Perinatal mental health encompasses your emotional and psychological wellbeing throughout pregnancy and the first year after birth. We explore what that can look like, when the adjustment to motherhood might be something more, and where you can find support.
Pregnancy and early motherhood can hold two truths at once.
You can love your baby and find motherhood incredibly hard.
You can have desperately wanted to become pregnant and struggle with how pregnancy makes you feel.
You can be grateful, happy and completely overwhelmed.
You can look as though you’re coping and know, privately, that you don’t feel like yourself.
For a long time, conversations about mental health around motherhood seemed to begin and end with postnatal depression. But perinatal mental health is much broader than that.
And understanding what it actually means can make it easier to recognise when you — or someone you love — might need a little more support.
What is perinatal mental health?
The perinatal period generally refers to pregnancy through to the first year after birth. Your perinatal mental health is, quite simply, your mental and emotional wellbeing throughout that period.
It encompasses the enormous psychological transition that can accompany pregnancy and becoming a parent, as well as mental health conditions including anxiety, depression and obsessive-compulsive disorder (OCD). Less commonly, serious conditions such as postpartum psychosis can occur after birth.
And mental health challenges during this period are not rare.
PANDA estimates that as many as one in five expecting or new mothers and one in ten expecting or new fathers experience symptoms of perinatal anxiety and/or depression.
Motherhood is a significant transition
Having a baby changes the practical details of your life in an instant.
Sleep. Work. Relationships. Freedom. Responsibility. Your body. Your routines. Your priorities.
But there can also be a quieter change happening underneath all of that: the way you understand yourself.
The transition into motherhood is sometimes described as matrescence. And while becoming a mother can be deeply meaningful, adjusting to such significant change isn’t necessarily effortless simply because you love your baby.
Some uncertainty, overwhelm and emotional adjustment during pregnancy and early parenthood is expected. After birth, the hormonal changes and adjustment of the first few days can also bring the commonly described baby blues, which PANDA says affect up to 80% of new parents after giving birth and usually resolve within a few days.
But sometimes it doesn’t feel temporary.
Sometimes things feel heavier, more frightening or harder to manage.
What can struggling with perinatal mental health look like?
There isn’t one experience that tells you something is wrong.
Anxiety might look like persistent worry about your baby, feeling constantly on edge or panicky, being unable to switch your mind off, or finding yourself consumed by whether you’re doing things correctly.
Depression doesn’t necessarily mean crying all day. It can involve low mood, hopelessness, withdrawal, irritability or changes in the way you relate to the people around you.
And anxiety and depression frequently occur together rather than fitting neatly into separate boxes.
There can also be thoughts that feel frightening to admit out loud.
Intrusive thoughts and images can occur during the perinatal period and are associated with conditions including anxiety, depression and OCD — although intrusive thoughts can also occur among people without a mental health disorder, particularly after having a baby.
Perinatal OCD can involve unwanted and recurring thoughts, images or urges alongside compulsive behaviours intended to reduce the resulting anxiety — such as repeatedly checking that a baby is breathing or excessive cleaning and sterilising.
Experiencing something like this can be incredibly distressing, particularly when it doesn’t resemble the version of new motherhood you expected.
But isn’t some of this just motherhood?
This can be one of the hardest distinctions to make.
Of course you’re tired with a newborn.
Of course you worry about your baby.
Of course your life feels different.
And of course there will be difficult days.
That’s partly why perinatal mental health concerns can go unrecognised: symptoms can be attributed to pregnancy or simply adjusting to life with a baby.
Rather than trying to determine whether you’re struggling enough to deserve help, it can be more useful to notice how you’re feeling and how much it’s affecting your wellbeing and ability to function in everyday life.
PANDA recommends reaching out when low mood, overwhelm, distressing thoughts or other changes are affecting your wellbeing or daily functioning.
You don’t need to diagnose yourself first.
You don’t have to wait until you’re in crisis
Mental health support doesn’t have to be the final step after you’ve exhausted everything else.
You might want support because you’re experiencing anxiety or depression.
You might be preparing for birth after a difficult previous experience.
You might want to debrief a birth that didn’t unfold as you expected.
You might be struggling with your changing identity, relationships or body.
Or you might simply recognise that you’re not feeling quite like yourself and want somewhere to talk about it.
There are different avenues of support depending on what you need. A GP, midwife or other trusted health professional can be a starting point, and psychological support is available specifically for the perinatal period. PANDA also operates Australia’s National Perinatal Mental Health Helpline for expecting and new parents and their families.
The Australian Government also funds Perinatal Mental Health Centres providing free specialised psychological support to eligible new and expectant parents, including people who have experienced pregnancy or infant loss or a traumatic birth. Access requires a GP referral and mental health care plan.
Finding psychological support through Earthside
As part of Earthside’s commitment to supporting women beyond the physical experience of pregnancy and birth, we’ve partnered with Clinical Psychologist and mum Isadora Aldam, founder of Self & Seasons Psychology.
Isadora has a particular interest in supporting women and families through the perinatal period and matrescence, including pregnancy, birth preparation and debriefing, adjustment to motherhood, identity changes, perinatal anxiety, depression and OCD.
Her sessions are available via telehealth across Australia, with both short and longer-term support welcome. Learn more here.
Because sometimes preparing for birth means thinking about your mind as well as your body.
And sometimes looking after a new baby needs to include looking after their mother, too.
Resources & support
If you’re finding pregnancy, postpartum or the transition to parenthood harder than expected, there are places you can turn for information and support. You don’t need to wait until things feel unmanageable before reaching out.
- PANDA — Perinatal Anxiety & Depression Australia — Specialist perinatal mental health support for expecting and new parents, as well as partners and support people. National Helpline: 1300 726 306, open seven days a week. PANDA also has an online mental health checklist and resources to help you understand what you may be experiencing.
- Pregnancy, Birth and Baby — Australian Government-funded pregnancy and parenting information, including mental wellbeing resources and access to a maternal child health nurse on 1800 882 436.
- Beyond Blue — Mental health information and support, including resources specifically for mental health during pregnancy and early parenthood.
- ForWhen — Perinatal Depression & Anxiety Helpline: 1300 24 23 22 — Support and connection to perinatal mental health services for expecting and new parents.
- Gidget Foundation Australia: 1300 851 758 — Specialist emotional wellbeing and mental health support for expectant and new parents, including online and telehealth services.
If you or someone else is in immediate danger, call 000. If you need immediate crisis support, Lifeline is available 24/7 on 13 11 14. PANDA specifically notes that its helpline is not a crisis service.
