We all have high expectations of joy and deep fulfillment when we’re about to have a baby. Our minds fill with images of radiant moms and dads cooing with delight over their tiny babies.

But for many parents, there is a darker side of that rainbow… exhaustion. The deep fatigue that is an almost universal stress to new parents can cast a pall over much of this happiness—which is why there is such a significant link between sleep deprivation and postpartum depression or anxiety.

Postpartum depression (PPD) and postpartum anxiety (PPA) is an unwelcome visitor to one in six new mothers (and many new fathers, too). Yet, despite how common it is, somehow it still feels like a rude surprise whenever it arrives.

In more than 30 years as a pediatrician, I have heard thousands of exasperated parents ask the same question: “Why didn’t anyone tell me it would be this hard?”

However, even when expectant couples are warned about how hard the first months can be, they often blithely believe that PPD or PPA is a problem “other people” have. Then baby arrives and stress, exhuastion and general overwhelm often sets in, which sets the stage for anxiety and/or depression.

The truth is, modern parenting doesn’t automatically grant us the same community structures that used to help new parents. Sure, we don’t have to wash our clothes in the river like past generations of parents, but two huge societal shifts make modern baby-rearing much tougher: For one, most new moms and dads have little experience—many have never even held a baby before. Secondly, few new parents have strong family support.

They say it takes a village to raise a child, and this is first time in human history that parents don’t have “the village” to help them. Today, families are spread across the country and it’s a luxury to have baby care help.

This lack of support can lead to serious sleep deprivation. And while most new parents expect that being tired is part of the job, profound exhaustion is not at all a trivial problem.

Recently, BabyCenter and I surveyed more than 1,000 new mothers. Almost 80 percent said they routinely felt tired or exhausted. Most said sleep deprivation was their biggest angst—well ahead of a lack of time or money.

Other studies confirm that 50 percent of new parents get fewer than 6.5 hours of fractured sleep each night. That little sleep can cause a similar mental impairment to being drunk and double the risk of serious car accident. Further, exhaustion can lead to marital stress, infant death from unsafe sleeping and failed breastfeeding.

And, as mentioned above, topping the list of the problems from extreme fatigue is PPD or PPA.  These affect about 15 percent of new moms—and many husbands. (Yes, men can get it, too.)

Unfortunately, many mothers don’t really know what PPD or PPA feels like. When people hear it mentioned, they imagine a mom who is sad and weepy. But, an even more common way it manifests is with anxiety, irritability and intrusive fears.

Many moms with PPD or PPA say they can’t turn off their minds… and can’t rest, even when the baby is sleeping. This can lead to marital stress, shame and secrecy, low self-esteem, poor bonding, obesity, accidents, infant sleep death, breastfeeding problems, lifelong depression and even suicide or infanticide. This list is not meant to provoke fear. Quite the opposite, it’s meant to encourage us to work as hard as possible to find a solution.

Fortunately, the conversation around PPD and PPA has begun to see the light of day. Chrissy Teigen penned a moving, insightful piece in Glamour to share her battle with postpartum with other moms and moms-to-be. Other stars—Brooke Shields, Sarah Michelle Gellar, Hayden Panettiere and Adele—have also chronicled their painful experiences. Centers to aid depressed new mothers have popped up across the United States, including, Los Angeles, San Diego, Chapel Hill and Providence. And The Motherhood Center opened in New York City just last month.

Today, medical groups such as the American Academy of Pediatrics to the American College of Obstetrics and Gynecology have strongly supported efforts to screen all new mothers for depression. And, thanks in large part to the leadership of Sen. Kirsten Gillibrand, the United States Congress passed a bill to provide resources to support screening and treatment services.

Yet, these important steps fall far short of what will ultimately be needed to stem this crisis. We cannot simply wait for women to get depressed and then hope they come to a doctor to get screened. We need robust programs to prevent PPD and PPA before it occurs.

Fortunately, new hope is on the horizon.

We now know that exhaustion can raise a woman’s risk of PPD or PPA 7-27-fold during the first months after birth. Crying is also associated with a 4-fold increase of PPD or PPA. So, by preventing crying and boosting sleep, we may be able to significantly lower the risk of developing PPD or PPA.

As the author of The Happiest Baby on the Block, some techniques that I suggest to parents include using motion, white noise and swaddling to help their babies fall asleep easier and stay asleep longer. (My latest project, the SNOO smart infant sleeper, combines many of these good practices. Studies are currently underway from major universities to investigate a potential link between the SNOO and reduced rates of parental depression and anxiety.)

The very hopeful news is that by using new ideas in baby care we are now able to give parents more sleep, less crying and more confidence. And, that gives us a real chance of helping parents and babies be happier and healthier during this amazing stage of life.