Five Tips to Protect Your Postpartum Mental Health

From a Postpartum Doula and a Parental Leave Expert

Our culture has a script for preparing for birth. We write birth plans. We see the doctor every few weeks. We take classes. We hire doulas. We brief our partners on what to expect in the delivery room. We read the books, listen to the podcasts, and pack the hospital bag. By the time we walk in, the day has been rehearsed for months.

Then the day ends. The baby comes home. And the script runs out.

May is Maternal Mental Health Month, and we are passionate about raising awareness around how to prevent the onset of Perinatal Mood and Anxiety Disorders (PMADs) for postpartum mothers. One in five birthing parents will experience a perinatal mood or anxiety disorder, and the majority of those cases surface after delivery, not during pregnancy. PMADs are among the most common complications of childbirth in the United States, and most of them go untreated. The cultural preparation we do for birth has no equivalent for what comes after.

So this is our version of an equivalent. Five tips from a postpartum doula and a parental leave expert who watch this stretch of life from different angles. Kelly Brusch has supported 400+ parents as a certified postpartum doula for the past 8 years and is the founder of Doulas of San Diego. Linzay Davis has helped thousands of parents strategically maximize their parental leave so they can spend more paid time at home after welcoming a baby and is the founder of Hello, Bundle.

If you are still pregnant, these are five things to line up before baby comes. If your baby is already here, these are five things that can quickly make life better and protect your mental health right now. All of them work better in place than scrambled for. None of them are too late to start.

1. Hire overnight postpartum care

An overnight postpartum doula comes into your home at night, takes care of you and your baby, and helps you get more sleep — even if you are breastfeeding. She brings the baby to you for feeds if you are nursing or pumping and is trained to triage common challenges new parents face in these areas; otherwise she handles the bottle. She manages diapers, soothing, and any nighttime fussing in between. You wake up rested. She leaves a written log of the night before she goes home in the morning. You parent your baby better the next day. Repeat.

Most families hire overnight care because they want more sleep, and they get it. What surprises them is the second thing that comes with the sleep: their mental health holds.

About 1 in 5 birthing parents will experience a perinatal mood or anxiety disorder. PMADs are not caused by one bad night. They are correlated with sustained sleep loss across weeks and months. New parents who get one or two or more stretches of consolidated sleep a week, every week, in the early postpartum period are meaningfully better protected from the kind of accumulated exhaustion that mood disorders feed on.

Sleep is the mechanism. Mental health is the product.

Overnight care does not prevent mood disorders. It does not replace therapy. What it does is buy you the rest and the bandwidth to notice if something more is going on and to act on it.

Why six weeks is the minimum

Anything less stops right when sleep loss compounds and PMADs are most likely to surface. After years of doing this work, we have learned that families who book only two weeks of overnights almost always regret it. They are not finished recovering at week two. The hardest stretch has barely started. Six weeks is the floor for the kind of recovery overnight care is designed to support.

What to look for when hiring overnight care after baby is born

• A team of doulas, not a one-doula arrangement. Six weeks of overnights is too many shifts for one human to cover well without burning out. The doula agencies that get this right build their teams around 1–2 primary doulas with backup coverage, so that families always have someone showing up, even when life happens on the doula side.
• Quality certification. Doulas are not licensed or a regulated profession — anyone can call themselves a doula. Look for a doula who holds and maintains certification from a reputable doula training organization. Our favorite is ProDoula!
• A documented model for what happens during the shift. If they cannot describe it, they do not have one.
• A clean answer to: "What happens if my doula is sick the night of?" If the answer is "she will find a way," that is not a system. If she says she has a backup, ask more questions: how does she vet the backup? Does she use the same person? Why would that person be available on a whim with short notice?

If you are in San Diego County, Doulas of San Diego does this best. If you are anywhere else, ask the questions and trust your gut on the answers.

2. Strategically build your parental leave plan to maximize your time and pay

Parental leave in the US isn't one benefit, or even a few. It's a patchwork of more than a dozen overlapping, complicated programs, and most parents have no idea what they qualify for, how those benefits stack together, or how to apply. They ask HR. They ask their manager. They ask their doctor. And they usually walk away more confused than when they started. In this system, you have to be your own advocate.

A few things to get clear on before your leave starts:

Know what you actually qualify for. Most people have heard of FMLA, but that's just the tip of the iceberg. Depending on your state and employer, your leave can include state disability insurance, paid family leave, employer short-term disability, baby bonding leave, and accrued PTO or sick time. And that's just the pay side. You also need to understand job protection, and how the two work together.

And if HR tells you that you don't qualify for something, push back. A lot of parental leave benefits have no minimum tenure requirement, meaning you could be eligible on day one of a new job. HR gets it wrong more than you'd think.

Know how to ask for a disability extension if you need one. Standard postpartum disability is six weeks for a vaginal delivery or eight weeks for a C-section, which, if you've ever had a baby, you know is not a lot of time. If you're experiencing any complications — from postpartum depression or anxiety to carpal tunnel — you may qualify for additional paid, job-protected time off to recover.

Your doctor has to certify any extensions, so tell them what you're actually experiencing. And if they don't bring it up, you can and should bring it up. Ask directly. Nearly every mom qualifies for additional disability time, because six to eight weeks is not enough for most women to fully recover, but the only women who get extra time are those who ask.

Don't assume your leave will look like anyone else's. Your work friend's leave, your sister's leave, even your own last leave — none of it is a reliable blueprint. Every leave is shaped by your employer, your state, your delivery, your recovery, and a dozen other factors. State benefits are constantly changing, we're seeing companies cut their parental leave policies left and right, and we don't know what your recovery will look like until you are actually recovering. The only way to know what your parental leave will look like is to map your own unique situation.

Hello, Bundle is the only nationwide parental leave consulting agency that puts you and your leave goals first. If you have any parental leave questions, join one of their free intro calls.

Once your leave picture is set, the next call to make is the one most parents put off until they need it.

3. Find a therapist who specializes in perinatal mental health (ideally establish care before baby is born)

Perinatal mental health is its own specialty. A therapist who is excellent with adults in general may not be the right person for the specific patterns of postpartum depression, anxiety, OCD, intrusive thoughts, or postpartum PTSD.

There is a credential to look for: PMH-C, Perinatal Mental Health Certified, through Postpartum Support International. This is the credential we look for when we refer.

Where to search:

• Postpartum Health Alliance directory (postpartumhealthalliance.org). San Diego–anchored, with a wider Southern California reach, and a useful starting point even outside the region.
• Postpartum Support International provider directory (postpartum.net). Searchable by state. Filters for PMH-C and telehealth.
• Your insurance member portal, filtered for "perinatal" or "postpartum." Cross-check any name against the PSI directory.

And get the appointment on the calendar before baby comes.

By the time you realize you need care, you're in the middle of it and might not be in a position to call insurance, search a database, vet ten therapists, and book out weeks in advance. If a name and an appointment are already on the calendar, the call to keep it or cancel it is a much smaller decision than the call to find a therapist from zero.

If there is any history of depression, anxiety, or trauma in your background, the case for doing this before baby is even stronger. You may not need the appointment. But if you do, the work of finding it is already done.

A therapist on the calendar is like a fire extinguisher in the kitchen. You hope you do not need it. You are glad it is there.

4. Find a pelvic floor physical therapist

Pelvic floor physical therapy is one of the most underused resources in the postpartum period, and one of the most misunderstood.

A common misconception is that pelvic floor PT is only for parents who delivered vaginally. That's not the case. Pelvic floor PTs are licensed physical therapists with additional certification in the specific demands of pregnancy, vaginal birth, and belly birth recovery. They handle scar tissue work after a cesarean. They handle core rehabilitation. They handle the strange new normals of a body that has just grown and birthed a human, regardless of how that human came out.

They are also frequently covered by insurance, which makes them one of the few postpartum specialists most families do not have to pay out of pocket for.

How to find one:

• Ask your OB, midwife, or pediatrician for a referral. Many will have a name they trust.
• Look for a PT who specializes in perinatal care, not generalists who occasionally see postpartum parents.
• Check what your insurance covers for outpatient physical therapy before you book. Most plans cover a set number of visits per year.
• Schedule the first appointment for the postpartum checkup window, when most providers clear you for return to activity. If something feels off before then, call sooner.

If you have a complicated recovery — an infected incision, a difficult tear, prolapse symptoms, leakage, or pain — this is not a "wait and see." Get on the calendar.

5. Write a postpartum plan

We hear so much about the importance of writing a birth plan. Almost no one writes a postpartum plan.

A birth plan covers roughly 18 to 36 hours. A postpartum plan covers the weeks and months that follow.

A postpartum plan answers questions like:

• Who is bringing food in the first two weeks, and when? Specific names, specific days.
• If you have other children, who is on backup for daycare drop-off and pickup, and who handles the bedtime routine when you cannot?
• Who is the first call when you feel like you might be losing it at 3 a.m.? (Spouse, mom, friend, doula, therapist. Name the person.)
• What gets canceled in the early postpartum period? Standing meetings. Travel. Visitors who are not net positives.
• Which professionals are on your bench: pediatrician, OB or midwife, lactation consultant, perinatal therapist, pelvic floor PT, overnight doula.
• Which household roles get hired, if your budget supports it: house cleaner, meal delivery, postpartum doula, daytime help, house manager.

The point of a postpartum plan is not to control how the postpartum period goes. The point is to remove every decision you can from a sleep-deprived parent at 2 a.m.

Two next steps

1. Join us live on May 27

Linzay Davis of Hello, Bundle, Dr. Ivy Colbert of Empower Physical Therapy, and I are running a free joint workshop on Wednesday, May 27, 2026. We'll cover all of the above in more depth and take live questions. Register for the workshop and you'll get our Postpartum Planning Template automatically. Stay for the live session and Hello, Bundle's Parental Leave Planning Playbook is yours too — it covers exactly what leave you qualify for, how to loop in HR, and how to protect your time and your pay. There may also be a little something from Doulas of San Diego for anyone who joins us live... You'll have to show up to find out. 

Click here to sign up for the live workshop

2. Line up your postpartum support today

The best time to get overnight care on the calendar is before you need it. If you're in San Diego County, we'd love to talk through what support looks like for your family. If you are in San Diego County, we'd love to talk through what support looks like for your family.

Click here to reach out to Doulas of San Diego