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Baby Swimming (with Mum)

Perinatal Mental Health

Perinatal Mental Health is a subject that is close to our hearts here at Puddle Ducks, so our team at Puddle Ducks Wakefield, Barnsley, Sheffield & South Leeds, in conjunction with Kelly from the Holistic Birth Company, have put together a factfile below with lots of helpful advice and information.

While having a baby can certainly be overwhelming, it's important to remember that you're not alone. Most new mums experience some of the symptoms mentioned below, it's normal to not feel yourself due to hormonal changes, tiredness and general anxiety about the fact that you are now a parent and all that brings with it.

The key is to recognise what is OK for you and if you feel like the balance has tipped the most important thing to do is tell someone, it really does get better, and there is help available for everyone.

If you'd like to find out where you can get help, go to the bottom of the page where you can find some links to organisations.

What is perinatal mental health and who does it effect?

  • Perinatal mental health (PMH) problems are those which occur during pregnancy or in the first year following the birth of a child.
  • Perinatal mental illness affects up to 27% of new and expectant mums and covers a wide range of conditions.
  • There are a number of different illnesses that fall under the Perinatal Mental illness umbrella:
    • Perinatal depression
    • Perinatal anxiety
    • Perinatal OCD
    • Postpartum Psychosis
    • Postpartum PTSD

What are the signs & symptoms to look out for?

  • Symptoms include

    • down, upset or tearful
    • restless, agitated or irritable
    • guilty, worthless and down on yourself
    • empty and numb
    • isolated and unable to relate to other people
    • finding no pleasure in life or things you usually enjoy
    • a sense of unreality
    • no self-confidence or self-esteem
    • hopeless and despairing
    • hostile or indifferent to your partner
    • hostile or indifferent to your baby
    • suicidal feelings.

  • Symptoms include:

    Physical effects on your body

    • a churning feeling in your stomach
    • feeling light-headed or dizzy
    • pins and needles
    • feeling restless or unable to sit still
    • headaches, backache or other aches and pains
    • faster breathing
    • a fast, thumping or irregular heartbeat
    • sweating or hot flushes
    • finding it hard to sleep, even when you have the chance
    • grinding your teeth, especially at night
    • nausea (feeling sick)
    • needing the toilet more or less often
    • changes in your sex drive
    • having panic attacks.

    Effects on your mind

    • feeling tense, nervous or unable to relax
    • having a sense of dread, or fearing the worst
    • feeling like the world is speeding up or slowing down
    • feeling like other people can see you're anxious and are looking at you
    • feeling like you can't stop worrying, or that bad things will happen if you stop worrying
    • worrying about anxiety itself, for example worrying about when panic attacks might happen
    • wanting lots of reassurance from other people or worrying that people are angry or upset with you
    • worrying that you're losing touch with reality
    • worrying a lot about things that might happen in the future
    • rumination – thinking a lot about bad experiences, or thinking over a situation again and again
    • depersonalisation – feeling disconnected from your mind or body, or like you're watching someone else (this is a type of dissociation)
    • derealisation – feeling disconnected from the world around you, or like the world isn't real (this is a type of dissociation).

  • Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. 

    Obsessions are unwelcome thoughts, images, urges, worries or doubts that repeatedly appear in your mind.

    For example:

    • intrusive thoughts about hurting your baby, during or after pregnancy
    • disturbing thoughts of sexually abusing your child
    • fear of being responsible for giving a child a serious disease
    • fear of making the wrong decision – for example, about vaccinations or medical treatment.

    Compulsions are repetitive activities that you do to reduce the distress and anxiety caused by obsessions.

    For example:

    • excessive washing of clothes, toys or bottles
    • avoiding changing soiled nappies because you're worried about accidentally touching your baby inappropriately
    • keeping your baby away from other people in case they hurt them or contaminate them
    • constant checking on the baby – for example, waking them up when they're asleep to check on them
    • repeatedly asking people around you for reassurance that your baby hasn't been hurt or abused
    • going over what happened each day to reassure yourself that you haven't harmed your baby.

  • Postpartum psychosis is a serious but rare mental health condition which develops after you give birth. It is sometimes called puerperal psychosis. 

    Postpartum psychosis can be an overwhelming and frightening experience, and it is important to seek help as soon as possible if you experience symptoms. But with the right support, most people fully recover.

    How you might feel/behave:

    • excited or elated
    • severely depressed
    • rapid mood changes
    • confused or disorientated
    • restless
    • unable to sleep, even when you have the chance
    • unable to concentrate
    • experiencing psychotic symptoms, like delusions or hallucinations.

  • Postnatal post-traumatic stress disorder (PTSD) is also known as birth trauma.

    You may develop postnatal PTSD if you experience traumatic events during labour.

    Some of the common signs and symptoms of postnatal PTSD include: 

    Re-living aspects of the trauma

    This may include:

    • vivid flashbacks
    • intrusive thoughts and images
    • nightmares
    • intense distress at real or symbolic reminders of the trauma
    • physical sensations such as pain, sweating, nausea or trembling.
    • alertness or feeling on edge
    • panicking when reminded of the trauma
    • being easily upset or angry
    • extreme alertness, sometimes known as 'hypervigilance'
    • finding it hard to sleep, even when you have the chance
    • irritability or aggressive behaviour
    • finding it hard to concentrate, including on simple or everyday tasks
    • being jumpy or easily startled
    • self-destructive or reckless behaviour
    • other symptoms of anxiety.

    Avoiding feelings or memories

    This may include:

    • feeling like you have to keep busy
    • avoiding situations that remind you of the trauma
    • being unable to remember details of what happened
    • feeling emotionally numb or cut off from your feelings
    • feeling physically numb or detached from your body
    • being unable to express affection
    • using alcohol or recreational drugs to avoid memories.

    Difficult beliefs and feelings

    This may include:

    • feeling like you can't trust anyone
    • feeling like nowhere is safe
    • feeling like nobody understands
    • blaming yourself for what happened
    • overwhelming feelings of anger, sadness, guilt or shame.

Things people can do to look after their own perinatal mental health

  • Build a support network

    Talking to other new parents, and finding that they share the anxieties and frustrations you are experiencing, can be very reassuring. It can also give you a chance to share skills and experiences, realise that you are not alone and get some emotional and practical support. It can help you feel more confident as a new parent. There are antenatal groups for parents who are expecting babies. Speak to your health visitor or local children’s centre.

  • Go to local parent-and-baby groups

    If you're feeling nervous about being around new people, try doing something based around an activity. This might make it easier to start talking to other parents. For example, you could try Puddle Ducks Aquanatal classes and Puddle Ducks Baby & Pre-school swimming lessons! These lessons give you an opportunity to make new friends, helping you to create a support network and share your experiences. Many of our parents become friends and connect with each other outside of lessons, whether that is a quick coffee after the lesson or catching up in the park. It is great to know you are not alone!

  • Contact specialist organisations

    Organisations like Home-Start or NCT help new parents to develop their support networks and look after their mental health.

  • Access online support

    There are lots of online communities where you can share your experiences of being a parent and living with a mental health problem. Websites like netmums have forums where you can talk to other parents. Mind runs an online peer support community called Side by Side for anyone who wants support for their mental health.

  • Peer support

    Peer support brings together people with similar experiences, so they can share those experiences and tips to help each other cope. Many organisations run peer support programmes for people with perinatal mental health problems. For example: 

    • Action Postpartum Psychosis runs a peer support network for anyone with experience of postpartum psychosis. 
    • PANDAS runs support groups for perinatal mental health problems.
    • Or you can also contact your local Mind to see if they offer any peer support groups in your area.

Women should speak to their GP or health visitor if they feel that their mental health is declining and they can refer them to their local NHS perinatal mental health services if deemed necessary.