By Dr. Barbara “Bobbie” Decker
I have spent my career studying the brain.
As a neurologist, I understand how complex, powerful, and delicate the brain is. I have treated patients through migraines, seizures, and neurological conditions across every stage of life—from family planning through pregnancy, postpartum, and menopause. I have explained the ways hormones influence the brain, the importance of sleep, and how chemistry matters.
Despite all this knowledge, I still lost touch with my own mind.
After the birth of my child, I experienced postpartum psychosis. Intrusive thoughts entered my mind. I became detached from reality. And I was terrified of what I might do to myself or, worse, to my baby.
Although mental health complications after childbirth are not rare, they are rarely talked about. And they can happen to anyone. Even to someone like me—someone trained to recognize them, surrounded by support, and with layers of safety nets.
Experiencing maternal mental health complications is not about knowledge. It is not about strength. And it is certainly not about being a good or bad mother. It is about the brain — and sometimes, the brain needs help.
Maternal, or perinatal, mental health conditions are not uncommon. As many as one in five women are affected—and for women of color, that number is even higher. Included are a wide range of conditions that can occur during pregnancy and up to a year after delivery. Many women experience the “baby blues,” which impact up to 85% of mothers and typically resolve within a couple of weeks. But there is a broader spectrum of potential conditions: postpartum depression, anxiety, obsessive-compulsive disorder, post-traumatic stress, bipolar disorder, and, in rare cases, psychosis.
Sadly, too many suffer in silence.
One of the most harmful misconceptions I encounter is the belief that struggling mentally after having a baby means you are failing as a mother. Many women feel guilt, shame, or fear—especially when their thoughts don’t match how they believe they are supposed to feel.
Some mothers experience intrusive or frightening thoughts. Others feel disconnected, overwhelmed, or unable to care for themselves. In more severe cases, women may entirely lose touch with reality. These are not character flaws. These are medical symptoms.
My own experience has changed how I practice medicine. I ask more questions. I listen more closely. I am more intentional about checking in—not just physically, but emotionally—because I know how easy it is for a person to hide what they’re going through.
I also know how isolating it can feel. I remember sitting in my car the day I finally decided to seek help. I was terrified. I didn’t think anyone would understand what I was experiencing. I wasn’t sure I could even say it out loud.
But just minutes after I walked into a support group, another woman shared the exact thoughts I had been too afraid to voice. In that moment, I realized I was not alone.
That sense of connection is powerful, and it is something we are working to foster in our community. At Mary Washington Healthcare, we support women along their entire birthing journey with coordinated care that begins in pregnancy and continues through postpartum recovery. This includes obstetric services, certified nurse midwives, advanced neonatal care, and education and support for families.
We have also implemented a postpartum safety initiative. This includes a post-birth alert bracelet and system-wide staff training to help ensure early recognition and response to serious complications after delivery.
When it comes to whole-person care, addressing maternal mental health holds equal importance. We connect women to behavioral health services through Snowden at Fredericksburg and integrate mental health screening and referrals into maternity care. We are also working to reduce stigma—because no woman should feel she has to struggle quietly.
Community and national resources can also make a difference. Local programs like Unspoken Mothers provide safe spaces where women can share openly and feel supported. Postpartum Support International offers its helpline: 1-800-944-4773; and the National Maternal Mental Health Hotline is available 24/7 at 1-833-TLC-MAMA.
There are effective treatments available. These can include therapy, medication when appropriate, strong social support, and simple but critical interventions like improving sleep and reducing isolation. Early recognition and intervention can make a meaningful difference for both mother and baby.
But recognition is the first step—and often the hardest.
If something feels off—if you feel overwhelmed, disconnected, anxious, or not like yourself—please reach out. And be assured, what is happening is not your fault. You are not a bad mother. Your thoughts do not define your love for your child.
Making a connection is so important. Talk to your doctor. Tell someone you trust. Call a helpline. Walk into a support group. Because I have been there, I can promise you—even if it feels impossible, there is a path forward.
As a neurologist, I understand the science of the brain. As a mother who has struggled, I understand something even more important: what it feels like when your brain betrays you.
That experience has made me a more compassionate physician and more dedicated than ever to ensuring that no woman feels unseen in her struggle.
This starts with one simple, powerful truth: You are not alone.
To learn more about Dr. Decker and Mary Washington Neurology including location and contact information, click here.
Editor’s note: This article was provided by Mary Washington Healthcare, a corporate sponsor of the Fredericksburg Free Press. As part of its continued partnership with MWHC, the Free Press will publish monthly public health awareness content on topics such as wellness, preventative care and the latest advancements in healthcare. This partnership seeks to help the community make informed health decisions while offering a behind-the-scenes look at local care and services. Content has been edited for clarity and style by the editorial staff.