Perinatal mental health and wellbeing

This information is an overview of the mental health difficulties that some parents may experience during the perinatal period. The perinatal period runs from the beginning of pregnancy up to one year after the birth of a baby. It is possible for partners and fathers to experience perinatal mental illness.

Some people find pregnancy and the process of becoming a parent difficult due to their own past experiences. People who have had negative experiences in childhood or bad memories of their own parents may find this time particularly challenging. This in turn might lead to difficulties with emotions or mental health illness in pregnancy or after birth. This can affect partners and fathers too.

It is known that for people who have had mental health difficulties before, pregnancy and birth can sometimes cause those same illnesses to come back. It is important to let your midwife or doctor know about any mental health problems you might have had in the past.

It is important to know that…

A range of help and support is available
Mental health illness is an illness like any other
It is not your fault that you are experiencing mental health illness – it can happen to anyone
Mental health illness does not mean that you are a bad parent
Your baby will not be taken away from you – babies are only taken into care in very exceptional circumstances.

Antenatal depression

Depression during pregnancy is common and is thought to affect around one in eight people. Untreated antenatal illness may increase your chance of developing postnatal illness so it is important to ask for help while you are pregnant.

If you are already taking medication for your mental health when you become pregnant, please do not alter this without support from your GP or psychiatrist.

Signs that you might be depressed include:

A persistent feeling of sadness and low mood.
Lack of enjoyment and loss of interest in the wider world.
Lack of energy and feeling tired all the time.
Trouble sleeping at night and feeling sleepy during the day.
Difficulty bonding with your baby/loss of interest in baby.
Withdrawing from contact with other people.
Memory loss; problems concentrating and making decisions.
Excessive anxiety about the baby.
Loss of appetite.

Perinatal anxiety

It is common for most new parents to experience anxieties around pregnancy, childbirth and being a new parent. However, if this anxiety doesn’t ease or worries become constant and have an effect on your day to day activities, it may be a sign of perinatal anxiety. These could be worries about the safety of your child, or concerns about yourself.

Baby blues

During the first week after childbirth, many people experience what is often called the “baby blues”. You may experience a low mood and feel mildly depressed at time when you expect you should feel happy. “

Baby blues” are likely due to the sudden hormonal and chemical changes that take place in your body after childbirth.

Symptoms include:

Feeling emotional and bursting into tears for no apparent reason
Feeling irritable or angry
Low mood
Anxiety and restlessness.

The “baby blues” do not last for more than two weeks after giving birth. If your symptoms last longer or start later, you might have postnatal depression and should seek advice.

Postnatal depression

Postnatal depression is a common issue, affecting more than one in every 10 women within a year of giving birth.

It is important to ask for help as soon as possible if you think you could be depressed. Symptoms may last for months or get worse and could have a significant impact on you, your baby and your family. It is possible for postnatal depression to start any time in the first year after giving birth but with the right support most people make a full recovery.

Signs that you might be depressed include:

A persistent feeling of sadness and low mood.
Lack of enjoyment and loss of interest in the wider world.
Lack of energy and feeling tired all the time.
Trouble sleeping at night and feeling sleepy during the day.
Difficulty bonding with your baby/loss of interest in baby.
Withdrawing from contact with other people.
Memory loss; problems concentrating and making decisions.
Frightening thoughts – for example, about hurting your baby.
Excessive anxiety about the baby.
Loss of appetite.

Many people experiencing this do not realise they have postnatal depression because it can start with mild symptoms and develop gradually.

Post-traumatic stress disorder (PTSD)

PTSD can sometimes occur as the result of a traumatic birth experience, such as a long or painful labour, or an emergency or problematic delivery. It can also develop after other types of trauma, such as life threatening situations.

The symptoms of postnatal PTSD can occur alone or in addition to the symptoms of postnatal depression; they can develop straight after the birth or months later.

Re-experiencing is the most typical symptom of PTSD. This is when a person involuntarily and vividly relives the traumatic event in the form of:

Flashbacks
Nightmares
Repetitive and distressing images or sensations
Physical sensations, such as pain, sweating, feeling sick or trembling.

Contact your GP for support if you are experiencing any of these symptoms.

Postpartum psychosis

Postpartum psychosis (also known as puerperal psychosis) is extremely rare. Only 1 or 2 mothers in 1000 develop a severe psychiatric illness that requires medical or hospital treatment after the birth of a baby. This illness can develop within hours of childbirth and is very serious, needing urgent attention.

Other people usually notice it first as the birthing person often acts strangely. Symptoms can include:

Rapidly changing mood
Bizarre behaviour
Lack of inhibition
Hallucinations
Confusion
Agitation
Lack of insight.

It is more likely to happen if you have a severe mental illness, a past history of severe mental illness or a family history of perinatal mental illness. Specialist mother and baby units can provide expert treatment without separating you from your baby. Most birthing people make a complete recovery, although this may take a few weeks or months.