During this short video I hope to provide some brief thoughts on how to
best support your mental health and that of your family in the perinatal period
especially in the context of the current COVID 19 outbreak. Perinatal mental
health refers to a person's mental health from the point of conception
throughout their pregnancy and until their baby is one year of age. We know
that approximately one in five women will experience a mental health problem
during their pregnancy or in the year after giving birth and that might be a
new mental health condition or it might be a repeat of a mental health condition
that existed before. It's also important to recognise and acknowledge that
partners can also experience mental health problems during this period with
some studies particularly around depression suggesting that one in five -
one in 10 new fathers may experience a mental health condition after their partner has given birth, so supporting
the whole family is really important; we recognise that for families who are
currently pregnant there may be slightly different concerns at the moment
compared with those who have already given birth to their babies so we hope
that this video will provide a little bit of advice for both groups. In respect
of those who are pregnant remember it's normal to be concerned about your unborn
baby and a heightened state of concern in the current situation is absolutely
to be expected; it's really important to share your concerns with your family so
you can support one another to normalise these worries. The Royal College of
midwives, obstetrics and gynecology and pediatrics and child health have
recently co-published some information on coronavirus for pregnant
women and their families and that provides some really useful information.
Their key messages are that in general the emerging evidence suggests that
pregnant women do not appear to have more likelihood of being seriously
unwell than other healthy adults if they develop the new coronavirus and it's
expected that the large majority of women who experience
coronavirus will only experience mild or moderate flu or cold symptoms. If you are
diagnosed with coronavirus there's no evidence to suggest an
increased risk of miscarriage. Transmission of the virus from the woman
to her baby during pregnancy or birth is probable but it's important to emphasise
that in all cases where newborns have got coronavirus very soon after birth
the baby has been well. It's really important that you continue to attend
your routine care when you are well and if you have a routine scan or visit
booked it's important to contact your maternity or mental health care team to
agree a plan; you might still be advised to attend that appointment but that
might also change. The other thing that's important to mention is delivery itself;
now maternity sites recognise the importance of partners being present at
the delivery and where possible providing your partner is well and does
not have virus symptoms you'll be supported to have your partner
present at the birth. For those who have already given birth remember there's no
right way for any person whether it be mother, father, partner or your extended
family to feel after you've had a baby. Allow yourself time to adjust and
practice self compassion; being kind to yourself is really key
Having a baby is a life-changing event and it's likely to be even more
challenging in the current state of lockdown with its significant
psychological impact. The recent findings of a review in The Lancet suggested that
the psychological impact of quarantine is really highlighting the increased
risk of psychological distress for people and the impact most commonly
expressed was being unable to leave your house visit friends family or engage in
social activities. Boredom, isolation, frustration and fears of being infected
or infecting others were also key; now with the arrival of a new born, there's
often the expectation of receiving visitors or having a celebration and whilst
for some, lockdown will delay these events and cause a sense of sadness, for other
people the lockdown restrictions may actually provide a welcome relief from
unwanted intrusion in the early days. However you feel it's really important
to talk and it's okay not to be okay. It can be really difficult to talk openly
about how you're feeling especially in the early days post-delivery when
emotions are changeable and sleep is limited; sometimes people describe things
such as feeling pressure to be happy or excited when actually they feel
something different or they'll describe that they feel they should be on top of
everything; maybe they're worried that they feel they're a bad parent because
they're struggling with mental health well perhaps you're worried that if you
share how you really feel your baby might be removed from you. A lot of new
parents experience these same concerns and worries so it's really important to
share those feelings with a trusted person and then to ask for extra support
from professionals should you need it. It's also really helpful to know how to
spot signs of depression or a more serious mental health condition in the
perinatal period and when to access help. We've probably all heard of the baby
blues which is that brief period of feeling emotional and tearful often
three to ten days after giving birth to your baby and this affects many new
mothers usually lasting only a few days and it's generally quite manageable but
for 10 to 15 percent of new mothers symptoms of a longer term depression or
other mental health condition may occur and often that's within the first six
weeks of having a baby though not always; these sorts of symptoms can come on
gradually or very suddenly and they can be mild or they may end up quite severe.
So what are those common signs and symptoms that you or your family might
be able to look out for - sometimes its feelings so people will say they feel
sad or low, they feel tearful for no apparent reason
they feel a sense of hopelessness or worthlessness, they feel ultra tired
unable to cope, irritable or angry, guilty, maybe feeling hostile or irritable
towards your partner and maybe feeling indifferent or hostile
towards your baby. Sometimes it's more about how somebody behaves so maybe
feeling that they're losing concentration, they're having disturbed
sleep, they've got a reduced appetite, less interest in sexual relations or
having really awful thoughts about death or wanting to harm themselves. Now if you
or your partner notice any of these symptoms or other symptoms such as a
sudden change in activity levels, talking lots, becoming excessively busy or
strange behaviour patterns that aren't normal for you,
fluctuation in your well-being or new thoughts or acts of violence, self-harm
or a persistent and ongoing new expression of worry that you're not a
good mother; those are very significant signs that you might need to seek help
from a health professional. Research tells us that 7 in 10 women will
actually under play how they really feel because they're fearful of what will
happen or what will be said if they tell somebody so this is why it's so
important for partners, friends, people in our social networks, to absolutely be
alert for these signs and it's really important for people not to ask just our
new mothers, but their family members 'how are you?' and really 'how are you?' in terms
of supporting mental health of your whole family in the perinatal period. I
would suggest that there are a few things that are really important to take
away - remember it's okay not to be okay, be kind to yourself, stay calm and talk,
ask one another regularly 'how are you, really, are you really okay?' focus on your
positives, recognise value and celebrate what you can do because at a time of
lockdown that is particularly important. Stay connected with your family and your
friends and with your healthcare providers and manage how you follow the
outbreak in the media - restrict the amount of time that you go online to
check and when you do, make sure that you're seeking
information from reliable sources. Remember if you have a partner, allow one
another to have some you time when you have a new baby and if you don't have a
partner and you're on your own, try and build some you time into your day at any
point that you can. Remember just make loose plans, recognising that in certain
times things will often change, babies absolutely do not follow grown-up
timetables so we can be better prepared if we can build flexibility into our own
expectations. If you haven't already, try to link with online support network so
you already have a network to call upon. There are a number of really good online
support networks for mothers, for partners, for fathers as well, and
remember if you or a partner, or a family member spots any sign of change in your
mental health or that of someone close to them please seek help early.