What we treat

Struggling when pregnant or with a new baby

Struggling when pregnant or having had a new baby

If you’re struggling with your mental health during pregnancy or having had a new baby, you may be experiencing perinatal mental health difficulties. ‘Perinatal’ covers the period during pregnancy and up to 2 years post-birth. ‘Antenatal’ means during pregnancy – you may have heard of antenatal classes for example – and the 2 years post-birth is known as the ‘postnatal’ period.

Perinatal mental health problems were previously known as postnatal depression. However research has shown that 50% of women develop difficulties during pregnancy – so not postnatally at all! Many women in the perinatal period identify with typical symptoms of depression (see our page on Depression) for example feeling down, depressed or hopeless; little interest or pleasure in doing things; feeling lethargic; sleep difficulties; and lack of motivation. However, many women don’t identify with these symptoms, instead finding they are much more anxious than depressed – having racing thoughts; feeling overwhelmed; worrying too much about different things; becoming over-active; and feeling restless. We therefore use the term ‘perinatal mental health difficulties’ as we feel this is a better reflection of women’s difficulties in the perinatal period. There is still lots of research and support that focuses on ‘postnatal depression’ though – this may well still be useful for you. You may also be struggling to bond with your baby or have frightening thoughts about the baby coming to harm – both of these are common experiences of new parents in the perinatal period. If thoughts of baby coming to harm become more frequent and very distressing, you may be experiencing perinatal Obsessive Compulsive Disorder – this is a little discussed but very common condition which can be treated using talking therapies we provide here at Talking Change (see our page on Obsessive Compulsive Disorder).

Perinatal mental health difficulties are distinct from something called the ‘baby blues’ – this is a period of up to 2 weeks post-birth whereby a new mum may feel tearful for no apparent reason, anxious or down. This is caused by the shift in hormones from growing a baby to producing breast milk. It is a very common condition affecting up to 80% of new mums. The majority of women recover from this without additional support; some women find that this is the onset of their perinatal mental health difficulties.

Research suggests that 1 in 5 women struggle with perinatal mental health difficulties; however the real figure may be much higher as it is thought that 7 in 10 women hide or underplay the severity of the illness. There are typically around 200 new mums a month in Portsmouth, therefore on average 10 women a week would develop perinatal mental health problems in Portsmouth, on average 480 per year. Most make a full recovery with self-help strategies and therapy. However, increasing numbers of studies have highlighted that the lockdown has disproportionately affected new mums, with the latest figures suggesting that depression among expectant and new mothers almost tripled during the pandemic, while the number of women experiencing moderate to high anxiety rose to more than 70%.

We also know that fathers can struggle with perinatal mental health problems too – current research indicates 1 in 10 new dads struggle with their mental health during the perinatal period. However, the actual figure is thought to be much higher, and again impacted negatively by the pandemic.

There are certain factors which make us more likely to develop perinatal mental health problems, such as prior difficulties with mental health, physical difficulties during pregnancy, prior trauma, a difficult relationship with or loss of your own parents. We also know that a difficult birth that didn’t go as expected can set us up for perinatal mental health difficulties, especially if it was traumatic – this is the case whether it was you yourself giving birth or if you were the partner watching the baby being born. As a result both mums and dads can develop a disorder called Post Traumatic Stress Disorder (see our page on Post Traumatic Stress Disorder). Once the baby has arrived there are certain factors which can contribute to perinatal mental health problems continuing, such as if the baby struggles to feed, sleep or go to the toilet; social isolation; relationship difficulties; difficulty adjusting to body changes; and feeling like we cannot live up to expectations of being a new parent.  

Please see below for our community partners list:

• Health Visiting Team – we have a very strong working relationship and regular meetings with Charlotte Gatehouse, Specialist Health Visitor for Perinatal and Infant Mental Health. The Health Visiting Team run the Bright Beginnings group – Talking Change regularly co-facilitate one of the sessions on this course. Charlotte in turn regularly co-facilitates one of the sessions of our Perinatal Support Group (more about this below).

• Specialist Perinatal Mental Health Midwives – for women identified as struggling with their mental health during pregnancy.

• Perinatal Mental Health Team – for smooth pathway between Primary and Secondary Care services.

• Family Nurse Partnership – for new mums under the Family Nurse Partnership in need of therapy.

• Neonatal Intensive Care Unit (NICU) – for new parents who are struggling with the trauma of having their baby admitted and discharged from NICU.

• Carers Peer Support based at the Mother and Baby Unit (MBU) at Melbury Lodge – for family members struggling with their own mental health once a mum has been admitted to the MBU.

• Recovery College – we are currently developing a ‘Understanding Perinatal Mental Health’ course alongside the Recovery College, scheduled for delivery in July 2021.

• Birth Reflections pathway – linking in with the new Birth Reflections pathway at QA that went live in April 2021. We have 3 CBT therapists on the Talking Change perinatal pathway, myself and another member have recently completed further trauma training with the prestigious OXCADAT Therapy Centre which will enable us to better work with patients presenting with birth trauma – we look forward to implementing this through working closely with the Birth Reflections in the future.

• Maternal Mental Health Service (MMHS) – we have linked in with the new MMHS to explore this pathway.

Please see our resources page for more help and information.