The transition to becoming new parents is one of the most significant changes in life, and most couples find it challenging. Many adjustments have to be made to successfully navigate this transition to becoming parents
Preparing for the arrival of a new baby is a good time to reflect on how their lives will change when they become parents. Having a baby is an exciting time but the changes he or she will bring often take new parents by surprise, perhaps causing more stress and anxiety. Some expectant parents might believe that the baby will not have a huge impact on their lives or that they will be able to manage more in their lives than is realistic, for example a tidy house, settled baby, great cooking, going out, looking great etc. In fact, having a baby causes significant changes, many of which are unexpected and involve a degree of loss and grief. For example a sense of a loss of freedom, work identity, financial independence and social contacts is not uncommon. Most new parents find some aspects of adjusting to life with a new baby to be difficult.
It can be helpful for the individuals to think about what experiences they have had of growing up in their own family and what they know about being a mother or a father. What they have learnt in their own families will affect how they become a parent and it will be very different for both of them. For example, we know that when people are faced with stress, such as having a baby, it is natural to go back to these early learnings to cope, even if they don't necessarily want to.
Talking about some of these different experiences as a couple and what the individuals have learnt about families can help the couple to see the differences as they become new parents. Talking about how they would like to be as their own new family can help to relieve some of the stress that goes with being new parents. Sometimes it can help to do this with someone they trust, a family member, friend or counsellor.
Myths of Motherhood:
There are many myths or common misconceptions about motherhood that can add to the stressors faced by new mothers as well as new fathers. Some of these are learnt from the new mother's own family and others are reinforced by the media or among friends. For example:
- A woman will intuitively know how to ‘mother'
- Motherhood is romantic
- The woman is responsible for a ‘happy' family
- Children are needed to ‘make' a happy family
- A mother's worth is judged by the behaviour of her baby, e.g. good sleeper
- Mothering must be 24 hours a day
- Women at home have more time to do things
- Mothers should know how to control her children
- A mother ‘copes' no matter what
- A mother is selfish if she expresses her own needs
Not being aware of some of these myths and their influence can change the way a new mother approaches her new role, slowing down her adjustment to it. For some women this can be a powerful part of PND. Being aware of these myths can help to make some choices about them and therefore minimize their effect.
Continuum of mood disorders
Many women and their partners are not aware that mood changes are common after childbirth and can vary from mild to severe. In fact in the year after childbirth a woman is more likely to need psychiatric help than at any time in her life. There are a number of recognised mood disorders associated with childbirth that can be viewed along a continuum:
Antenatal Depression – symptoms of depression that develop during the pregnancy
Baby Blues – at the milder, less severe end of the continuum is the, affecting about 80% of new mothers and occurring between the third and fifth day after birth. Symptoms include emotional distress, tearfulness, anxiety, mood fluctuations and irritability. The ‘blues' are transient and usually pass within a short time with understanding and support.
Postnatal Depression (PND) – more serious than the ‘blues', PND can be mild, moderate or severe. Many women do not know that PND can occur unexpectedly after delivery and typically blame themselves, their partners or their baby for the way they feel.
Postpartum Psychosis – at the severe end of the continuum, it affects 1 in 1000 mothers, usually in the first 2 to 4 weeks after delivery. Postnatal psychosis is a serious condition. The mother herself may be unaware she is ill as her grasp on reality is affected. Symptoms include severe mood disturbance (either marked elation or depression or fluctuations from one to the other), disturbance in thought processes, bizarre thoughts, insomnia and inappropriate responses to the baby. There is risk to the life of both mother and baby if the problem is not recognised and treated. Postnatal psychosis requires a hospital admission. With appropriate treatment women suffering from postnatal psychosis usually fully recover.
Biopsychosocial Model of mood disorders related to childbirth and recovery
PANDA views post and antenatal mood disorders and the process of recovery within a biopsychosocial model. This recognizes individuals holistically and more broadly than the medical model alone, and that mood disorders related to childbirth exist within family and social systems. This model is also based on the knowledge that treatment for depression is most successful when a combination of interventions is implemented.
There are many factors that contribute to the development of mood disorders, including biological (medical), psychological and social aspects. Similarly the symptoms of mood disorders usually present within these categories and therefore strategies for managing them and successful recovery must address all aspects of the person's life.