Everything you need to know about postnatal mental health


It’s really common to struggle with your mental health after having a baby. So, why is that and what should you do to get the support you need?


From the baby blues to complete and utter exhaustion, giving birth can sometimes feel like entering a washing machine spin cycle when it comes to your mental health.


“Being a new parent is tough and it’s hard work, and you’re going to have low days,” says Mary Ross-Davie, who works as director of Royal College of Midwives for Scotland and is a former perinatal mental health midwife. But for some women, the low days can lead to more serious mental health challenges. Here, we find out what’s going on inside, why you’re not alone and how to get the support you need…



Why do postnatal mental health problems happen?

Unfortunately, women are vulnerable to mental health changes after having a baby – and not only because you’re now grappling with some big, brand new responsibilities, but also because of what’s happening inside your body.


Within 48 hours of the birth, levels of the hormones oestrogen and progesterone – previously at an all-time pregnancy high – take a massive tumble. “These dramatic hormonal changes can have a big impact on your mood,” says Mary.


There’s also your physical recovery from the birth, which could have included a Caesarean section or medical procedures, such as stitches. These can leave you feeling sore or physically uncomfortable – which frankly doesn’t help!


On top of the physical changes, there are lots of other factors that can affect your mental health post-birth. Lack of sleep can be a trigger for mental health problems, including anxiety, depression and stress, according to scientists. And as a new mum, you’re almost certainly not getting enough: you’re basically exhausted all day long, and this goes on for day after day, week after week.

These dramatic hormonal changes can have a big impact on your mood

Then there are the abrupt changes to your lifestyle and routine because of your new responsibilities. “Routines are important when it comes to our mental health, so when they’re interrupted, they can leave you without your usual coping mechanisms,” says Mary.


“For example, when you’re a new mum, you might not have the time to prepare and eat a healthy meal, so you might revert to less healthy but quick, easy-to-eat food. This change can impact your mood.”


Finally, you’re also likely to be feeling more isolated and lonely. “You’ve probably got less time to see friends, and this can leave you without your normal support network,” says Mary.



What kinds of mental health issues are we talking about?

According to the NHS, the ‘baby blues’ usually occur during the first week after you’ve had a baby and only last for a few days. They’re completely normal – in fact, more than half of new mums are affected – and definitely nothing to worry about, though you’ll probably need an extra hug. Symptoms include a low mood, bursting into tears for no apparent reason, and feeling irritable.


Postnatal depression (PND) is a clinical depression, affecting around one in 10 women. It can start about two to eight weeks after the birth, although you can get it up to a year after having your baby. Symptoms include:

• feelings of sadness or low mood

• anxiety

• loss of interest in the outside world

• trouble bonding with your baby

• feelings of hopelessness and not being able to cope

• difficulty sleeping

• constant tiredness


Another serious postnatal mental health condition is postpartum psychosis, also called puerperal pyschosis. This is a rare psychiatric illness, affecting one or two in 1000 women and usually starts within the first two weeks of the birth. Signs of postpartum psychosis include:

• excessively high mood (mania)

• depression

• confusion

• delusions

• hallucinations

• paranoia

• difficulty sleeping



When should you get help?

If you have any concerns at all, speak to your midwife, healthcare visitor or GP and make sure you’re honest about how much sleep you’re getting and exactly how you feel. “It’s especially important to seek help if your feelings are preventing you from finding joy in your new baby or from caring for them in the way you would like,” says Mary, “or if your mood is preventing you from getting up and dressed and out of the house.”

You’re most definitely not to blame for what you’re experiencing

Remember, you’re not a bad parent if you have symptoms of a mental health problem. “There’s nothing to be ashamed of and you’ve done nothing wrong,” says Professor Lorraine Sherr, professor of clinical and health psychology at University College London. “You’re most definitely not to blame for what you’re experiencing.” But it is important to get help. Postnatal depression and postpartum psychosis are clinical illnesses that can be fixed, just as you would a broken bone.


Not sure if what you’re experiencing is a mental health issue or just the normal difficulties of being a sleep-deprived new parent? “It’s still worth speaking to an expert if you’re worried,” says Mary. “Yes, you may well be feeling the perfectly normal ups and downs of being a new parent, but it’s worth checking if you’re not sure. No-one will judge you.”



How to protect your mental health after having your baby

It’s important to have a support network, so make sure you keep talking to those you love, whether in person or on the phone.


You can also widen your support network by looking out for well-baby clinics and self-help groups, such as online baby forums, breastfeeding groups and NCT groups. These can offer a valuable lifeline to meet other new mums who are in exactly the same position as you, and also provide an opportunity to set a new routine. “Your GP, midwife or health visitor can give you information if you’re not sure where to start,” says Lorraine.


The other key is to make sure you take time out from your baby to relax – even if it’s just for five minutes each day. “Find something that relaxes you and gives you time to pause and reflect. This might be a warm bath, yoga, listening to music, or even doing a bit of work,” says Lorraine. “It’s important to take the time to care for yourself.”


Finally, learn your triggers for stress and anxiety in this new phase in your life – and then put things in place that can help you. “It’s important to understand what makes you feel low so that you can plan in advance how you can minimise that,” says Lorraine.



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