Midwife Jay

Postnatal Emotional Wellbeing

Having a baby is a huge emotional journey, and the hormones of pregnancy and postpartum make it even more intense! Some degree of emotional upheaval is normal, but it is important to recognise signs of postnatal anxiety and depression early.

‘Baby blues’

Around 3-5 days after birth, it is very common to have feelings of upset and sadness or tearfulness, as the hormones of pregnancy leave your body. This usually lasts a few days. Good whānau support and being gentle with yourself is the key to coming through these (often very intense) feelings.

Postnatal depression

If those intense feelings last more than a few days, you may be developing postnatal depression. Postnatal depression is common, affecting around 10-20% of birthing parents and up to 10% of non-birthing parents. It should always be taken seriously, as it affects your quality of life and your parenting ability.

Symptoms of postnatal depression include:

  • Low mood – feelings of sadness, worthlessness, hopelessness, uselessness, or anger
  • Loss of pleasure in life – baby may not be a source of happiness any more, or may be the only source of happiness
  • Low energy – feeling unable to get going or get things done, or inability to cope with the demands of a new baby or the household
  • Changes in appetite – either decreased or increased
  • Changes in sleeping patterns – either not sleeping or sleeping more than usual
  • Cognitive changes – difficulty with memory, attention, or concentration
  • Negative thinking – about the birth, about parenting, or in general
  • Suicidal thoughts or worries about baby being hurt or dying

If these sorts of feelings are overwhelming or persist for more than two weeks, please let your midwife know, as they can connect you with services to help.

Postnatal anxiety

Postnatal anxiety is also common, and may occur alongside postnatal depression or on its own. Around 15% of birthing parents experience postnatal anxiety. Non-birthing parents can also develop postnatal anxiety. It should be taken seriously, as it can affect your quality of life and your parenting.

Symptoms of postnatal anxiety include:

  • Feeling anxious all the time
  • Intense emotions – worry, often about the baby, or an overwhelming sense of dread
  • Cognitive symptoms – irritability, restlessness, inability to focus or think
  • Physical symptoms – lightheadedness, dizziness, heart palpitations, stomach upset
  • Compulsive symptoms – Avoiding or carefully repeating certain things or behaviours in an attempt to control anxiety
  • Panic attacks

If you are struggling with these things, please talk to your midwife, as they can help connect you with services who can assist. You don’t have to suffer through this alone!

Postpartum psychosis

While postnatal anxiety and depression are common, postpartum psychosis is rare – affecting around 0.1% of birthing parents. It is very serious and requires immediate hospital-level treatment.

Symptoms of postpartum psychosis include:

  • Mood disturbances
    • Very low mood, or extremely elevated mood
    • Extreme irritability, impatience, anger, or rage
    • Rapid changes from joy to misery or anger
    • Racing thoughts, rapid speech, jumping from topic to topic
    • Insomnia
    • Deep depression, withdrawal, or silence
    • Increased activity – suddenly reorganising the house or deep cleaning
    • Pleasure seeking – increased sexual activity, spending sprees
    • Struggling to care for self or baby, or lack of awareness of own or baby’s needs
  • Psychotic symptoms (thoughts, feelings, or beliefs that are not in touch with reality)
    • Hallucinations – hearing voices, smelling or seeing things that aren’t there
    • Delusions – believing things that are strange or out of character, like that people are plotting against you or your baby, or the baby is special or evil in some way
    • Thought disturbances – feeling that people can hear your thoughts or are interfering with your thinking

Postpartum psychosis is terrifying for both the person experiencing it and their whānau or support people. It often involves a lack of insight, meaning that the person experiencing it does not recognise that they are unwell and losing touch with reality. It is so important for support people to reach out to your midwife, GP, or mental health services if they think you might be becoming psychotic.

For more information