You Don’t Have to Power Through: Rethinking Perinatal Mental Health with Dr. Sarah Oreck
Listen to the full episode above, or dive into the key takeaways from this conversation:
Understanding Perinatal Mental Health: More Than Just "Baby Blues"
Perinatal mental health encompasses the emotional and psychological experiences from pregnancy through several years postpartum. As Dr. Oreck emphasizes, "Mood and anxiety issues are the number one complication of childbirth—not gestational diabetes, not hypertension or preeclampsia."
New mom experiencing mental health struggles
Common Perinatal Mental Health Issues and Terms
Postpartum Depression (PPD) affects approximately 10-20% of new mothers, causing persistent sadness, fatigue, and difficulty bonding with your baby.
Postpartum Anxiety (PPA) manifests as excessive worry, racing thoughts, and physical symptoms like rapid heartbeat or difficulty sleeping.
Intrusive Thoughts are unwanted, distressing thoughts about harm coming to your baby—and they're more common than you think.
Matrescence refers to the profound identity shift of becoming a mother, comparable to adolescence in its psychological impact.
Pre-existing Conditions like ADHD, depression, or anxiety often require specialized management during pregnancy and postpartum.
Why High-Achieving Women Struggle to Seek Help
Many accomplished women delay seeking support for perinatal mental health challenges. Dr. Oreck explains: "This is not an individual sport, but motherhood doesn't work the way achievement does."
Barriers to Perinatal Mental Health Care
Provider Shortages: Long wait times for specialized perinatal mental health professionals
Fragmented Care: Disconnected services between OB-GYNs, therapists, and psychiatrists
Internalized Stigma: The belief that "I should be able to handle this myself"
Insurance Challenges: Limited in-network options for specialized care
Time Constraints: Difficulty finding childcare or scheduling around baby's needs
Demystifying Intrusive Thoughts: When Your Brain Goes Into Overdrive
"I have stairs in my home and every time I held my baby, I envisioned we'd tumble down. It's your brain trying to protect the baby," Dr. Oreck shares from her own experience.
The Science Behind Postpartum Intrusive Thoughts
Research shows that postpartum brains undergo significant neurological changes, including heightened activity in the amygdala—your brain's alarm system. These intrusive thoughts often represent your mind's attempt to anticipate and prevent danger.
When Intrusive Thoughts Become Concerning
Normal intrusive thoughts become problematic when they:
Interfere with daily functioning
Lead to avoidance behaviors (like refusing to bathe your baby)
Cause significant distress or impairment
Persist despite reassurance
Revolutionary Approaches to Perinatal Mental Health Care
At Mavida Health, Dr. Oreck has created the comprehensive care model she wished existed during her own perinatal journey.
Integrated Care Features
Specialized Training: All providers receive extensive perinatal mental health education
Multiple Modalities: Individual therapy, couples counseling, and group support
Medication Management: Expert psychiatric care when needed
Insurance Accessibility: In-network with major insurance providers
Holistic Approach: Addressing both mental health and relationship dynamics
Expert Answers to Common Perinatal Mental Health Questions
Medications During Pregnancy and Breastfeeding
Q: Can I continue Wellbutrin or Adderall while pregnant or breastfeeding?
Dr. Oreck provides nuanced, evidence-based guidance for each medication, considering both maternal mental health needs and fetal/infant safety. The decision requires careful risk-benefit analysis with a qualified reproductive psychiatrist.
Natural Support Options
Q: What supplements actually help with anxiety or sleep during the perinatal period?
While supplements aren't regulated like medications, certain options like magnesium, omega-3 fatty acids, and vitamin D may provide modest benefits when used under professional guidance.
Relationship Preparation
Q: How can we prepare our relationship for another baby?
Dr. Oreck emphasizes proactive communication, establishing support systems, and addressing any unresolved issues from previous pregnancies or postpartum experiences.
Creating Your Perinatal Mental Health Action Plan
Proactive Steps for Expecting and New Mothers
Build Your Support Network Early: Identify trusted friends, family members, and professionals before you need them. We highly recommend Mavida Health - Code MYSHA20 will get you 20% off your first visit.
Include Mental Health in Your Birth Plan: Just as you plan for your OB-GYN and pediatrician, secure a mental health provider who specializes in perinatal care.
Normalize Preventive Mental Health Care: Consider therapy for matrescence—the normal but challenging transition to motherhood—not just crisis intervention.
Educate Your Partner: Ensure your support person understands perinatal mental health signs and symptoms.
Know Your Resources: Familiarize yourself with local and national support organizations before delivery.
Breaking the Silence: You Deserve Support
As Dr. Oreck powerfully states: "You don't have to suffer—even if your friends did." The narrative that maternal struggle is inevitable and must be endured in silence is both harmful and false.
Mother holding her infant
Signs It's Time to Seek Professional Help
Persistent sadness or anxiety lasting more than two weeks
Difficulty bonding with your baby
Intrusive thoughts that interfere with daily activities
Changes in appetite or sleep beyond normal newborn disruption
Feeling overwhelmed or unable to cope
Thoughts of self-harm or harming your baby
The Bottom Line: Maternal Mental Health Matters
Perinatal mental health challenges are common, treatable, and nothing to be ashamed of. By understanding the science behind these experiences and knowing when to seek help, you can navigate this transformative period with greater confidence and support.
Remember: prioritizing your mental health isn't selfish—it's essential for both you and your family's wellbeing. You deserve care, support, and the opportunity to thrive during this significant life transition.
Resources for Perinatal Mental Health Support
Postpartum Support International: Comprehensive resources and provider directory
Mavida Health: Specialized perinatal mental health care
(*Code MYSHA20 for 20% off your first visit)
