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Perinatal Anxiety and Depression

Postnatal Care

By Dr Vijay Roach MRCOG FRANZCOG
Obstetrician & Gynaecologist
Chairman Gidget Foundation Australia
Vice-President Royal Australian and New Zealand College of Obstetricians and Gynaecologists

The Gidget Foundation is pleased to be associated with Calmbirth. Educating women and their partners in pregnancy, birth and early parenting, independent of an individual’s birth or parenting choices, is a positive step towards improving emotional wellbeing during pregnancy and early parenting

The arrival of a new baby brings joy along with challenges. The journey to parenthood is a time of adjustment for all couples. Understanding fluctuations in mood is important. Distress, anxiety and depression can be treated and with good recovery outcomes. Emotional health should not be overlooked.

Anxiety and depression during the perinatal period affects around 20% of mothers and 10% of fathers, almost 100,000 parents in Australia each year and is underreported and undertreated. Sadly, suicide is the leading cause of maternal death in Australia in the year after birth.

All health disorders are impacted by the combination of biological/psychological and social factors i.e. biopsychosocial. Mood disturbance in pregnancy and early parenting may manifest as the “baby blues” (which are self-limiting and usually resolve within the first few weeks), sleep deprivation, isolation, adjustment disorder or classical symptoms of anxiety or depression. Postnatal psychosis is rare, significant and affects about 1 in 1000 women.

It’s important to evaluate the woman in the context of her personality and social environment. Untreated mental illness can have a profound impact on the mother, father, child and other family members. Sequelae can include ongoing depression, marriage breakdown, intergenerational effects and social and economic impacts

Fathers too can be significantly affected, either de novo or because they are impacted by the illness of their partner. A father may feel extremely isolated and confused.  Some may be experiencing anxiety and depression themselves.  

Recently there has been acknowledgement that dads should be included in the care that is developed for mums.  Factors that might affect dads include:

  • lack of social and emotional support,
  • lack of sleep,
  • relationship stress and unmet expectations of fatherhood.  
  • Dads can find accessing support difficult, either because they don’t want to acknowledge their vulnerability, or they simply don’t know where to find help.

You wont know if you don’t ask. While screening for mental health problems in pregnancy is recommended, and is available in public hospitals, it is uncommon in the private sector. Changes to Medicare to be implemented in November this year mean that it will be mandatory for obstetricians to offer screening to pregnant women in much the same way that they check blood pressure and monitor the baby. We know from our experience introducing universal screening to women birthing in private maternity units in New South Wales through personalised appointments with trained Gidget midwives that these programs change the culture, with midwives and obstetricians more aware of the importance of mental health.

Men and women affected by perinatal mental illness can benefit from talking therapies such as cognitive behavioral therapy and interpersonal therapy. Medication is often useful, particularly SSRIs. Occasionally women and their babies will benefit from admission to a dedicated Mother Baby Unit. It’s also important to place value on support from family and friends.

The Gidget Foundation’s mission is to raise awareness of emotional wellbeing in pregnancy and early parenting. Gidget was a vibrant and joyful Northern Beaches mother.  She had a loving, supportive family and a wide network of caring friends.  Gidget took her own life while suffering postnatal depression.  Her baby was 9 months old.  Her personal suffering was isolating and her death left a hole in the lives of many.

Initially established by Gidget’s friends and sisters the Foundation is now supported by passionate individuals, community leaders, businesses and health professionals. We promote the importance of maintaining good emotional health while working to ensure easy access to professional care for anyone needing help and support.

Programs include:

  • Gidget House Centres: Free counselling services for expectant and new parents in person and via Skype.
  • Emotional Wellbeing Programs:  Free midwife support for pregnant women at selected hospitals.
  • Education:  Community, workplace, students / health professionals.
  • Research: advocacy and contribution to media and professional publications.
  • Parents Matter in the Workplace

Resources include:

  • DVD Behind the Mask https://www.youtube.com/watch?v=FjqOqJLkyFs
  • Beyond the Baby Blues (Knox, O’Reilly, Smith), a definitive Australian guide
  • Brochures and other written material
  • Website gidgetfoundation.com.auand Facebook page

The Gidget Foundation receives no government funding and is entirely supported by the generosity of philanthropic individuals, businesses and grants.  Our community of supporters is an engaged and sophisticated group of well-networked professionals.

The Gidget Foundation recognises the importance of antenatal and postnatal education for women and their partners in pregnancy and early parenting. Informing and empowering couples, independent of their birth choices, leads to better physical outcomes, less risk of birth trauma and improved emotional wellbeing for parents and their infants.

There is no health without mental health. Becoming a parent should be a time of great celebration and fulfilment. When it isn’t happy, people need services, support and care. The good news is that, with help, men and women get better, and have the opportunity to enjoy their baby and all the delight and wonder that becoming a parent can bring.

 

 

 

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