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Your emotional wellbeing

Having a baby and becoming a parent is a major life event, bringing changes to your home life, social life and relationships.

Parents of a new baby experience a variety of feelings after the birth; you may feel happy and proud of yourself, or just relieved that the birth is over.

This information should help you decide if the emotions you (or your partner) are experiencing after having your baby are usual or whether you may need to seek some extra support.

At the end of this information is a list of useful support groups and organisations for parents. It is impossible to prepare for the changes that pregnancy and becoming a parent brings. It can be difficult to find time for yourself, your partner or your family when you have to deal with the non-stop demands of a new baby.

Meeting your baby’s needs can be rewarding, but can also feel stressful.

Try not to expect too much of yourself or your partner.

It is likely that during the first few weeks and months of parenthood you will feel a mixture of emotions.

It is important that you talk honestly to your partner, friends or family about how you feel.

In reality becoming a parent means constantly experiencing new events and learning new skills.

No one knows automatically how to be a parent.

This information focuses upon postnatal depression and outlines some symptoms and possible treatments. In addition, it offers advice to the mother, her partner and family and friends.

Postnatal mood changes

Baby blues

The ‘baby blues’ are experienced by as many as 8 out of 10 women and normally begin with a few days of the baby’s birth. Bursting into tears for no obvious reason, or feeling on top of the world one minute and miserable the next are common feelings that may coincide with your milk production (whether you are breast feeding or not).

Remember that having a baby can turn your world upside down.

In the first few weeks and months you may feel emotionally and physically drained. Becoming a parent for the first time can feel like an overwhelming responsibility. You may expect to love your baby immediately, but this can take a while and is not always instinctive. Not loving your baby straight away does not mean that you are not a ‘good’ or ‘natural’ mother. Don’t be too hard on yourself. We all learn to be a parent when we actually have a baby, not before. Give yourself plenty of time to adjust to your new life and find time to rest and eat a good diet as this will help you stay physically and emotionally healthy.

Talk to someone you can trust about how you are feeling, like your partner, your mum, a friend, or your midwife or health visitor. Confiding in someone can help and they can give you the support you feel you need. If you think you are becoming more unhappy or upset, or if the low mood lasts for more than one week, you are probably experiencing something other than the baby blues. Talk to your midwife, health visitor or doctor – help from these healthcare professionals should be sought, especially if you have experienced depression before.

Postnatal depression (PND)

Postnatal depression affects 1 in 10 women following the birth of their babies. This illness usually begins in the first six months after childbirth, although for some women, the depression may begin during pregnancy. Postnatal depression can occur at any time within the first year of the birth of your baby, but can last for longer than a year if help is not sought and treatment received.

Untreated postnatal depression can lead to the breakdown of relationships with partners and children. However, early diagnosis and treatment of postnatal depression will result in a faster recovery. Quite often a close family friend or perhaps your partner may recognise something is wrong before you do.

Symptoms of postnatal depression

If you feel any of the following please talk to someone you feel you can trust about them. If this person is not your midwife, health visitor or GP then please speak to them as soon as possible. They will be able to help you get well again. The symptoms of postnatal depression are different for each individual. There are many symptoms of depression; feelings some women may experience include:

Anxiety

You may feel very anxious; or become obsessed with unjustified fears about your baby, yourself or your partner. You may only feel safe if someone is with you at all times.

Panic attacks

These can occur at any time, but they are most common in unpredictable situations. You may feel your heart beating faster, the palms of your hands becoming sweaty, feeling sick and even as though you are going to faint.

Tension

Appetite disturbances, lethargy, headaches, blurred vision and stomach pains can all be signs of tension and your body’s way of saying something does not feel right; they can make it difficult to unwind and relax.

Irritability

You may lose your temper with your children, partner and others who cannot understand what they have done to trigger your anger.

Depression

Feeling depressed can vary from feeling low, sad or as severe as if your whole world is an empty place and you are unable to look forward to things anymore. Your thoughts may be negative and focus on your failures and have no interest in everyday life. Going out might be difficult for you and you may even find talking to people is too much for you to do. You may experience some mixed emotions about your baby, and this can cause you some distress. You might even feel that your baby or partner would be better off without you.

Exhaustion

You may feel constantly tired, unable to cope with daily tasks and feel uninterested in your appearance and surroundings. You might have difficulty sleeping. Conversely you might want to sleep all the time no matter how much you have.

Lack of concentration

You may feel confused, finding it difficult to read or watch TV.

Inability to make decisions

Making simple decisions such as what to wear may seem impossible.

Strange thoughts

For example you may believe that if you do not walk on the cracks in the pavement that your baby will sleep through the night, or that if you do walk on the cracks in the pavement that your baby will die – this is known as ’magical thinking’. These thoughts can be very frightening and can make you scared to tell anyone how you feel and you may think that your baby will be taken from you.

Lack of interest in sex

For most women it takes some time for them to be interested in sex after their baby is born. They may need time to heal after the birth and may be too tired in the early weeks following the birth. However, with postnatal depression it may take longer to regain an interest in a sexual relationship and this can become another source of stress.

Guilt, shame and blame

One of the many emotions women describe is an overwhelming sense of guilt. They may feel that they should be ‘grateful for their baby’ and that they should just ‘pull themselves together’. It is difficult because sometimes the people who are nearest to you may be saying these things and then you may feel ashamed and blame yourself. This is one of the most common feelings associated with depression and it is difficult to admit to feeling this way. It is not your fault; these are real emotions and have happened because you have postnatal depression

YOU WILL GET BETTER

If you think you could be depressed, talk to your health care professional as soon as you can. Postnatal depression is an illness.

It is not your fault.

You would not expect a broken arm to get better without the help of health professional. Don’t expect your feelings to get better without their help either. If you do not feel able to cope with explaining how you feel to them on your own ask someone that you trust to be with you. You can ask your midwife, health visitor or GP to come and see you at home if you prefer. There are lots of different ways you can be helped.

 

Causes of postnatal depression

Each circumstance is unique, one or a combination of the following may cause you depression:

Feeling that you have no–one to confide in

• Relationship problems

• Living away from your family or feeling isolated

• The death of someone close to you

• You or your partner losing your job or other financial worries

• Housing problems

• Difficult pregnancy

• Difficult birth

• Feeling depressed in your pregnancy

• Illness of the baby or a family member

• Unrealistic expectations of parenthood

• A previous or family history of depression

• Experiencing violence in the home or any other abuse, past or present

It is difficult to predict just who will experience postnatal depression. However, it is possible not to have any of the above factors but still find yourself with the illness.

 

Treatment options for postnatal depression

Early detection of postnatal depression is important for recovery. The first and most important step is that you, your partner and your family accept that this illness is temporary and that given time you will recover. The most helpful methods of treatment are talking therapies such as counselling and psychotherapy, and medication in the form of antidepressants. These treatments can be combined.

Counselling and psychotherapy

These therapies involve talking to someone; your doctor may be able to recommend you to a trained professional. Professional counselling can be a great help if you are depressed and local GP practices often have access to a counselling or psychotherapy service. One form of psychotherapy, Cognitive Behavioural Therapy (CBT) has been shown to be as effective as antidepressants. CBT involves looking at how you think about things, confronting negative thoughts and focusing your attention on positive thoughts and actions.

Medication

They are generally NOT addictive and work for many people.

Your doctor will advise which is suitable for you and will take into consideration such things as whether you are breast feeding and wish to continue breast feeding.

Hospital-based care

About 1 in 4 women suffering from PND develop more severe symptoms such as feeling suicidal and therefore need more specialised help. Your GP, midwife or health visitor will refer you to a psychiatrist if necessary. Although you may receive psychiatric treatment to help you recover, this must form part of an overall strategy of support and practical help involving partners, family and friends. In-patient care is rare unless you have severe depression. In the East Midlands there are special mother and baby facilities so that mothers needing extra help do not have to be separated from their babies. You will need a lot of support around you during your hospital stay and when you go home. Voluntary support, for example Home-start, can sometimes be arranged for you.

Self help

There are a number of ways you can help yourself get better:

Rest and relax each day

Use the relaxation techniques taught antenatally, or contact leisure centres for postnatal exercise groups or yoga (crèche facilities may be available).

Do gentle exercise

Just getting out of the house and going for a walk can help you feel better.

Take life one day at a time

Try to focus on the positive in things. Not everything in your life is always negative, even if it feels like it at the moment.

Let yourself and your partner be intimate. A kiss and a cuddle can be a source of great comfort and reassurance, even if you don’t feel like having sex.

Eat a balanced diet

Mothers often are so busy looking after their babies that they forget about themselves. Women are often keen to lose the weight they have gained in pregnancy and start to diet soon after the baby is born. Remember you need time to recover and a good diet and exercise will help you regain your health and vitality. A lot of women experience low iron levels (anaemia) in late pregnancy and after the birth, leaving them feeling tired or exhausted. You may be offered a blood test after the birth to check your iron levels and, if low, you will be prescribed iron tablets and given dietary advice to help bring your iron levels back to normal

Be open about your feelings and worries

This will help others understand what you need. Talk to your midwife, health visitor or GP – no question is ever too small or too silly, or join a postnatal group. These groups are a good way of meeting with other mothers, exchanging information, relaxing and building up confidence. You can also find some PND support groups in some areas which have proved very helpful in sharing feelings with other women about coping with PND.

How your partner and your family can help

Living with a depressed woman can be very difficult and

frustrating. It might be useful to think of the baby’s arrival as a

crisis that will pass.

Give support, encouragement and hope. Be patient and

understanding. Your help at this time of crisis is absolutely

invaluable.

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How your partner and your family can help (continued)

Most importantly, be prepared to seek help, both for her and for

yourself if you feel you need it. There are a number of things you

can do to help:

• Be patient. Remember that depression is an illness.

Remember that depression is an illness.

• Let her explain her true feelings. It may not be easy to hear

It may not be easy to hear

what she has to say. Treat her fears and feelings seriously.

• Be sympathetic. It will have taken great courage to admit

It will have taken great courage to admit

these feelings to herself and saying them aloud to you will

have taken a great deal more courage.

• Offer help with practical childcare arrangements and offer to

with practical childcare arrangements and offer to

do the cleaning/washing/ironing whilst she spends some time

relaxing and getting to know your baby.

• Find out more about depression and PND.

about depression and PND.

As the depressed mother’s partner, you are perhaps the most

important person in terms of helping her to recover. Whilst this

may seem very flattering, it may also feel like a burden at times.

Try and remember that she does not want to be a burden to you

or be ill.

As well as the previous suggestions the following will be of help:

• Frequently reassure her that her illness is temporary and that

her that her illness is temporary and that

she will get well.

• Reassure her of your love and support.

• Ensure that she gets enough food and rest.

• Encourage her to be active. Going for a short walk together

Going for a short walk together

will help you to feel better too.

• Draw her attention to any small improvements you notice in

you notice in

her well-being. Praising her will reinforce the behaviour that

has lead to that improvement and give her the hope and

courage to continue.

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How your partner and your family can help (continued)

• Make time for yourselves as a couple without your children.

as a couple without your children.

• Look after yourself. Get help if you need it-don’t keep it to

Get help if you need it-don’t keep it to

yourselves.

Depression after the birth of a baby threatens the mother and

father’s health, marriage, friendships and career, as well as the

baby’s and children’s welfare. Dealing with it on a day-to-day

basis can be a huge challenge for family and friends. With

support and patience, together you can help the depressed

mother to recover.

‘Emotional wellbeing’ information originally produced by the Emotional

Transition to Parenthood Sub-Group of the Maternity Service Liaison

Committee for Leicester and Leicestershire.

Postnatal post-traumatic stress disorder (PTSD)

PTSD symptoms may appear soon after the birth or may be

delayed for some months. The reasons women develop this are

unclear but often women describe feeling ‘out of control’ and very

afraid during the birth. Emergency deliveries or being separated

from the baby, and past history of trauma in childhood or domestic

abuse / violence are also associated with this condition.

How does it affect you?

This problem is usually noticed when women say they are having

difficulty with:

• Flashbacks

• Nightmares

• Panic attacks

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Postnatal post-traumatic stress disorder (PTSD) (continued)

• Sleeping problems

• Irritability and anger

• Irrational behaviour

• Difficulty bonding.

You need to talk to someone about how you are feeling: your

midwife, GP or health visitor will be able to advise you where to

get help.

Puerperal psychosis

This is a rare condition affecting only about 1 in 500 new

mothers. Women with a family history of mental illness or who

have suffered from puerperal psychosis in previous pregnancies

are a higher risk. Symptoms include hallucinations (seeing or

hearing things that others do not), delusions (incredible beliefs

such as thinking you must save the world) and mania (extremely

energetic and bizarre activity like washing clothes in the middle

of the night). The symptoms can be severe and sometimes very

frightening for you, your partner and your family. In fact your

partner may be the first to know that you are unwell. It is

important that your partner or someone close to you knows the

symptoms to look out for. These symptoms will appear suddenly,

often within the first two weeks following the birth. It will be

very obvious that medical help is needed and it should be sought

immediately from your GP or from the Emergency Services.

Seeking help quickly will make sure that you recover quickly.

Women with this illness are often treated in hospital with

specialist care and will usually make a full recovery.

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Section four: Support & Advice

Pregnancy, Birth and Postnatal Support and Advice

Birth Reflections

A listening and information service with an opportunity to talk,

in private, with a midwife about issues around labour and birth.

Tel: 0116 258 4857

(leave a message and a midwife will call you back)

Birth Trauma Association

Support for women who have had a traumatic birth experience.

Website: www.birthtraumaassociation.org.uk

Bridges

Supporting young children, parents and families, including a

directory of services.

Tel: 0116 305 8730

Website: www.irtbridges.org.uk

 

 

 

 

 

 

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