Who Does What in Postpartum Care? Your Care Team Explained

"Call a therapist. Talk to your OB. Ask about medication." Your doctor said it kindly, and it landed like three more jobs on a list you already can't finish. Who do you call first? What do you even say? And why does it feel like you're the project manager of your own recovery?

Because, right now, you are. That's one of the hardest parts of postpartum care. The person least able to coordinate anything is usually the one coordinating. So let me do some of it for you here.

Who's on the team, and what each one is for

Your OB, midwife, or primary care doctor. The front door. They screen, rule out medical causes (thyroid, anemia, and sleep deprivation can all look like depression), and refer. They may also prescribe. What to say: "I'm worried about how I've been feeling. Can we talk about what might be going on and who I should see?"

A therapist or psychologist. That's me. This is where the actual work happens: understanding what's driving the anxiety or depression, building the skills to get through it, and planning for what's ahead. Psychologists don't prescribe; I coordinate with the people who do. What to ask any therapist: "What would we focus on, how do we set goals, and how will we know it's working?"

A prescriber. Could be your OB, a psychiatrist, or a psychiatric nurse practitioner. They decide whether medication fits, which one, and how to monitor it. What to ask: "What are the benefits and risks for me specifically, and what's the plan for follow-up?" I wrote a separate guide to the questions worth asking about medication.

A pharmacist. Underused and free. They can explain instructions, interactions, and what to do about a missed dose, often faster than the prescriber's office can call you back.

You may not need all four. Plenty of moms get well with therapy alone; some need medication for a stretch; a few need both plus a specialist. Nobody expects you to know which you are in advance. That's what the front-door conversation is for.

Make someone own the next step

This is the single most useful habit I can give you. At the end of every appointment, before you stand up, ask: "What happens next, and who does it?" Will the office send the referral, or should you call? Who do you contact if you hear nothing in two weeks? Which clinician needs to know if your symptoms change?

"We'll get that referral over" is where moms fall through the cracks. "Dr. Patel's office will call you by Friday, and here's their number if they don't" is a plan.

Your providers probably can't see each other's notes

Separate offices don't share records by default. If you want your therapist and prescriber talking (I usually do), you'll sign a release that says so, and you can ask exactly what gets shared. It's also fine to ask what confidentiality covers and where its limits are. Knowing the rules makes it easier to be honest.

Keep one note

On your phone: provider names and numbers, next appointment, current plan, current medication and dose, questions as they come to you. It doesn't replace anyone's records. It just means you don't have to hold it all in a head that's running on four hours of sleep.

Where I fit

I'm the therapist piece. If you're not sure whether therapy is the right starting point, that's a fine thing to figure out on a free 15-minute consultation; I'll tell you honestly if I think you should see your doctor first. If you've never done this before, here's what the first session is like, and here's how the different kinds of support compare.

Don't let coordination delay an emergency

If you can't keep yourself or your baby safe, or you're hearing or seeing things others don't or feel severely confused, call 911 or go to the nearest emergency room. Call or text 988 for crisis support. No referral needed.