Beyond postpartum depression

When new moms feel persistently sad, anxious, or alone, getting the right help is vital – for themselves and their babies. Learn how thousands are finding hope and healing.

“Being a new mom of two is great, but it’s very stressful… I won’t lie,” says Mandi. Two and half years after giving birth to her first daughter, her second arrived in mid-March 2024. “Nights are especially hard with feedings every two to three hours.” Even with great support from her husband, Dan, and both of their families, having two little ones relying on her for everything fuels fear and anxiety at times.

After both births, she faced the added challenge of having her newborns arrive early and needing to spend time in the Special Care Nursery at Newton-Wellesley Hospital. While the nurses were wonderfully supportive, "it was really sad, difficult, and stressful to have to drive home every night without our baby,” Mandi recounts.

Looking out the car window, she’d think about their baby alone, her tiny chest rising and falling, her impossibly small fingers curling and uncurling in the air.

Once their new baby came home this spring, along with the anxiety of caring for her, “I had the constant worry about her sister getting enough attention and love and not feeling displaced.”

Thankfully, Mandi realized she didn’t need to face her fears alone.

During her pregnancy, she sought help from Buffy Sheff Ross, MSW, LICSW, through the Perinatal Mood and Anxiety Disorder Initiative at Newton-Wellesley Hospital—something she wishes she had done before and after her first daughter’s birth.

“Buffy has helped me so much with coping skills like deep breathing, journaling, and asking for—and saying yes to— help from my support network. She is incredibly open and real. She tells it like it is. ‘Mandi, what’s going on?’ she’ll ask. She’ll dig in and we’ll figure it out together.”

“Buffy has taught me how to give myself a bit more grace, to trust myself,” she says. “Who knew how powerful that permission could be?”

The myth of motherhood

Look at pictures, movies, social media. Over and over, we’re bombarded with images of a new mom, blissfully nursing her angelic baby in a perfect, pastel-decorated nursery. Sure, there are many heart-expanding moments of new motherhood, but for some, they can also seem few and far between during those first long hours, days, and sometimes weeks and months of feeling stressed, afraid, and overwhelmed.

Many women have feelings of sadness in the first few days after having a baby, most commonly due to a drop in hormones. For the 10 percent of new mothers who experience postpartum depression, strong feelings of sadness, anxiety, worry, and tiredness persist, often long after giving birth. Such feelings can make it difficult for some mothers to bond with their baby or to take care of themselves and the baby.

What can make postpartum depression even worse is the persistent shame, silence, and stigma surrounding it.

Postpartum depression is treatable

“Why am I crying all the time? Why am I not bonding with my baby? Why am I afraid to be alone with my baby? Why don’t I trust myself? Many new mothers can feel ashamed of having thoughts and feelings like these,” explains Buffy. “And asking for help seems only to compound that shame and feeling of isolation.”

“But we know that people want to feel better and get better, and our program has seen great response and outcome,” she notes. “Postpartum depression is treatable, and we have many resources and strategies to help.”

Launched in 2019, the clinical social worker’s vital role with new moms grew out of the efforts of the Maternity Services Council, a part of NWH’s Community Collaborative. It exemplifies the Collaborative’s unique community-based approach to addressing the most compelling health needs of our neighbors.

The initiative reflects the Council’s special mission to build awareness and improve treatment of pregnancy-related depression—and was made possible in large part through the generosity of the Marriott Daughters Foundation.

The Council also sponsors online and in-person support groups for new mothers, led by Angela Rostami, MSN, CNM, a certified nurse midwife.

As an active part of the Council, Buffy shares members’ deep interest in improving services during pregnancy and after delivery. Together, they embrace education, advocacy, philanthropy, and targeted programs to best meet the needs of new mothers and families.

All about relationships

As with all of NWH’s efforts to respond to community health needs, relationships are key. The perinatal initiative works hand in hand with physicians and practices in identifying anyone with symptoms of or at risk for postpartum depression.

Obstetricians at three local practices—Wellesley Women’s Care, Newton-Wellesley Ob/Gyn and About Women By Women—ask their patients to complete the Edinburgh Postnatal Depression Scale at four points in time: the initial prenatal visit, the 24–30 week prenatal appointment, the six-week postpartum visit, and six months after the baby is born. If a mom’s score on the scale is 10 or more—out of 30—she is referred to Buffy.

“Whether a mom is eager to talk to me because she acknowledges her struggles or is reluctant after a referral from her OB, I always say, ‘I’m here—anytime, you are not alone.’ I tell them I’m here to provide therapy, connect them to therapists in the community, support groups and any other concrete need they may have.”

Her clear message to them: “You will get better. You may feel overwhelmed now, but we will get you the supports you need, and you will feel better!”

What support looks like

Here’s what support can look like. Rather than staying silent and alone, a new mother overcomes cultural shame about therapy and seeks help to feel better and stronger. When an expectant mother has all of the emotions from a prior traumatic birth rise back to the surface, she finds support to face her past trauma and let them go. Yet another mother struggles to get out of bed in the morning after the birth of her child. In her case, Buffy asks what she did to cope before the baby. “She was a runner. So, we got her to put her sneakers back on—asked her friends and family to cover her for a small window of time each day to run—and soon her darkness dissipated.”

“Once we get people talking, once they don’t feel alone, they are on the path to feeling better and stronger,” says Buffy.

Navigating the path of new motherhood

To date, Buffy and her team have helped more than 2,400 patients. The program—and the broader work of the Maternity Services Council—underscores the hospital’s commitment to the community.

“Our relationships with providers continue to grow, there is more trust as we help more women navigate the sometimes-challenging path of new motherhood, and there has definitely been strong word of mouth,” she notes. “We get women seeking our help from all over, not just those in our backyard. We know that what we are doing works and mothers are getting the assistance they need.”

As part of her role, Buffy also provides resources and strategies for mothers who may have trouble conceiving, have miscarried or had a stillbirth, or who had to terminate a pregnancy because of anomalies.

“There can be a lot of loss in the OB world, but there is also a lot of healing and joy,” she reflects. “I love what I do. People will thank me for reaching out, for helping them through a difficult time. In getting to help all these mothers and families, I think we are the lucky ones.”

The power of support

“Give yourself grace and ask for help. Trust your gut. You can do more than you think you can. Listen to your baby and yourself; you will teach each other. You know how to do this!”

Those are just a few of the nuggets of advice that Angela Rostami, MSN, CNM, gives to mothers in her postpartum support groups. A certified nurse midwife, she also brings to the role the perspective of working in Labor and Delivery at Newton-Wellesley.

Sponsored by NWH’s Maternity Services Council, the support groups meet twice a week online and monthly in person at the Weston Public Library. They also have a robust WhatsApp community of various chat chains that offers resources and information about meet-ups in various neighborhoods so mothers can get out of the house for a coffee or a walk and feel understood, supported, and heard by their peers.

“What I see most with mothers who are struggling after their baby’s birth is a deep feeling of lack of control,” Angela says. Without the right support, “this can spiral into anxiety and depression, which in turn can feel like a painfully stuck place.”

“What I love about our support groups is getting to see the growth,” she reflects. “You see moms emerge from feelings of unsteadiness and go on to give advice and anecdotes to the newer moms who join them.”

“I may initiate a topic, but the mothers really lead the groups and support each other through the collective insight of their experiences,” she adds.

Mothers join her groups at different times—while pregnant, still in the hospital with a new infant, six months out and still struggling, or after having a third child and needing a new layer of support.

Topics of conversation can run the gamut from how to cope with guilt around not bonding with their baby, to how to ask for and accept help, to how to handle the fear of returning to work.

“Recently, we had a new mom who was really struggling with the idea of leaving the house. She had so much fear and anxiety around driving alone with her baby, keeping him safe outside the cocoon of home,” says Angela. “Another mom who was attending again after the birth of her second child jumped right in to help. She had had the same fears after having her first child. The group had helped her take baby steps—sit in the back yard with baby, sit in the car with baby, and so forth—until she had the confidence to take that first drive alone with her newborn. Just listening to the veteran mother, you could see relief and hope spread over the new mom’s face.”

Angela reminds her new mothers that there is no one correct way to mother.

“Every family unit—every mom, baby, partner—is unique,” she says. “I love working with these moms; they are strong, and they empower each other, and in so doing, themselves.”