Postpartum Depression in Moms of Multiples

Is PPD Multiplied with Multiples?

Postpartum Depression in Moms of Multiples
Postpartum Depression in Moms of Multiples. Don Bayley / E+ / Getty Images

Emotional and physical upheaval is an issue for many women after having a baby, and even more so for moms of multiples. Because it varies in intensity and the way that it affects women, many people confuse postpartum depression and baby blues. Postpartum depression (PPD) may initially begin as the "Baby Blues," but over time develops into depression. The combination of physical and emotional changes after childbirth that produces PPD can be intensified in mothers of multiples, making them particularly at risk for the condition.

The increased hormonal fluctuations that accompany their pregnancies and the intensified demands of caring for two, three or more infants make it even more likely that a mom of multiples will feel overwhelmed, drained or depressed after her babies are born. When researchers evaluated mothers nine months after delivery, they found that mothers of multiple births were more than forty percent more likely to report having moderate or severe postpartum depressive symptoms compared with mothers of single babies. 

It's important to understand the characteristics of Baby Blues and PPD, in order to know when to seek help. Baby Blues is a hormonal and physical condition, which often occurs within the first week of childbirth. These feelings are normal and usually subside within 2 to 3 weeks. It is estimated that as many as 80% of moms experience some symptoms of Baby Blues, such as mood swings or feeling sadness, although the symptoms can vary in degree of intensity.


Baby Blues are characterized by:

  • Crying often, and not always understanding why
  • Feeling tired and exhausted
  • Experiencing insomnia
  • Feeling easily irritated

Postpartum Depression (PPD) is any depression that extends beyond 2 to 3 weeks following birth. Contrary to popular belief, PPD can begin anytime up to twelve months following a delivery.

It occurs more frequently than many other pregnancy conditions, such as pre-eclampsia, gestational diabetes, and pre-term labor. Yet, new mothers are not as educated on PPD as they are on these common pregnancy conditions.

About ten percent of mothers report symptoms of postpartum depression, but actual cases are probably more common. There are many mothers who never seek medical attention for PPD and thus are not included in these figures.

PPD is characterized by:

  • Baby Blues that just don't seem to go away
  • Stronger depression, experiencing feelings of hopelessness, of being completely overwhelmed, doubt, or guilt
  • Marked change in appetite
  • Chronic fatigue
  • Recurrent thoughts of death/suicide
  • Previous history of PPD

If you are feeling these symptoms, tell your doctor. Your physician can help you dramatically hasten the conclusion of symptoms and lead you to a place of wellness much more quickly.

Newsworthy stories, such as Andrea Yates' killing her five children in 2001, make the public painfully aware of Postpartum Psychosis. Fortunately, postpartum psychosis is a rare condition that affects a very small segment of the population.

Postpartum Psychosis is characterized by:

  • Hallucinations or delusions
  • Urge to injure child or others
  • The presence of other disorders as well such as bipolar illness, schizophrenia, and other disorders.

If you are feeling any of the symptoms listed above, do not hesitate to contact your physician immediately. There is help available.

Suzie is a mom of four children including identical twin boys. Read on to learn about her experience and how she sought and received assistance with her postpartum depression after having twins. 


Choi, Y. Bishai, D. Minkovitz, CS. “Multiple births are a risk factor for postpartum maternal depressive symptoms.” Pediatrics, April 2009, pg. 1147.

Fox, Traci B. “Postpartum depression.” U.S. National Library of Medicine. Accessed September 21, 2015.

It is a normal day that begins at 5:00 a.m., after a long night with the twins. I nurse my four-month-old twins and quickly lay them back down, hoping to steal another hour of precious sleep.

At six-thirty my five-year-old is staring me down, starving for breakfast. "Okay," I tell him, "Mommy will be there in a minute." I close my eyes wishing I could just stay in bed five more minutes. Before I can complete that thought, I feel a jabbing in my arm.

I open my eyes. It is my three-year-old. "Mommy, the babies are crying and they woke me up." The day has officially begun.

The clock reads 8:05 a.m. I am holding my sweet little boys who are fast asleep on my chest. Do I cat nap with them on the couch while the big two watch Disney, or do I try to lay them down and get a load of laundry started? I choose the catnap -- if I lay them down they are sure to wake up.

By 10:15 a.m., I manage to get all four dressed and loaded in the Suburban. We're driving in a torrential summer thunderstorm on the way to the pediatrician's office. "No matter," I think quickly. "I'll just valet at the hospital." When I pull up to the valet the attendant says, "Sorry, lot full." I lower my window to give him the full effect of my four children -- ages five and under -- in the car. "Please," I ask, "I have four small children in the car. Please do not make them get out in the rain." My sympathy plea does not work.

He obviously has never had one child, let alone four in a thunderstorm. "Sorry, lot's full."

The closest spot is located at the back of the remote parking lot. Thankfully, the rain has somewhat let up and I manage to get our stroller and my other children inside the hospital without getting too wet.

The twins are screaming now. I think it's time for them to eat, but I can't remember what time I fed them last. All the feedings just seem to run together. I brought some formula with me (nursing twins in public is somewhat of a sideshow). Once inside the pediatrician's office, I pray, "Please Lord let them take the formula." They drink some, maybe a half-ounce each, and are screaming again. I'm holding them both now while trying to read a book to my other children. "Mommy, what's taking soooo long?" they ask (for the 100th time).

Finally, we're admitted -- all four kids and our huge stroller -- into a room smaller than my utility room. Before long the pediatrician comes in, "Oh my, you brought them all," he says as he scans the room. "Yes," I say politely. (Surely he knows that if I had a choice I would not be here alone. I do not have a nanny, and my husband already used all of his free days when I was in the hospital for three weeks before they were born.) The twins are still screaming and don't enjoy the exam in the least.

The shots come and thankfully a nurse comes in for back up. She holds one while I try to comfort the other. Unfortunately, there is no back up for my other two children, who are sure their brothers are being tortured.

We somehow make it back to the car where I promptly call my husband on my cell phone and inform him in no uncertain terms, "I will NEVER take all four of them to the doctor alone again. You can't imagine how hard it was." To which he lovingly replies, "Okay honey, we'll work something out."

But of course, for reasons that neither he nor I could avoid, I did, many times. And for the first nine months of my twins' lives, every day began as this day and ended with me emotionally and physically drained. Finally, at nine months they slept through the night; at fourteen months they walked. Each of these events proved to be huge milestones and made my life considerably easier. Yet, until they were about 18 months old, I still felt as though all my emotional reserves had been depleted.

The weariness of everyday life had taken its toll and I no longer felt the joy I used to feel as a mother.

I was suffering from Postpartum Depression.

PPD does not mean you don't love your children. I couldn't have loved my four children more. I loved to hold them; I loved to read to them, I loved each of them intensely.

It doesn't mean that you're not a good mother. I was a great mom. My children were very well cared for. I was room mom for my son's class. I was intent on making sure my older children were not "lost" in all of the needs of the babies. I still worked from home. I still cleaned and cooked. There are cases where the PPD is so severe that it interferes with these daily tasks, but, for me, I appeared quite normal. In fact, in reality, I was so good at being a good mom that no one, not even my husband, had any idea of just how badly I felt.

Postpartum Depression happens to the best of mothers. If you are feeling like you are suffering from PPD, don't accept the lie that you are not a good mother, or that you will never feel better again. You can get to the other side, you can get back to the point where a day isn't so overwhelming and where you are excited to face a new day.

Just as we establish routines for our children to help their days run smoother, mothers of multiples also need routines. These steps can help prevent the onset of Postpartum Depression and help get you to the other side if you are currently suffering from PPD.

Step 1: Begin Your Day The Right Way.

Even though you need your sleep, try to begin the day with a few moments to yourself before the rest of the family awakens.

You could use the time to journal, meditate or just savor the silence. Doing this step first helps the rest of the day run smoother. My daily routine begins early before the rest of the family is awake. It allows me to have time alone. It is my time to re-connect to my heavenly Father and ask Him for the things I need every day.

Step 2: Prioritize Your Tasks.

Pick the top three things you want to get done today and work on those things. The tasks may be simple and small like running a load of laundry, or taking a shower. Write it down and check it off. When it gets accomplished you will feel like you are making progress.

Step 3: Don't Sweat the Small Stuff.

Conversely, if you do not get everything done in a day you want to - don't worry about it. Let every day be a new day. Let what you do in a single day be enough. If you have fed your children and loved your children you have already accomplished plenty!

Step 4: Take Time for Yourself.

Before I had children I never cared if I had time alone. Now I absolutely crave it. You need to have time without anyone making demands on you. You need time alone. When your husband comes home, take a walk, or take a bath. Even if you only get 15 minutes a day alone - take it!

Step 5: Take Care of Yourself.

Drink 6-8 large glasses of water, walk, get plenty of rest, take vitamins, and don't forget to splurge on yourself every once in a while! When you feel better about the way you look it manifests into every other area of your life.

Step 6: Ask For Help.

If you are feeling overwhelmed ask for help from your husband, your doctor, friends or family. Listen to how you feel. If you need help, don't be embarrassed to ask.

Step 7: End Your Day in Prayer or Meditation.

Take a few moments before you go to sleep to look back at your day. Pat yourself on the back for the things you did right that day, for the tasks you accomplished. End your day with a few quiet moments in prayer or meditation.

Suzie Chafin is a Dallas, Texas mom of four children, including identical twin boys. She writes and lectures about family topics such as postpartum depression, managing multiples, and Christian parenting.