Held: A guide to perinatal mental health, loss, and finding support
The perinatal period — defined as the time spanning pregnancy through the first year after birth — is one of the most significant transitions a person can experience. It brings with it profound hormonal shifts, identity changes, relational reorganization, and for many, unexpected emotional and psychological challenges.
Perinatal mental health is not a single condition. It is a spectrum — one that encompasses a wide range of experiences affecting birthing people, partners, and families. Understanding what that spectrum looks like, and knowing that help and community exist, can be the difference between suffering in silence and finding a path forward.
The scope of perinatal mood and anxiety disorders
Perinatal mood and anxiety disorders (PMADs) are among the most common complications of pregnancy and the postpartum period — and among the most underdiagnosed. They include depression, anxiety, obsessive-compulsive disorder, post-traumatic stress disorder, and in rarer cases, postpartum psychosis. These conditions can emerge during pregnancy, immediately after birth, or at any point within the first year postpartum.
1 in 5women experience a perinatal mood or anxiety disorder
1 in 10men and non-birthing partners are also affected
~50%of cases go undiagnosed or untreated
Despite how common they are, PMADs remain significantly underreported. Stigma, the cultural pressure to experience new parenthood as purely joyful, and limited screening in clinical settings all contribute to a treatment gap that leaves many people struggling without support.
It is important to note that PMADs are distinct from the "baby blues" — the brief period of emotional lability that affects up to 80% of new mothers in the days immediately following birth, driven largely by the rapid drop in estrogen and progesterone after delivery. The baby blues typically resolve within two weeks. When symptoms persist or intensify beyond that window, a perinatal mood disorder may be present.
What the spectrum looks like
PMADs do not present the same way for everyone. The following conditions fall within the perinatal mental health spectrum:
Postpartum depression (PPD) — Persistent low mood, tearfulness, difficulty bonding, changes in sleep and appetite, feelings of worthlessness or hopelessness. PPD is the most commonly recognized PMAD but is often still dismissed or minimized.
Perinatal anxiety — Excessive worry, racing thoughts, physical symptoms such as heart palpitations and shortness of breath, difficulty sleeping even when the baby sleeps. Anxiety during and after pregnancy is actually more prevalent than depression and is frequently overlooked.
Perinatal OCD — Intrusive, unwanted thoughts, often related to harming the baby. These thoughts are ego-dystonic — meaning they are deeply distressing and not reflective of a parent's wishes or intentions — but they cause significant shame and fear, and often prevent people from seeking help.
Birth-related PTSD — Flashbacks, avoidance, and hyperarousal following a traumatic birth experience. Research suggests up to 9% of women meet criteria for PTSD following childbirth.
Postpartum psychosis — A psychiatric emergency characterized by rapid onset of hallucinations, delusions, disorganized thinking, and severe mood disruption. Rare but serious, affecting approximately 1-2 per 1,000 births, it requires immediate medical attention.
If you or someone you know is experiencing symptoms of postpartum psychosis, please seek emergency care immediately. This is a medical crisis that responds well to treatment when caught early.
Perinatal loss: a grief that deserves to be named
Perinatal loss — encompassing miscarriage, ectopic pregnancy, stillbirth, and newborn death — is far more common than public conversation acknowledges. In the United States, approximately 10–20% of known pregnancies end in miscarriage, and stillbirth affects roughly 1 in 160 pregnancies. These are not rare events. They are losses experienced quietly, often without formal acknowledgment or structured support.
The grief that follows perinatal loss is complex and frequently disenfranchised — meaning it exists in a social context that may not fully recognize or validate its weight. Many bereaved parents report feeling pressure to "move on," fielding well-meaning but minimizing comments, or finding that their loss is treated as less significant because it occurred before birth. Research has consistently shown that perinatal loss can result in prolonged grief disorder, depression, anxiety, and PTSD — and that these outcomes are more likely when adequate support is absent.
Partners grieve too, often in isolation. Siblings may be affected in ways that go unaddressed. Subsequent pregnancies frequently carry profound anxiety alongside hope. All of this deserves clinical attention and compassionate community.
Naming the loss matters. Many families find it meaningful to name their baby, hold a memorial, or find other ways to acknowledge the life that was anticipated. Therapeutic support — and connection with others who understand — is not a luxury in the aftermath of perinatal loss. It is often essential.
What the research tells us about treatment
Evidence-based treatment for PMADs includes psychotherapy — particularly cognitive behavioral therapy (CBT) and interpersonal therapy (IPT), both of which have strong research support for perinatal populations — as well as medication when clinically indicated. The American College of Obstetricians and Gynecologists (ACOG) and the American Psychiatric Association both recommend universal screening for perinatal depression using validated tools such as the Edinburgh Postnatal Depression Scale (EPDS).
From a biopsychosocial perspective, effective care considers the full picture: biological factors such as hormonal shifts and sleep deprivation, psychological factors including attachment history and coping style, and social factors such as partner support, financial stress, and access to community. No single intervention addresses all of these domains — which is why a combination of professional support and peer connection tends to produce the best outcomes.
Importantly, research consistently demonstrates that social support is one of the strongest protective factors against the development and severity of PMADs. Feeling seen, understood, and accompanied — by a partner, a therapist, a support group, or a community of other parents — measurably reduces the burden of perinatal mental health challenges.
Resources in the Syracuse, NY area
Local support — Central New York
Crouse Health — Perinatal Family Support Program
A free support group and individual session program for pregnant and postpartum individuals experiencing anxiety, depression, or difficulty with the transition to parenthood. Open to moms, partners, and babies regardless of where delivery occurred. Virtual sessions available. Led by Christine Kowaleski, DNP, MHNP-BC, Chair of PSI's New York Chapter.
📞 315-470-7940 · crouse.org
Healthy Moms, Healthy Babies — Perinatal Mental Health Clinic
A New York State-operated perinatal mental health clinic serving the Syracuse area. Accepts Medicaid and offers virtual services.
📞 315-426-7783
Hope for Bereaved — Perinatal Loss Support
Offers a support group specifically for loss of an infant through miscarriage, stillbirth, or newborn death. Meets the third Wednesday of every month, 6:30–8:30 p.m.
📞 315-475-9675 · Helpline: 315-475-4673 · hopeforbereaved.com
Ray of Hope for Bereaved Parents
A local support group for bereaved parents meeting the first Tuesday of each month at 7pm at Westminster Presbyterian Church.
Contact: Jenna Heery · 315-253-3331 · rayofhopeforbereavedparents@gmail.com
State & national resources
Postpartum Support International (PSI)
The leading national organization for perinatal mental health. Offers a helpline, online support groups, a provider directory, and a peer mentor matching program. PSI's NY Chapter is active and connected to Crouse Health in Syracuse.
📞 1-800-944-4773 · postpartum.net
National Maternal Mental Health Hotline
Free, confidential support available 24 hours a day, 7 days a week for pregnant and postpartum individuals and their families. Connects callers with counselors and local resources.
📞 Call or text 1-833-TLC-MAMA (1-833-852-6262)
Postpartum Resource Center of New York
A statewide helpline and resource directory offering peer support, education, and referrals. Available 7 days a week, 9am–5pm.
📞 1-855-631-0001 · postpartumny.org
988 Suicide & Crisis Lifeline
For anyone in acute mental health crisis, including postpartum psychosis or thoughts of self-harm. Available 24/7.
📞 Call or text 988
In crisis now? Call or text 988 · or the National Maternal Mental Health Hotline at 1-833-852-6262, available 24/7.
A final word on community
Whatever you are moving through — the fog of postpartum depression, the relentlessness of perinatal anxiety, the quiet devastation of loss — you do not have to navigate it alone. Research supports what many parents already know intuitively: being in community with others who understand makes a difference. It reduces shame. It restores perspective. It reminds us that our struggles are human, not failures.
If you are a partner, a family member, or a friend of someone in the perinatal period, your role matters too. Showing up, listening without trying to fix, and encouraging professional support are among the most meaningful things you can offer.
If this resonates with you and you're considering therapy or simply want to learn more, I'd be glad to connect. Feel free to reach out at cmetzlmft@gmail.com.
You are allowed to need support. Asking for it is not weakness — it is the first act of care for yourself and everyone around you.