Perinatal Mental Health and Postnatal Wellbeing

Perinatal Mental Health refers to mental health conditions which occur during pregnancy and after having a baby.

There are several perinatal mental health conditions that can occur with different symptoms. These can include; depression, anxiety, obsessive-compulsive disorder (OCD), bipolar disorder, postpartum psychosis and post-traumatic stress disorder (PTSD).

Recognising the symptoms of a mental health condition is the starting point to getting the right support for your postnatal wellbeing. If you or someone close to you is struggling with their mental health, please talk to your GP, Midwife or Health Visitor and they will provide advice and support, including a referral to the perinatal mental health team if required.

Specialist Perinatal Mental Health Service Website

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Bonding and Attachment

Some parents may not feel a connection with their baby during pregnancy or establish an immediate affectionate bond with baby early on, and some parents do. This is normal.

The process of bonding with your new-born can feel very different for each parent and their baby, and has no time limit. Bonds that are meant to last a lifetime don’t bind overnight; rather, they form gradually over the days, weeks and months following the arrival of your baby. The more time you spend with your baby, cuddling, feeding, massaging, singing and talking to your baby, the closer you will feel to them. 

Postnatal wellbeing includes a lot of fluctuations and forming that bond as well as adjusting to it can take time.  If however you find that you are continuing to have difficulties bonding with your baby after weeks or months and feeling sad, low or depressed, it could be a sign of post natal depression. 

What you might notice: 

You may notice that you avoid caring for your baby or avoid being left on your own with them. Some mums notice that they are easily frustrated with their babies being unsettled and irritable. You may feel like you don’t know what your baby needs or how to comfort them.  

You may notice that you don’t feel a love for your baby like you thought you would. Some mums describe a ‘disconnect’ from their baby. 

Forming that bond can take time to adjust to.  If however you find that you are continuing to have difficulties bonding with your baby after weeks or months and feeling sad, low or depressed, it could be a sign of post natal depression.

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Bipolar Disorder and Postpartum Psychosis

Understanding Bipolar disorder and pregnancy:

Women with bipolar disorder are at a particularly higher risk of relapse particularly in the first days/weeks following childbirth. Women with bipolar disorder can experience both postnatal depression and postpartum psychosis. Episodes of postpartum psychosis occur in approximately 25% of births to women with bipolar disorder. Episodes of depression also occurs in 25% with Bipolar disorder meaning that 50% of women with Bipolar disorder will experience a post partum episode. The risk can be further increased where a woman has previously experienced a post partum episode. All postpartum episodes in women with bipolar disorder must be taken seriously.

Understanding Postpartum psychosis and pregnancy:

Postpartum psychosis can affect 1 in 500 women after birth. It is a severe mental health condition that can appear quickly. Women are usually mentally well during pregnancy but immediately after delivery or in the first few days / weeks, they rapidly becomes very unwell and this is usually very obvious to those that know her well. Symptoms may include thinking, speaking and acting very differently with bizarre beliefs and experiences related to self, others or the baby. This should be considered an emergency that requires immediate medical treatment.

There are many ways a postpartum episode can start. Women often have symptoms of depression or mania or a mixture of these. Symptoms can change very quickly from hour to hour and from one day to the next. Most commonly postpartum psychosis begins in the first few weeks after birth. Often, symptoms begin in the first few days after having a baby. Getting the right help ensures that this can be managed and women can enjoy their experience of being a mother.

What to do: During pregnancy let people know as soon as possible. If you are taking medication, do not stop taking these suddenly before getting advice. It is important to let all those involved with your pregnancy know that you have bipolar disorder or psychosis, and that there is a risk of becoming unwell again following delivery.

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Maternal OCD

Obsessive Compulsive Disorder (OCD) is a common mental health condition that can affect anyone. If a woman has OCD during pregnancy or after birth it is known as Perinatal or Maternal OCD.

It affects 2 in 100 women in pregnancy and 2 -3 in every 100 women in the year after giving birth. 

OCD has three main parts: 

  1. Thoughts or images that keep coming into your mind. These are called obsessions. 
  2. Anxiety - as a result of these thoughts. 
  3. Thoughts or actions you keep repeating to try to reduce your anxiety. These are called compulsions.

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Postnatal Depression (PND)

Postnatal Depression (PND) can affect 10-15% of women having a baby. The symptoms are similar to those in depression at other times. PND often starts within one or two months after having a baby. About a third of women with PND have symptoms which started in pregnancy and continue after birth.  

Sometimes there is an obvious reason for PND, but not always. You may feel distressed, or guilty for feeling like this, as you expected to be happy about having a baby. However, PND can happen to anyone and it is not your fault. It's never too late to seek help in managing your postnatal wellbeing. Even if you have been depressed for a while, you can get better. The help you need will depend on how severe your condition is.

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Becoming pregnant and being a new parent can be an anxious and unknown time. Anxiety is something we all experience from time to time and is a completely normal way for our bodies and brains to respond to a threat. Anxiety becomes problematic when the feeling is there a lot of the time; is too strong or when it carries on even when it is not needed.  If you feel like the thoughts and physical symptoms of anxiety are interfering with being able to enjoy this period in your life or being the kind of mum (or parent) you would like to be, then it could be an indicator to seek some help. 

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