Emotional wellbeing

In the first few days following the birth of a baby, most women experience a range of feelings. These can vary from extreme happiness to mood swing, aniety, exhaustion and tearfulness. These affect about half to three quarters of women and most commonly occur on the third of fourth day of birth but may occur up the days after delivery. These feelings are normal and short-lived and you should be back to your normal state within a few days. We do not know why the ‘blues’ occur but we think they may be related to the bodily changes that occur after a woman has given birth.

Anxiety can affect people in different ways and sometimes prevent them from doing ordinary everyday things. We all have anxiety where we worry more, feel our heart is racing,possibly feeling dizzy or nauseous and this is normal when we are taking an exam, having an interview etc. If these symptoms are happening when you wouldn’t expect them to and stop you doing things then you many need to speak to someone and get some help to deal with your anxiety.

Sometimes, a woman can have intrusive thoughts that are distressing about causing harm or harm coming to her baby. Please share any such thoughts as this can be part of an OCD disorder which is very distressing but very treatable.

Stress is another common problem that can affect anyone but if you are finding that you are feeling or experiencing stress causing increased irritability, affecting sleep, worrying more, increasing your anxiety, feeling you can’t cope with all the demands being made on your time please tell someone and get some help. We know that stress during pregnancy can affect foetal brain development and in the post birth period it can contribute to a greater risk of low mood.

Depression in the ante natal period can make you more vulnerable to post natal depression (PND). PND is estimated as occurring in about 10% of mothers (and sometimes the father’s too) and can be relatively mild and resolve with some extra support at home. In more severe cases you might need some additional professional support to help you manage your low mood.

The symptoms of depression whether in the ante-natal or post-natal period include:

• Feeling low with depressed mood for the majority of days or majority of the time
• Lack of interest or enjoyment and pleasure in things that you would usually enjoy
• Loss of appetite
• Difficulty in sleeping
• Having little energy or motivation to do things, finding it hard to concentrate
• Feeling or being more tearful than you would expect to be
• Worrying more and feeling anxious, isolating yourself away from friends and avoiding contact
• Feeling that you aren’t doing a good job of being a mother
• Feeling guilty about not enjoying your baby or thinking you are being a bad mother
• Sometimes when someone is particularly low they can have thoughts of suicide as a way of dealing with how they feel – you must tell someone and seek help if these thoughts start to happen
• Sometimes mothers can have intrusive thoughts about causing harm to their baby-these are very distressing and often caused by increased anxiety so please tell someone about this is you are having these thoughts

• Any new mother can get depression (about 1 in 10 get PND) but we also know that you are at increased risk if:
• You have had a previous history of depression or other mental health disorder.
• Increased risk of PND if you have depression during pregnancy.
• Being alone or isolated with little support and poor social contact network.
• Poor relationship with your partner.
• Recent stressful events such as moving house or bereavement.

There are other everyday things that can contribute to a woman developing depression that relate to the needs of caring for your new baby. These include the baby’s temperament, overwhelming feelings of tiredness from having to cope with disturbed sleep patterns and social isolation - having to be at home all day with just you and your baby.

Some research studies have reported that post-natal depression can affect the mother’s ability to bond with her bump or her new baby. The first few months are very important for the development of the baby and later difficulties can arise in the baby’s intellectual and emotional development if the bond between mother and baby is delayed or if their needs aren’t being met. Research has shown that as long as it is done with care and love, extra help from a partner or other adult can make an important difference.

Common mental health and emotional problems can respond very well to treatment and support but you need to tell someone such as your partner, midwife, GP or health visitor that you are struggling and want some help.

Sometimes, some extra support at home or from family and friends is enough to help you overcome your difficulties but if it isn’t or you are worried please tell your midwife, GP or health visitor as they will know what is available in your area. Babies can be very demanding and it is important that you look after yourself as well as the baby.

• Accept offers of help
• Cut down on domestic chores
• Rest when baby sleeps
• Keep meals simple
• Do not have too many visitors at any one time (helps avoid feeling overwhelmed)

This condition, which is also called puerperal psychosis is extremely rare and only one or two women in 1,000 develop a severe psychotic episode out of the blue and without prior warning that requires medical or hospital treatment. This illness can develop within hours of childbirth and is very serious needing urgent attention. Other people often notice first as the mother acts strangely, odd or unusual. If you start to have thoughts, feelings, or hear voices that seem odd or unusual that you find distressing, even if you think others will see them as silly, you must tell someone straight away and get help. Specialist mother and baby units can provide expert treatment without separating you form your baby. Most women make a full recovery although this may take a few weeks or months.

If you think your emotional wellbeing is not as it should be, it is very important that you seek advice for your own particular situation. It may be easier to contact someone you know such as you midwife health visitor or GP.

Alternatively you may wish to contact a self-help organisation for help and advice, such as:

• The Association for Postnatal Illness

Tel: 020 7386 0868

Contact: https://apni.org/contact/

• Action on Postpartum Psychosis (APP)

Tel: 020 3322 9900

Contact: app@app-network.org