Approximately 1 in 5 mothers experience perinatal mood and anxiety disorders (PMADs) — a spectrum of mental health conditions that can develop during pregnancy or in the year following childbirth. Despite how common these conditions are, many Omaha mothers suffer in silence, unsure where to turn or whether their feelings are “normal enough” to warrant help.
The reality is stark but hopeful: postpartum depression, anxiety, and related disorders are among the most common complications of childbirth—and they’re highly treatable when mothers know what to look for and where to find support. In a recent episode of Omaha Mom Talks, local experts broke down the warning signs and resources available to struggling mothers.
Jump to Frequently Asked Questions
The Invisible Struggle: Why Postpartum Mental Health Still Goes Untreated
Rachel Brabec, a licensed mental health practitioner in Omaha specializing in perinatal mental health, sees the pattern repeatedly in her practice. Mothers wait months before seeking help, often only after a pediatrician notices something wrong or a partner insists they talk to someone.
“Women tell me they thought they just needed to push through it,” Brabec says. “They believed asking for help meant they weren’t cut out for motherhood.”
This misconception is dangerous. Untreated perinatal mental health disorders can persist for months or years, affecting not just the mother’s wellbeing but her relationship with her baby, her partner and her sense of self. Yet with proper treatment — whether through therapy, medication, support groups or a combination — most mothers experience significant improvement within weeks.
The first barrier to treatment is often the simplest: knowing what you’re experiencing has a name, and that name isn’t “bad mother.”
Beyond Baby Blues: Understanding the Types of Postpartum Mental Health Conditions
Postpartum Depression (PPD): When Sadness Won’t Lift
The “baby blues” affect up to 80% of new mothers — mood swings, tearfulness, anxiety that typically peak around day five and resolve within two weeks. Postpartum depression is different. It’s characterized by persistent sadness, hopelessness and guilt that interferes with a mother’s ability to function.
Key warning signs include:
- Overwhelming sadness or frequent crying
- Loss of interest in activities, including caring for your baby
- Difficulty bonding with your newborn
- Severe anxiety or panic attacks
- Feelings of worthlessness or inadequacy as a mother
- Thoughts of harming yourself or your baby
“I had clients who couldn’t answer simple questions about what they wanted for dinner because the depression made every decision feel insurmountable,” Brabec explains. “That level of impairment is a clear signal that professional help is needed.”
Postpartum Anxiety: When Your Brain Won’t Turn Off
While postpartum depression gets more attention, postpartum anxiety is equally common and often more debilitating. Unlike general new-parent worry, postpartum anxiety involves racing thoughts, constant worst-case-scenario thinking and physical symptoms like heart palpitations or difficulty breathing.
Brabec experienced this firsthand after her own children were born. “I remember obsessing over the sharp edges of countertops, convinced my baby would somehow get hurt. Even when everything was fine, my brain kept generating new catastrophes to worry about.”
Mothers with postpartum anxiety often can’t sleep even when the baby is sleeping. They may develop rigid routines or rules, feeling that any deviation could lead to disaster. The need for control becomes all-consuming.
Perinatal OCD: When Intrusive Thoughts Take Over
Perhaps the most frightening postpartum condition is perinatal obsessive-compulsive disorder. Mothers experience intrusive thoughts — often violent or disturbing images of harm coming to their baby — that they can’t control.
“These thoughts are terrifying, but they’re also a symptom, not a prediction or desire,” Brabec emphasizes. “Mothers with perinatal OCD are horrified by these thoughts, which is actually what distinguishes OCD from psychosis. They don’t want to act on them — they’re desperately trying to prevent them.”
Common intrusive thoughts include images of dropping the baby, fears of contamination or disturbing sexual thoughts. Mothers may develop compulsive behaviors like excessive cleaning, repeatedly checking the baby’s breathing, or avoiding situations where they fear they might lose control.
Postpartum PTSD: When Birth Becomes Trauma
Not all births go as planned. Emergency C-sections, frightening complications, feeling ignored or violated during labor — these experiences can lead to post-traumatic stress disorder.
Mothers with postpartum PTSD may experience:
- Flashbacks or nightmares about the birth
- Avoidance of the hospital, doctor’s offices or conversations about childbirth
- Hypervigilance and difficulty relaxing
- Emotional numbness or detachment
- Severe anxiety about future pregnancies
“I’ve worked with mothers who couldn’t drive past the hospital where they gave birth without having a panic attack,” Brabec notes. “The trauma can be that visceral.”
Who’s at Risk? Risk Factors for Perinatal Mental Health Disorders
While PMADs can affect any mother regardless of circumstances, certain factors increase risk:
Medical and biological factors:
- History of depression, anxiety or other mental health conditions
- Hormonal changes and imbalances
- Previous pregnancy loss or traumatic birth
- Thyroid dysfunction
- Complications during pregnancy or delivery
Social and environmental factors:
- Lack of social support or isolation
- Relationship problems with a partner
- Financial stress
- Unplanned or unwanted pregnancy
- History of abuse or trauma
Lifestyle factors:
- Sleep deprivation (beyond typical newborn care)
- Difficulty breastfeeding or feeding challenges
- High-need or colicky baby
- Multiple births (twins, triplets)
Importantly, PMADs don’t just affect birthing mothers. Research shows approximately 1 in 10 non-birthing partners experience postpartum depression or anxiety, facing many of the same risk factors and symptoms.
Breaking the Silence: Why Moms Don’t Ask for Help
Despite how common perinatal mental health disorders are, many mothers delay seeking help for months — or never seek it at all. The barriers are both internal and external.
The myth of the “good mother”: Social media, advertising and cultural messaging paint motherhood as instinctive and blissful. When reality doesn’t match expectations, mothers internalize shame rather than recognizing they’re experiencing a medical condition.
Fear of judgment: Many mothers worry that admitting they’re struggling will lead to judgment from family, friends or even healthcare providers. Some fear their baby will be taken away if they’re honest about thoughts of harm.
Lack of screening: While postpartum depression screening has improved, many mothers slip through the cracks. Some providers only screen at the six-week postpartum visit, missing mothers who develop symptoms later. Others never screen non-birthing partners.
Minimization: Well-meaning friends and family often dismiss concerns with phrases like “all new moms are tired” or “you just need to get out more.” This minimization makes mothers question whether their experience warrants professional help.
“One of the most powerful things I can tell a struggling mother is: ‘This is not you. This is a symptom,'” Brabec says. “Separating the disorder from their identity as a mother is often the first step toward recovery.”
Getting Help: What Treatment Looks Like
The good news: perinatal mental health disorders are highly treatable. Most mothers who receive appropriate care see significant improvement, often within weeks.
Therapy Options
Cognitive Behavioral Therapy (CBT): Helps mothers identify and change negative thought patterns and behaviors contributing to depression or anxiety.
Interpersonal Therapy (IPT): Focuses on improving relationships and communication, particularly helpful for mothers experiencing relationship strain.
Exposure and Response Prevention (ERP): Specifically designed for OCD, this therapy helps mothers gradually face feared situations without performing compulsive behaviors.
EMDR (Eye Movement Desensitization and Reprocessing): Effective for processing birth trauma and postpartum PTSD.
Medication
Many mothers benefit from medication, either alone or in combination with therapy. Common options include SSRIs (selective serotonin reuptake inhibitors), which are generally considered safe during breastfeeding. A perinatal psychiatrist can help determine the best medication based on symptoms, medical history and feeding preferences.
“There’s often guilt around taking medication, especially while breastfeeding,” Brabec notes. “But an untreated mother struggling with severe depression or anxiety can have long-term impacts on both her and her baby’s wellbeing. Medication can be the intervention that allows her to show up as the mother she wants to be.”
Support Groups
Connecting with other mothers experiencing similar challenges reduces isolation and provides practical coping strategies. Both in-person and online support groups can be valuable components of recovery.
Practical Support
Sometimes the most helpful interventions are practical: meal delivery, help with household tasks, childcare support so the mother can sleep or attend therapy appointments. Recovery isn’t just clinical — it requires addressing the exhaustion and overwhelm of early parenthood.
Where Omaha Moms Can Find Help
Immediate Crisis Resources
If you’re experiencing thoughts of harming yourself or your baby:
- Call 988 (Suicide and Crisis Lifeline)
- Text “HELP” to 741741 (Crisis Text Line)
- Call Postpartum Support International: 1-800-944-4773
- Go to your nearest emergency room
Local Omaha Mental Health Providers
Specialized Perinatal Therapists: Look for licensed therapists with specific training in perinatal mental health through:
- Psychology Today’s directory (filter for “postpartum depression”)
- Postpartum Support International’s provider directory
- Referrals from your OB-GYN or pediatrician
Rachel Brabec is one of several Omaha practitioners with advanced training in perinatal mental health. She co-founded a local perinatal consultation group, creating a network of providers specifically equipped to support mothers through pregnancy and postpartum challenges.
Support Groups and Community Resources
Milk Works: This Omaha-based breastfeeding support organization offers lactation help and general postpartum support. Their consultants are trained to recognize signs of PMADs and connect mothers with additional resources.
Lean In: Provides free support groups for new parents navigating early parenthood challenges.
Postpartum Support International: Offers free online support groups for specific situations, including groups for mothers experiencing anxiety, depression, loss, NICU experiences and non-birthing partners.
Starting the Conversation with Your Doctor
If you’re hesitant about seeing a mental health specialist, start by talking to any healthcare provider you trust:
Your OB-GYN: Many obstetricians now provide postpartum mental health screening and can prescribe medication or refer you to specialists.
Your pediatrician: Increasingly, pediatricians screen mothers during well-child visits, recognizing that maternal mental health directly impacts infant wellbeing.
Your primary care doctor: Can provide initial assessment, prescribe medication and connect you with mental health resources.
You don’t need a formal diagnosis or even a clear sense of what’s wrong to start the conversation. Simply saying “I’m not okay” or “I’m struggling more than I expected” is enough.
What Partners and Family Can Do
If someone you love is struggling postpartum, your support can be life-changing. Here’s how to help:
Believe them: Don’t minimize their experience or suggest they just need more sleep or time. Take their concerns seriously.
Help them access care: Offer to research therapists, make phone calls or attend appointments with them. The overwhelm of depression and anxiety can make these tasks feel impossible.
Provide practical support: Take over specific household tasks, bring meals, hold the baby so they can shower or sleep. Practical help reduces the burden that exacerbates mental health struggles.
Educate yourself: Learn about PMADs so you can recognize symptoms and understand what your loved one is experiencing.
Take care of yourself: Partners and family members can also experience burnout, anxiety and depression. Seek your own support if needed.
“Sometimes the most powerful support is just showing up,” Brabec reflects, recalling times she’s simply sat with struggling mothers, offering presence without trying to fix everything. “A meal drop-off, a hug, acknowledging how hard this is — these gestures matter tremendously.”
The Path Forward: Normalizing Maternal Mental Health
The conversation around perinatal mental health is slowly shifting. More healthcare providers are screening for PMADs. More mothers are speaking openly about their struggles. More research is uncovering the biological, social and environmental factors that contribute to these conditions.
But gaps remain. Many mothers still don’t receive screening. Many insurance plans inadequately cover mental health care. Many communities lack providers with specialized perinatal training.
What’s needed is cultural change: recognizing that maternal mental health is as important as physical health during pregnancy and postpartum. That asking for help is a sign of strength, not weakness. That the transition to motherhood is profound and challenging, even when you desperately wanted your baby.
“Every mother deserves to feel joy in her motherhood journey,” Brabec says. “When that joy is obscured by depression, anxiety or trauma, help is available. These conditions are temporary and treatable. You can feel like yourself again.”
Frequently Asked Questions
How long does postpartum depression last? Without treatment, postpartum depression can persist for months or even years. With appropriate treatment, most mothers see significant improvement within weeks to months. Early intervention typically leads to faster recovery.
Is some anxiety normal after having a baby? Yes — some worry about your newborn is expected. Postpartum anxiety becomes a concern when it interferes with daily functioning, prevents sleep even when the baby sleeps or causes significant distress. If your worry feels overwhelming or constant, discuss it with a healthcare provider.
Can postpartum depression start during pregnancy? Absolutely. Perinatal depression can begin during pregnancy (prenatal or antenatal depression). Some studies suggest up to 70% of postpartum depression actually begins during pregnancy, making prenatal mental health screening crucial.
Will I need medication? Treatment varies by individual. Some mothers benefit from therapy alone, while others find medication helpful or necessary. Many use a combination. Work with a provider familiar with perinatal mental health to determine the best approach for your situation. Many medications are compatible with breastfeeding.
What if I’m having scary thoughts about harming my baby? Intrusive thoughts about harm are a common symptom of perinatal OCD and don’t mean you’ll act on them. However, these thoughts cause significant distress and warrant professional help. If you’re concerned you might act on these thoughts, seek immediate crisis support. The fact that these thoughts disturb you is actually a positive sign — it means you want to protect your baby and need help managing the anxiety disorder causing these intrusive thoughts.
Can my partner get postpartum depression? Yes. Research shows 1 in 10 non-birthing partners experience postpartum depression or anxiety. Partners face significant life changes, sleep deprivation and stress. Support and resources are available for partners experiencing perinatal mental health challenges.
If you’re struggling with your mental health during pregnancy or after giving birth, you deserve support. Reach out to a healthcare provider, call Postpartum Support International at 1-800-944-4773, or connect with local Omaha resources. You are not alone, and with the right help, you can feel like yourself again.
For more resources on maternal mental health and parenting in Omaha, listen to the Omaha Mom Talks podcast hosted by Jessie Gutierrez, a mental health therapist and mom exploring the realities of motherhood in the Omaha community.
