Postnatal Depression and Anxiety
Childbirth is a joyful event for many, but it can also bring significant physiological, social, and emotional changes that negatively impact overall physical and mental wellbeing. Many parents initially feel overwhelmed and unable to cope. However, these feelings generally resolve quickly. When these feelings persist, it can be indicative of a more serious mental health issue.
Globally, postnatal depression and anxiety (PNDA) is the most common birth complication. Most cases occur within the first six weeks of childbirth but may occur within the first year following delivery. While it does occur in men and adoptive parents, it more commonly affects birth mothers. Approximately 14% of Australian mothers develop PNDA, with 5-10% developing severe depressive symptoms. PNDA occurs at higher rates in young mothers (aged ≤25 years), with up to 30% developing PNDA.
Treatment options for PNDA include counselling or psychology, medication, and psychosocial interventions such as peer or new mother’s groups, either individually or in combination. Having a support network to assist you through this time is important.
At Navicare, we have observed a large increase in the number of families seeking support for PNDA in recent months. We asked Nurse Sue Hall, the Nursing Unit Manager at Tieri Family Unit & Child Health Centre some questions about postnatal depression, and how to seek help for it.
What are some unique challenges that new mothers in remote mining communities, like Tieri and Moranbah, face when it comes to postnatal depression and anxiety?
PNDA is difficult in any situation, but living in isolated rural and remote areas brings more challenges. Having limited local family support makes things difficult, as does the extremely high and unrealistic pressure from social media to be the perfect mother / parents. Mothers / parents need to socialize to experience real parenting, to observe the difficulty and how other parents handle those situations. I feel we are seeing more depression and isolation due to Covid and people’s inability to socialize on a daily basis. Families need each other to help raise their children.
How does the absence of fathers, who often go away for extended periods working in the mines, impact the mental health and wellbeing of new mothers?
Absent fathers can have a devasting effect on the relationship with the mother and the children. Families do best when together. Mothers can become resentful that Dad is getting away, even though he is working very hard. Dad can feel that he is not appreciated when he is home and does not fit in, as he does not know how the family works. In this situation, there needs to be great communication, and if mother has PNDA, that can become more difficult.
What signs and symptoms should new mothers, and their families, look out for that might indicate postnatal depression or anxiety?
Fathers may notice that Mum:
Is not responding to their baby when it cries.
Is struggling to complete simple tasks.
Is crying more than usual.
Feels there is something wrong with the baby and is doctor shopping or visiting multiple child health services.
May feel something is wrong but does not know what it is.
Other symptoms include sleep disturbances, fatigue, loss of enjoyment of activities, impaired concentration, and excessive feelings of guilt and worthlessness. They may feel disconnected from their baby and worry that they are unable to provide adequate care for them.
Why might new mothers or parents avoid seeking support for PNDA?
New parents may feel they cannot be honest about their feelings and may feel judged and unsupported by their family. They may also feel guilt or shame that they are struggling with the transition to parenthood.
How is PNDA diagnosed?
Midwives do PNDA checks during your antenatal journey, and the test may even be done online. The Child health Nurse will also do a PNDA check at 6-weeks and again at 6-months after you have your baby. Your GP may also diagnose PNDA at any point during your pregnancy or after childbirth. The health professional must have good listening skills. Most of the time, when you tell mothers you think they have PNDA, they are relieved. The next hard task is getting a plan in place, and this is when the dad can be very helpful.
How can you get help for PNDA?
Mums should be supported to go to their GP or child health service to discuss their concerns. The GP may write mum a Mental Health Treatment Plan (MHTP) so she can access Medicare-rebated psychology sessions. Navicare is a free service which can connect you to a psychologist who specialises in PNDA. There are a number of services available, especially via Telehealth, and some of these are bulk billed. Families may also have access to free counselling through their employer’s Employee Assistance Program. These programs are available to the partners and dependant children of employees. There are also a number of free counselling services for PNDA (links provided below).
What practical advice or strategies do you recommend to new mothers to help them improve their mood and manage postnatal depression and anxiety?
Find a health professional you can build a relationship with, who listens and gives you time. Visit them regularly.
Phone a friend or family member.
Dad, take time to sit and ask about her day, and offer to help with bub.
Maybe ask a friend to accompany you to playgroup. You don’t have to stay the whole time.
Take time to exercise, even if it’s a walk around the yard or around the block as a family.
Engage in self-care – eat well, take naps, read a book, or otherwise do something for yourself.
Call a PNDA support line or join an online parenting group.
Being a new parent is hard, especially with postnatal depression. Recognising the signs of PND early and seeking treatment will make this transition easier.
For parenting advice or support for PNDA, consider reaching out to one of the following services:
Perinatal anxiety and depression Australia (PANDA)
1300 726 306 (9am-7.30pm, Monday to Friday)
Pregnancy, Birth & Baby Helpline
1800 882 436 (7am-midnight, 7 days)
Parentline
1300 301 300 (8am-10pm, 7 days)
Read about being a new parent in a rural or remote town:
Making the parenthood transition in a small town | PANDA
Parenting in a rural or remote location (gidgetfoundation.org.au)