Mental Health During Pregnancy and After Childbirth

Many women feel tearful, anxious, irritable, overwhelmed or unusually emotional during the first few days after giving birth. This is commonly known as the baby blues.

The baby blues are very common and normally improve within two weeks. Rest, practical help and emotional support can make this period easier.

Speak to a midwife, health visitor or GP if these feelings:

• last longer than two weeks
• become more severe
• begin later
• make everyday life or caring for the baby difficult

These could be signs of postnatal depression or another mental-health condition.

Postnatal depression can begin during pregnancy, shortly after childbirth or at any time during the first year after the baby is born.

Possible signs include:

• persistent sadness or low mood
• feeling hopeless or unable to cope
• losing interest or enjoyment in things
• feeling guilty, worthless or like a bad parent
• difficulty bonding with the baby
• withdrawing from other people
• irritability or restlessness
• difficulty concentrating or making decisions
• sleeping problems that are not explained only by the baby waking
• frightening thoughts about self-harm, suicide or harm coming to the baby

A person does not need to experience every symptom before asking for help.

Some anxiety is understandable when caring for a new baby. However, anxiety may need professional support when the worry becomes constant, overwhelming or difficult to control.

Possible signs include:

• continually fearing that something terrible will happen
• repeatedly checking the baby
• feeling unable to relax or sleep
• racing thoughts
• panic attacks
• a racing heartbeat, shaking, dizziness or breathlessness
• avoiding leaving home or allowing anyone else to care for the baby
• repeatedly seeking reassurance

Perinatal obsessive-compulsive disorder, or perinatal OCD, can develop during pregnancy or after childbirth.

It may involve unwanted and distressing thoughts, images or urges, often involving something happening to the baby. These are called intrusive thoughts. A person may also feel compelled to check, clean, repeat actions or seek reassurance.

Having an unwanted intrusive thought does not mean that someone wants it to happen or will act upon it. However, anyone distressed by these thoughts should speak honestly with a GP, midwife or health visitor. Healthcare professionals understand this condition and can arrange appropriate support.

A frightening, painful, emergency or poorly managed birth can sometimes lead to birth trauma or post-traumatic stress disorder, known as PTSD. Partners who witness a traumatic birth may also be affected.

Possible signs include:

• flashbacks or feeling as though the birth is happening again
• nightmares
• intrusive memories
• avoiding conversations, appointments or places connected with the birth
• feeling constantly alert, unsafe or easily startled
• panic, anger or emotional numbness
• difficulty sleeping or concentrating
• intense fear of another pregnancy or birth

Someone can be affected by birth trauma even if other people believe the birth went well or the baby was born safely.

Family members and friends can help by:

• listening without judgement
• taking the person’s concerns seriously
• helping with meals, housework and everyday tasks
• allowing the mother opportunities to sleep and rest
• attending appointments with her if requested
• helping her contact a GP, midwife or health visitor
• watching for sudden confusion, hallucinations, unusual beliefs or extreme changes in behaviour
• seeking emergency help when there is an immediate risk

Fathers and partners can also experience depression, anxiety or PTSD during pregnancy or after a baby is born. They should contact their GP or an NHS talking-therapies service if they are struggling.