We still don’t really talk about it – or at least perhaps not completely honestly – but having a baby is hard. Hard on the body, hard on the mind.
There is still an expectation that pregnancy and parenthood are solely lightness and joy, and even if they aren’t, we still, as mothers, put that expectation on ourselves.
But it is tough.
As a GP, I see patients all the time who have had operations and are signed off work for a period of time. They’re told not to lift anything heavier than a kettle, to rest, to sleep, to heal. And yet, when you have had a baby – whether you delivered vaginally or abdominally – instead of having that time off for your body to rest, to heal and to recover, you’re dealing with the huge hormonal changes and shifts that happen after birth and looking after a newborn baby as well!
Maternal mental health problems are more common than most people think. One of the scariest statistics I have ever come across –which still jolts me every time I read it – is that the commonest cause of maternal death, from 6 weeks to 1 year after having a baby, is suicide. This is how seriously we need to be taking maternal mental health. It can be life-threatening.
Unfortunately, for many reasons, lots of women suffer in silence, or are too frightened to come forward and ask for help. But it is so important you do.
You can see your GP about how you’re feeling at any time; you don’t need to wait for your postnatal check-up. Saying that, your postnatal check-up is an appointment for you, not for baby. Your GP will ask you about your mental health, and how you are finding things as a new mum (or as a new mum again); if you’re not finding things OK, please use the opportunity to say so.
Signs and symptoms you may want to talk to your doctor about
- Mood changes in the week after birth. Many women will experience what is often called the “baby blues”, mood changes during the 1st week or so after your baby is born, and which are thought to be due to the hormonal changes after delivery. You might notice that you are emotional, irritable, anxious or feel low but these tend to go away after a few days on their own. I remember for each of my children, on about day 4, being overwhelmed with emotions about everything and being extremely tearful – and extremely relieved when, after a few days, although the fatigue kicked in hugely, my symptoms disappeared.
- Persistent low mood and feelings of hopelessness. Postnatal depression affects about 1 in 10 women, and tends to start between about 2 and 8 weeks after delivery – but it can start as late as a year after birth. Symptoms can include low mood, feeling sad and depressed, feeling of hopeless and feeling that you are worthless or a bad mother. You may not be able to find the pleasure in anything, feel that you can’t manage or be very tearful. People often describe feeling extremely guilty about their feelings – especially if, for example if they feel unconnected to their baby.
- Anxiety and intrusive thoughts. Although I didn’t have postnatal depression, I did have intrusive thoughts. Whenever I walked down the stairs holding my eldest child, an intrusive and unwanted thought would come into my head and, in my mind’s eye, I would see myself dropping him down the stairs, I would see him spreadeagled, unmoving on the floor and feel my heart race with fear. These intrusive thoughts can be extremely distressing and can have a significant impact on your ability to function and parent. You may have thoughts about hurting yourself or your baby.
- Flashback or distressing thoughts about your labour and birth. Post traumatic stress disorder can also be related to pregnancy, for example, if you have had a distressing time giving birth. Here, there may be intrusive thoughts and flashbacks about the event, as well as nightmares and physical sensation of panic.
- Hallucinations, delusions, extreme confusion. More rarely – in about 1 in 500 women – a condition called post-partum psychosis may occur. It tends to start within 2 weeks of delivery but often happens within a few days. Here, you may have hallucinations, delusions, feel paranoid or very confused. You may not necessarily be aware of your own symptoms and often it is a partner or loved one who is concerned. Post-partum psychosis is a medical emergency and needs treatment urgently.
There are treatments available – treatments that work, including psychological (talking) therapy as well as medications. I see women every week who are struggling postnatally and thankfully, in my job I also get to see them as they get better with support.
Over the years, many women have told me of the voice in their head telling them that they are a failure or a bad mum for feeling low and that needing help would prove how bad a parent they are.
To everyone out there who may have that voice in their head: the voice is wrong. Saying you are struggling and asking for help shows just how great a parent you are.
About our expert, Dr Philippa Kaye
Dr Philippa Kaye works as a GP in both NHS and private practice. She attended Downing College, Cambridge, then took medical studies at Guy’s, King’s and St Thomas’s medical schools in London, training in paediatrics, gynaecology, care of the elderly, acute medicine, psychiatry and general practice. Dr Philippa has also written a number of books, including ones on child health, diabetes in childhood and adolescence. She is a mum of 3.
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