Start the conversation about perinatal mental health issues

Posted on 10 November, 2020

Perinatal mental health and birth trauma are very real issues, but not often discussed.

Perinatal Mental Health Week started on Sunday 8 November and marks a week of public awareness of mental health conditions, such as anxiety and depression, which can affect parents in late pregnancy and around the time of a child’s birth.

Perinatal mental health conditions can affect any parent during pregnancy and in the period soon after birth, even those who are not experiencing parenthood for the first time, and they can be devastating.

A baby’s birth, that precious first moment when a fresh little person opens their eyes on the world, can be a source of enormous joy and satisfaction for a family. Unfortunately, in many cases it is also a life-changing event which can leave new parents feeling utterly alone and lost, struggling to keep themselves together under a huge weight of societal and personal expectations.

Ordinarily, birth brings new challenges, even in the best of circumstances. Parents may have to tackle money pressures; lack of sleep; health concerns (sometimes arising from birth-related injuries); changes to the relationship between partners; and the emotional upheaval of a new way of interacting with the world around them.

In 2020, birthing families have encountered new worries and setbacks. Straight out of the anxiety-provoking summer bushfire season, families having children this year have had to navigate the frighteningly unknown territory of a global pandemic.

Many have faced COVID19-related restrictions in their access to midwives, doctors and other treatment providers as well as support networks.

Parents who thought they could securely provide for their baby have lost their jobs. Others have had to agonise over the circumstances in which they will be able to give birth, or whether they would have their partner with them during the birth, or what might happen to them or their baby if they caught COVID19 during pregnancy.

Extended family (sometimes even those living close by) have been unable to meet the baby, or help and support the new parents in the ways they might normally do.

A lot of people have felt more isolated and alone than ever before, adding to the pressure associated with becoming a new parent.

All of these circumstances put new parents at a heightened risk of psychological mental health issues.

The most important thing you can do for someone you think may be suffering from depression, anxiety or another mental health condition in connection with pregnancy or birth, is to make sure they are not suffering in silence.

Let them know you are there for them, that you care about them and that you are willing to listen.

Encourage them to seek support for their mental wellbeing, starting by checking in with their GP or mental health professional for advice. Just starting that conversation with your friend, partner or family member, reminding them that they are not alone and that they can get help, can make all the difference in helping them find the path to recovery.

The authors of this article both work in a volunteer capacity for the Australasian Birth Trauma Association (ABTA), a not-for-profit association which aims to reduce the instance and impact of birth-related trauma, and offers free peer mentoring services to those affected.

This means connecting with someone who has had a similar experience, and who can offer support and perspective while working through it.

While parents do not necessarily have to have experienced birth-related trauma in order to develop perinatal mental health issues, births gone wrong do often lead to PTSD, anxiety and depression.

The expectations of birth may have differed significantly from how it played out in reality, or perhaps serious complications arose which led to physical harm to the mother or child.  Sometimes birth also brings with it that most tragic event of all: the death of the child or mother.

Whilst many pregnancies end happily for families, this is not always the case. Each person’s experience is unique, but the stories the Australasian Birth Trauma Association hears often have a common element of a new parent feeling helpless and alone: a mother sitting in a hospital bed, in pain or shock, unable to grasp what she “did wrong” to miss out on the perfect birth she had thought she had prepared for; or sometimes a partner left unexpectedly clutching their baby, as the mother is wheeled off to theatre, unsure whether they would be coming back.  This type of event can cause trauma and give rise to ongoing mental health issues.

In one of ABTA’s recent blogs, Madeleine shared her story of giving birth during the COVID19 pandemic, after having experienced a traumatic birth with her first-born child.

Madeleine ended up on stress leave from work, with bans being implemented to elective surgeries, adding extra worry and stress for her birth plan. She continued to experience negative mental health issues after birth, despite describing the birth as a “beautiful” event.

She tells of the troubles of having less support from family and friends due to restrictions, the stress of the looming pandemic and possible exposure to COVID19, and developing mastitis postpartum.

Madeleine writes: “Having a baby during the pandemic has been frightening and incredibly hard.” You can read the full story here.

The perinatal health period technically only extends for a few weeks after birth. In the course of our community support projects for affected families, the ABTA has spoken with parents (both mums and partners) who have continued to feel the impact of the trauma they suffered at the time of birth, for years and even decades afterwards.

This long-lasting effect can have serious consequences for people’s ability to get on with their lives, care for their families, work, and engage with the world around them. Starting the conversation about these experiences is an important part of recovery, no matter how long ago it happened.

If you or a loved one needs advice and support, contact the Australasian Birth Trauma Association (ABTA). Peer mentoring support is available free of charge from the ABTA.

Other organisations working in perinatal health include PANDA (1300 726 306) and the Gidget Foundation (1300 851 758).