Postnatal depression – we’ve all heard about it, and many of us have thought, ‘Ah, but it wont happen to me, i’m so happy, i’m having a baby!’
When pregnant, you tend to focus on growing your baby and the impending birth – not so much the postnatal period.
But there is something really important that you need to start thinking about: what you can do and who you can draw upon to support you after you’ve had your beautiful baby.
Sadly, approximately one in seven new mothers experience postnatal depression after giving birth.
That’s an enormously high number, and it doesn’t even include unreported cases.
It may be a little hard to believe you could be one of them, especially when all you may be thinking about right now is how wonderful it might be with a new baby. But no-one can predict what huge changes you may go through after the birth, how support will pan out, nor how you’re going to feel about yourself, your baby, your relationship or the support you’re getting.
Perhaps you already have concerns about coping, or have previously had postnatal depression. Even more sobering is the fact that the leading cause of maternal death in Australia is suicide. Surprised? This is why now, more than ever, you need to prepare yourself as best you can to avoid postnatal depression and anxiety.
Here are 8 important tips (in no particular order, all are important!) which can make a massive difference to your emotional health as a new mother.
Postnatal Depression Fighter #1 – Keep Connected With Your Partner
I’m putting one of the biggest issues out there first: the relationship a woman has with her partner is crucial. In fact, a large study in Scandinavia has just identified that the single biggest factor in antenatal anxiety was a woman’s relationship with her partner – and there is a big link between mood disorders prenatally and postnatally.
Elly Taylor, relationship counsellor and author of the must-read book, Becoming Us says: “It is important to realise that parents go into parenthood emotionally bonded to their partner. This bond gives us a sense of security, comfort and helps us to build our confidence. After the baby comes along, there is so much time, energy and focus going in to meeting the baby’s needs and bonding with them, some couples can, without even realising it, become disconnected,” says Elly. “It’s vital that couple either stay connected during the perinatal period – or re-connect after baby comes because there is a higher chance of postnatal depression in relationships where partners aren’t supportive or involved in the perinatal period.”
Relationship really does tie into emotional health. My last pregnancy was the most challenging for me, both emotionally and physically, and despite being the ‘trust that its all happening for a reason’ kind of person that I was, I felt so disconnected in my relationship, anxious and depressed. I was worried that things weren’t going to work out. But having found a great relationship counsellor, especially one who specialised in parenting (even ran dad workshops!), it held us together and made us so much stronger as people and a couple. Pick the wrong counsellor and it can be devastating. The relationship psychologist we saw initially had us accepting that we may break up and that was okay! But today, we’re closer than we’ve ever been, and I am sure I have found the love of my life.
Your relationship is so very important. Nurture it, work at it, trust it, and if you need help, find the right person to help you to make sense of your usually temporary relationship hurdles. What we fear may be permanent (especially when hormonal and pregnant!) is usually only temporary, just like everything in life. Hang in there and get help – and make connection a priority in both of your lives.
Post Natal Depression Fighter #2 – Placenta Encapsulation
Okay, okay, hear me out on this one! When I was writing the BellyBelly article on placenta encapsulation, many women (and their partners) wrote to me to share their experiences after choosing to encapsulate their placenta.
I couldn’t believe the amount of people who said that this time around, they didn’t get postnatal depression (and had previously) and felt like they had much more energy, recovered quickly and felt so much better. While there isn’t a great deal of official research on placenta consumption in humans, we do know our fellow mammals consume their placentas, and I think they have it right.
Consuming the placenta is said to help balance hormones (custom made ones, just for you!), boost your iron levels (which can prevent symptoms of low iron, which includes fatigue, depression and much more – on top of usual baby tiredness) and it is said to help with milk production to name a few. Many mothers who have read my article on placenta encapsulation after having had postnatal depression say that they really wish they encapsulated their placenta, as it would have been so much better than potentially going through depression.
After I published that article, I decided to encapsulate my own placenta. I have struggled with decent iron (ferritin) levels for as long as I can remember, and had crappy energy to go with it. But to my absolute astonishment, just recently (10 months post birth) I had my ferritin levels measured once again. Usually I am below 10, somewhere between 4-7, so I thought there had to be a mistake – I was at 50! I don’t remember a time in my life it was that high! But I am certainly coping with sleep deprivation much better this time around (third baby after a big gap) and I did not get depression or anxiety as I have previously. No matter if it was the rich source of iron or something else, what does it matter if you’ve avoided fatigue and PND?
For more information, check out our article on placenta encapsulation and you could well be less likely to end up with depression.
Post Natal Depression Fighter #3 – Have Realistic Expectations
Elly Taylor says that her biggest tip on avoiding postnatal depression would be to set yourself realistic expectations. “Seek out information so you have realistic expectations of birth and early parenting. Expectations of these things are often unrealistic, and the higher they are the further there is to come down afterwards.”
Unrealistic expectations – especially when we’re living in an era where women are out working in busy jobs involving deadlines, schedules and time frames – as well as there being a plethora of baby sleep experts out there, telling us that you can get your baby to feed and sleep on (unrealistic) schedules can set new mothers up for failure… and postnatal depression. Another situation which can lead to unrealistic expectations are when you’ve had problems conceiving. As BellyBelly moderator, Nothing2Lose says: “When you’re an LTTTC’er (long term trying to conceive), it’s very easy to romanticise how perfect everything will be once you have a baby. Reality can’t possibly match up.” Some women that have struggled to conceive and finally got that desperately wanted baby can put incredible pressure upon themselves to give everything, be everything and cotton wool their babies, which can lead to utter exhaustion, feelings of failure and postnatal depression. Or they may just be incredibly unprepared for what hits when they are home.
There are plenty of articles here on BellyBelly for you to read about what a baby is biologically programmed to need and what he expects (not chooses, its the way all human babies are) – knowing this can make your time as a new parent so much easier. Its important that you expect your baby to feed, need and want you a good deal of the time in the early days. Your baby will make a HUGE adjustment between two different worlds from one he’s always known – a warm, dark, cosy, squishy home where he didn’t ever feel hunger, thirst, cold, the pressure of passing a poo or wind – all of these things are very strange for him. Its different and uncomfortable to feel hungry. Its different to see light, feel breeze across their face. This period has been named ‘the fourth trimester’, and for a very good reason. You need to be able to ease your baby into his new world, knowing that it WILL get easier with time.
Its important to ignore old world advice of ‘creating a rod for your own back’ because you wont. Baby wearing is a great way to help transition a newborn as he’s close to you, warm and in a nice tight place. Its important to understand that your newborn will most likely want to feed frequently to get the milk supply established as per his own needs (and at times of growth spurts) so if your baby wants to feed every 1.5-2 hours, accept that this is normal (unless he is not putting on weight and has a lack of wet nappies). Scheduled feeding especially with a newborn can be detrimental and is only going to add more stress and pressure to you and your baby’s lives. You can find many more suggestions on easing this transition in our articles, especially about baby crying and baby not sleeping.
Another thing to consider is that there is so much pressure to ‘get on with it’ after you’ve had a baby, but did you know that many cultures have lying-in periods of around 40 days? Mothers are allowed time to recover, rest and be cared for so she can return to the community feeling strong and supported. While we may not have people around us who can do that for us, you can give yourself permission to stay in your pyjamas all day, create a nest for you and your baby and enjoy lots of cuddles, feeding and quiet time. When you hear those naughty voices in your head telling you that you should get up and create what looks like a ‘display home’, you can politely tell your mind, ‘thanks for sharing!’ and get back to snuggling with baby. Keep visitors to a minimum so you don’t feel the pressure to be looking your best or to have your house at its best.
Remember that you wont get another opportunity to have the best excuse for doing nothing but nurture your baby – and yourself by having your own lying in period. Once its past, you’ll find it harder to convince yourself that you can do nothing but tend to yourself and baby all day.
Post Natal Depression Fighter #4 – Hire A Doula
Many studies from around the world have shown that new mothers fare better emotionally where a doula supported them at birth. Some quick findings:
- Mothers are 34% less likely to rate their childbirth experience negatively
- Fathers are more satisfied with their role at the birth
- Mothers are more satisfied with their partners role at the birth
- Relationships are better post-birth where a doula was supporting the couple
The experience you have giving birth and what you are left to deal with afterwards can have a big impact on how you cope emotionally. In an era of inductions, caesareans and emergencies, many of them unnecessary, (my teacher, Rhea Dempsey, calls it the ‘labour bypass era’!) some women give birth feeling out of control, unsupported and even traumatised. You are much less likely to have a negative experience which spills out into motherhood, because a birth experience can change how you feel about your body and what its capable of. Some women who have a traumatic or disappointing birth (or have had troubles with miscarriage or loss in the past) can feel that their body has failed them, which can worsen if they also struggle with breastfeeding – another reason for them to believe that they are ‘broken’ and not a good mother.
A review of many doula studies concluded that a doulas role was much more effective than that of hospital staff, a mothers friends or her family. A doula brings some fabulous skills and knowledge to the table, working for YOU and not the hospital – she has your best interests at heart, without being overly emotionally attached. Sometimes mums and partners really do hate seeing their daughter/partner in pain, and they also may not understand what is going on, so it can affect the support they are giving you. A doula can think with both her head and her heart at the same time.
If a birth doula isn’t for you, another thing to consider is hiring a postnatal doula. She can help you with not only practical help as a new mother, but also to de-brief the birth, helping you to unpack your story. A postnatal doula is another way mothers feel more supported, nurtured and less depressed in the postnatal period. Postnatal doulas are angels – you’ll be so glad you hired one.
Post Natal Depression Fighter #5 – Make Sure You Find Ways To Get More Sleep
Here’s another tip which is majorly important. Not having enough sleep is enough to make anyone grumpy or snappy on a normal day – but night after night after the exhausting process of giving birth, it can really start to eat away at you and make you feel depressed. Sleep debt can be a real problem for new mothers and studies have shown that sleep deprivation (especially in the early days) can be a big indicator for postnatal depression.
Make sure your iron levels are adequate (a simple blood test at the doctor will let you know your ferritin levels which is it the important measure of iron, so ask for that) as giving birth can knock that around a bit. If your ferritin is low, it could be contributing to your exhaustion. Get naps during the day when you can and get to bed early at night if you need to – it may take a little while, but it will all pass, so don’t feel guilty or silly. If you like, your partner can look after the baby on weekends for a little bit, so you can take a daytime nap between feeds. Another good option is to enlist a postnatal doula, family or friends to come and look after the baby so you can nap – but I tend to find I get much better sleep, day and night, by cosleeping. Cosleeping is brilliant, but like anything, there are safety guidelines which must be followed, for example, you must never cosleep if you are a smoker.
Check out our great cosleeping articles, many written by the world’s leading expert on sleep and babies, Professor James McKenna, which includes extremely well researched articles addressing safety concerns like, Rolling Onto Baby While Cosleeping, Sleeping With Baby – Is It Safe? and many more.
Post Natal Depression Fighter #6 – Aim To Do Some Light Exercise
Its well documented that exercise seems to help reduce anxiety and depression. I’m not saying that you need to go and join a gym class, but try for a leisurely stroll with your baby for 30 minutes per day – and if thats too difficult then its okay to start small. A walk around the block is a great way to start, then build up from there.
When you’re depressed you tend to feel tired and drained, some people find it hard to even get off the couch. But as soon as you feel ready to exercise after your baby, a regular walk can be a great help for your mind as well as your body. Exercise releases feel-good hormones (endorphins) into your system, helps you sleep better at night, strengthens your immune system and gives you more energy. In turn, it helps your body get back into shape after the birth, increasing your self esteem.
According to the Black Dog Institute’s website, there is the following evidence for exercise and depression:
- Numerous studies have shown that people who exercise regularly experience fewer symptoms of depression and anxiety than those who do not exercise regularly
- Several trials have shown that regular exercise of moderate intensity can be an effective treatment by itself for mild to moderate depression
- Two trials have found that 16 weeks of regular exercise is equally effective as an SSRI antidepressant medication in the treatment of mild to moderate depression in older adults who have been inactive
- Research also suggests that exercise can further assist depression in individuals with depression who have responded only partially to an antidepressant medication
- Both aerobic exercise (e.g. brisk walking, cycling or jogging) and resistance or strength training (e.g. weight-lifting) have been found to be beneficial for depression.
Here’s another HUGE bonus: not only will getting regular, light exercise make you feel better, but vitamin D from sunshine is very beneficial for your immune system and mood too. Many people, especially in colder climates or if you’re housebound, have been found to be deficient in vitamin D, which can effect mood, energy levels and your immune system, so make sure you get out in the sun daily.
Post Natal Depression Fighter #7 – Eat And Drink Well
Its a simple fact: what we put into our bodies affects how we feel emotionally and physically. Its important that you try to eat and drink well, to help supply your body with the best nutrition, energy and feel good hormones possible. As a new mother, it can be hard to find the time to prepare a decent meal sometimes, so try to freeze nutritious, healthy meals ahead of time – or better still – have family and friends on a meal making roster to help you out.
There is a well known link between the gut (immune system) and the brain (mental health) – its been described as like the body having two brains. An unbalanced, unhealthy gut can lead to sickness, lowered immunity and an unhappy brain too – anxiety and depression often go hand in hand with gut issues. Unfortunately, the wonderful good bacteria – probiotics – that serve our immune system (and as it appears, mood too), are under constant attack from our diet, which is too often full of processed and refined foods, sugar, artificial sugar etc (which feeds the bad bacteria) as well as our environment. Many of these things are hidden so you need to read labels.
Its a MUST these days to eat well, eliminate as much sugar as you can and be on a good quality probiotic, in order to avoid disease (of both the mind and body). When buying probiotics, I don’t mean that sugar filled Yakult stuff which only has one probiotic – acidophilus – in it, nor any cheap supermarket brand or yoghurt drinks, but a quality naturopath recommended probiotic. You can also buy or make kefir, which is fermented milk, and a great source of probiotics. Fermented vegetables are also a great way to get a good intake of good bacteria.
Fish oils are well known to be important for brain function, connections have been found between low levels of omega-3 and depression. Make sure you’re getting plenty in your diet or supplement with a good quality fish oil. Some good sources of omega-3 are:
- Wild Salmon
- Chia seeds (yummy over avocado on toast!)
Whole grain oats and brewers yeast are also packed with nutrition – both of which can be found in our lactation cookies recipe, so they help your milk supply too!
Clinical trials have shown the benefits of tryptophan (which manufactures the feel good hormone, serotonin) in preventing and aiding depression. Its found in many protein rich foods, which are very important as a breastfeeding mother. You can find it in foods like:
- Fish, chicken and beef
- Brown rice
The B group vitamins are also important in the production of serotonin. You can find these in foods like:
- Leafy greens
- Red meat
Absolutely avoid the mood and health stealers that are processed foods, white flours (bread, biscuits cake etc), alcohol, caffeine and sugar – all will rob you of health and energy.
Good quality, filtered water can also mean the difference between feeling tired, sluggish and foggy, or not. Especially if you’re breastfeeding, you’ll need to drink plenty of water to avoid constipation (and as a result, nasty anal fissures or haemorrhoids) due to the extra demands for water on your body. When you don’t drink enough water, or bad quality water, you can end up feeling terrible! Unfortunately tap water these days has horrible additives like chlorine and fluoride which are harmful to the good bacteria in your gut. Water systems can get rid of nasties, hydrate you much better than tap or bottled water and have you feeling much better. Our tap water comes out smelling like a swimming pool most days, the chlorine smell is awful. I complained, so the water supply company came out and tested our tap water and filtered water – they were stunned to find absolutely no chlorine in the filtered water!
Post Natal Depression Fighter #8 – Understanding Self Esteem
When you’re pregnant, you may feel huge and uncomfortable, but for quite a few women, they may find their self esteem is generally good. They are often the centre of attention, people are looking out for them and having a big round belly can actually make you feel better about your body – there’s no need to worry about that podgy winter tummy! Pregnant bellies are beautiful. But as a new mother, that can all change.
“Before a baby comes along, a mother’s self-esteem – how she feels about herself – is usually based on her work, her friends, her interests and her partner. After the baby, life changes considerably, and her main source of self-esteem as a new mother will be her partner. If she and her partner are becoming disconnected, conflict and distance creeps in to a relationship and her partner is less likely to be in a position to give her positive messages which contribute to her new mother self-esteem – and this sense of emotional isolation from a partner can contribute to PND,” says Elly.
So what can you do to help self esteem issues? Elly suggests debriefing what’s happening for you and for your partner regularly (dads have their own process to go through too) to help stay connected, and to be aware that for a new mum (and new dad), self-esteem is a fragile thing, so commit to being supportive of each other’s early parenting efforts.
If you find things are getting difficult, seek help with a great relationship counsellor or NLP therapist before it escalates. You can also support your mind and body with Chinese medicine, osteopathy and chiropractic care, which can affect your mood if you’re out of alignment.
Don’t forget to grab a copy of Elly Taylor’s book, ‘Becoming Us ,’ for more great advice on the changes that come with motherhood – especially the most important one – the relationship with your partner.
Please share this article with anyone who you know is pregnant.