When you’re pregnant, you tend to focus on growing your baby and the impending birth – not so much the postnatal period or even your own well being.
But there is something really important that you need to start thinking about. Some call it the ‘baby blues’; it’s postpartum depression.
What can you do? Who can you draw upon for emotional support after you’ve had your beautiful baby – especially if you develop postpartum depression?
Sadly, approximately one in seven new mothers experiences depression after giving birth. That’s an enormously high number that affects women and that figure doesn’t even include unreported cases.
It might be a little hard to believe you could be one of them, especially when all you might be thinking about right now is how wonderful it will be with a new baby.
Tips to help prevent postnatal depression
No one can predict what huge changes you might go through after the birth or how support will pan out. You simply don’t know 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 you have previously had postpartum 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 well as you can to avoid postnatal depression and anxiety.
Here are 11 important tips (in no particular order, because they are all important) which can make a massive difference to your emotional health as a new mother and prevent postpartum depression.
#1. Stay 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.
Elly Taylor, relationship counselor and author of the must-read book, Becoming Us says: ‘It is important to realize 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 as a new parent’. Elly says ‘It’s vital that couples either stay connected during the postpartum 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’.
The relationship really does tie into emotional health. Find a relationship counselor, especially one who specializes in parenting, if you need one. Speak with your healthcare provider for advice.
Your relationship is very important. Nurture it, work at it and trust it. If you need help, find the right person to help you make sense of your usually temporary relationship hurdles.
What we fear might be permanent (especially when we’re hormonal and pregnant) is usually only temporary, just like everything in life. Make connection a priority in both of your lives. Hang in there and get help if you need it.
#2. Placenta encapsulation for postpartum depression
Okay, okay, hear me out on this one. While there isn’t a great deal of official research on placenta consumption in human beings, we know our fellow mammals consume their placentas. I think they have it right.
For many women, consuming the placenta is said to help balance hormones – custom made ones, just for you. It boosts your iron levels, which can prevent symptoms of low iron, including fatigue, depression, and others, as well as the usual baby tiredness, and it is said to help with milk production.
Many mothers who have read articles on placenta encapsulation after having had postnatal depression say that they really wish they had encapsulated their placenta. It would have been so much better than potentially treating postpartum depression, especially in those first few weeks.
For more information, check out our article on What Is A Placenta? 13 Amazing Placenta Facts and you could be less likely to end up with depression.
#3. Have realistic expectations
Elly Taylor says that her biggest tip on avoiding postnatal depression would be to set 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’.
We live in an era where women are out working in busy jobs involving deadlines, schedules, and time frames. As well as that, there is a plethora of baby sleep experts out there, telling you that you can get your baby to feed and sleep according to (unrealistic) schedules. These unrealistic expectations can set new mothers up for failure – and for postnatal depression.
All mothers desperately want baby to be happy and content. They will often put incredible pressure upon themselves to give everything, be everything, and ‘cotton wool’ their babies.
This can lead to utter exhaustion, feelings of failure, and postnatal depression. Or they might simply be incredibly unprepared for what hits when they are home.
It’s important to ignore old world advice against ‘creating a rod for your own back’ because you won’t. Babywearing, for example, is a great way to help transition a newborn as he’s warm, and in a nice tight place, close to you.
It’s important to understand that your newborn will most likely want to feed frequently to get the milk supply established according to his own needs, and during growth spurts. 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 Baby Crying? 10 Reasons Why Babies Cry and our articles on Baby Sleep.
#4. Rest and recovery
Another thing to consider is the pressure to ‘get on with it’ after you’ve had a baby. 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 they can return to the community feeling strong and supported.
Although you might not always have people around who can do that, 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 and watch him breast feed.
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. This will prevent any panic attacks if this is something you have experienced before.
Remember that you won’t have a better opportunity to have the best excuse of all for doing nothing but nurture your baby – and yourself – by having your own lying-in period.
Once it’s past, you’ll find it harder to convince yourself that you can do nothing but tend to yourself and baby all day.
You might like to read more about Why You Should Have A Post Natal Month After The Birth.
#5. Hire a doula
Many studies from around the world have shown that new mothers fare better emotionally when a doula supports them at the 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, when a doula supports the couple.
The experience of 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 (Rhea Dempsey, calls it the ‘labor bypass era’) – when some women give birth they feel out of control, unsupported, and even traumatized.
A supported birth experience can change how you feel about your body and what it’s capable of. You are much less likely to have a negative experience that spills out into motherhood. Some women who have a traumatic or disappointing birth, or have had troubles with miscarriage or loss in the past, can feel their bodies have failed them. This can become worse if they also struggle with breastfeeding – another reason for them to believe that they are ‘broken’ and not good mothers.
A review of many doula studies concluded that a doula’s role was much more effective than that of hospital staff, a mother’s friends or even her family. A doula brings some fabulous skills and knowledge to the table. She works for you and not for the hospital and 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 might not understand what is going on, which can affect the support they can give you. A doula can think with 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 not only give practical help to you as a new mother, but can also de-brief the birth, helping you to unpack your story. Having a postnatal doula is another way mothers feel more supported, nurtured, and less depressed in the postnatal period. Postnatal doulas are angels and you’ll be so glad you hired one.
Read our article to find out more information on What Is A Doula?|11 Important Facts About Doulas or search for a doula on the FindA Doula directory.
#6. Get as much sleep as you can
Here’s another extremely important tip. Not having enough sleep is enough to make anyone grumpy or snappy on a normal day but after the exhausting process of giving birth, a lack of sleep night after night can really start to eat away at you and make you feel depressed.
Sleep deprivation can be a real problem for new mothers. Studies have shown that sleep deprivation (especially in the early days) can be a big indicator for postpartum psychosis.
Make sure your iron levels are adequate. A simple blood test at the doctor’s office will let you know your ferritin levels, which is the important measure of iron. Ask for this test, as giving birth can knock the levels around a bit.
If your ferritin is low, it could be contributing to your exhaustion. Get naps during the day whenever you can – perhaps when baby sleeps – and go to bed early at night if you need to. It might take a some time but it will all pass, so don’t feel guilty or silly.
If you like, your partner can look after the baby at weekends for a while, so you can take a daytime nap between feeds. Another good option is to enlist a postnatal doula, or ask family or friends to come and look after the baby so you can nap.
#7. Co-sleeping
To help prevent postpartum depression mothers tend to find they get much better sleep, day and night, by co-sleeping.
Co-sleeping is brilliant but, like anything else, there are safety guidelines that must be followed – for example, you must never co-sleep 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. They include extremely well-researched articles addressing safety concerns like Rolling Onto Baby While Cosleeping, Sleeping With Baby – Is It Safe? and many more.
#8. Aim to do some light exercise
It’s well documented that physical activity seems to help reduce postpartum anxiety and depression. I’m not saying you need to go and join a gym class, but try for a leisurely stroll with your baby for 30 minutes per day. If that doesn’t working for you, then it’s okay to start small. A walk around the block is a great way to begin, then build up from there.
When you’re depressed, you tend to feel tired and drained; some people even find it hard to get off the couch. But as soon as you feel ready to exercise after your baby is born, a regular walk can have a significant impact on your mind as well as your body.
Exercise releases feel-good hormones (endorphins) into your system. It helps you sleep better at night, strengthens your immune system, and gives you more energy. It also 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 preventing 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 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 beneficial for your immune system and your postpartum mood.
Many people, especially those in colder climates or those who are housebound, have been found to be deficient in vitamin D. This can affect mood, energy levels, and the immune system. Make sure you get out in the sun every day.
#9. Eat and drink well
It’s a simple fact: what we put into our bodies affects how we feel emotionally and physically. It’s important that you try to eat and drink well, to supply your body with the best nutrition, energy, and feel-good hormones possible. If you are breast feeding you will need to replace fluid and keep up your milk supply to feed the baby.
As a new mother, you might sometimes find it hard to make the time to prepare a decent meal. Try to freeze nutritious, healthy meals ahead of time or, better still, have family members 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); it’s been described as similar to the body having two brains. An unbalanced, unhealthy gut can lead to sickness, lowered immunity, and an unhappy brain. Postpartum 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, our moods too, are under constant attack from our environment. Our diet, especially, is too often full of processed and refined foods, sugar, artificial sugars that feeds the bad bacteria. Many of these things are hidden so you need to read labels.
It’s 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 which has only one probiotic – acidophilus – in it, nor the cheap supermarket brands or yogurt drinks. You should choose 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 an 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 to help with your postpartum mood.
Some good sources of omega-3 are:
- Tuna
- Wild salmon
- Anchovies
- Mackerel
- Chia seeds (yummy sprinkled over avocado on toast!)
- Flaxseeds
- Walnuts.
Whole grain oats and brewers yeast are also packed with nutrition – both of which can be found in our lactation cookies recipe. 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. It’s found in many protein-rich foods, which are very important to a breastfeeding mother. You can find tryptophan in foods such as:
- Fish, chicken, and beef
- Nuts
- Eggs
- Bananas
- Brown rice
- Peas
- Pumpkin
- Spinach.
The B group vitamins are also important in the production of serotonin. You can find them in foods such as:
- Nuts
- Seeds
- Leafy greens
- Eggs
- Chicken
- Red meat.
Absolutely avoid the mood and health stealers that are processed foods, white flours (bread, biscuits cake, etc), alcohol, caffeine, and sugar; all of these will rob you of health and energy.
Please read more about Pregnancy Nutrition | The Most Important Things You Need To Know.
#10. Stay hydrated
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 hemorrhoids, 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 often has horrible additives like chlorine and fluoride which are harmful to the good bacteria in your gut. Water systems can get rid of nasties and 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 the filtered water; they were stunned to find absolutely no chlorine in the filtered water.
#11. Understand self esteem
When you’re pregnant, you might feel huge and uncomfortable but quite a few women find their self-esteem is generally good.
If you and your partner are becoming disconnected, and conflict and distance creep into your relationship, your partner is less likely to be in a position to give you positive messages that contribute to your new mother self-esteem. ‘This sense of emotional isolation from a partner can contribute to PND’, says Elly.
So what can you do to address problems with self-esteem? Elly suggests debriefing what’s happening for you and for your partner regularly (dads have their own process to go through too). This will help you stay connected, and be aware that for a new mum (and a new dad), self-esteem is a fragile thing. Commit to being supportive of each other’s early parenting efforts.
If you find things are getting difficult, before the problem escalates, seek help from a relationship counselor or NLP therapist. You can also try Chinese medicine, osteopathy, and chiropractic care to support your mind and body. If they are out of alignment, it can affect your mood.
#12. Research to prevent postpartum depression
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.
#13. Treating postpartum depression
If you notice the symptoms of postpartum depression, the first step is to recognize it, or take on the advice of friends and family members.
You might cry all the time and have real trouble coping on a day-to-day basis. If so, don’t hesitate to speak with your midwife or health care provider.
They will help you with a referral to a specialist for counseling or discuss medications if required.
Recommended readings:
PND Prevention And Treatment – The Chinese Medicine Approach