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Support guide for perinatal mental health

Pregnancy is often a very happy and exciting time.  But not everyone feels this way. You may have mixed, or even negative, feelings about being pregnant. You may find it more difficult than others to cope with the changes and uncertainties which pregnancy brings. Many things can affect how you feel in pregnancy. These include physical symptoms (e.g. morning sickness), the support you have (or do not have), and stressful events in your life.

People often worry about how they will cope with pregnancy or having a baby. It is normal to feel stressed or anxious at times. When you are pregnant, it is common to worry about:

  • The changes in your role (becoming a mother/parent, stopping work)
  • The changes in your relationships
  • Whether you will be a good parent
  • Fear that there will be problems with the pregnancy or the baby
  • Physical health problems and pregnancy complications
  • Fear of childbirth
  • Lack of support and being alone

As many as 1 in 5 people giving birth and 1 in 10 partners have mental health problems in pregnancy or after birth. It can happen to anyone. Depression and anxiety are the most common mental health problems in pregnancy. Just like at other times in life, you can have many different types of mental illness and the severity can vary. You may already have had a mental illness when you became pregnant.

Mental health problems you have had in the past can be worrying because they can increase the risk of becoming unwell, particularly after birth. However, with the right help this can often be prevented. You can also develop mental health problems for the first time in pregnancy or after birth.

How your mental health is affected during pregnancy depends on many things. These include:

  • The type of mental illness you have had already
  • Stopping medication for a mental health problem – you have a high risk of relapse if you do this when you become pregnant. This is more likely if you have had a severe illness, several episodes of illness or a recent episode
  • Recent stressful events in your life (such as a death in the family or a relationship ending)
  • How you feel about your pregnancy – you may or may not be happy about being pregnant
  • Upsetting memories about difficulties in your own childhood

Symptoms

Symptoms of mental illness in pregnancy are like symptoms you may have at other times, but some may focus on the pregnancy. For instance, you may have anxious or negative thoughts about your pregnancy or your baby. You may find changes in your weight and shape difficult, particularly if you have had an eating disorder.

Sometimes symptoms caused by your pregnancy can be confused with symptoms of mental illness. For example, broken sleep and lack of energy are common in both pregnancy and depression.

Following the birth of baby, it is common to experience a range of emotions. Many people can feel tearful due to hormones, tiredness and all the adjustments that come with a new baby.   These amplified emotions are common especially around day 2-3 and may continue for a short while.

If you experience low mood or a decline in your mental health, especially one that lasts longer than two weeks it is always best to reach out and tell someone.   There are many forms of support available and a wide range of professionals to help you find the most appropriate treatment.

Buckinghamshire Healthcare NHS Trust (BHT) is committed to supporting mental health. We understand it is common for people who are pregnant and partners to experience:

  • Low mood, sadness and tearfulness
  • Anxiety, OCD, worry and tension
  • Irritability and anger
  • Difficult or unexpected feelings towards your pregnancy or baby
  • Poor sleep even when your baby sleeps well
  • Feeling unable to cope or enjoy anything
  • Thoughts that you are not a good enough parent
  • Worrying thoughts about your baby
  • Relationship and social stress, such as housing, financial or relationship issues.
  • Anxiety about labour or struggling to come to terms with a difficult birth

Asking for help

It can be difficult to talk about how you are feeling and to ask for help. Struggling emotionally at this time can happen to anyone, especially after any big life change like welcoming a new member to the family. Asking for help does not mean you cannot cope or are not able to care for your child.   It is the start of getting the right help and support to ensure you can be the parent you want to be.

Where to find support

BHT Maternity service

To make sure you have the right support for you, please tell your midwife or obstetrician if you, or a close member of your family, has current or past mental health issues, or feel your mental health is declining. They can refer you to our dedicated Perinatal Wellbeing team for enhanced support during pregnancy and up to 28 days after your baby is born. You can also self-refer to the team’s specialist midwives at bht.perinatalmentalhealth@nhs.net.

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It is important that you attend your antenatal appointments during pregnancy to ensure you have all the care and support you need.