Be Mindful of the Postpartum Depression Challenge

According to the American College of Obstetricians and Gynecologists, an estimated 14-23% of pregnant woman deal with depression, and 5-25% experience postpartum depression. It isn’t just the physical changes that new moms have to manage and accept, but also the volatility of the emotional journey that often marks this unique time in a new mom’s life. It’s particularly important for health and exercise professionals to understand the signs of postpartum depression in their clients, including:

• Feeling restless or irritable
• Feeling worthless or guilty
• Having no energy
• Lacking interest in activities previously enjoyed
• Overeating and weight gain
• Feeling sad, depressed or crying an unusual amount
• Inability to eat or extreme weight loss
• Trouble focusing, making decisions or remembering
• Sleeplessness not related to newborn sleep patterns
• Being overly worried about the baby or lacking interest in the baby
• Experiencing headaches, chest pain, heart palpitations, numbness or hyperventilation

If you suspect a postpartum client is battling depression, consult with a mental health professional in your network (without violating client confidentiality) to seek guidance and, when necessary, facilitate a referral to that professional. It is not within the scope of practice of health and exercise professionals to diagnose mental health concerns, but it behooves us to recognize when a postpartum client is struggling. Therefore, it’s crucial to converse with postpartum clients and dial in to how they are feeling and coping while adjusting to their new life dynamics. Building rapport is fundamental, but taking extra steps to care for these special clients is essential to their wellness success and goal achievement.

The Real Focus of Postpartum Recovery 

New moms require a significant amount of recovery time to heal (up to two years depending on the situation) from the trauma the body experienced during pregnancy and delivery. New moms are incredibly strong and focused on caring for a new baby, but the focus also needs to be on self-care to aid the healing process.

The American Council on Exercise gently reminds its professionals that the initial focus following the first six weeks after delivery is “to gradually increase physical activity as a means of relaxation, personal time and a regaining of the sense of control, rather than on improving physical fitness” (American Council on Exercise, 2014). New moms who delivered via cesarean-section will likely require additional time beyond six weeks.

The primary postpartum goal is not to immediately get back to a pre-pregnancy physique. Health and exercise professionals need to understand how to assist new moms in shaping realistic goals focused on self-care and healing rather than on the physical dimension alone. Just as it took time to develop and birth a baby, it will take time to recover. As such, it is essential that you respect the mental challenge this requires.

What Health and Exercise Professionals Can and Should Promote

When your postpartum clients are ready to return to activity, be sure to incorporate more than exercises for new moms. While activity is important for mental health and regaining physical strength, it is not the biggest priority during this time. Instead, educate your clients about other areas that are just as beneficial to health and fitness as physical exercise. For example:

• Rest. The postpartum period is exhausting. It’s important to encourage naps and downtime whenever possible. House chores can wait. Clients can’t pour from an empty cup.
• Flexibility. New moms spend a great deal of time carrying, holding and feeding their newborns. This, by nature, places the body in awkward and contorted positions, which ultimately contributes to soreness, tightness and muscular imbalances. During this time, help your clients focus on flexibility and stretching tight areas of the body. This will aid in reducing discomfort and pain.   
• Light activity. Be sure your postpartum clients have obtained the requisite medical clearance to participate in light activity. Any exercise should be restorative and not overly fatiguing. New moms are already fatigued and benefit from light walking, postnatal yoga, pelvic-floor exercises, light weights and other flexibility routines.
• Nutrition. Nutrition is no less important during the postpartum period than any other period of life. Many new moms choose or have the ability to breastfeed their babies, which requires additional caloric intake. Help clients choose food options that are nourishing to support healing. This is an opportune time to consult with a registered dietitian and offer cooking demonstrations and easy meal-prep options.
• Connectedness. It’s easy for a postpartum client to become laser focused on the care of the baby and less involved with friends or her partner. You can help promote connectedness by offering mommy and me classes for a group of new moms or offer sessions for your postpartum client and her partner. These sessions may take the shape of couples’ yoga or “walk and talk” activities. 

The postpartum period is unique to each new mom; tune into your clients’ needs as you would any other population and shift the focus from physical fitness to a more holistic experience. This time isn’t about training for a marathon or “getting back to one’s old self.” Rather, it’s about fully engaging with a new “normal” and stepping into a new self. 

Author: Dr. Erin Nitschke, NFPT-CPT, NSCA-CPT, ACE Health Coach, Fitness Nutrition Specialist, Therapeutic Exercise Specialist, and Pn1 is a health and human performance college professor, fitness blogger, mother, and passionate fitness professional. She has over 15 years of experience in the fitness industry and college instruction.