Maternal Mental Health Maternity Patient Information Leaflet

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Feeling good about your mental health Maternal mental health is a term used to describe how you feel emotionally during your pregnancy, delivery and for one year afterwards. These may be feelings of elation, happiness or you may feel overwhelmed, slightly weepy and can sometimes impact on your mental health and well being. However these may be normal reactions to pregnancy and childbirth. The birth of a baby is a major life changing event. All women need support during pregnancy and after the birth of the baby. Women with poor mental health may need even more support from specialist services.

Tip: Before and after you have had your baby, if you get an offer of help, take it! Use the time just for you!

What may cause changes to mother's mental health? Any women may experience mental health problems. It may be due to changes in hormone levels, lack of sleep or worries relating to the baby, but there may be other reasons. You may have a pre-existing mental health condition that you need to tell your midwife about.

Tip: Whatever the reason. If you have concerns or worries, share them with someone – family, friends or your midwife and/or health visitor.

Antenatal care Throughout your pregnancy your midwife will ask about any family history of mental ill health and if you have any past or current problems. Please take the opportunity to discuss anything that you have concerns about so that the appropriate care can be tailored to your individual needs.

Tip: if you feel tense, anxious or have difficulty sleeping please tell your midwife.

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Postnatal care Baby blues About half of all women are affected by the 'baby blues' after the birth of their baby. 'Baby Blues' is a time of mild depression usually occurring in the first week following the birth of their baby. You may feel very emotional and tearful without explanation. Although you may worry about this, it usually passes within 10 days.

Tip: Try to get as much practical help as possible from your partner, family and friends.

Postnatal mental health As many as 10% of all postnatal women can experience depression. It is different from 'baby blues' and usually starts later - between six weeks to a year after delivery. Depression can happen whatever your personal circumstances, and whether or not your baby is your first. No woman will go through all of the following experiences, but you may have to deal with more than one of them, in any combination:

• Despondency: a feeling that nothing is any good; that there is no hope

• Lethargy, tiredness, or numbness that makes it difficult to do anything or take an interest in the outside world

• A sense of inadequacy; feeling unable to cope • Guilt about not coping, or about not loving the baby enough • Tearfulness, unusual irritability, which makes the guilt worse • Loss of appetite, which may go with feeling hungry all the

time but being unable to eat • Sleep problems: difficulty in getting to sleep, or early waking,

or vivid nightmares • Hostility or indifference to a normally loved husband/partner • Loss of interest in sex • Panic attacks, which can occur at any time, causing rapid

heartbeat, sweaty palms and feelings of sickness or faintness • Symptoms like stomach pains, headaches, blurred vision

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• Strong anxiety, often about things which wouldn't normally • bother you, such as being alone in the house • Difficulty in concentrating or making decisions • Physical obsessive fears about health – the baby's, your

partner's or family member's, or your own • Thoughts about death

All or some of these feelings can be very frightening, and can make a mother feel she is going mad and completely out of control. It may make her afraid to tell anyone about these feelings. It's important to realise that this does not necessarily mean that a mother will actually harm herself or her children, although it can and does happen occasionally. The more she can bring these feelings out into the open and talk about them, the less likely she will act on them. The earlier depression is spotted, the better. It makes recovery much easier and means that mother and baby, as well as the rest of the family, will be less affected.

Tip: As with 'baby blues' you can try and get as much rest as possible, accept any practical help and support that is offered, no one expects you to be superwoman.

Try to set some time aside for you, try a relaxing bath while your husband/partner cares for baby.

What can I do to get better? Depression usually clears up in time, although it may take up to a year. Love, support and nurture from family and friends play a vital role in helping a new mother.

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How can family and friends help? Whatever you do, please do not:

• Tell her to pull herself together. She is already feeling bad about herself, and doing her best

• Walk out on her, however difficult the circumstances. • Leave her alone with the baby for long periods • Give her alcohol or encourage her to drink too much

All of these things will make her mental health worse.

There are many things that you can do to help:

• Encourage the mother to seek help from a GP, Health Visitor, • Midwife, Community Mental Health Team, friends, family of self-

help groups • Try to ensure she gets sufficient rest, food and exercise • Support her • Remind her that she is not going mad and that she will get • better • Give her a massage – this will help her to relax and restore

wellbeing • Reassure her of your support and that you will not abandon her • Try to ensure that she does not spend all of her time alone to

cope with baby - this can be the most stressful aspect of mothering

• Be prepared to talk about it, so that the problem does not remain invisible

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Useful organisations: The Association for Postnatal Illness 25 Jerdan Place London SW6 1BE Tel: 020 7386 0868 Web: www.apni.org.uk British Association for Counselling and Psychotherapy (BACP) 1 Regent Place Warwicks CV21 2PJ Tel: 0870 443 5252 Fax: 0870 443 5160 Email: bacp@bacp.co.uk Website: www.counselling.co.uk Send an A5 SAE for details of local practitioners British Confederation of Psychotherapists (BCP) 37 Mapesbury Road London NW2 4HJ Tel: 020 8830 5173 Fax: 020 8452 3684 MAMA (Meet-a-Mum Association) 77 Westbury View Peasedown St John Bath BA2 8TZ Helpline: 020 8768 0123, Office tel: 01761 433598 Email: meet-a-mum-assoc@blueyonder.co.uk Website: www.mama.org.uk

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The National Childbirth trust (NCT) Alexandra House Oldham Terrace London W3 6NH Enquiry line: 0870 444 8707 Email: enquiries@national-childbirth-trust.co.uk, Website: www.nctpregnancyandbabycare.com

Useful Websites www.patient.co.uk www.livinglifetothefull.com www.equip.nhs.uk

References: 'Understanding Postnatal Depression' (2001), MIND Publications. 'Coping with Postnatal Depression' Information for Patients no. 57 (2002). Dudley Group of Hospitals NHS Trust.

If you have any questions or if there is anything you do not understand about this leaflet please contact:

Your GP or named midwife, the details of both can be found on the front of your green pregnancy notes.

If you have had your baby, speak to your GP.

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Originator: Dudley PCT and DGH Maternal Mental Health Working Group Date: November 2012 Version: 1 Date for Review: November 2015 DGOH Ref No: DGOH/PIL/00268

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