You have just been through a life-changing experience!
Your body is healing and your mind is expanding in new and different ways. It can be all-consuming, and you may feel raw, overwhelmed, and lonely.
Important things to remember during your 4th trimester:
• You are not alone.
• You are learning, growing and becoming stronger.
• You are the heartbeat of your home.
• Caring for you means caring for your baby.
People often focus more on how to care for a newborn than on what mothers experience after giving birth. This is YOUR time to honor everything you’ve just been through and to take good care of yourself.
This booklet will help by offering answers, reassurance, and guidance you can lean on.
Normal Baby Behavior & Safe Sleep
NORMAL BABY BEHAVIOR & SAFE SLEEP
What is Normal Baby Behavior?
Babies communicate in ways that are new to you, and it can take time to understand what they need. Their behavior—crying, waking often, wanting to be held—may be challenging at times, but it is completely normal. Even on the most exhausting days, it’s important to continue following safe sleep practices that keep your baby protected.
Parents are often concerned with the following issues:
• Crying: Why is my baby crying?
• Feeding: When do I feed and how much?
• Sleep: Is it normal for my baby to wake often? What is safe sleep?
Crying
Crying is a baby’s way of saying, “something needs to change now!” You can calm your baby by:
• Holding them close or with skin-to-skin contact.
• Speaking or singing softly using calming sounds or words
• Rocking them gently with a back-and-forth motion.
• Gently massaging their back, arms, and legs.
Feeding
Babies use cues when they are ready to eat, like:
• Move their hands or fists to their mouth
• Make sucking motions or soft noises
• Smack their lips.
• Nuzzle against your chest or search for the breast.
When babies are full and want to stop eating, they may:
• Release or “fall off” the breast or bottle
• Turn away from the breast or nipple.
• Relax their body and open their hands.
Sleep
It is normal for babies to wake up often at night.
• Newborns spend more time in active, light sleep which helps them wake more easily to eat, stay warm, and move when needed.
• Light sleep helps babies’ brain to grow.
• As babies get older, they will sleep for longer stretches of time and spend more time in deep sleep.
Safe Sleep For Your Baby
A safe sleep area can help reduce baby’s risk for Sudden Infant Death Syndrome (SIDS) and other sleep-related deaths, such as from accidental suffocation. SIDS is the term used for a sudden, unexplained death of a baby, usually occurring during sleep.
Back to Sleep For Every Sleep
Back sleeping is safest for infants. Stomach or side sleeping increases the risk of SIDs. Babies should be placed on their backs to sleep for every sleep, including naps.
• Babies who are placed to sleep on their tummies have a much higher risk of unexpected death, especially if they usually sleep on their backs.
Sleep Surface
Soft surfaces — like couches, sofas, memory foam, or fluffy blankets — can cause your baby’s breathing to get cut off.
• Make sure their sleep surface is firm, flat, and level (not at an angle) and covered only with a fitted sheet.
• Sign up for recall alerts on the Consumer Product Safety Commission (CPSC) website at CPSC.gov/SafeSleep to make sure crib or nursery products have not been recalled.
Emergency Safe Sleep Plan
Natural disasters, like tornadoes, hurricanes, floods, or fires, are scary and can happen quickly. Make a plan to keep your baby sleeping safely.
• Have safe sleep items, like a portable crib and a fitted sheet, ready to take with you in case you have to leave your home.
• Place your baby on their back to sleep for naps and at night.
• Share a room with your baby, not your bed.
Clean and Clear Crib
Soft objects, bedding, and other items in the sleep environment can become a barrier to baby’s breathing and lead to death.
• Remove all items out of crib.
• Only put one baby per crib; babies should not share a sleep space with a twin, other siblings, or pets.
WHAT DOES A SAFE SLEEP ENVIRONMENT LOOK LIKE?
The following image shows a safe sleep environment for baby.
Room share: Give babies their own sleep space in your room, separate from your bed.
Use a firm, flat, and level sleep surface, covered only by a fitted sheet*
Remove everything from baby’s sleep area, except a fitted sheet to cover the mattress. No objects, toys, or other items.
Use a wearable blanket to keep baby warm without blankets in the sleep area.
Make sure baby’s head and face stay uncovered during sleep.
Place babies on their backs to sleep, for naps and at night.
Couches and armchairs are not safe for baby to sleep on alone, with people, or with pets.
Keep baby’s surroundings smoke/vape free.
The Consumer Product Safety Commission sets safety standards for infant sleep surfaces (such as a mattress) and sleep spaces (like a crib). Visit https://www.cpsc.gov/SafeSleep to learn more.
SAFE SLEEP FOR YOUR BABY
Reduce the Risk of Sudden Infant Death Syndrome (SIDS) and Other Sleep-Related Infant Deaths
Place babies on their backs to sleep for naps and at night.
Use a sleep surface for baby that is firm (returns to original shape quickly if pressed on), flat (like a table, not a hammock), level (not at an angle or incline), and covered only with a fitted sheet
Feed your baby human milk, like by breastfeeding.
Share a room with baby for at least the first 6 months. Give babies their own sleep space (crib, bassinet, or portable play yard) in your room, separate from your bed.
Keep things out of baby’s sleep area—no objects, toys, or other items.
Offer baby a pacifier for naps and at night once they are breastfeeding well.
NIH Pub. No. 22-HD-5759 | August 2022
Stay smoke- and vapefree during pregnancy, and keep baby’s surroundings smokeand vape-free.
Stay drug- and alcoholfree during pregnancy, and make sure anyone caring for baby is drugand alcohol-free.
Avoid letting baby get too hot, and keep baby’s head and face uncovered during sleep. Get regular medical care throughout pregnancy
Follow health care provider advice on vaccines, checkups, and other health issues for baby
Feeding babies human milk by direct breastfeeding, if possible, or by pumping from the breast, reduces the risk of SIDS. Feeding only human milk, with no formula or other things added, for the first 6 months provides the greatest protection from SIDS.
Avoid products and devices that go against safe sleep guidance, especially those that claim to “prevent” SIDS and sleep-related deaths.
Avoid heart, breathing, motion, and other monitors to reduce the risk of SIDS.
Avoid swaddling once baby starts to roll over (usually around 3 months of age), and keep in mind that swaddling does not reduce SIDS risk.
Give babies plenty of “tummy time” when they are awake, and when someone is watching them.
For more information about the Safe to Sleep® campaign, contact us:
Feeding baby only breast milk for the first six months provides the greatest protection from SIDS.
• The longer your baby is exclusively breastfed, the lower the risk of dying from SIDS.
• Feeding baby breast milk from the breast or bottle is more protective than not feeding baby any breast milk at all.
Breastfeeding & Bedsharing
Breastfeeding and bedsharing can be a hard topic to talk about with your doctor. Create a plan so you feel confident to discuss about the following topics:
• Preparing a safe sleep space.
• Normal hormone-driven sleep during breastfeeding.
• What to do when you are drowsy or falling asleep when feeding.
Room Sharing
Keeping your baby close by allows you to watch and respond to their needs right away. Room share for at least the first six months and if possible, the first year.
• Before bringing your baby into bed with you, remove all soft bedding, toys, and pillows.
• If you fall asleep with your baby in your bed, place them back on a separate safe sleep surface as soon as you wake up.
Stay Smoke & Vape Free
Keep baby’s surroundings smoke and vape free during pregnancy and after birth.
• If your baby is around those who smoke or vape, it can be harder for them to breathe and increases the risk of SIDs.
• Do not let babies share a bed with adult smokers or vape users.
Stay Drug & Alcohol Free
Babies exposed to alcohol and drugs during pregnancy and after birth may have a harder time waking up when they need help.
• Sharing a bed with baby is riskier if parents or caregivers use drugs or alcohol.
• Parents are more likely to roll over onto their baby while under the influence.
Overheating
If your baby gets too hot, they may have trouble waking up and getting oxygen.
• Keep the baby’s room at a temperature that feels comfortable to you in light clothing.
• Use a lightweight sleep sack or footed sleeper instead of a blanket.
• When indoors, keep your baby’s head free of hats or other coverings.
• A sweaty or damp baby is too hot.
Baby Checkups & Vaccines
Vaccines help babies stay healthy and may protect them from SIDS.
• Doctors have the most up-to-date advice on how to keep baby safe and healthy.
• Go to all recommended checkups to make sure your baby is growing and developing well.
• Earn rewards for going to checkups and getting vaccines on time. (Limitations and restrictions apply.)
Your Baby Needs Checkups & Vaccines As They Grow!
Babies need regular checkups to monitor their growth and vaccines to protect them from serious diseases. Give your baby the best start in life by going to checkups and getting vaccines on time.
HepB (1st dose) Usually given within 24 hours of birth or before leaving the hospital.
Flu (each flu season) + Catch up on any missed vaccines!
Flu (each flu season) + Catch up on any missed vaccines!
STAR, STAR Kids, and CHIP Members can earn up to $155 for going to checkups and getting vaccines!
Call 210-358-6055 or email healthyhelp@cfhp.com to claim gift cards.
DTaP: Diphtheria, Tetanus, and Pertussis (Whooping Cough)
HepA: Hepatitis A
HepB: Hepatitis B
Hib: Haemophilus Influenza Type B
Flu: Influenza
Limitations and restrictions may apply. Rewards are effective starting September 1, 2025 and may change yearly. Scan the QR code to see the latest gift card amounts.
for completing 2-month checkup
for completing 4-month checkup
$20 for completing Rota series + $10 for completing 6-month checkup
for completing 9-month checkup
$25 for completing flu series + $10 for completing 12-month checkup
for completing 15-month checkup
for completing 18-month checkup
$10 for completing 24-month checkup + $20 for completing childhood vaccine series for completing 30-month checkup
Total
$155
OTHER VACCINES
RSV: Babies whose mothers did not get the RSV vaccine during pregnancy, and some babies 8-19 months who are at increased risk, should get the RSV vaccine
IPV: Polio
MMR: Measles, Mumps, and Rubella
PCV: Pneumococcal Conjugate Vaccine
Rota: Rotavirus
VZV: Varicella Zoster Virus (Chickenpox)
COVID-19: The COVID-19 vaccine is safe and effective for babies 6 months and up. Parents should discuss the benefits of the COVID-19 vaccine with their child’s doctor.
Talk to your child’s doctor if they have a medical condition that puts them at higher risk of infection, is traveling outside the United States, or missed a vaccine recommended for their age.
GIFT CARD REWARDS! CHECK UP
VACCINES
VACCINE KEY
Baby Monitors & Devices
Using a baby monitor or device at home does not prevent the risk of SIDS or warn you in time that your baby is at risk of SIDS.
• Always follow safe sleep practices, even if choose to use a baby monitor or device.
• If your baby was born early or has a special health issue, talk with their doctor about how to follow safe sleep practices.
Tummy Time
Tummy time can begin right after birth and can also be done with baby on your chest. It strengthens muscles that support a baby’s head and may prevent flat spots.
• Tummy time helps babies develop arm, shoulder, and neck strength.
• Supervised tummy time each day helps a baby’s brain grow by learning and playing.
• Give your baby tummy time each day and ask your baby’s caregivers to use tummy time, too.
Swaddling & Rolling Over
Avoid swaddling once your baby starts to roll over (two to three months of age).
• If you swaddle your baby, always place the baby on their back to sleep.
• If your baby is placed on their stomach or rolls onto their stomach while swaddled, the risk of death is higher.
• Swaddling does not reduce the risk of SIDS.
Pacifiers
Suckling, either during breastfeeding or when using a pacifier during sleep, can help keep your baby from sleeping too deeply.
• Use a pacifier that is free of toys or cords.
• Never attach a pacifier to baby’s clothes to avoid choking, strangulation, or suffocation.
• If pacifier falls out of baby’s mouth during sleep, there is no need to put it back.
Babies Born Early
If your baby was in the Neonatal Intensive Care Unit (NICU), you don’t have to recreate a NICU environment at home.
• Ask the hospital staff how to prepare for safe sleep at home.
• The plan can include how to change your baby’s sleep position from their side to their back.
Sleep Training
The term “sleep training” is often used to describe any methods parents use to get their baby to sleep longer at night.
Sleep training babies younger than six months can result in:
• Poor nutrition (it may limit the number of times your baby is eating)
• Separation from mom (this can impact if you are successful at breastfeeding)
Putting your baby to sleep in a separate room for sleep training may also be linked to an increased risk of SIDS.
Postpartum Healing and Support
Postpartum Healing and Support
“I honor my body and my journey. It’s okay to rest, to ask for help, and to care for myself with kindness. Each day, I grow stronger, and I am worthy of the same love and care I give to others.”
Postpartum Support Care Team
• OB/GYN or primary care provider
• Partner, family, and friends
• Baby’s pediatrician
• Other health professionals (lactation consultant, mental health provider, physical therapist)
Healing and Recovery at Home
Care After Vaginal Birth
• Bleeding may last 4 to 6 weeks, but your bleeding should start to get less after 2 weeks
• Do not use tampons or douche
• If you are having afterpains (cramps), it’s safe to take over-thecounter pain medication
Care After C-section:
• Recovery may take 4 weeks or more
• No heavy lifting or strenuous activity
• Monitor your incision site for signs and symptoms of infection:
» Fever/chills
» Redness or oozing
» Foul smell
» Opening of incision
Conditions to Watch for After Birth
There are some conditions that can happen after childbirth that come on suddenly and get worse quickly. Without treatment right away, they can cause serious and sometimes life-threatening issues.
Four of these conditions are:
1. Postpartum Preeclampsia
2. Postpartum Hemorrhage
3. Postpartum Endometritis
4. Gestational Diabetes
Postpartum Preeclampsia
Postpartum preeclampsia is a serious blood pressure disorder. If you are diagnosed with preeclampsia or heart-related complications during pregnancy, it is important to go to your postpartum visit 3 to 7 days after you leave the hospital and keep seeing your doctor as recommended.
Postpartum Preeclampsia – Signs & Symptoms
If you recognize these warning signs, call your doctor right away:
• Changes in vision (blurring, light sensitivity, seeing spots)
• A headache that won’t go away
• Shortness of breath
• Swelling of the face or hands
• Pain in the shoulder or abdominal (belly) area, often on the upper right side
• Nausea or vomiting
• Sudden weight gain (2 to 3 pounds or more in a week)
Postpartum Hemorrhage
Vaginal bleeding and discharge after delivery is normal and will become lighter days and weeks following birth. This is called lochia.
Postpartum hemorrhage is bleeding that’s much heavier than usual — meaning you’re soaking through 2 pads an hour for more than 1 to 2 hours. This can happen anywhere from 24 hours to 12 weeks after birth.
Postpartum Hemorrhage – Signs & Symptoms
If you recognize these warning signs, call your doctor right away:
• Low blood pressure
• Pale or clammy skin
• Feeling faint, dizzy, or weak
• Confused
• Rapid heart rate
• Pain and swelling near the vagina or perineum (the area between the vagina and the anus)
Postpartum Endometritis
Postpartum endometritis is an infection caused by bacteria that gets into the lining of the uterus during childbirth. This can happen anywhere from 2-10 days to 6 weeks after birth.
Postpartum Endometritis – Signs & Symptoms
If you recognize these warning signs, call your doctor right away:
• Fever and chills
• Feeling tired or sick
• Abdominal pain or tenderness
• Notice of a foul-smelling vaginal discharge
If not treated, postpartum endometritis can lead to hemorrhage (heavy bleeding), sepsis (the body’s response to an infection that is not treated), or organ failure (major organs in the body stop working).
Gestational Diabetes
Gestational diabetes during pregnancy usually goes away after birth, but it is a warning sign for your future health. Women who have gestational diabetes are more likely to have it again during future pregnancies and 15–70% will develop diabetes later in life.
After Delivery:
• Get a blood test 4 to 12 weeks after birth to check your blood sugar.
• If your blood sugar is normal, get screened for diabetes every 1 to 3 years.
Pelvic Support and Exercises
Pelvic Support and Exercises
Pelvic Organ Prolapse
Pelvic organ prolapse is when the pelvic organs (bladder, uterus, or rectum) drop from their normal position due to weakened support muscles and tissues often from pregnancy and childbirth.
Pelvic Organ Prolapse – Signs and Symptoms
• Pelvic pressure or fullness
• Urinary incontinence (leaking urine)
• Lower back pain
• Difficulty having a bowel movement
• Problems inserting tampon
Pelvic Floor Exercises
Kegel exercises help strengthen your pelvic floor muscles and can be done at any time.
Follow these easy steps:
1. Squeeze the muscles that you use to stop the flow of pee. This contraction pulls your vagina and rectum up and back.
2. Hold for 3 seconds
3. Relax for 3 seconds.
Try to do 10 squeeze holds, 3 times a day. Increase how long you hold by 1 second each week. Work your way up to 10-second holds.
Exercise and Diet
EXERCISE AND DIET
Postpartum Exercise
Start exercising only when you feel ready and after you’ve been cleared by your doctor. Exercise provides many health benefits to moms, including:
• Boost in energy
• Better sleep
• Stress relief
• Stronger abdominal muscles
• Less risk of postpartum depression
Workout Plan
Start slowly. Listen to your body, stay hydrated, and stop if you feel any pain.
• Aim for 150 minutes of aerobic activity a week. Anything that gets your heart beating faster counts.
• Do muscle-strengthening activities 2 days a week.
Is that more than you can do right now? Start with 5 minutes. It all adds up!
Your Way! Walk. Run. Zumba. Dance. Play.
Eating Healthy
Diet is one of the most important aspects in your life. It affects your health, energy level, immune system, and weight. When you eat well, you are also modeling good nutrition for your family and children.
Well-Balanced Diet
When deciding what to eat or drink, choose options that are full of nutrients and limited in added sugars, saturated fat, and sodium.
Try to eat food from ALL five food groups: fruits, vegetables, grains, dairy, and protein.
• Make half your plate fruits and vegetables
• Eat whole grains: oats, brown rice, whole-grain breads
• Rotate proteins like chicken, lean meats, seafood
• Eat healthy dairy choices like milk, yogurt, and cottage cheese
• Drink plenty of water
Feeding
FEEDING
Every mom wants to give their baby the healthiest possible start in life. There are two ways to feed your baby: breastfeeding and formula feeding. It’s a personal choice, often best made with your doctor.
Breastfeeding
Breastfeeding is a natural process that allows your body to produce milk for your baby. Breastmilk is your baby’s primary source of nutrition for the first 6 months of life. It has just the right nutrients in just the right amounts and is designed to nourish your baby fully and help their mind and body grown.
Benefits of Breastfeeding
Breastfeeding may lower your baby’s risk of certain infections and diseases later, including:
• Ear infections
• Asthma
• High blood pressure
• Type 2 diabetes
Breastfeeding is good for moms, too. It can help you recover more quickly from childbirth, reduce your risk for high blood pressure, certain breast and ovarian cancers, and type 2 diabetes.
Breastfeeding Prep
• Wash your hands before you feed.
• Get in a position where you feel comfortable and supported.
• Have a nursing or bed pillow or folded blankets handy to support your baby .
• Drink plenty of water.
If you are pumping, store pumped breast milk appropriately and clean and sterilize pump and bottle parts.
The Best Care for Breast Care
• Apply nipple cream to avoid cracking of nipples.
• Apply a cold compress for pain or swelling.
• Hand express if you feel engorged (very full).
• Pat dry or air dry the breast to avoid cracking of nipples.
• Take over-the-counter pain medication for sore, cracked nipples and/ or afterbirth pains.
• Wear a supportive bra
Breastfeeding Positions
Cradle Hold: Sit up as straight as you can and cradle your baby in the crook of your arm. The baby’s body should be turned toward you and the baby’s belly should be against yours. Support the baby’s head in the bend of your elbow so that the baby is facing your breast.
Cross-Cradle Hold: Just like in the cradle hold, nuzzle your baby’s belly against yours. Hold the baby in the arm opposite the breast you are using to nurse. For example, if the baby is nursing from your right breast, hold the baby with your left arm. Place the baby’s bottom in the crook of your left arm and support the baby’s head and neck with your left hand. This position gives you more control of the baby’s head. It’s a good position for a newborn who is having trouble nursing.
Football Hold: Tuck your baby under your arm like a football. Hold the baby at your side, level with your waist, so the baby is facing you. Support the baby’s back with your upper arm and hold the baby’s head level with your breast.
Side-Lying Position: Lie on your side and nestle your baby next to you. Place your fingers beneath your breast and lift it up to help your baby reach your nipple. Rest your head on your lower arm. You may want to tuck a pillow behind your back to help hold yourself up. This position is good for night feedings. It’s also good if you have had a C-section because it keeps the baby’s weight off your abdomen and incision.
Breastfeeding Tips
• Cup your breast in your hand and stroke your baby’s lower lip with your nipple. This stimulates the baby’s instinct to turn toward the nipple, open their mouth, and latch.
• When the baby opens their mouth wide, pull the baby close to you and aim your nipple toward the roof of the baby’s mouth.
• Bring your baby to your breast, not your breast to your baby.
• Use pillows or folded blankets to help support the baby.
Mastitis
Mastitis is inflammation of the breast caused by an infection. It can take place when milk ducts are not properly drained causing swelling. Infection may occur from cracked or sore nipples. It is most common during the first 6 months of breastfeeding and can be very painful.
If you have any of the following symptoms, you may have mastitis and should call your doctor right away:
• Pain, swelling, and warmth to area
• Chills and flu-like symptoms
• Fever
Breastfeeding Support
If you have questions about breastfeeding, are struggling with your breastfeeding relationship, or are not sure what is really best for your baby, help is available at no cost from our local, growing breastfeeding community. It takes a village!
• International Board-Certified Lactation Consultants (IBCLC) specialize in breastfeeding and can provide hands-on support.
• Postpartum doulas can offer emotional support and reassurance in your breastfeeding journey.
• Your OB/GYN or doctor can help you find a lactation consultant, write a prescription for a breast pump, and teach you about medication safety while breastfeeding.
• Local breastfeeding organizations can offer you evaluations and support from lactations consultants, nursing accessories and breast pumps, plus a welcoming space, support groups, and resources:
» Latched Support: 210-504-8015
» San Antonio Lactation Support Center: 210-210-7138
» La Leche League of San Antonio: 210-341-9669
» WIC Lactation Peer Counselors: Contact your local WIC office
Formula Feeding
Formula is commercially prepared alternative to breastfeeding. It contains milk proteins, calories, fat, vitamins, and minerals needed for your baby’s growth and development.
Benefits of Formula Feeding
• Gives you more flexibility for work, errands, and caring for other children.
• Lets your partner or family members help—by preparing bottles or giving a feeding—so they can bond with your baby, too.
• Allows you to measure how much your baby is eating.
Formula Prep
• Wash your hands.
• Prepare your baby’s bottle in a clean area.
• Clean and sanitize bottles and store them appropriately.
• Check temperature before feeding
Bottle Feeding Positions
• Hold baby’s head higher than the rest of their body.
• Hold bottle as level as possible.
• Do not prop up your baby’s bottle with a pillow or blanket or leave them unattended.
• Throw away any formula left in bottle after one hour.
Formula Support
WIC (Women, Infants, and Children) can provide both milk-and soybased formulas and therapeutic formulas for medical conditions. Call 210-207-4650 to make an appointment at your local WIC clinic.
Family Feeding Support
There are many ways your partner and family can help with feeding:
• Set up a comfortable breastfeeding spot for you.
• Prepare bottles, store pumped milk, and clean bottles/pump parts.
• Burp baby after feedings.
• Check in on you and show patience and understanding.
• Prepare meals and snacks and bring you water.
Family Planning
Family Planning
Family planning and/or birth control is a way to avoid pregnancy. It is recommended to wait at least 18 months between pregnancies before having another baby. Talk with your doctor about birth control options and consider:
• Timing: How soon can you start birth control of choice?
• Breastfeeding: Which options are safe? Will they affect your milk supply?
• Effectiveness: Is your previous birth control option still the best choice to prevent pregnancy?
• Health risks: What health risks are associated with different birth control options?
It is recommended to wait to resume sexual activity until after your postpartum visit and exam. Giving your body time to heal reduces the risk of infection.
You may or may not feel ready to have sex again shortly after delivery. Talking with your partner about how you both feel is important
Mom’s View on Sex After Baby
• Loss of interest
• Feeling tired
• Feeling “touched out”
• Leaking breasts
• Vaginal tenderness or dryness
• Hormone changes
Partner’s View on Sex After Baby
• Fear of hurting mom
• New stresses
• Feeling tired
Sexual Discomfort
If sex is uncomfortable, talk with your partner about how you are feeling. They might feel the same way. To make sex more comfortable, try:
• Pelvic floor exercises.
• Using a lubricant.
• Giving yourself plenty of time and choosing a time when you feel rested and relax.
If sex continues to be painful, make an appointment with your doctor to talk about treatment that can help.
Resources & Support
Healthy Texas Women offers women’s health and family planning services at no cost to eligible women in Texas, including:
• Family planning options
• Pregnancy testing
• Pelvic examinations
• Sexually transmitted infection services
• Breast and cervical cancer screenings
• Mammograms
• Screening and treatment for postpartum depression
Learn more at HealthyTexasWomen.org.
Emotional and Mental Health
Emotional and Mental Health
“I give myself permission to feel, to heal, and to grow. My mental health matters and caring for my mind is an act of love—for myself and for those I care for. I am not alone, and each step I take is a step toward strength and peace.”
Mental Health Matters
• One in 5 adults in America suffers from mental health issues.
• Mental health issues are more common in women than in men.
• Mental health crisis (like suicide and overdose) are the leading underlying cause of pregnancy-related deaths in the United States.
Common Mental Health Conditions
• Anxiety disorders
• Depression
• Posttraumatic stress disorder (PTSD)
• Bipolar disorder
Perinatal Mental Health
• Up to 85% of women will experience the “baby blues.”
• 20% of women experience clinical depression during and/or in the time following birth.
• Postpartum psychosis will occur in 1–2 of every 1,000 births.
• Postpartum Depression (PPD), a form of depression, can occur up to 1 year after having a baby, but most commonly starts 1–3 weeks after childbirth.
Postpartum Depression Signs & Symptoms
• Feelings of sadness and anxiety
• Pulling away from family and friends
• Growing inability to care for yourself or baby
• Thoughts of harming yourself
If the signs and symptoms of postpartum depression do not improve after two weeks or get worse, it’s important to get help.
Mental Wellness Tips
• Get plenty of rest
• Ask for help
• Focus on your baby, not chores
• Talk about your feelings
Mental Health Support
If you need help right away, call 24/7/365:
• Suicide and Crisis Lifeline: 988 (call or text)
• Community First Nurse Advice Line: 210-227-2347
• Community First Behavioral Health Line:
» STAR Kids/STAR+PLUS: 1-844-541-2347
» All Other Health Plans: 1-877-221-2226
• National Maternal Mental Health Hotline: 1-833-TLC-MAMA (1-833-852-6262)
You can also talk to a trusted support person, join a support group, or call your doctor, OB/GYN, or your baby’s pediatrician.
Mental Health Treatment
Did you know that mental health treatment and support is a covered benefit under your health plan. You don’t need a referral to make an appointment. You can find a mental health provider online at CommunityFirstHealthPlan.com/Find-Provider.
Treatment options may include:
• Talk therapy
• Medication
• Combination of treatments
Intimate Partner Violence
Intimate Partner Violence
1 out of every 6 pregnant women in the United States experience intimate partner violence, regardless of their background.
Intimate partner violence can take many forms, such as:
• Physical violence
• Sexual violence
• Emotional abuse
• Financial abuse Violence may intensify when stress levels are high.
Warning Signs
Talk to someone if in the last year you’ve experienced one or more of the following with your partner or ex-partner:
• Fear
• Felt put down or emotionally hurt
• Been forced into any sexual activity
• Been hit, kicked, slapped, or physically hurt
Help & Support
• Family Violence Prevention Services: 210-733-8810
• Bexar County Family Justice Center: 210-631-0100
• Rape Crisis Center: 210-349-7273
• National Domestic Violence Hotline: 1-800-799-7233
• Text: LOVEIS (22522) if you are unable to speak safely
“I deserve to feel safe, supported, and respected. My experiences do not define my worth—I am resilient, and I have the right to heal and rebuild in peace. I am not alone, and help is available to guide me toward safety and strength.”
Substance Use and Misuse
“Healing begins with honesty and compassion – not shame. Acknowledging your struggle is not weakness –it’s strength. It’s about choosing yourself again and again.”
Substance Use and Misuse
1 in 5 moms suffer from postpartum depression. An estimated 60% of mothers with depressive symptoms go untreated. When untreated, it can lead to use and misuse of substances, including:
• Opioids
• Alcohol
• Smoking
• Vaping
Am I Addicted?
• Do you feel a very strong mental and/or physical need for a substance?
• Do you need higher amounts to feel better over time?
• Are you unable to stop using the substance?
• Are you doing things to get the substance that are dangerous?
Opioids
Your doctor may prescribe opioids for severe pain after childbirth.
Risks When Using Opioids
• Sleepiness
• Unable to feel emotionally connected to your baby
• Addictive
• Interferes with decision making
If you are taking opioids, you may not need to take all pills prescribed. There are safe ways to dispose of unused medication.
Alcohol
Mothers with postpartum depression may turn to alcohol to selfmedicate their symptoms.
Risks When Using Alcohol
• Worsens symptoms of depression
• Unable to feel emotionally connected to your baby
• Adversely interacts with anti-depressants
• Addictive
• Increases family conflicts or other relationship problems
Smoking and Vaping
Smoking and vaping may have negative effects on you and your baby.
• Cigarette smoke contains gases made of chemicals including nicotine, arsenic, lead, and carbon monoxide.
• Vaping (a battery-operated device that heats liquid into fine spray to be inhaled) includes nicotine, lead, ethylene glycol, etc.
Benefits to Being Tobacco Free
• More energy and helps you breathe more easily.
• Saves money for other expenses.
• Makes your clothes, hair, and home smell better.
• Gives you more birth control methods.
• Helps prevent heart disease, lung disease, and cancer.
• Helps prevent colds and serious illnesses like pneumonia.
Addiction Help
If you are concerned about addiction:
• Talk to your provider
• Join a Medication Assisted Treatment (MAT) program
“I am strong and capable of overcoming challenges. I deserve love and respect, especially from myself. Each step I take toward healing reflects my courage and resilience.”
CONTACT US
Community First Health Educators
Our Health Educators can connect you to local resources and support for postpartum depression, breastfeeding, parenting, and more.
210-358-6055
healthyhelp@cfhp.com
Nurse Advice Line
Need medical advice after hours? Call the Community First 24/7 Nurse Advice Line to speak to a Registered Nurse in English or Spanish.
1-800-434-2347
Behavioral Health Support
Need help finding mental health support or care? Call the Community First 24/7 Behavioral Support Line.
STAR Kids/STAR+PLUS: 1-844-541-2347
All Other Health Plans: 1-877-221-2226
SOURCES
• ACOG, 3 Conditions to Watch for After Childbirth
• ACOG, Gestational Diabetes
• ACOG, Breastfeeding Your Baby
• ACOG, Postpartum Depression
• Alcohol.org, Self-Medicating With Alcohol: Postpartum Depression Symptoms
• American Academy of Pediatrics, Recommendations for Reducing Infant Deaths in the Sleep Environment
• Birth Injury Center, Breastfeeding vs. Baby Formula: A Guide for Parents
• CDC, Breastfeeding Recommendations and Guidance
• CDC, Infant Formula Preparation and Storage
• CDC, Clinical Screening and Diagnosis for Critical Congenital Heart Defects
• City of San Antonio, WIC Breastfeeding Resources
• City of San Antonio, Lactation Support Center
• City of San Antonio, Domestic Violence Resources
• Healthwise, Caring for Yourself After Vaginal Delivery
• Healthwise, 5 Ways to Prepare for Breastfeeding
• Healthwise, Mastitis While Breastfeeding
• La Leche League International, Breastfeeding Support
• MotherToBaby, Cigarette Smoke
• National Center for Education in Maternal and Child Health, NAPPSS, An Individualized Approach to Helping Families Embrace Safe Sleep and Breastfeeding
• NIH: National Library of Medicine, Postpartum Substance Use and Depressive Symptoms: A Review
• Office of Disease Prevention and Health Promotion, Move Your Way
• Postpartum Support International, The Blue Dot Project
• Texas Department of State Health Services (DSHS), Safe Infant Sleep
• Texas Health and Human Services, Healthy Texas Women
• Texas Health and Human Services, Information for Parents of Newborns
SOURCES
• Texas WIC, How to Mix Infant Formula
• Texas WIC, Breastmilk Counts
• The Mother Baby Center, The 4th Trimester: What is it and How Long Does it Last?
• UC Davis Human Lactation Center, Jane Henig, PhD, IBCLC, Understanding Baby Behavior
• UNC Collaborative for Maternal & Infant Health, Show Your Love Mental Health Matters
• U.S. Department of Agriculture, MyPlate
• WIC Breastfeeding Support, Nutrition While Breastfeeding
• WIC Breastfeeding Support, Breastfeeding Basics
• 4th Trimester Project, Ready for Sex
• 4th Trimester Project, Physical Pain with Sex
• 4th Trimester Project, Postpartum Mental Health & Wellness
