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Maternal mental health

Perinatal mood and anxiety disorders are among the most common complications of pregnancy and childbirth. In CDC survey data from 31 states, about one in eight women who had recently given birth reported symptoms of postpartum depression, and in some states the figure was closer to one in four. Clinical reference literature published by the National Institutes of Health puts perinatal depression at roughly one in seven, and notes that up to half of cases go undiagnosed.

Depression is only part of the picture, since anxiety is at least as common and often goes unnamed. What matters more than any figure: these conditions are common, they are treatable, and they are not a reflection of how much you love your baby or how well you are doing as a mother.

This page explains what these conditions are, where to get help in New York, and what we offer ourselves. If you are reading it because something feels wrong, that instinct is worth acting on.

A note from Anna

Founder

May is National Maternal Mental Health Awareness Month. We think any month is a good month to talk about this.

The move from pregnancy into motherhood is an enormous transition, and the fourth trimester brings a great many feelings with it. Every mother experiences it differently. What is almost universal is the gap between what we expected while we were pregnant and what we actually found once the baby arrived.

I feel as strongly about this organization today as I did in 2004, when it started. The reason is that I have never forgotten the isolation and the anxiety I felt postpartum, or how much getting to know other mothers in those early days helped. Knowing a support network was forming around me made me a happier new mother, and left more room for the joy.

Perinatal mood and anxiety disorders should not be a taboo subject, and they are not one here. If you are feeling low, please say so. Tell your friends, your family, your doctor.

These conditions are treatable. There is a great deal of help in this city, and you should not have to work out on your own which door to knock on.

Anna Grossman
Founder and Director, HRP Mamas
If you need help now Someone is available, day or night 988 — Suicide and Crisis Lifeline. Call or text, 24 hours a day, free and confidential. 1-833-TLC-MAMA (1-833-852-6262) — National Maternal Mental Health Hotline. Call or text, 24 hours a day, free and confidential, for pregnant and postpartum people and their families. English and Spanish, with interpreters in 60 more languages. TTY users dial 711 then the number. NYC 988 — New York City's own crisis and mental health line, formerly NYC Well. Call or text 988, or 1-888-NYC-WELL. Counselors in English, Spanish and Chinese, with interpreters in more than 200 languages. Text HOME to 741741 — Crisis Text Line, any time, for any kind of crisis. 911, or your nearest emergency room — If you are in immediate danger, or if you are having thoughts of harming yourself or your baby.

What these conditions are

PMADs
The term

PMAD stands for perinatal mood and anxiety disorder. Perinatal covers pregnancy, the postpartum period and pregnancy loss. The plural matters: postpartum depression is the condition most people have heard of, but it is one of several, and anxiety is at least as common.

They can begin during pregnancy as well as after birth, they can appear months in rather than in the first weeks, and they can follow any birth, including a straightforward one and a second or third baby after uncomplicated earlier ones.

Baby blues, and what is different

Most new mothers have a period of tearfulness, irritability and feeling overwhelmed in the first days after birth. This is common, it is linked to the enormous hormonal shift after delivery, and it usually settles within about two weeks without treatment.

What is different is when the feelings last longer than that, get worse rather than better, or make it hard to function, sleep when the baby sleeps, or care for yourself and your baby. That is the point at which it is worth speaking to someone, and it is early rather than late to do so.

More than depression

Perinatal depression can look like persistent sadness, but it often looks like numbness, irritability, rage, or a flat absence of feeling toward a baby you expected to feel flooded with love for.

Perinatal anxiety can mean constant worry, a racing mind, physical symptoms, or an inability to sleep even when the baby is asleep. Perinatal OCD often involves intrusive, unwanted thoughts about harm coming to the baby, which are frightening precisely because they are so at odds with what you want. These thoughts are a recognized symptom and are not a sign that you are dangerous.

Birth-related trauma can follow a frightening or unwanted birth experience, and can bring flashbacks, avoidance and hypervigilance. Perinatal mental health conditions after a loss are their own category and deserve their own support.

Postpartum psychosis is rare, but it is a medical emergency. It can involve confusion, not sleeping at all, paranoia, or seeing and believing things others do not. If you or someone around you sees this, go to an emergency room or call 911. It is treatable, and it needs treating immediately.

When to say something

You do not need to reach a threshold to deserve help. There is no minimum level of suffering that qualifies, and you do not have to be sure something is wrong before asking.

Tell your obstetrician, midwife or pediatrician. All of them are used to this conversation and most now screen for it routinely. If it is easier to start anonymously, the hotlines above are free, confidential and staffed around the clock.

Treatment works. Therapy, peer support, medication where appropriate, and practical changes to sleep and support all help, and most people recover fully. Waiting rarely makes it easier.

Where to find help

National
PSI HelpLine — 1-800-944-4773, press 1 for Spanish or 2 for English. Text 800-944-4773 in English, 971-203-7773 in Spanish. Leave a message any time and a trained volunteer returns it. This is a support line rather than a crisis line, and messages are returned between 8am and 11pm Eastern. PSI online support groups — more than fifty free groups led by trained facilitators, including groups for dads and partners, for parents after loss, for military families and for queer and trans parents. PSI provider directory — therapists, psychiatrists and other clinicians with specific training in perinatal mental health, searchable by location. National Maternal Mental Health Hotline — 1-833-TLC-MAMA. Free, confidential, 24 hours a day, by call or text, and open to partners and family as well.

Local New York organizations are listed below. Our provider directory also lists pediatricians, lactation consultants and doulas near the neighborhoods we cover.

In New York

Local
The Motherhood Center — a Manhattan center specializing in perinatal mood and anxiety disorders, offering day programs, individual therapy, medication management and virtual support groups facilitated by licensed perinatal therapists. The Seleni Institute — a nonprofit on the Upper East Side providing maternal and reproductive mental health care, covering pregnancy, infertility, loss and parenting, and training clinicians in perinatal mental health. Postpartum Resource Center of New York — statewide helpline on 1-855-631-0001, open seven days a week, with all calls returned the same day. Free peer support from coaches who have lived through perinatal mental health conditions themselves. English and Spanish, with a language line for others. NYC 988 — the city's free, confidential crisis and referral line, by phone, text or chat, at any hour. New York State Department of Health — official information on perinatal depression, screening and where to find care in the state. 2020 Mom — a national nonprofit working to close gaps in maternal mental health care, with plain-language information for families. The Postpartum Stress Center — treatment and professional training in perinatal mood and anxiety disorders, and the source of much of the clinical writing on the subject.

Call 311 for information about free and low-cost services in New York City.

Further reading

Books

Books our facilitators and members return to. None of them replaces speaking to a clinician, and reading about this is not the same as being treated for it. They are here because several are the things people wish they had been handed in the first weeks.

01This Isn’t What I ExpectedKaren Kleiman and Valerie Davis Raskin · The standard practical guide to postpartum depression, first published in 1994 and revised in a second edition in 2013. Kleiman founded The Postpartum Stress Center, whose 12 hour postpartum depression course our director has completed.
02Good Moms Have Scary ThoughtsKaren Kleiman, illustrated by Molly McIntyre · Familius, 2019. An illustrated book about intrusive thoughts, written for the mother who is frightened by what has gone through her mind and has not told anyone.
03Dropping the Baby and Other Scary ThoughtsKaren Kleiman and Amy Wenzel · 2010. A fuller treatment of unwanted thoughts in motherhood, for parents and for the clinicians who work with them.
04The Postpartum HusbandKaren Kleiman · Written for partners: what postpartum depression looks like from the outside and what actually helps.
05Beyond the BluesShoshana Bennett and Pec Indman · A concise manual covering screening, finding a therapist, and treatment options including medication. Revised regularly, most recently in 2024. Both authors are past officers of Postpartum Support International.
06What No One Tells YouAlexandra Sacks and Catherine Birndorf · Simon and Schuster, 2019. On the emotional shift into motherhood rather than illness, and where the ordinary difficulty ends and a condition begins. Birndorf co-founded The Motherhood Center here in New York.

We do not earn anything from these listings and none of the authors is affiliated with us.

What we offer

Members
Peer support, alongside care

Our free weekly groups for expectant and new mothers are peer support: parents who have been where you are, led by experienced facilitators. Research links peer support to better maternal wellbeing and a lower risk of postnatal depression, and the groups are one of the reasons members tell us the first year felt survivable.

They are not therapy and not medical care, and they do not replace either. If something feels heavier than a hard week, please speak to a clinician as well as coming along. Both at once is the right answer more often than either alone.

Members can also post sensitive questions anonymously through our admins, so that nobody has to put their name to something they would rather ask quietly.

For partners and family

Partners get these conditions too. Paternal and non-birthing-parent depression is real, under-recognized and treatable, and the hotlines and PSI groups above are open to partners.

If you are worried about someone: say what you have noticed rather than asking whether they are fine, offer a specific practical thing rather than a general offer, and know that you can call the hotlines yourself for advice about how to help. You do not need her permission to ask a professional what to do.

One more time

You are not alone, you are not to blame, and with help you will be well.

Postpartum Support International, an organization our facilitators have trained with, has said this to parents for decades, and it holds. These conditions are common and they respond to treatment. Reaching out early is not an overreaction.

Our support groups Join us
Please note

Inclusion in these lists is not an endorsement by the Hudson River Park Mothers Group. This page is offered for general information only and is not medical, legal or other professional advice. Prevalence figures are from the Centers for Disease Control and Prevention, Vital Signs: Postpartum Depressive Symptoms and Provider Discussions About Perinatal Depression, United States, 2018 (MMWR, 2020), and from Perinatal Depression, StatPearls, National Library of Medicine. If something here is out of date, please tell us.