Emotional health and wellbeing after birth

Emotional health and wellbeing after birth Managing family life is a challenge. You have less time for your own needs as well as dealing with everything parenting throws at you: sleepless night with a newborn, toddler upsets or another bout of illness. Sometimes having a baby can make parents and carers feel lonely or disconnected from old friends or that they've lost their identity. Parenting might just be different to what you expected it to be.

Everyone has good days and bad days when it comes to parenting but if you start to feel overwhelmed by the demands on you or and are finding life a struggle there is support out there for you. There are little things we can all do to help look after our mental health including moving more every day, practising mindfulness, doing more feel-good things for yourself, staying physically healthy, getting enough sleep and talking about how you feel.

Having good mental health helps us relax and enjoy our lives more. Every Mind Matters has expert advice and practical tips to help you look after your mental health and wellbeing. Take the Mind Quiz to get a plan with simple wellbeing tips and more support online.

Be open with friends and family about how your feeling is important. Reach out to your GP or health visitor if you feel you're having lots of bad days.

First weeks with your baby and baby blues

Perinatal mental illness

First weeks with your baby and baby blues

It's very common to feel mixed emotions after giving birth.

Even if your birth was uncomplicated, you may be finding adjusting to becoming a parent to your newborn a struggle at times. If things were difficult in labour and you or your baby needed emergency assistance or there was birth trauma, you may need extra support to cope with what has happened.

Some parents may fall in love with their baby during pregnancy or as soon as they're born but others need more time to build up that special closeness. The more you hold, feed and talk to your baby, the closer you will feel to them. Find out more about ways to bond with your baby.

The early weeks can be overwhelming. You'll make lots of beautiful memories with your baby but they'll be lots of exhausting and messy times too. You'll be recovering from the birth, you and baby will be learning to breastfeed if that's what you've chosen to do, all with little sleep.

The first week or so after your baby arrives, it's common for parents to get the 'baby blues' with symptoms including:

feeling emotional and bursting into tears for no apparent reason
feeling irritable or touchy
low mood
anxiety and restlessness.

These feelings usually go away after a few days and you'll start to feel like yourself again.

Some babies cry more than others and this can cause a lot of stress for parents. You can find more information in our 'Coping with crying' section.

Perinatal mental illness

Perinatal mental illness Most people get the 'baby blues' but these should pass. If your feelings are still making your day-to-day life difficult or hard to cope with, this may be a sign you need more support.

One in five women will develop perinatal mental health problems such as anxiety or depression in the time from being pregnant and after they have had their baby. It also effects around one in ten dads and partners as well.

Having a mental health issue doesn't mean you don't love or care for your baby but if you continue to feel that way, it can make it harder for you to enjoy being with your baby and responding to them.

Reaching out for support from your GP or health visitor is one of the bravest and best things you can do for you and your baby.

You and your partner can talk about how your feeling when your health visitor comes to visit you at home at 10 to 14 days and again at six to eight-week visits.

Your health visitor will ask you some questions at every appointment to check in with you regarding your emotional wellbeing. These are:

During the last month, have you been bothered by feeling down, depressed or hopeless?
- Yes
- No.
During the last month, have you been bothered by having little interest or pleasure in doing things?
- Yes
- No.
Over the last two weeks, how often have you been bothered by feeling nervous, anxious or on edge?
- Not at all - 0
- Several days - 1
- More than half the days - 2
- Nearly every day - 3.
Over the last two weeks, how often have you been bothered by not being able to stop or control worrying?
- Not at all - 0
- Several days - 1
- More than half the days - 2
- Nearly every day- 3.

At your 6 to 8 weeks health visitor appointment, you will be asked some more detailed questions around your emotional health and wellbeing to understand how we can best support you as you adjust to life with your new baby.

Contact your health visitor, midwife or GP if you are worried about you or your partner's mental health. Health visitors are trained to support you and will not judge you. They'll start by asking you some questions about how you feel to make sure you get the best support for you. Most perinatal mental health problems are temporary and parents progress and recover well with treatment.

Perinatal depression

Perinatal depression is a type of depression that some parents have during pregnancy or during their child's first year. You might feel:

sad or low a lot of the time

loss of interest and lack of enjoyment in the wider world or things you used to enjoy

a lack of energy

tired all the time or have trouble sleeping

finding it difficult to relate to your baby or withdraw from people

finding it difficult to concentrate or make decisions

scared of frightening thoughts.

Two women shared their experiences of perinatal depression that you might find useful to watch - Stephanie and Theresa. Perinatal Positivity have a range of films and resources to support you.

Perinatal anxiety

Having a child causes huge changes to your body in terms of the physical shock and hormonal fluctuations, which in turn can have an impact on mood, as well as impacting on your family life, sleep levels and stress. This can lead to either parent becoming more anxious and worried than usual.

Signs that you or someone you know may have perinatal anxiety include:

finding it hard to sleep

feeling or being sick

feeling lightheaded or dizzy

stomach cramps

being able to feel your heartbeat going faster than usual or feeling you can't catch your breath

feeling nervous or unable to relax

having a sense of dread, or fearing the worst

feeling like the world is slowing down or speeding up.

Birth trauma and Post-Traumatic Stress Disorder (PTSD)

About 30,000 people have a traumatic birth in the UK each year.

Instead of their pregnancy and birth being joyful and a happy event, their experience of giving birth was difficult and left them feeling vulnerable and distressed. Birth trauma and post-traumatic stress disorder (PTSD) can affect mothers, fathers, same sex partners or other birth partners.

Some of the factors that make birth trauma more likely are:

lengthy labour or short and very painful labour

poor pain relief

feelings of loss of control

high levels of medical intervention

use of forceps

emergency caesarean section

impersonal treatment or problems with staff attitudes

not feeling listened too

lack of information or explanation

lack of privacy and dignity

fear for baby's safety

stillbirth.

Your hospital can give you the opportunity to debrief your birth, helping you to make sense of the birth and the medical interventions that took place, with an independent midwife who wasn't involved with your care. If any aspect of your reproductive journey, birth or feeding your child feels or felt traumatic to you, speak to your health visitor or GP.

For more information on birth trauma visit www.makebirthbetter.org/birth-trauma-support-for-parents.

Post-Traumatic Stress Disorder (PTSD)

PTSD is an anxiety disorder caused by a frightening or distressing event.

Research suggests that six per cent of women who give birth go on to develop postnatal PTSD but it's believed this figure could be much higher as many women go undiagnosed. Partners could also develop PTSD after witnessing a traumatic event.

The symptoms of PTSD are:

Re-experiencing the traumatic event through flashbacks, nightmares or intrusive memories. These can make you feel distressed and panicky.

Avoiding anything that reminds you of the trauma. This can mean refusing to walk past the hospital where you gave birth, or avoiding meeting other women with new babies.

Feeling hypervigilant - this means that you are constantly alert, irritable and jumpy. You worry something terrible is going to happen to your baby.

Feeling low and unhappy. You may feel guilty and blame yourself for your traumatic birth.

You may have difficulty remembering parts of your birth experience.

Speak to your GP or Health Visitor who can support you in getting treatment. Trauma-focused cognitive behaviour therapy (CBT) and EMDR therapy (Eye Movement Desensitization and Reprocessing) are recommended treatments.

The Birth Trauma Association spoke to five women about their experience of birth trauma and their experience of post-traumatic stress disorder (PTSD) after childbirth in this video that you might find useful.

Partner's mental health

It's a myth that perinatal mental health issues only affect the person who gave birth to your baby.

Fathers and partners can share the anxieties in worries that their partner has during pregnancy, the birth and the early days of parenting. It's a challenge for both parents caring for their new baby and coming to terms with parenthood. It's important both parents are emotionally well and able to enjoy and care for their new baby. Fathers and/or partners are important and good mental health is important for them, their partners, and their children. Close involvement of fathers / partners from birth supports positive relationships.

Fathers and partners may experience perinatal mental health issues even if their partner doesn't. They might have found the birth traumatic but their partner didn't.

It's important to seek help if you are struggling. The Health Visiting Service is here to support all parents and carers regardless of gender or sexuality. If you're struggling, reach out to your local team for advice and support. You can phone your local team Monday to Friday, 9am to 5pm (except bank holidays).

You can find more information on our 'Partner's' section.

We spoke with five local women about their experience of perinatal mental health issues. These women wanted to empower other families to seek help and let them know that things can get better. The women talk about their experiences during pregnancy and after their children arrived, along with mental health triggers including suicidal thoughts and support they received. If you have any of these feelings please contact your GP or Health Visiting Team. The topics discussed in this recording are sensitive in nature; if you feel uncomfortable or distressed you can stop listening at any time. You can find more support options at the bottom of the page.

Useful resources

The NHS website has useful information on where to get urgent help for mental health.
Find talking therapies near you at NHS talking therapies
Samaritans is a registered charity aimed at providing emotional support to anyone in emotional distress, struggling to cope, or at risk of suicide. Visit the Samaritans website or call 116 123 (24-hour emergency helpline).
Mind, provides advice and support to empower anyone experiencing a mental health problem.
Kent and Medway NHS and Social Care Partnership Trust provide mental health services across Kent and Medway. You can call their free 24-hour helpline on 0800 783 9111if you need urgent mental health support, advice and guidance.
Make Birth Better is an organisation supporting families effected by birth trauma.
Tommy's: mental health before, during and after pregnancy. 0800 0147800 midwife@tommys.org, Monday to Friday, 9am to 5pm.
Kent and Medway Clinical Commissioning Group provides an online Mental wellbeing information hub that has useful information for parent and carers.
PATH is an EU-funded project that aims to enable women, families and healthcare professionals to prevent, diagnose and successfully manage mild to moderate perinatal mental health issues.
You can talk to a trained and caring team 24/7 via the the Release the Pressure service. Text the word 'Kent' to 85258 or call freephone 0800 107 0160. Find more information at www.releasethepressure.uk.
Citizens Advice provides dedicated confidential and impartial money advice to new or soon-to-be parents if you're struggling with your money and mental health.