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Conditions: Perinatal and Postnatal Wellbeing

What is meant by perinatal and postnatal mental health difficulties?

A “perinatal” mental health problem is one that you experience any time from becoming pregnant up to a year after you give birth; “postnatal” or “postpartum” denotes the period after childbirth.

Having a baby is a significant event that constitutes a big change and an adjustment. It's natural to experience a range of complex and conflicting emotions during pregnancy and after giving birth. Sometimes these difficult feelings would start having adverse effect on your day-to-day life, and this may indicate that you are experiencing perinatal or postnatal difficulties or mental health problems. This may be a new mental health problem or an episode of a problem you've experienced in the past.

For example, if you recently had a baby and you are struggling with your mental health, it can be hard to be open about how you're feeling. It is common to experience pressure to be elated and excited and to ‘be on top of everything’ as well as be worried that finding things difficult would mean that you are a bad parent or that your baby will be taken away from you. It is important to remember that if you are finding things difficult, this is not your fault, and it is a common experience and that you can ask for help or support if you need it. It is also not uncommon to experience thoughts about harming your baby, which can be very unsettling and scary. But it's important to remember that having these thoughts doesn't mean you are going to harm your child.


Are your difficulties connected to anything specific?

Antenatal, Perinatal, or Postnatal Depression - If you experience depression while you are pregnant, this is known as “antenatal depression”. If you experience depression any time from becoming a parent to around one year after giving birth, this is referred to as “perinatal depression”. Postnatal depression (PND) occurs during roughly the first year after giving birth.

Antenatal, Perinatal, or Postnatal Anxiety - There may be more awareness about the prevalence of depression during or after pregnancy however many people also experience anxiety during pregnancy and after giving birth. In fact, it is common to experience depression and anxiety together.

 Perinatal OCD - Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. Perinatal OCD refers to the experience OCD during pregnancy or in the first year after giving birth. It is natural to worry about your child's wellbeing however if you begin to experience obsessive and compulsive symptoms that affect your daily life, you may be experiencing perinatal OCD. The obsessions and compulsions you may experience are likely to relate to feelings more specifically about being a parent and your baby.

You may experience intrusive thoughts about hurting your baby, during or after pregnancy and have disturbing thoughts of sexually abusing your child for example. You may also fear that you will be responsible for giving a child a serious disease. It is also common to experience fear of making wrong decisions concerning welfare of your child. Such thoughts can be frightening but it is important to remember they are not your fault and that having intrusive thoughts does not mean you will act on them.

Postpartum PTSD - Postnatal post-traumatic stress disorder (PTSD) is a type of anxiety disorder, and it is often referred to as “birth trauma”. You may develop postnatal PTSD if you experience traumatic events during labour or childbirth. Postnatal PTSD can develop as a result of any unexpected, shocking or traumatic experiences during labour and birth. Examples of traumatic events may include a difficult, long, and painful labour and delivery or any unplanned events such as having emergency treatments and a caesarean section. You may believe that having a baby makes up for any traumatic experiences or that joys of parenthood will erase the blueprint of the trauma. However, it may be important to validate your difficult experiences and remember that traumatic events can naturally have a negative impact on your wellbeing and your relationship with your baby and others around you. Your experience may therefore make it difficult to feel close to your baby (for example out of fear of losing them) or it may make you feel anxious about having another baby in the future. You may also be left with complex feelings and experience disappointment and anger about your experience and how your care was handled. As a result, you may be reliving aspects of the trauma, feel alert and on edge as well as engage in avoidance of difficult memories and feelings.

 Postpartum Psychosis - Postpartum psychosis can be an overwhelming and distressing experience, and it is pivotal to seek help as soon as possible if you experience symptoms. With the right level of support, most people fully recover. The symptoms of postpartum psychosis usually emerge quite suddenly and tend to occur within a few weeks after you give birth. In the case of postpartum psychosis, you are likely to experience a mix of psychosis, depression, and mania. This means that you may experience drastic mood changes (feel elated and unable to sleep, and then feel severely depressed as well as confused and disorientated) and you may experience delusions and/or hallucinations. Hallucinations are when you experience things that others around you don't (hearing voices, seeing visual hallucinations and other unexplained sensations are common examples). Delusions are strong beliefs that other people don't share (For instance you may experience paranoia and believe that you are being followed, that your thoughts are being read or that you are invincible and have divine powers and can influence things outside of your control).

Treatment recommendations

Psychological therapy and counselling can help you learn how to manage your difficulties better. There is a wide range of therapies that are effective for difficulties associated with perinatal and postanal wellbeing and mental health. The selected treatment would be individually tailored to your needs following a comprehensive assessment process in our service.

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