How to Talk to Your OB/GYN About Postpartum Depression (Script + What to Expect)

Introduction

You know something is wrong.

You're not sleeping even when the baby sleeps. You cry all the time. You feel disconnected from your baby, your partner, yourself. You don't recognize the person you've become.

But when your OB/GYN asks "How are you feeling?" at your 6-week checkup, you smile and say "Fine."

Why?

Maybe you're ashamed. Maybe you think it's just exhaustion. Maybe you're afraid of judgment, or that they'll take your baby away, or that they won't believe you.

Here's the truth: Your OB/GYN WANTS to know if you're struggling. Postpartum depression is common (affecting 1 in 7 women), treatable, and NOT your fault. Doctors are trained to screen for it—but they can't help if you don't speak up.

This guide will help you:

Find the words to tell your doctor you're struggling (with actual scripts you can use)
Understand what happens during PPD screening
Know what to expect after you disclose
Advocate for yourself if your doctor dismisses your concerns
Bring this conversation up at ANY appointment (not just the 6-week checkup)

Let's remove the fear and give you the tools to get the help you deserve.

Why It's Hard to Tell Your Doctor

You're not alone in struggling to disclose postpartum depression. Here's why it's so difficult:

"I Should Be Grateful"

You wanted this baby. You love your baby. Society tells you motherhood is magical and joyful—so admitting you're miserable feels like betrayal.

Reality: Loving your baby and struggling with PPD can coexist. Gratitude doesn't prevent depression.

"I Don't Want to Be Judged"

You worry your doctor will think you're weak, ungrateful, or a bad mother.

Reality: OB/GYNs see postpartum depression constantly. They know it's a medical condition, not a character flaw.

"They'll Take My Baby Away"

You're terrified that admitting you're struggling means losing custody.

Reality: Disclosing postpartum depression does NOT result in losing your baby. Child Protective Services is NOT called for PPD. Seeking help is the OPPOSITE of neglect—it's responsible parenting.

Exception: If you say you have active plans to harm yourself or your baby, your doctor must ensure safety (emergency evaluation). But simply having PPD does NOT trigger this.

"I Don't Want to Admit How Bad It Is"

Saying it out loud makes it real. As long as you don't tell anyone, you can keep pretending you're managing.

Reality: Silence makes PPD worse. Speaking up is the first step toward feeling like yourself again.

"I'm Embarrassed"

You're supposed to be bonding with your baby, but instead you feel nothing. Or you resent them. You're ashamed of these feelings.

Reality: Difficulty bonding, resentment, and emotional numbness are SYMPTOMS of PPD—not evidence that you're a bad mother.

When to Bring Up Postpartum Depression

You don't have to wait for the 6-week checkup. Bring this up at ANY appointment if you're struggling.

Best Times to Discuss PPD with Your OB/GYN:

✅ 6-week postpartum checkup (when formal screening usually happens) ✅ 2-week postpartum checkup (if symptoms start early) ✅ During pregnancy (if you're at high risk and want preventive care) ✅ ANY appointment where you're struggling (don't wait for a specific checkup) ✅ At your baby's pediatrician appointments (pediatricians also screen mothers)

Important: If you're in crisis (thoughts of harming yourself or baby), do NOT wait for an appointment. Go to the ER or call 988.

What to Say: Word-for-Word Scripts

The hardest part is starting the conversation. Here are scripts you can use EXACTLY as written—or adapt to fit your situation.

Script #1: "I Think I Have Postpartum Depression"

When to use: You're pretty sure you have PPD and want to be direct.

What to say:

"I need to talk to you about how I've been feeling. I think I have postpartum depression. I'm not sleeping even when the baby sleeps, I cry all the time, and I don't feel like myself. I need help."

Why this works: It's clear, direct, and uses the term "postpartum depression." Your doctor will take this seriously and start assessment immediately.

Script #2: "I'm Struggling More Than I Expected"

When to use: You're not sure if it's PPD or just normal new mom overwhelm.

What to say:

"I'm really struggling. I thought I'd feel more joy, but mostly I feel sad and overwhelmed. I'm crying a lot, I'm not sleeping well, and I don't feel connected to my baby. Is this normal, or could it be postpartum depression?"

Why this works: It opens the door for your doctor to assess whether what you're experiencing is within normal range or clinical PPD.

Script #3: "I Don't Feel Like Myself"

When to use: You can't quite articulate specific symptoms, but you know something is wrong.

What to say:

"I don't feel like myself since having the baby. I'm not sure how to describe it, but something feels off. I'm not as happy as I thought I'd be, and I'm worried something might be wrong."

Why this works: Your doctor will ask follow-up questions to tease out symptoms. You don't need to have everything figured out—just express that you're concerned.

Script #4: "I'm Having Scary Thoughts"

When to use: You're experiencing intrusive thoughts (harm thoughts, suicidal thoughts, thoughts of running away).

What to say:

"I'm having thoughts that scare me. I keep thinking about [harming myself / harming the baby / running away and never coming back]. I don't WANT to act on these thoughts, but they're intrusive and distressing. I need help."

Why this works: It's specific and emphasizes that you're NOT planning to act on the thoughts (this is important—it shows insight, which means you're not in immediate danger). Your doctor will assess urgency and refer you to mental health care.

Important clarification: If you say "I have thoughts of harming my baby but I would never act on them," this is postpartum OCD, not a danger. If you say "I want to harm my baby and I'm planning to do it," this is a psychiatric emergency and will be treated as such.

Script #5: "I'm Not Bonding with My Baby"

When to use: Your primary concern is lack of connection or emotional numbness toward your baby.

What to say:

"I'm really struggling to bond with my baby. I'm going through the motions—feeding, changing diapers—but I don't feel the love or connection I expected. I feel guilty about this, and I'm wondering if it could be postpartum depression."

Why this works: Bonding difficulties are a hallmark of PPD. Your doctor will screen for other symptoms and discuss treatment options that specifically help with bonding.

Script #6: "My Partner Is Worried About Me"

When to use: Your partner, family, or friends have expressed concern, but you've been in denial.

What to say:

"My partner says they're worried about me. They've noticed I'm crying a lot, not sleeping, and seem really sad. I've been trying to push through, but I think they might be right that I need help."

Why this works: Sometimes loved ones see changes we can't. Acknowledging their concern shows insight and makes it easier for your doctor to assess objectively.

What Happens After You Disclose: The PPD Screening Process

Once you tell your doctor you're struggling, here's what typically happens:

Step 1: Formal Screening Tool (5-10 minutes)

Most OB/GYNs use the Edinburgh Postnatal Depression Scale (EPDS)—a 10-question screening tool.

Sample questions:

"I have been able to laugh and see the funny side of things" (multiple choice: as much as always / not quite so much / definitely not so much / not at all)
"I have looked forward with enjoyment to things" (multiple choice scale)
"I have blamed myself unnecessarily when things went wrong" (multiple choice scale)
"I have felt scared or panicky for no very good reason" (multiple choice scale)

Scoring:

0-9: No indication of PPD
10-12: Possible PPD (further assessment needed)
13+: Likely PPD (treatment recommended)

Question 10 asks about self-harm: "The thought of harming myself has occurred to me" (never / hardly ever / sometimes / yes, quite often)

Important: If you endorse ANY frequency of self-harm thoughts, your doctor will do a safety assessment.

Step 2: Follow-Up Questions (5-15 minutes)

Your doctor will ask additional questions to understand:

When symptoms started
How severe they are
How they're affecting your daily functioning
Whether you have support at home
If you've had depression before
If you're having thoughts of harming yourself or your baby

Be honest. The more accurately you describe your symptoms, the better your doctor can help.

Step 3: Safety Assessment (If Needed)

If you mentioned thoughts of self-harm or harming your baby, your doctor will assess immediate danger:

Questions they'll ask:

"Do you have a plan to harm yourself?"
"Do you have access to means (medications, weapons)?"
"Are you safe to go home today?"
"Can someone stay with you?"

Possible outcomes:

Low risk: You're having thoughts but no plan or intent → Referred to urgent outpatient mental health care (within 1-3 days)
Moderate risk: Some plan but no immediate intent → May arrange emergency therapy appointment or crisis intervention
High risk: Active plan and intent → Emergency psychiatric evaluation (ER or crisis unit)

Most women with PPD are LOW risk (having thoughts but not planning to act). Disclosing thoughts does NOT automatically mean hospitalization.

Step 4: Treatment Discussion (10-20 minutes)

Your doctor will discuss treatment options:

Options typically offered:

Therapy referral (individual therapy with perinatal mental health specialist)
Medication (usually SSRIs like Zoloft or Lexapro)
Combination treatment (therapy + medication - most effective for moderate-severe PPD)
Support resources (postpartum support groups, hotlines)

Your doctor may:

Write a prescription for antidepressants (if you agree to try medication)
Provide referrals to therapists specializing in postpartum depression
Give you phone numbers for crisis support (988, Postpartum Support International)
Schedule a follow-up appointment in 2-4 weeks to check on you

Step 5: Follow-Up Plan

Your doctor should: ✅ Schedule follow-up appointment (usually 2-4 weeks) ✅ Confirm you have support at home ✅ Give you emergency contacts (what to do if symptoms worsen) ✅ Ensure you have a clear plan (therapy appointment scheduled, prescription filled, support in place)

If your doctor does NOT do these things, advocate for yourself (see section below).

What If Your Doctor Dismisses You?

Unfortunately, some doctors minimize or dismiss postpartum depression concerns. This is unacceptable—but it happens.

Signs Your Doctor Is Dismissing You:

❌ "All new moms feel this way—you'll be fine." ❌ "Just get more sleep and you'll feel better." ❌ "Give it a few more weeks and see if it improves." ❌ "You don't look depressed to me." ❌ Doesn't do formal screening or ask follow-up questions ❌ Doesn't offer referrals or treatment options

If this happens, DO NOT give up. Advocate for yourself.

How to Advocate If Dismissed

Step 1: Be Direct and Persistent

What to say:

"I appreciate your perspective, but I know my body and I know something is wrong. I need you to take this seriously and refer me to a mental health specialist."

"I understand that some sadness is normal, but what I'm experiencing is beyond normal. I'm not functioning well, and I need treatment. Can you please do a formal PPD screening?"

Step 2: Ask for the Edinburgh Screening

What to say:

"I'd like to fill out the Edinburgh Postnatal Depression Scale. Can you provide that?"

Why this works: It's a standardized tool. If you score 10+, your doctor can't easily dismiss you.

Step 3: Request a Referral

What to say:

"Even if you think this will pass on its own, I'd feel better talking to a therapist. Can you refer me to someone who specializes in postpartum depression?"

Why this works: You're not arguing about whether you have PPD—you're simply asking for a referral. Most doctors will agree to this.

Step 4: Ask for Documentation

What to say:

"I'd like you to note in my chart that I reported symptoms of postpartum depression and requested treatment. Can you confirm that's documented?"

Why this works: Doctors are legally required to document your concerns. Knowing it's in your chart makes it harder for them to dismiss you.

Step 5: Find a New Doctor

If your doctor still dismisses you:

Request your medical records
Find a new OB/GYN or family doctor
Go directly to a therapist (you don't NEED a doctor's referral to see a therapist)
Call Postpartum Support International for provider recommendations: 1-800-944-4773

You deserve a doctor who listens and takes your concerns seriously.

Tips for Making the Appointment Easier

Before Your Appointment:

1. Write Down Your Symptoms

When they started
How often they occur
How they're affecting your life

Example: "Started 3 weeks postpartum. Crying daily. Can't sleep even when baby sleeps. Feeling disconnected from baby. Not enjoying anything."

Bring this list to your appointment (easier than trying to remember in the moment).

2. Bring Your Partner or Support Person

Benefits:

Emotional support (you don't have to do this alone)
They can provide objective observations ("I've noticed she's been crying every day")
They can help you remember what the doctor says
They can advocate for you if you get emotional or shut down

What to tell them beforehand: "I'm going to tell my doctor I think I have postpartum depression. I need you there for support—and if I struggle to speak up, I need you to advocate for me."

3. Practice Saying It Out Loud

Before your appointment, say to yourself (or your partner): "I think I have postpartum depression. I need help."

Practicing reduces the fear of actually saying it.

4. Remind Yourself: This Doesn't Make You a Bad Mother

Mantra to repeat: "Asking for help is what good mothers do. Taking care of my mental health is taking care of my baby."

What If You Can't Say It Out Loud?

Some women freeze up when trying to disclose PPD. Here are alternatives:

Option 1: Hand Your Doctor a Note

Write on a piece of paper:

"I'm struggling with postpartum depression. I'm having a hard time talking about it, but I need help. Can you please screen me and discuss treatment options?"

Hand it to your doctor at the start of the appointment.

Option 2: Text or Call Ahead

Call your doctor's office before your appointment:

"I'm coming in for my postpartum checkup tomorrow, and I want to discuss possible postpartum depression. Can you make sure my doctor is aware so they can plan time to talk about it?"

Why this works: Your doctor will be prepared, and you won't feel ambushed during the appointment.

Option 3: Have Your Partner Speak for You

If you absolutely cannot voice it yourself, your partner can say:

"We're concerned she might have postpartum depression. She's been crying a lot, not sleeping, and struggling to bond with the baby. Can you screen her?"

This is not weakness—it's asking for support when you need it.

After You Disclose: What Happens Next

If You're Prescribed Medication:

Questions to ask your doctor:

"What medication are you prescribing?"
"Is it safe while breastfeeding?"
"What side effects should I expect?"
"How long before I feel better?"
"How long will I need to take this?"

[Link to medication side effects blog post for detailed info]

If You're Referred to Therapy:

Questions to ask:

"Can you recommend a specific therapist who specializes in postpartum depression?"
"What type of therapy is most effective for PPD?" (Answer: CBT or IPT)
"Is this covered by my insurance?"
"How soon can I get an appointment?"

[Link to CBT blog post for what to expect in therapy]

If You're Told to "Wait and See":

This is NOT appropriate for moderate-severe PPD.

What to say:

"I understand you want to see if symptoms improve, but I'm struggling NOW. I'd like to start treatment now rather than wait."

If they still refuse treatment, seek a second opinion.

Reassurance: Common Fears (And the Reality)

Fear: "They'll think I'm a bad mother"

Reality: Your doctor sees postpartum depression as a medical condition, not a moral failing. Seeking help proves you're a GOOD mother.

Fear: "They'll take my baby"

Reality: Disclosing PPD does NOT result in losing custody. Only immediate danger to yourself or baby triggers protective intervention—and even then, the goal is support, not removal.

Fear: "I'll be forced to take medication I don't want"

Reality: Treatment is YOUR choice. Your doctor can recommend medication, but you decide whether to take it.

Fear: "They'll judge me"

Reality: OB/GYNs treat postpartum depression constantly. You are NOT the first or the hundredth patient they've seen with PPD this year.

The Bottom Line

Telling your doctor about postpartum depression is hard—but it's the most important conversation you'll have for your recovery.

Remember:

You don't have to have perfect words—"I'm struggling" is enough
Bring a support person if you need to
Write it down if you can't say it out loud
Advocate for yourself if dismissed
Treatment works (60-75% improvement with therapy or medication)

Your doctor WANTS to help you. But they can't help if you don't speak up.

You deserve to feel like yourself again. Your baby deserves a healthy mother. Say the words. Get the help. You won't regret it.

Ready to Get Help?

If you're in the Austin area and need therapy for postpartum depression, Dr. Jana Rundle specializes in perinatal mental health and can help—even if your OB/GYN didn't refer you.

What Bloom Psychology Offers:

No referral needed (you can self-refer directly)
Specialized postpartum depression therapy (CBT, IPT)
Virtual and in-person sessions (flexible for new moms)
Insurance accepted (superbills provided for out-of-network reimbursement)

Contact Information:

Phone: (512) 648-2722
Email: contact@bloompsychology.com
Free 15-minute consultation available

Related Resources

On the Bloom Blog:

Bloom Services:

External Resources:

Postpartum Support International Helpline: 1-800-944-4773
National Maternal Mental Health Hotline: 1-833-TLC-MAMA
Edinburgh Postnatal Depression Scale - Take the screening online

Key Takeaways

You don't have to wait for the 6-week checkup - bring this up at ANY appointment
Use word-for-word scripts if you're struggling to find the words
Bring a support person for emotional support and advocacy
Your doctor will likely use the Edinburgh screening (10 questions, takes 5 minutes)
Disclosing PPD does NOT mean losing your baby (this fear keeps many women silent)
If your doctor dismisses you, advocate for yourself - you deserve to be heard
You can write it down instead of saying it if words won't come
Treatment options: therapy, medication, or both (your choice)
Most women feel significant improvement within 4-6 weeks of starting treatment
Asking for help is what good mothers do - not a sign of failure

You've got this. Say the words. Get the help. Feel like yourself again.

Word Count: ~2,000 words ✅ Status: Complete draft - ready for Dr. Jana review Internal Links: 4 (blog posts + service pages) External Links: 3 (PSI, National Hotline, EPDS online) Unique Value: Word-for-word scripts (immediately actionable); addresses fear of disclosure Downloadable Asset Idea: "What to Say to Your Doctor" printable template (lead gen opportunity) Next Steps:

Dr. Jana review
Create downloadable "Doctor Conversation Template" PDF
Meta tags and SEO optimization
Featured image (supportive, empowering)
Publish to Supabase blog_posts table
Promote to new moms groups, OB/GYN offices

SEO Notes:

Primary keyword "talking to ob/gyn about postpartum depression" naturally integrated
Related keywords: how to tell doctor about PPD, postpartum depression screening, what to say to doctor about depression
Optimized for featured snippets (scripts in blockquotes, clear lists)
Addresses user intent at point of need (they're about to have appointment or just left one feeling unheard)
Empowers advocacy (what to do if dismissed)

Frequently Asked Questions

When should I talk to my OB/GYN about postpartum depression?

Talk to your OB/GYN if you experience any PPD symptoms (persistent sadness, anxiety, difficulty bonding, sleep problems, loss of interest in activities, thoughts of harming yourself or baby) for more than 2 weeks. Don't wait for your 6-week checkup – call sooner if symptoms are severe or interfering with caregiving. Most OB/GYNs are equipped to screen, diagnose, and treat PPD or refer you to specialists.

What will my OB/GYN do if I tell them I have postpartum depression?

Your OB/GYN will likely: ask screening questions (Edinburgh Postnatal Depression Scale), assess symptom severity, check for medical causes (thyroid problems, anemia), discuss treatment options (therapy, medication, or both), provide referrals to perinatal mental health specialists, and schedule follow-up appointments to monitor progress. Many OB/GYNs can prescribe antidepressants or refer you to psychiatrists.

What if I'm embarrassed to tell my doctor about PPD symptoms?

Remember that OB/GYNs screen every postpartum patient for depression – you're not the first mother they've treated. PPD is a medical condition, not a character flaw or parenting failure. Doctors understand the biology behind PPD (hormonal changes, sleep deprivation, brain chemistry) and won't judge you. If you can't say it aloud, write your symptoms on the intake form or hand your doctor a note.

Will my OB/GYN prescribe antidepressants or refer me elsewhere?

Many OB/GYNs are comfortable prescribing SSRIs for postpartum depression, especially sertraline (Zoloft) or escitalopram (Lexapro), which are safe for breastfeeding. For more complex cases (previous psychiatric history, severe symptoms, psychosis risk, or medication resistance), they'll refer you to a perinatal psychiatrist. For therapy, they'll provide referrals to licensed therapists specializing in postpartum mental health.

What if my OB/GYN dismisses my postpartum depression concerns?

If your doctor minimizes your symptoms or suggests "just wait it out," advocate for yourself: say "I'm not functioning normally and I need help now," request the Edinburgh screening, ask specifically for a mental health referral, or seek a second opinion from another OB/GYN or your primary care doctor. You can also call a perinatal mental health warmline (like Postpartum Support International: 1-800-944-4773) for provider referrals.

How to Talk to Your OB/GYN About Postpartum Depression (Script + What to Expect)