We’re excited to collaborate with PECNA this month (Psychological Evaluation Center of North America) on the very important topic of postpartum depression for gestational carriers. While the surrogacy journey is an immensely rewarding experience, For gestational carriers, the process of carrying and nurturing life for intended parents brings a sense of fulfillment and pride. However, after the birth, gestational carriers may experience unexpected emotions, including postpartum depression (PPD). While surrogates may be emotionally prepared for the delivery, they are still subject to the hormonal changes that occur after childbirth. These hormonal fluctuations, combined with the emotional complexity of the surrogacy experience, can increase their vulnerability to postpartum depression.
What is Postpartum Depression?
Post-birth hormonal changes affect all those who give birth, regardless of whether they are gestational surrogates or biological mothers. This natural drop in hormones, particularly estrogen and progesterone, occurs after delivery and can lead to temporary emotional shifts known as the “baby blues.” These mood swings, which may include sadness, irritability, or fatigue, are common and typically resolve within two weeks. They are considered a normal part of the postpartum recovery process and do not necessarily indicate a mental health condition.
However, if these emotional fluctuations persist or intensify, they may develop into postpartum depression, a more serious condition requiring professional attention. Postpartum depression (PPD) is a mood disorder that can affect women after childbirth. It goes beyond the “baby blues,” which are characterized by temporary mood swings and emotional lows. PPD symptoms include persistent sadness, anxiety, fatigue, difficulty concentrating, and changes in sleep or appetite.
In gestational carriers, postpartum depression is rarely linked to an attachment to the baby but is more often a result of the hormonal changes that naturally occur after giving birth. Additionally, the emotional adjustment to ending the surrogacy journey, including changes in the relationship with the intended parents and the conclusion of an important chapter, can contribute to feelings of loss or distress. These factors make gestational carriers vulnerable to PPD, even with their emotional preparedness for the surrogacy process.
Why Gestational Surrogates May Experience PPD
Surrogacy involves complex emotional dynamics that require careful attention, making mental health just as important as physical recovery. Gestational surrogates often develop a deep connection with the intended parents and their shared journey toward a common goal. When the journey comes to an end, gestational surrogates may experience feelings of loss or question their sense of purpose, asking themselves, “What do I do now?”
Additionally, the relationship with the intended parents may change after the birth, contributing to feelings of disconnection or sadness. Gestational surrogates may also face social stigma or misunderstanding, leading to feelings of guilt or loneliness. These emotional pressures, combined with hormonal fluctuations, can increase the risk of postpartum depression.
Signs and Symptoms of Postpartum Depression in Gestational Surrogates
Recognizing PPD is key to addressing it early. Emotional symptoms might include prolonged sadness, hopelessness, irritability, or emotional numbness. Physical symptoms like fatigue, changes in appetite or sleep patterns, and trouble concentrating are also common.
Behaviorally, gestational surrogates may withdraw from social activities, neglect self-care, or lose interest in things they once enjoyed. If these symptoms persist for more than two weeks, it’s important to seek professional help. Mental health professionals experienced in surrogacy can offer tailored support for the specific emotional challenges surrogates face.
PPD Screening: How It’s Conducted and Why It’s Important
Early screening for postpartum depression (PPD) is critical for gestational surrogates, as it ensures they receive the support they need. PPD screenings typically involve a combination of self-reported questionnaires and interviews with a mental health professional familiar with the surrogacy process. Tools like the Edinburgh Postnatal Depression Scale (EPDS) and the Patient Health Questionnaire-9 (PHQ-9) are commonly used to assess emotional well-being. These assessments evaluate mood, anxiety, sleep, and other behavioral factors to provide a comprehensive understanding of a gestational surrogate’s mental health.
Screening is essential because it helps identify PPD early, enabling gestational surrogates to receive appropriate care before symptoms escalate. Early intervention ensures a smoother emotional recovery, helping surrogates manage feelings of grief or loss and adjust to post-birth life. This proactive step is key in addressing the mental health challenges unique to the surrogacy experience.
Coping Strategies for Surrogates with PPD
The good news is that postpartum depression is treatable, and there are many strategies that surrogates can use to cope with it:
- Seek professional support: Engaging with a mental health professional who understands the emotional complexities of surrogacy can make a significant difference. Therapy provides tools to process feelings of grief and navigate emotional transitions.
- Build a support system: Surround yourself with a network of supportive friends, family, or even other surrogates. Talking openly about your experiences can ease feelings of isolation and offer emotional validation.
- Engage in self-care: Prioritizing your own well-being is essential. Regular physical activity, adequate sleep, and healthy eating contribute to emotional health. Journaling or mindfulness exercises can also help manage emotions.
- Post-surrogacy counseling: Consider ongoing counseling tailored to surrogates after their journey. This helps process lingering emotions and brings healthy closure to the surrogacy experience.
Long-Term Emotional Care for Surrogates
Mental health care shouldn’t stop after the initial postpartum period. Ongoing attention to emotional well-being is just as important:
- Maintaining communication with intended parents: Staying connected with the intended parents, depending on the surrogacy arrangement, can help both parties transition emotionally. Open communication offers either closure or continued connection, easing emotional shifts.
- Re-establishing daily routines: Focus on returning to your daily life by setting new goals and rediscovering passions outside of the surrogacy experience.
- Understanding emotional triggers: Be aware of situations that might evoke feelings of grief or loss and prepare to manage them with healthy coping strategies.
Remember, you are not alone.
Surrogacy is a beautiful and fulfilling journey, but it also brings emotional challenges. Surrogates who experience postpartum depression deserve care and support throughout the process and beyond. Understanding and addressing PPD is crucial for mental well-being. If you’re a surrogate facing these challenges, reach out for help—early intervention can make all the difference.
In honor of mental health awareness week in October, it is a great time to acknowledge the unique emotional needs that surrogacy, infertility, and the relationships we develop during surrogacy entails. At Alcea we strive to offer support to all clients within our community. We believe that mental health care is an integral part of the surrogacy journey that begins with thorough evaluations of both carrier and intended parents and extends throughout the many stages and nuanced emotional elements of the journey.
Remember, you are not alone. By prioritizing your mental health and seeking support, you can ensure a fulfilling and healing experience after surrogacy.
About PECNA
Psychological Evaluation Center of North America (PECNA) specializes in providing comprehensive psychological assessments and emotional support services for gestational surrogates, intended parents, and individuals navigating the complexities of third-party reproduction. Our expert clinicians understand the unique emotional challenges of surrogacy, from pre-surrogacy counseling and psychological evaluations to postpartum depression screening. We are dedicated to offering compassionate, personalized care to help surrogates and intended parents maintain emotional well-being throughout their journey. Contact PECNA today to learn more about our services and how we can support your third-party fertility experience.