What is Perinatal Mental Health?

The Perinatal period extends from when pregnancy begins to the first year after the baby is born.

Mental health is determined by many factors including hormonal, social and psychological. Mental health problems are often associated with times of stress or change in our lives.

Perinatal mental health is about the emotional well-being of pregnant women and their child, partner and families.

All women should be routinely assessed in pregnancy and postnatally for a history of depression or other mental illness.

Postnatal and Antenatal Depression

In recent years, perinatal mental health has been recognised as a major public health concern. Researchers, healthcare professionals and people in the general community have highlighted the huge impact of mental health problems during the perinatal period and the need for improved care in this area.

The most common perinatal mental health problem is postnatal depression, with rates ranging between 13% in the first few weeks to 20% of women in the first year after the birth of their child (Priest et al 2003). A significant number of women will first become depressed in pregnancy.

A number of studies have documented the negative impact that prolonged, severe
postnatal depression can have on relationships, families and children. This ranges from depression in partners to higher rates of divorce, less strong bonding with the infant and reduced emotional adjustment and cognitive development among children. (Boyce 1994, Cox et al 1993, Evans et al 2001, Hay et al 2001, Holden 1991, Murray and Cooper 2003, Murray 1992, Sharp 1994, Webster 2002).

For a mother experiencing postnatal depression, both the impact on her wellbeing and that of her infant and family provide her with many reasons to seek help at this crucial time for the development of the family unit.

Perinatal mental health is closely connected to infant mental health, so looking after mum means looking after the baby too. Research in this area being undertaken by Professor Marie-Paule Austin and her team at Burwood Hospital, further demonstrates the importance of focussing on the critical relationship between mother and baby.

Working with mothers and infants to improve their interaction and attachment may be seen as prevention of the development of mental health problems in children.

Help should be sought as early as possible, as this is likely to be most effective in providing optimal outcomes for the mother, infant and family. However, it is never too late to seek help.

Antenatal and Postnatal Anxiety

Anxiety often goes hand-in-hand with depression during pregnancy and the postnatal period. Worrying thoughts around the progress of the pregnancy or the health of the mother or baby are normal and usually settle in response to reassurance.

However 10-15 per cent of childbearing women show symptoms that are more clearly due to an anxiety disorder rather than to depression and treatment needs to take this into account.

If you are anxious to the point of excessive worrying, cannot relax or respond to reassurance, are physically or mentally restless, it is important to seek help from your doctor.

Women who have had previous pregnancy, labour or delivery complications; miscarriages or experienced the death of a baby are more likely to show increased levels of anxiety during subsequent pregnancies. A history of phobia, generalised anxiety disorder or obsessive compulsive disorder increases the risk of anxiety symptoms in pregnancy and after the birth.

Developing postnatal anxiety or depression does not mean you do not love your baby. In fact, these mothers tend to be overwhelmed with concern about their babies and the fear that they are not being a "good enough" mother.

Postpartum psychosis

This serious but rare condition arises early in the postnatal period, and is characterised by severe mood swings, loss of touch with reality, distractibility, and inability to function. It requires urgent admission for treatment. Although the symptoms of postpartum psychosis can be dramatic and frightening, this condition is usually rapidly responsive to treatment.

Relapse of other conditions

The postnatal period is associated with increased likelihood of relapse of pre-existing mental health conditions.