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Navigating the baby blues: Coping with pre- and post-natal mental health issues

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Exploring the prevalence of both pre- and postnatal mental health issues, Kate Farr finds out what can be done to help.

According to the Family Health Department, up to 80% of new mothers in Hong Kong are affected by the ‘baby blues’. Characterised by mood swings, tearfulness and irritability, this temporary state is caused by hormonal fluctuations on the third or fourth day following birth, and is usually nothing more than a passing blip. But for up to 20% of new mums, this low mood persists, becoming the longer-term, and potentially far more serious, postnatal (postpartum) depression.

Prenatal (antenatal) depression, is thought to affect up to 25% of women during pregnancy, with some studies showing even higher numbers. But despite the widespread acknowledgement of both pre- and postnatal depression within the medical community, the baby blues still carry a stigma. Expectant and new mothers are shocked to find themselves unhappy around their long-anticipated ‘bundles of joy,’ and many don’t seek treatment.

Pregnancy woes

Sofie Jacobs, founder and head midwife of Hong Kong-wide  midwifery service Urban  Hatch regularly sees expectant mothers suffering from prenatal depression – a condition that is rarely discussed, but that she believes is vital to highlight.

“While pregnancy is automatically associated with joy, for many women and their partners, it can also mean financial worries, changes to the relationship, and physical discomfort, not to mention issues arising from a previous traumatic birth, miscarriage, or infertility,” Sofie says. “All of these can be triggers to antenatal depression.”

Sofie believes that, in order to shed some of this stigma, the more negative aspects of pregnancy and birth must be openly discussed. “We need to get the word out there that pregnancy doesn’t always mean happiness, and that it is ok for women (and men) to talk openly about it and seek support.”

Sofie is also quick to point out that as with any form of clinical depression, antenatal depression can be treated – usually via psychological treatment, sometimes combined with medication.

Birth traumas

DB-based doula and birth educator Cathee Jackson works with mothers to assist with a positive delivery, and believes that experiencing a traumatic birth can have a significant impact on a new mother’s mental health. “There is a cultural pressure to think that a healthy baby is all that matters, and how a baby arrives is not important and that isn’t true,” she says. “Both parents’ feelings are valid. So getting support, and being able to come to terms with each unique birthing experience is important.”

When it comes to obtaining that support, Cathee stresses the importance of starting close to home and expanding your network outwards. “First and foremost, being supported by friends and family is key,” she says. “Family is so important in offering physical support, for example, helping to care for the baby while the mother rests, and providing emotional support. Friends in a similar situation can also be a great support, but on the other hand, this can sometimes lead to comparisons and one-upmanship – even without meaning to.”

Cathee recommends that mums, who experience persistent mood swings after their confinement look to professionals for support. “External bodies, like local or online support groups can be helpful and there are options of medication for things like sleep support,” she says. “It’s important for mums to discuss things with their GP. Doctors can prescribe antidepressants or anxiety medication if necessary,  and they can also refer patients on for therapy treatments.”

Transitioning to parenthood

Psychologist Dr Quratulain Zaidi of Central’s Mind N Life practice has many years’ experience working with mothers suffering from postnatal depression, and she believes that it’s high time we were more open about both the positive and the negative sides of parenthood. “We’re conditioned to believe that, right from the moment of birth, a new mum is supposed to feel nothing but joy when she looks at her baby. This makes it so much harder to speak out about feeling afraid, overwhelmed or isolated, despite these feelings actually being incredibly common.”

So why is there such a code of silence around these issues? Dr Zaidi explains: “Sadly, there is still such a stigma that surrounds both depression and also the struggle that many new mothers face – we’re all meant to be experts from day one! But the reality is that new parents  are bombarded with so many life- changing situations as soon as they  have a baby; from the loss of their old identity and the acceptance of their new role, to the seismic overnight shift in the relationship with a partner – the changes are numerous and significant.”

Dr Zaidi suggests that expectant parents try to face these issues head-on, working together to ensure there is a clear line of communication, as well as coming up with common strategies to deal with everything from visitors to night feeds. “Try to ensure that you are on the same page before the baby arrives,” she says. “It’s always easier to manage problems and resolve disagreements when you’re not sleep-deprived and physically and emotionally drained.”

With a toolkit that encompasses a solid support network and easy access to professional help where required, all three of our experts are hopeful that new mothers can get the support they need to settle into their new, 24/7 job.

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The DB Doula Breastfeeding Group meets at Zak’s each month. To find out more, call Cathee Jackson on 5993 3699 or email [email protected]

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