Perinatal and Postpartum Psychiatry
Pregnancy and the transition into parenthood can bring excitement, anticipation, uncertainty, and significant emotional change. Alongside moments of joy, many women experience anxiety, self-doubt, intrusive thoughts, overwhelm, mood changes, or emotions that don’t always match what you expected this season of life to look like.
At Sunstone Psychiatry for Women, we provide specialized perinatal and postpartum psychiatry before, during, and after pregnancy.
Whether you’re experiencing anxiety during pregnancy, postpartum depression, intrusive thoughts, overwhelming worry, or emotional changes that leave you feeling unlike yourself, our goal is to help you feel more balanced and more confident throughout your parenthood journey.
Understanding Perinatal & Postpartum Psychiatric Care
Perinatal and postpartum psychiatry focuses on mental health during pregnancy and throughout the first year after childbirth. Because treatment decisions must account for hormonal changes, reproductive health considerations, and major life adjustments, care during this stage may require a more specialized approach.
At Sunstone Psychiatry for Women, our focus is not just on treating symptoms. We work to understand the full picture of what you’re navigating so we can create a treatment plan that aligns with your mental health, your goals, and the life you’re building. Whether you’re pregnant, adjusting to postpartum recovery, breastfeeding, or planning for future pregnancies, our care is tailored to meet you where you are.
Why Pregnancy & Postpartum Changes Impact Mental Health
For many women, pregnancy and the postpartum period bring physical, emotional, and lifestyle changes that can influence mental health in meaningful ways. While these changes are often temporary, they can sometimes contribute to symptoms that begin to interfere with daily life, relationships, or overall functioning.
Hormonal Changes
Sleep Disruption
Interrupted sleep and physical recovery can make it more difficult to manage stress and emotional challenges.
Life & Identity Changes
Becoming a parent often brings changes in relationships, routines, responsibilities, and one’s sense of self.
Mental Health History
Previous experiences with anxiety, depression, trauma, or mood disorders can increase vulnerability during this stage of life.
Seeking care is not a sign of failure or weakness. It is an opportunity to better understand what you're experiencing and explore options for feeling more like yourself again.
Maternal Mental Health by the Numbers
Approximately 16% of mothers in Philadelphia report postpartum depressive symptoms.
Mental health conditions and substance use disorders are the leading causes of pregnancy-associated deaths in Pennsylvania.
Fewer than 20% of women are screened for maternal mental health disorders.
Signs It May Be Time to Seek Support
If any of these feel familiar, you are not alone. A psychiatric evaluation can help you better understand what you’re experiencing and explore treatment options that fit your needs. You may benefit from a psychiatric evaluation if you are experiencing:
- Ongoing sadness, hopelessness, or emotional numbness
- Excessive worry or anxiety that feels difficult to control
- Intrusive or distressing thoughts
- Panic attacks or intense fear
- Difficulty bonding with your baby
- Significant mood changes during pregnancy or the postpartum period
- Sleep disruption that worsens emotional symptoms
- Uncertainty about medication during pregnancy or breastfeeding
Conditions We Treat
Mental health concerns during pregnancy and the postpartum period can show up differently for every woman. Our team provides psychiatric evaluation and medication management for a range of perinatal and postpartum conditions.
Perinatal Mood & Anxiety Disorders (PMADs)
A group of maternal mental health conditions that can occur during pregnancy and throughout the postpartum period.
Perinatal & Postpartum Depression
Persistent sadness, hopelessness, emotional numbness, guilt, or loss of interest that extends beyond the typical “baby blues.”
Perinatal & Postpartum Anxiety
Excessive worry, racing thoughts, panic symptoms, and constant fear related to pregnancy, childbirth, or your baby’s well-being.
Perinatal & Postpartum OCD
Distressing, unwanted thoughts that may feel frightening or difficult to control, often accompanied by compulsive behaviors or reassurance-seeking.
Medication Management During Pregnancy & the Postpartum Period
Deciding whether medication is right for you during pregnancy or the postpartum period can be a difficult decision to make. At Sunstone, we help women navigate these decisions with clarity, education, and support.
01
Personalized Recommendations
Treatment plans tailored to your symptoms, medical history, and stage of pregnancy or postpartum recovery.
02
Risk & Benefit Discussions
Clear conversations about medication options, safety considerations, and what to expect during treatment.
03
Ongoing Monitoring
Regular follow-ups and adjustments to ensure your care remains effective throughout pregnancy, the postpartum period, or breastfeeding.
When medication is appropriate, recommendations are made thoughtfully and collaboratively, with careful consideration of your symptoms, treatment goals, stage of pregnancy or postpartum recovery.
Why Choose Sunstone
Women-Centered Care
Our care is designed around the many factors that can influence women’s mental health, from hormonal changes and reproductive health to relationships, responsibilities, and major life transitions. We take the time to understand your unique circumstances so treatment reflects the full context of your life.
Convenient Telehealth
We recognize how full and demanding life can be, especially during pregnancy and the postpartum period. That’s why our telehealth appointments make it possible for you to receive specialized psychiatric care from the familiarity and privacy of your home.
Specialized Perinatal Expertise
Perinatal mental health is one of our core areas of focus. We provide psychiatric care informed by the emotional, hormonal, and life-stage factors that can influence mental health during pregnancy and the postpartum period.
Collaborative Treatment
We believe patients feel their best when they feel heard. Our approach is collaborative and personalized, taking into account your symptoms, goals, overall well-being, and comfort level.
Our Clinical Collaboration with The Postpartum Stress Center
Sunstone Psychiatry for Women is proud to collaborate with The Postpartum Stress Center, a nationally recognized psychotherapy practice founded by Karen Kleiman, MSW, LCSW, and specializing in perinatal mental health. Together, our practices support coordinated psychiatric and psychotherapeutic care when appropriate and with each patient’s consent.
The Postpartum Stress Center, LLC, founded in 1988 by Karen Kleiman, is a pioneering psychotherapy practice specializing in perinatal mental health and has been serving women and families for more than three decades. Its mission extends through the Karen Kleiman Training Center, which offers professional education and advanced clinical training for maternal mental health providers. The Center provides individual and couples therapy, support groups, and expert care for pregnancy and postpartum mood and anxiety disorders, serving as a trusted resource for individuals and families seeking specialized support. Beyond perinatal care, it also offers a full range of psychotherapy services for individuals, couples, and families across the lifespan.
Start Your Postpartum Mental Health Journey Today
Perinatal Psychiatry FAQs
What Defines Postpartum Baby Blues, Postpartum Depression, and Postpartum Psychosis?
Having a baby brings big emotional changes. Many new parents feel more emotional than usual in the weeks after delivery — and most of the time this is normal and temporary. But sometimes these feelings become more serious and need professional care. Knowing the difference can help you get the right support at the right time.
This guide explains three different conditions that can happen after childbirth. They are not the same thing, and they range from very common and mild to rare and serious.
Baby Blues
The “baby blues” are very common and usually go away on their own. Up to 8 in 10 new mothers experience them.
- When it starts: Usually in the first few days after delivery, often peaking around days 3 to 5 (around the time your milk comes in).
- How long it lasts: A short time — symptoms usually fade on their own within about 2 weeks.
- What it feels like: Mood swings, crying easily, feeling irritable or anxious, trouble sleeping, and feeling overwhelmed. These feelings come and go and do not stop you from caring for yourself or your baby.
- What helps: Rest when you can, accept help from others, and give yourself time. No medical treatment is usually needed.
Important: If these feelings last longer than 2 weeks, get more intense, or start to interfere with daily life, it may be more than baby blues — reach out to us.
Postpartum Depression
Postpartum depression is a real medical condition that is treatable — and it is common. It is more than the baby blues.
- When it starts: Any time from delivery through the first year, most often within the first few months. Sometimes it actually begins during pregnancy.
- How long it lasts: Symptoms last more than 2 weeks, happen almost every day, and last most of the day. Without treatment it can last for months.
- What it feels like:
- Persistent sad, empty, or hopeless mood
- Loss of interest or pleasure in things you used to enjoy
- Trouble bonding with your baby
- Changes in sleep or appetite beyond what the baby causes
- Feeling worthless, guilty, or like a “bad parent”
- Trouble concentrating
- Excessive worry or anxiety about the baby
- Thoughts of harming yourself or feeling life is not worth living
- What helps: Postpartum depression responds well to treatment. Talk therapy (such as cognitive behavioral therapy or interpersonal therapy) is a first-line option, and medications are safe and effective when needed — including options compatible with breastfeeding. You do not have to wait it out alone.
Important: If you ever have thoughts of harming yourself or your baby, treat it as urgent — contact us right away, call or text 988 (the Suicide and Crisis Lifeline), or go to the nearest emergency room.
Postpartum Psychosis
Postpartum psychosis is rare but is a medical emergency. It needs immediate help — do not wait. It affects about 1 to 2 out of every 1,000 births.
- When it starts: Suddenly, usually within the first 2 weeks after delivery — often within the first few days.
- What it feels like: Symptoms can come on fast and may change quickly from hour to hour:
- Seeing, hearing, or believing things that are not real (hallucinations or delusions)
- Feeling confused, disoriented, or “not yourself”
- Severe mood swings, racing thoughts, or unusually high/elevated energy
- Extreme suspicion, fear, or restlessness
- Behaving in ways that are out of character
- Thoughts of harming yourself or your baby
- What to do: This is an emergency. Call 911, go to the nearest emergency room, or call/text 988 immediately. A person with these symptoms should not be left alone and should not be left alone with the baby until they have been evaluated. With prompt treatment, people recover.
What is the difference between postpartum anxiety and postpartum OCD?
Postpartum anxiety is a general term for excessive worry and fear that many mothers experience after having a baby. It can show up as constant worrying (often about the baby’s health or safety), feeling on edge or unable to relax, racing thoughts, trouble sleeping even when the baby is asleep, a racing heart, or physical tension.
Postpartum OCD is a specific type of anxiety condition. In OCD, the worry takes the form of “obsessions”—unwanted, disturbing thoughts that pop into the mind over and over—usually followed by “compulsions,” which are repeated actions or mental rituals a mother does to try to make the anxiety go away or keep her baby safe (for example, checking many times whether the baby is breathing, cleaning or washing over and over, or avoiding being alone with the baby).
In short, all postpartum OCD involves anxiety, but not all postpartum anxiety is OCD—OCD is set apart by that repeating cycle of intrusive thoughts and the rituals done in response to them.
WHAT ARE INTRUSIVE THOUGHTS?
An “intrusive thought” is an unwanted, upsetting thought, image, or mental “what if” that suddenly enters your mind without you wanting it or meaning to have it. In postpartum OCD, these thoughts are often frightening and center on something bad happening to the baby—such as the baby being harmed by accident or even a scary thought of harming the baby yourself. It is very important to understand that these thoughts are not wishes or intentions, and they do not mean you will act on them or that you are a bad parent. In fact, mothers with OCD find these thoughts horrifying and go out of their way to keep their baby safe—which is exactly the opposite of wanting them to happen. Their disturbing, unwanted nature is what causes so much distress, and it is also what distinguishes them from the very different, dangerous beliefs seen in postpartum psychosis
Is it normal to feel this way during pregnancy or after having a baby?
Emotional ups and downs are common, but persistent sadness, anxiety, or intrusive thoughts that interfere with daily life or bonding with your baby may indicate a treatable perinatal mental health condition, not a personal failing.
When should I seek help?
Contact Sunstone Psychiatry if:
- Sad, anxious, or overwhelmed feelings last longer than 2 weeks
- Your symptoms are getting worse instead of better
- You are having trouble caring for yourself or your baby
- You just don’t feel like yourself and want support
Seek emergency help right away (call 911, go to the ER, or call/text 988) if you or someone you love has:
- Any thoughts of harming yourself or your baby
- Hallucinations, delusions, severe confusion, or sudden dramatic changes in behavior
Reaching out is a sign of strength, not weakness. These conditions are common, they are not your fault, and they are treatable. We are here to help.
Is medication safe during pregnancy or while breastfeeding?
When mental health symptoms go untreated during pregnancy, they can raise the chances of problems like early delivery, low birth weight, difficulty bonding with the baby, and worsening depression after birth—and in serious cases they can put a mother’s own life at risk. Most commonly used mental health medications, such as certain antidepressants, have a strong track record and are not linked to meaningful increases in birth defects. A few medicines are better avoided or need closer monitoring, so the best approach is to work with your care team to choose the right medication and dose, keep taking what works, and check in regularly throughout pregnancy and after delivery. The goal is to keep you well, because a healthy mom is one of the best things for a healthy baby.
Do you accept insurance?
Sunstone is a self-pay, out-of-network practice. A superbill is available upon request for potential out-of-network reimbursement.
Are you currently accepting new patients?
Yes, we are currently welcoming new patients. You can get started by completing our online inquiry form.
Let’s get you started. We’re here to help.
Whether you’re navigating anxiety, hormonal shifts, or the challenges of the peripartum and perimenopausal years — or simply feeling overwhelmed — Sunstone Psychiatry for Women is here for you.
have questions before submitting an inquiry form?
If you’re unsure whether our practice may be a good fit, we’re happy to answer questions before you complete an inquiry form.
Sources
- Maternal Mental Health Leadership Alliance (MMHLA). Maternal Mental Health Fact Sheet. https://policycentermmh.org/maternal-mental-health-fact-sheet/
- University of Pennsylvania Leonard Davis Institute of Health Economics. Maternal deaths surge after birth, with mental health a key factor. https://ldi.upenn.edu/our-work/research-updates/maternal-deaths-surge-after-birth-with-mental-health-a-key-factor/
- City of Philadelphia Department of Public Health. Community Health Assessment Report (CHART). https://www.phila.gov/media/20220930121445/CHARTv7e2.pdf
- National Center for Biotechnology Information (NCBI / PMC). Perinatal Mental Health Research Overview. https://pmc.ncbi.nlm.nih.gov/articles/PMC9681705/