Why do we not talk about difficult feelings like post-natal depression during pregnancy and childbirth?

We are bombarded with images of content babies and happy parents, of celebrities bouncing back to normal weight, shape, mood and work, weeks after giving birth.  But the reality is that pregnancy, childbirth and the post-natal period, leads to major changes that can leave women feeling anxious, depressed and/or having unwanted and difficult feelings towards their babies.  There is increasing understanding of perinatal mental health issues, but there is still a tendency for women to feel ashamed of these experiences and to put on a front of coping.

How can we help to understand and normalize these experiences?

Understanding evolutionary development can help to normalize some of these experiences.  For example, in distant times, twilight hours and early mornings were the most risky in terms of predators, which can explain why these may be times when new mothers can feel particularly anxious as we are hard-wired to be more alert to signs of threat.

Changes in our environment, particularly reduced social contact, further exacerbates normal fluctuations in mood after childbirth.  Historically, women have been cared for by the other women within extended families or tribes, allowing the mother to rest and look after her baby when she feels able.  Now, women can experience significant social isolation, being alone for hours and having to manage the demands of the new baby as well as cooking, laundry, cleaning etc.

How common is post-natal depression and what are the signs?

Post-natal depression is normally associated with low mood and lack of motivation.  However, high anxiety and irritability are also signs.  Around 10% of women experience post-natal depression, so it is much more common than many people think.  Women who have had previous mood related difficulties and those who have experienced traumatic incidents in the past may be particularly vulnerable to experiencing mental health issues after childbirth.

Do women always feel a “rush of love” for their babies

A common myth is that a mother will automatically feel overwhelming love for her baby.  In fact, feelings of detachment, anger and resentment and an absence of joy and contentment, are incredibly common.  However, if you feel you are at risk to yourself or your baby, it is important to seek help from your GP or A&E immediately so that you can be given appropriate medical treatment and support to care for your baby.

When are you most likely to experience these difficulties?

There is a period a few days after birth, when emotional changes are most likely, associated with the rapid drop in oestrogen and progesterone.  However, if your symptoms persist for more than two weeks, then it is important to seek further assessment from your GP or health visitor.

What can help?

 There are effective medical interventions which are safe during pregnancy and whilst breast-feeding.

As social isolation is one of the key factors that contribute to post-natal depression, it is vitally important to ensure you see other people regularly.  Existing friends and family can be helpful as well as seeking out new friendships through groups aimed at pregnant and new mothers.  Try to confide in someone you trust as often sharing your thoughts and feelings (and often hearing that the other person has experienced something similar) can make a huge difference to how you feel.

Sleep and nutrition are important at all times in maintaining our emotional wellbeing, but particularly difficult to achieve during pregnancy and with a young baby.  So it is important to take any opportunities to sleep, and to use any source of support to help you to eat regularly and healthily and to get some rest.

Trying to become pregnant, pregnancy, childbirth and parenting can all present challenges to emotional wellbeing.  This can be further complicated by our own experiences of childhood and being parented.  Talking therapy can help you to make sense of your current emotions and to develop ways of coping, reduce distress and encourage a positive relationship with your baby now and in the future.

Recommended reading:

Michelle Cree “Post-natal Depression; using compassion focused therapy to enhance mood, confidence and bonding.”