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Having a baby is usually a positive experience for mothers and fathers, society expects us to feel happy and fulfilled as we welcome a new life into our world.

Yet parents have a major readjustment to deal with; the loss of independence, changes in financial status or security and sometimes changes in relationships with those in different circumstances. Although we may feel prepared for these changes, having a baby can still be a shock for many parents.

It is perfectly normal to feel emotional, vulnerable and sensitive after your baby is born. Some mothers may feel confused about their feelings- that they should be feeling overjoyed and instantly in love with their baby. This is not always the case; there are understandable reasons for perhaps feeling not like that. For example you may have had a difficult labour, birth, a traumatic delivery which can leave you feeling exhausted and possibly unfulfilled of the expectations you may have had.

Don’t forget we are not taught how to be mothers; it is something we need to learn for ourselves and at this time of our lives we sometimes need to be mothered ourselves.

Baby Blues:

Approximately one in two mothers experience Baby Blues after the birth of their child. The Blues typically happen between day three and day five coinciding with the hormonal changes that occur as the breast milk starts to come in. Mothers may feel weepy, irritable low mood and lacking in confidence around their baby. This is very normal and the Blues usually subside after a week or so. It is perfectly okay to have a good cry and to be able to talk to someone about how you are feeling.

The mother will need lots of reassurance that her feelings are quite normal and lots of tender loving care.

Postnatal Depression:

Postnatal Depression is a recognised and treatable condition which affects approximately one in five mothers and approximately one in ten fathers.

It can affect anyone irrespective of background and can occur straight after delivery but often does not get acknowledged or recognised until later on. The most common signs and symptoms of PND are low mood, anxiety, unable to look forward to anything, lacking in motivation and extreme tiredness. Some mothers describe the feeling of having a foggy or woolly head and that they feel quite different to how they did before. Obviously many new mothers feel extremely tired but combined with other symptoms which are causing her distress or problems, may be a sign of PND.

High anxiety may lead to panic attacks which are very common with PND but can also be very frightening.

Puerperal Psychosis:

This is a totally different condition to Postnatal Depression. It affects approximately one in five hundred to a thousand new mothers and occurs within the first six weeks after delivery. The mother may experience delusions, hallucinations and erratic behaviour which are commonly noticed by family members first. Usually this condition is treated in hospital, preferably in a mother and baby unit, where if appropriate the mother can have her baby with her.

As with all the conditions above there are a number of things that can be done to help. It is very important to contact your GP or health visitor to find out about options and choices available, because different things suit different people and their varying symptoms and circumstances.

The Health Visitor

The health visitor can be extremely helpful, initially by using a tool known as the Edinburgh Postnatal Depression Scale. This is a self report questionnaire that the mother fills in on her own with the health visitor present, and consists of ten short statements about how she has been feeling in the last seven days. It is usually used between six and eight weeks after delivery and gives her an opportunity to talk about her feelings. Some mothers may feel assessed or judged by this tool, it should not be seen as threatening but as helpful in identifying how she is feeling. Health visitors can offer support to mothers, by visiting them in their own home on a regular basis, allowing them to talk about their feelings.

Sometimes mothers may not feel easy talking to health professionals about their negative feelings and thoughts, and sadly some women may have the idea that their child might be taken away from them if they do share these. This is not the case, health professionals are here to help.

The GP

It is important for a mother with PND to see her GP. For some women, just the consultation, and the acknowledgement between the GP and the woman that there is a depressive illness, possibly mild, is enough and she may not require any other treatment. However the GP may suggest anti-depressants which can be extremely useful in aiding the mother’s recovery. Some women may be anxious about taking medication whilst breast feeding; but there are some anti-depressants that are fine to take. It is important to discuss this with your GP.

The GP may suggest counselling for the mother or a referral to the Community Mental Health team who may have expertise in this area. Postnatal Depression support groups can also be extremely helpful for her as she will be with other mothers who are experiencing similar feelings. This will help to reduce her sense of isolation and to normalise her feelings for her.

Whatever treatment and or support a mother receives, it is important to remember that her recovery will be gradual with more bad days than good to begin with. As she recovers her bad days will decrease, good days increase and eventually she will feel like her oldself again.