AIMS Journal, 2023, Vol 35, No 4
By Alex Smith
I often hear new parents saying that they wish they had known what life with a new baby was really like, that they wish they had been prepared. As an antenatal teacher who tries to help parents prepare and equip themselves for ‘the most challenging new job ever’, for this ‘uncertain adventure’, for this ‘seismic shift in their lives’, I sometimes feel I am being accused of glossing over the realities, or worse still, not even addressing them. I have come to two realisations. One is that it is almost impossible to describe a colour to someone who has never seen it (or a similar one) before. The other is that the ability to block out the potential reality of what is to come, may be a biological necessity and, in a way, an expression of perennial courage and hope. Whatever strategies we use to help parents prepare, we must take care not to undermine courage and hope but to focus instead on resourcefulness and resilience. Using the medium of story and metaphor may help. What follows is a run through some of the different manifestations of emotional and mental upheaval that can be experienced during the perinatal period, using the weather as a metaphor.[1]
About three days after a baby is born, many women have a day of ‘light showers’; of feeling very tearful. This is a normal response to a sudden drop in levels of endorphins. All that is required is kindness, cocoa and plenty of tissues! The early weeks of parenthood can feel a bit like a strange and endless blur, but soon enough things come into focus and the rhythm of the day starts to take shape.
It is normal for new mothers and fathers to experience emotional ups and downs as they adjust to their new life.
The emotional weather is naturally changeable with darker days and brighter days. This may be more intense at first, but as the weeks and months go by, the weather changes from wintry patterns, through spring, and then to summer, when it is still normal to have occasional blustery spells but generally it feels warm and pleasant. Use all the strategies you have available to lower stress levels during this time - for you, your partner and for the baby. Try everything that you normally find relaxing: warm showers; music; singing; dancing; phone calls with old friends; a meet-up with new baby friends; light reading; knitting; a brisk or gentle walk; a nap; a warm drink; funny TV; some yoga stretches; a massage; calm breathing. Things that can be fitted around the unpredictability of a baby, or even better, done with the baby are helpful. A gentle but flexible routine with even just two or three very simple pleasures that can be fitted into a few minutes here and another few there every day, makes all the difference. Many parents find it helps to ‘tag-team’ to ensure that both get 30 minutes to themselves each day, and people who live at a distance from friends and family may consider engaging the support of a postnatal doula in the early weeks.[2]
It is also normal for new parents to feel down in the dumps occasionally. Mild depression that comes and goes, like grey clouds floating overhead, can serve to prevent a new parent from taking on extra commitments when they are already fully occupied with navigating the huge changes that come with the arrival of a baby. Some parents feel anxious rather than depressed, and similarly, waves of mild anxiety can serve to keep the novice parent alert and attentive to the needs of the baby. In this way, depression and anxiety, like waves of labour pain, can be reframed as having a positive purpose - at least for a while. Regard and prioritise the stress-reducing practices in the section above as important ‘treatment’ that is effective when taken regularly. Be kind and patient with yourself and with each other.
It is not usual for the postnatal-life barometer to be set to gloomy or stormy all of the time.
If days and weeks go by without any calm and sunny spells, or if these are becoming fewer and fewer, this could be a sign of clinical depression or anxiety. If all of the joy and pleasure of life seems to have disappeared behind a constant threatening cloud, this is when extra support or treatment of some kind or another could be very helpful. The first port of call is usually the health visitor, GP or practice nurse, but other people may prefer to approach their homoeopath or a private therapist.
Neither of these two different conditions are depression. This distinction is important.
Puerperal psychosis is very uncommon but very serious and needs prompt recognition and treatment - usually in hospital or, ideally, in a mother and baby unit.[3] It often starts within a few days of the birth with the mother suddenly starting to behave very oddly. She may find it hard to sleep and will be saying very strange things. It is scary for her loved ones. This is the only time you call the doctor behind her back.
If the situation feels desperate, call 111, or even 999.
PTSD symptoms that persist beyond a couple of months after a birth are increasingly common. This expression of postnatal distress is often related to having felt neglected, unheard, disbelieved, disrespected, and trapped within a system where one or other parent felt they had no control. The mother or father (or other person present) may have bad dreams or flashbacks and cannot stop thinking about what happened. They feel stuck in the events as if they were still happening and may be edgy and on hyper alert all or most of the time. Talking about things, and being treated for depression, can make the symptoms worse. Many people suffering from symptoms of PTSD find Eye Movement Desensitization and Reprocessing treatment (EMDR), or Rewind Therapy, very helpful.
It is reassuring to know that with appropriate treatment and support people make a full recovery from postnatal distress and illness.
Seeking support and treatment as soon as you realise that the situation is not within the range of the normal ups and downs of life with a new baby, is helpful.
In the meantime, ensure that the baby has plenty of loving and responsive support as well.
It takes a village to raise a child and utilising the support of friends and family is great for everyone involved.
Author Bio: Alex is an editor for the AIMS journal, a grandmother and great grandmother, and witness to some truly wonderful physiological births. She has close to half a century’s experience as a childbirth educator.
Notes:
[1] Note: I am not alone in the use of a meteorological metaphor in connection with mental illness.
Sulis W. The Continuum Between Temperament and Mental Illness as Dynamical Phases and Transitions. Front Psychiatry. 2021 Jan 18;11:614982. doi: 10.3389/fpsyt.2020.614982. PMID: 33536952; PMCID: PMC7848037.
[2] Editor’s note: It is sometimes possible to apply for funding for the support of a doula: https://doula.org.uk/doula-access-fund
[3] Editor’s note: There are no mother and baby units in Northern Ireland.
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