Hitting record on a conversation we need to have
I recently recorded a mini session for the Perinatal Mental Health Collective called ADHD in Women Through Life Transitions: Supporting Identity, Capacity, and Well Being. It is a prerecorded training for practitioners who support women and parents through pregnancy, postpartum, and the early years of caregiving.
Twenty minutes is not a lot of time for a topic this big. So I built the session around one question: what does a perinatal provider need to notice, understand, and do differently on Monday morning? Every slide had to earn its place, and every point had to come back to real clinical care.
Recording it felt like a full circle moment. I sat down to talk about executive functioning, sensory overwhelm, and the mental load of motherhood while living all three as a mom of four boys. If you have ever tried to record a polished training while your household is very much awake, you know the special kind of focus that takes. If you need your CE check out the conference here Perinatal Mental Health Collective Conference
This post shares the heart of what I taught, plus some extra thoughts on ADHD and nesting that did not fit in twenty minutes.
Why ADHD gets missed in perinatal care
For years, ADHD was framed as a childhood condition that mostly showed up in busy little boys. Many women learned to compensate quietly, so they reach adulthood undiagnosed or are diagnosed late. Then a baby arrives, and the systems that held everything together start to crack.
The research is finally catching up. An Ontario population study using ICES data compared about 23,000 mothers with ADHD before pregnancy to over one million without. Mothers with ADHD had higher rates of mental health care contact from conception to one year postpartum, including psychiatric emergency visits. The authors note that ADHD affects about 1 in 50 women of reproductive age.
A large Swedish register study found a similar picture. About 17% of mothers diagnosed with ADHD were also diagnosed with postpartum depression, compared with about 3% of mothers without ADHD. Postpartum anxiety followed the same pattern.
Here is what I want every provider to hear: these numbers are not a reason for alarm. They are a reason to ask. When mood concerns show up, ask about ADHD. When ADHD is known, keep screening for mood.
Why it gets harder during life transitions
In the session, I described the perinatal period with three simple ideas. Each one helps explain why symptoms that were manageable before can suddenly feel overwhelming.
More demands. Feeding schedules, appointments, sleep deprivation, and a thousand small decisions every day.
Less structure. Work routines, regular sleep, and outside accountability often disappear overnight.
Brain and hormone shifts. For those who carry a pregnancy, changing hormones can affect attention, mood, and how well familiar coping strategies work.
Under those pressures, a few patterns show up again and again in my work:
Masking. Many women have spent years looking like they have it together. Newborn life leaves very little energy left to keep up the performance.
Sensory overwhelm. Crying, constant touch, noise, and clutter can push a sensitive nervous system past its limit.
Executive functioning strain. Planning, remembering, starting tasks, and switching gears all get heavier when sleep is gone.
Burnout. It can look like depression from the outside, yet it often grows from running on empty for far too long.
None of this is a moral failing. When a parent loses her systems, it tells us her load has outgrown her supports. It does not tell us she is failing her baby.
And caregiving here means parenting in all its forms. Adoptive, foster, and kinship parents, parents through surrogacy, and non birthing partners can feel these same pressures too.
What I ran out of time to say: NESTS and ADHD
Confession: I ran out of time in my presentation. The part I didn't get to was NESTS, the basics of perinatal wellbeing. So here it is.
NESTS is a simple check on the foundations every new parent needs. Now add ADHD, diagnosed or not, plus more demands and less structure. Those basics get a lot harder to hold onto.
N: Nourishment (Eating). Is she even remembering to eat? Hunger cues are easy to miss when attention is pulled in every direction. Try visible, grab and go snacks, a water bottle at every feeding spot, and meals tied to existing routines like feeds.
E: Exercise. Can she move her body, or does the thought alone send her into freeze? Skip the workout plan. A short walk with the stroller, stretching during tummy time, or dancing in the kitchen all count.
S: Sleep. Protect one longer stretch where possible, share night duties, and lower the bar on everything else. HELP HER SLEEP WHEN IT WORKS FOR HER
T: Time for self. Even ten minutes of something that feels like, her can refill a depleted nervous system.
S: Support. Who is in her circle? Name specific people for specific tasks, because "let me know if you need anything" rarely works for an ADHD brain.
As providers, we can check in on NESTS at every visit. It is quick, concrete, and it often reveals overwhelm long before a client has words for it.
(Nutrition, Exercise, Sleep, Time for self, Support).
Practical tools for providers
The heart of the session was practical. These are neurodivergent affirming strategies you can bring into your work right away.
Lead with validation. Shame shrinks when struggles are named as a brain and load mismatch, not a character flaw.
Reduce decision load. Offer two choices instead of ten, set decide by dates, and write plans down so they live outside her head.
Externalize everything. Visual reminders, phone alarms, checklists on the fridge, and shared family calendars.
Support the senses. Earplugs, dimmer lighting, short sensory breaks, and permission to step away and regulate.
Use small, values based actions. From my Behavioural Activation work, tiny scheduled steps rebuild momentum when everything feels too big.
Talk about medication with care. Support informed choice by weighing the risks of treatment against the risks of unmanaged ADHD, and connect clients with trusted resources.
Build a circle. Map who can help, from partners and family to peer groups and community programs.
Make systems friendlier. Text reminders, flexible scheduling, and clear written summaries help everyone, and they help ADHD clients most.
Gretchen Nelson of The Touchstone Institute describes emotional tensions that many perinatal clients with ADHD hold at once, such as wanting connection while sliding into self blame. Naming those tensions out loud in session can reduce shame and lead to more accurate treatment planning. And from my Circle of Security work, I remind parents often that repair matters far more than getting it right.
A quick word for my fellow helpers too. Many of us in caring roles live this as well, so these same supports and this same kindness belong to us.
Closing thoughts
Women with ADHD do not need to be fixed. They need to be seen, supported, and given tools that fit how their brains actually work. When perinatal providers understand ADHD, care becomes kinder, more accurate, and far more effective.
Thank you to the Perinatal Mental Health Collective for the opportunity to share this work. I am so grateful for every provider who chooses to learn a little more so their clients can feel a little less alone.
Connect with me
Website: thedandelionspace.ca
Email: info@thedandelionspace.ca
Instagram: @thegoodenoughmommavictoria
Podcast: Nervous Systers
In Kindness, Victoria
This blog is for educational purposes and is not a substitute for individual clinical care. Full references are in the companion sources document.