Protecting the mental health of new mothers

A new baby brings much change, but what can be forgotten is that new mothers need lots of understanding and support from those around them in order to protect their mental health, boost their confidence as mothers, and reduce the risk of postnatal depression, says Professor Jane Fisher, the Jean Hailes Professor of Women’s Health at Monash University.

November 18-24 was Postnatal Depression Awareness Week with more than 47,000 women each year diagnosed with this condition, according to PANDA, the Post and Antenatal Depression Association. Signs include crying, irritability, finding it difficult to manage daily chores, anxiety, and a loss of confidence and self-esteem. These can be reduced if postnatal mental health is protected.

There are three things that Prof Fisher says most people underestimate as they make the transition from being childless to the reality of becoming a parent.

The first is how much work it takes to care for a baby and run a household with a baby in it. The actual work of caring for a baby is more time consuming than people imagine, says Prof Fisher.

“Mothers are often asked the insulting question, ‘Do you work?’ suggesting that caring for a baby is a leisure activity,” she explains.

“In truth, taking care of a baby requires a woman to do a double shift every day, to be on call for the third shift, to have no days off, no job description and nothing to guide her work. There is no occupation equivalent to mothering a baby – it’s permanent, irreversible and constant.”

It can help to share the housework and care for a baby with a partner, in a way that feels fair.

“If you have a partner who’s involved in caring for a baby and who takes on a fair share of work, that’s a great benefit for a new mother,” says Prof Fisher.

“But men can get nervous about caring for a new baby and women can be critical, for example, when he puts the nappy on back to front. So couples need to remember how destructive it is to criticise each other and instead acknowledge they are both learning and affirm each other’s efforts.”

The second is how awful it feels when a baby cries and is difficult to soothe.

“A quarter to a third of women have a baby who cries a lot, is difficult to settle and wakes frequently,” explains Prof Fisher.

Well-slept babies cry less and are generally easier to care for. Establishing a feed-play-sleep routine in which a baby is settled to sleep in a cot between feeds can help. There are practical things parents can do to help a baby into a more settled pattern.

“Ask your maternal and child health nurse to show you how to recognise your baby’s tired cues and how to settle your baby to sleep,” advises Prof Fisher.

The third is that as well as the extraordinary wonder of having a baby, women lose many things when they become mothers, such as their ability to earn an income, the identity that comes with their job, freedom to come and go, and social and leisure activities.

“Each woman misses different things. It might be physical activity, social interaction, mental stimulation or the sense of purpose they had in their job,” says Prof Fisher. “Ask a woman ‘what do you miss most about how life used to be before you had a baby?’ and then help her work out a plan to re-introduce some of these things in new ways.”

“There is a beautiful phrase that ‘the birth of a baby is always the birth of a mother’. And just as a baby has lots to learn, mothers have to acquire new skills and knowledge, too, and they need support to do this. If family and friends can respond to these needs, it can help to prevent mental health problems.”

The early days for new parents: things to remember

• You are not alone if you find being a new parent challenging. Every parent has to learn new skills and knowledge at this time of their lives.
• Ask a maternal and child health nurse for advice and practical guidance on caring for a baby, such as how to establish a feed-play-sleep routine.
• Talk to your partner about ways in which the increased work can be shared and avoid criticising each other’s parenting efforts.
• Share the bathing, nappy changing and settling of your baby with your partner.
• Accept practical help from friends and family.
• Identify what you miss from how life used to be and work out how you can begin to replace that activity or interest, maybe in a changed way.