. BMJ Open, 10(e034947). doi.org/10.1136/bmjopen-201