The Darker Side of Postpartum

September 21, 2023

The Darker Side of Postpartum: Mental Health & Finding Support

The postpartum period can bring joy, connection and enormous change. It can also be emotionally difficult, and for some mothers those difficulties go beyond the expected adjustment to life with a newborn.

Mental health deserves the same attention as physical recovery after birth. Experiencing depression, anxiety or another mental health difficulty does not mean that someone is failing at motherhood, and support is available.

This guide looks at some of the mental health challenges that can occur after birth, how to recognise when additional help may be needed, and where mothers in the UK can find professional and urgent support. These early months form part of the wider fourth trimester, a significant period of adjustment for both mother and baby.

Understanding Postnatal Depression

Postnatal depression is a type of depression that can develop after having a baby. According to the NHS, it affects more than 1 in 10 women within a year of giving birth. Symptoms can begin during pregnancy, soon after birth or later in the first year.

Possible signs include persistent low mood, loss of enjoyment, feelings of hopelessness or guilt, anxiety, difficulty bonding with the baby and thoughts of suicide, self-harm or harming the baby.

Feeling down, anxious or tearful for a few days after birth can be part of the commonly described “baby blues”. NHS guidance says these feelings usually resolve within two weeks. If they continue, worsen or you are struggling to cope, it is important to seek help.

Postpartum Anxiety

Anxiety can also become difficult to manage during the postpartum period. Worries about the baby, feeding, sleep, health or whether you are “doing things right” can become overwhelming for some mothers.

If anxiety is persistent, becoming harder to manage or interfering with everyday life, speak to your GP, midwife or health visitor.

Our dedicated guide to postpartum anxiety explores the subject in more detail, including ways to find appropriate support.

Postpartum Psychosis

Postpartum psychosis is a rare but serious mental health condition that can develop suddenly after having a baby. Symptoms can include severe changes in mood, confusion, hallucinations and delusions.

Postpartum psychosis is a medical emergency and requires urgent professional assessment.

NHS guidance says it affects around 1 in 1,000 women who give birth, most commonly beginning in the first few weeks after birth. It advises contacting a GP immediately; if that isn't possible, call NHS 111 or an out-of-hours service. If there is imminent danger of harm, call 999.

Talking About How You Feel

Mothers can sometimes feel pressure to appear happy after having a baby, which may make difficult feelings harder to talk about.You do not need to diagnose yourself before asking for support.

If you are worried about your mental health, speak honestly with someone you trust and contact your GP, midwife or health visitor.

Professional support is available, and seeking it early can help ensure you receive care appropriate to your individual circumstances.

Finding Professional Support in the UK

If you feel you need help with your mental health during pregnancy or after birth, the NHS recommends speaking to a midwife, health visitor or GP — whichever healthcare professional you feel most comfortable approaching.

Where appropriate, they can refer you to a specialist community perinatal mental health team or, for severe mental health conditions requiring hospital treatment, a mother and baby unit.

In England, eligible adults can also self-refer to NHS Talking Therapies without first obtaining a GP referral.

Practical and Emotional Support

Trusted partners, family members and friends can provide valuable practical and emotional support. This might mean preparing meals, taking care of household tasks, listening without judgement or helping create opportunities for rest.

Some mothers also find connecting with other parents helpful. However, peer support should complement rather than replace professional care when mental health symptoms require it.

Looking After Yourself Alongside Professional Support

Small acts of self-care can sit alongside appropriate professional support. Eating regularly, staying hydrated, accepting opportunities to rest, spending time outside when appropriate and making space for things you enjoy may help you look after your general wellbeing.

These are not substitutes for mental health treatment. If you are struggling, you do not need to manage the problem through self-care alone.

Mindfulness and Therapy:

Practicing mindfulness techniques, such as deep breathing and meditation, can help manage stress and anxiety. Additionally, participating in therapy, such as cognitive-behavioral therapy (CBT), can equip you with coping strategies and tools to navigate the emotional rollercoaster of postpartum.

Online Resources:

The digital age has brought forth a wealth of online resources that can be incredibly beneficial for UK-based mothers. Websites like the NHS's "Every Mind Matters" offer guidance on managing mental health during and after pregnancy. Online forums and communities like "Mumsnet" provide a platform to connect with other mothers, share experiences, and seek advice.

If You Need Urgent Help

If you think there is a risk that you might harm yourself or your baby, call 999.

If you need urgent mental health help but it is not an emergency, use NHS 111 online or call 111 and select the mental health option.

If you or someone else is in immediate danger, call 999 or go to A&E.

Final Thoughts

The postpartum period can involve many different emotions, and needing additional mental health support is not something a mother should have to hide or manage alone.

If something does not feel right, speak to your GP, midwife or health visitor. Support is available for postnatal depression, anxiety and other perinatal mental health conditions.

And when help feels urgent, seek it urgently. You will not be wasting anyone's time.