We tell new mothers, “It takes a village.”

We encourage them to ask for help, accept support, rest when the baby rests, and speak up when something does not feel right.

But there is a question we do not ask often enough:

Have we prepared the village to recognize when Mom is not okay?

Families spend months preparing for a baby’s arrival. They buy car seats, assemble cribs, attend baby showers, choose names, pack hospital bags, and learn how to feed, bathe, burp, and soothe a newborn.

Yet many partners, grandparents, siblings, friends, and other trusted supporters enter the postpartum period knowing very little about what may happen to the mother’s mental and emotional health.

That needs to change.

Maternal Mental Health Education Should Begin Before Birth

The postpartum period should not be the first time a family hears the words “postpartum depression, postpartum anxiety, or postpartum psychosis”.

The American College of Obstetricians and Gynecologists (ACOG) recommends proactively providing prenatal patients and members of their support systems with education about the signs and symptoms of perinatal mood and anxiety disorders. These conversations should begin early in pregnancy and continue postpartum.

That matters because Mom may not always be the first person to recognize that something has changed.

Partners, relatives, and friends may notice that she has stopped eating. That she cannot sleep even when the baby sleeps. That she cries constantly. That she seems unusually fearful, withdrawn, agitated, confused, or simply unlike herself.

Family and friends can be among the first to recognize symptoms and can play an important role in encouraging care, helping with appointments, providing emotional support, caring for the baby, and assisting with everyday responsibilities.

The village does not need to diagnose Mom. The village needs to know when to act.

What If Every Family Had a Postpartum Plan?

Birth plans are common. Why not a postpartum family support plan?

Before the baby arrives, families could talk about:

• Who is checking on Mom, not just the baby?
• Who can help protect her opportunities for uninterrupted sleep?
• Who knows what Mom is normally like and may recognize significant behavioral changes?
• Who can help with meals, laundry, childcare, transportation, or appointments?
• What mental health warning signs should everyone know?
• Who will call her healthcare provider if the family becomes concerned?
• What is the plan if Mom says she is afraid she may hurt herself or the baby, becomes severely confused, experiences hallucinations or delusions, or appears disconnected from reality?

These conversations do not need to frighten families.

They prepare them.

Just as families learn infant CPR hoping they will never need to use it, families can learn maternal mental health warning signs hoping they will never face a crisis.

Not Every Mother Has the Same Village

We also have to be careful about romanticizing the word “village”.

Some mothers have partners, parents, siblings, friends, neighbors, and financial resources surrounding them.

Others do not.

A mother may be raising her baby thousands of miles from her family. She may be navigating a new country, unstable housing, financial hardship, language barriers, an unsafe relationship, or single parenthood. Her “village” may consist of one exhausted friend, or no one at all.

For these mothers, telling them to simply “ask for help” is not enough.

Healthcare systems, community organizations, faith communities, doulas, community health workers, peer-support programs, and social-service organizations may need to become part of that village.