It all began at UPMC Magee-Womens Hospital in Oakland, the place where our entire world shifted in a single day: The day my son was born.
My baby boy is the greatest joy in my life, and I am incredibly thankful for him every day. He has changed who I am as a person. He’s given me a greater purpose. Made me a mom. My baby is the most incredible gift, and I would never, ever regret anything that led me to him.
And still, birth and postpartum have been the most difficult experiences I have ever faced.
Those two truths can exist together, even when we’re taught to believe they should not.
Since coming home with my baby, much of my world has shrunk to the quiet rhythm of our days in Allison Park. I’m currently on maternity leave from my work as an elementary teacher in the Fox Chapel Area School District. In my other career as a photographer, I’m used to documenting families’ milestones all across every corner of Pittsburgh, and I suddenly found myself spending day after day within the same four walls — a stillness that felt unfamiliar and heavy.
Postpartum is not talked about enough. Women are not adequately prepared for what it truly entails — mentally, emotionally and physically. With 1 in 5 women experiencing a perinatal mood or anxiety disorder, and up to 85% experiencing the “baby blues,” postpartum mental health is far more common than most of us realize. We talk about birth plans and nursery themes, but we rarely talk about the challenges that surface after the baby arrives.
The silence does far more harm than the conversation ever could.
That silence nearly swallowed me whole.
The reality I didn’t expect
When I was pregnant, I skipped the chapters about postpartum mental health. I skimmed the part about the “baby blues” and thought: That won’t be me. How could it be? This was supposed to be the greatest time of my life.
What I didn’t understand then was that perinatal mood or anxiety disorders aren’t something you opt into … or out of. You don’t get to skip the chapters. You don’t get to decide that your brain and nervous system will cooperate just because you want them to or because they have in the past.
I imagined that a few months in I’d find myself glowing, feeling rested and confident with a sense of freedom returning.
Instead, I found myself still in the trenches.
Days blurred together in a cycle of sleep deprivation, baby’s crying spells, troubleshooting and exhaustion. Every day felt like an experiment: new strategies, new theories, constant problem-solving. My mental capacity slowly wore down.
This time isn’t just about learning how to care for a baby; it’s about becoming someone entirely new overnight. Your sense of self shifts all at once, without a warm-up. Difficulty here isn’t a personal shortcoming. It’s a human response to a massive life change.
I assumed that if I needed help, it would be there. It wasn’t.
Specialized postpartum mental health care continues to be difficult to access. This is not an individual failure — it’s a systemic one. Too many women are told to reach out for help without being told how hard it may be to actually receive it.
A baby who needed more
My postpartum experience was further complicated by a baby who needed more support than expected. He had long stretches of crying, medical concerns and sleep issues. Each challenge on its own was manageable. Together, they compounded.
My notes looked like a medical chart crossed with a diary. At some point, we stopped searching for the answer and started layering small ones. None of it was instant, and none of it was perfect. Progress came quietly, unevenly and without a clear explanation.
Nights stretched on endlessly, marked by frequent wakings and heightened anxiety. Even when my husband took over, my body stayed on alert — half-awake, bracing for the next cry.
Even in the hardest nights, though, there was still so much love: holding my baby close, nursing him and smiling at him. I was reminding myself again and again that he wasn’t giving me a hard time — he was having a hard time.
Sleep deprivation alone can break a person. Add postpartum hormones, and it becomes something else entirely.
After each major crying spell that lasted days, a new skill suddenly appeared. It was as if his body was saying, “Something is changing … but first, I scream.”
These nights live permanently in my body. These are the nights that broke me.
Cries etched into my nervous system
My baby’s cry feels permanently engraved into my nervous system, looping endlessly. I used to think “phantom cries” were a cute parenting joke, like, “Aw, I miss my baby so much that I thought I heard a little cry.”
No. With postpartum anxiety, it is not cute.
By four months postpartum, my anxiety had reached a point where I would hear clear, screaming cries even when my baby was sleeping peacefully beside me. Not muffled. Not questionable. I would tell myself it wasn’t real. And my body wouldn’t listen.
There were moments when that overload tipped even further. I fainted, my nervous system pushed past its limits. My body shut down before my mind could catch up. It was another reminder that postpartum stress doesn’t always look like tears or racing thoughts; sometimes it looks like the body pulling the emergency brake.
I lay awake in the middle of the night, afraid of the cry meant to protect him.
Women’s bodies are wired for this. Our hormones are calibrated to hear, respond and react instantly. It’s a system built for survival, not rest, but one that also brings panic.
There was also physical pain: a deep, hormonal pain that flared during nursing and intensified when my baby cried for extended periods. Early on, it was debilitating. Even months later, there are flare-ups that cause weakness in my legs and immobility.
Local resources for postpartum health
Although this essay draws attention to gaps in local resources, these organizations offer a range of supports to birthing and beyond.
- The Alexis Joy Foundation, a dedicated postpartum treatment center at West Penn Hospital, 4800 Friendship Ave., Pittsburgh, PA 15224, 412-578-4030
- Postpartum Pittsburgh, a non-profit organization connecting parents with postpartum symptoms to online and offline resources.
This is the part of postpartum that’s rarely talked about. It’s not just the emotions, but the way the body responds, how the nervous system and hormones activate before the mind ever has a chance to intervene. My reactions don’t live only in my thoughts; they live in my body, in reflexes I don’t consciously choose.
This matters. It expands the story of postpartum beyond feelings and into physiology. It helps explain why prolonged crying can be so destabilizing, why it can feel overwhelming even when you’re doing everything “right.” This isn’t a failure of coping, it’s a body responding exactly as it was wired to, even when that wiring comes at a cost.
For me, life narrowed down to survival.
Alongside the physical responses came compulsive vigilance, nights spent checking and re-checking: breathing, movement, sleep, feeds, medications. Even when I knew my baby was safe, my mind latched onto monitoring as a way to manage fear.
My nervous system was stuck in overdrive, unable to power down.
Postpartum doesn’t just change how you feel. It changes how you think, how you react, how your mind scans for danger. These patterns can be exhausting, invisible and deeply isolating. It can feel heavy in ways that are difficult to explain, especially when you’re living it.
Finding roses among the thorns
None of this is a lack of love. It’s context and normalization. It is not a sad story; it’s an honest one. It’s what living through a hard season can look like. There is light here too.
Some of my favorite moments are the quiet ones: the weight of my baby sleeping on my chest, the little sigh of his breath against my skin, the laughter that now comes more easily. These moments matter. They are the reason we keep going.
I know someday I’ll miss this.
And still, I sometimes wish time away.
During the brutal nights, I wish for morning … and when morning arrives, I wish for more sleep.
Just like my unmatched love for my baby and the haunting trials of early motherhood, both things can exist.
But, all of it is worth it.
Worth it for the way my baby lights up first thing in the morning simply because he sees my face. Worth it for the calm that settles over him when he hears my voice. Worth it to feel his tiny hand wrapping around my finger. Worth it for the sounds of his cooing.
I don’t need this season to be easy to know it is meaningful.
Why I’m sharing this
This isn’t just my experience. It’s happening quietly in homes all across Pittsburgh. Behind nursery doors. In the middle of the night.
New parents can be taught how to swaddle and change a diaper. They are sent home with paperwork and follow-up appointments. But if they aren’t prepared for the hormonal crash, the nervous system overload, the mental health risks, and the long waitlists for specialized care, then they are only being told half the story.
Over and over, women tell me the same thing: Time softens the edges of even the hardest days. Some forget naturally. Some choose to forget. Some choose to remember, and talk about it.
I’m choosing to remember.
This story is anchored in growth, bonding and forward movement … not just survival.
Postpartum mental health struggles are real. They are common. And they are still not talked about enough.
If we pride ourselves on being a city that shows up for one another, then postpartum support can’t be an afterthought. It has to be part of the plan. Pittsburgh could lead in this. We have world-class hospitals. We have strong communities. We have women willing to tell the truth. If we listen and act, the next mother won’t have to piece everything together in the dark.
If you didn’t enjoy every moment, nothing is wrong with you.
If you feel overwhelmed by love and fear at the same time, nothing is wrong with you.
If your body and mind changed in ways you weren’t prepared for, nothing is wrong with you.
We should talk about this. Out loud. Without shame.
Postpartum, Out Loud
Cara Zlatos is a teacher and the photographer behind Cara Eliza Photography, documenting families across the Pittsburgh area. She can be reached at carazlatos@gmail.com or on her website: caraelizaphotography.mypixieset.com.
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