A Free Guide to Mental Health in Pregnancy and Postpartum
Becoming a mother is one of the most significant transitions in a woman’s life. Not only is there the physical growth and birth of the baby, but there is a parallel emotional journey towards motherhood.
The way a woman experiences her pregnancy is individual to her. We all come to pregnancy with our own important personal histories. You may have been through many cycles of fertility treatment; you may not want children; you may have conceived in a blended cultural family; you may have experienced a previous pregnancy loss; you may have conceived straight away and are ecstatic……
Becoming a mother is one of the most significant transitions in a woman’s life. Not only is there the physical growth and birth of the baby, but there is a parallel emotional journey towards motherhood.
The way a woman experiences her pregnancy is individual to her. We all come to pregnancy with our own important personal histories. You may have been through many cycles of fertility treatment; you may not want children; you may have conceived in a blended cultural family; you may have experienced a previous pregnancy loss; you may have conceived straight away and are ecstatic; you may be recently bereaved; you may have experienced birth trauma; you may have become pregnant at the same time as your best friend… this is by no means a complete list, but highlights how each and every woman will be experiencing and living her pregnancy differently.
Most women experience changes in their mood and relationships during pregnancy. This is to be expected as it is a huge life-changing time. For most, these feelings come and go, and may feel momentarily overwhelming, but you are able to continue living your life as you would like. For some, however, these feelings and emotions can be all-consuming, and they hinder every-day life. A pre-existing mental health diagnosis can sometimes be an indication of maternal mental health challenges in pregnancy or with a new baby, although not always.
Please know, that the behaviours and thoughts I list below are not to be used to diagnose, these are for personal reference only. The list is not exhaustive, and there may be symptoms and behaviours not mentioned. If you are concerned about yourself or a loved one, please speak to a professional.
Ante/Postnatal Anxiety – anxiety can heighten during pregnancy. This can feel like restlessness; running thoughts; heart thumping; sweaty palms; panic; breathlessness; hypervigilance; insomnia; exhaustion.
Ante/Postnatal Depression – can feel like a heavy dampening of everything; a lack of joy and excitement; some describe feeling empty and no variation in mood; struggling to sleep, sheer exhaustion; no motivation.
Ante/Postnatal Obsessive and compulsive behaviours and thought patterns (OCD). Thoughts that can feel overwhelming, intrusive and terrifying. Obsessively counting kicks/movement. Fear of baby dying. Compulsively cleaning, disinfecting, bathing.
Postnatal maternal OCD can sometimes present as relentless thoughts around the terror of harming your baby. Although you know you will never act upon these thoughts, they can be so chilling and abhorrent, and flood your mind. Please know these thoughts are common, and your baby is safe.
Birth Trauma – is when you were or perceived that you or your baby were under threat of death or serious injury. Re-experiencing the trauma through flashbacks, intrusive thoughts and nightmares; being hypervigilant, especially around the baby; feel guilt around the birth, or feelings of depression.
Postpartum Psychosis – is a rare, but treatable medical emergency. It can present in many different ways but is often accompanied by hallucinations, delusions and mania. It can appear suddenly and can change from moment to moment. If you suspect yourself or a loved one of experience postpartum psychosis, please read the APP website and call a healthcare professional immediately.
Although I have listed some of the occasions when mental health is strained, please know that for many women, the experience of becoming a mother is positive and fulfilling.
However, if you are struggling, there are some things you can do to help alleviate this.
Speak to your midwife or GP.
Speak to your friends.
Join ante/postnatal classes.
Gentle exercise (especially outdoors).
Try and carve out some alone time, or social time – whichever is most comforting to you.
Care for your body.
Journal or note your thoughts down in a way that feels right to you. Sometimes telling someone else feels too much, and by writing you are telling yourself, and this can be surprisingly effective.
An incredibly uplifting and hopeful thought to hold on to is that with help and support, most perinatal mental health challenges are temporary.
Some really useful websites:
You can find a FREE shareable PDF of this and many other resources HERE.
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Elisha Nunhofer is a person-centred psychotherapist who specialises in maternal mental health. She has extensive experience of working with clients who are exploring the possibility of having children; going through fertility treatment; have experienced all forms of pregnancy loss and termination; ante and postnatal depression and anxiety; adoption and surrogacy.
She sees clients via video call or in-person in East Sussex. For more information, please visit her website.
A Free Guide to Having a Doula
To doula or not to doula…that is the question!
Ever heard of a doula? Wondered what one is, what they do and how they can help? Is it all witchcraft and incense? Hopefully, I can dispel a few myths here!
What is a doula?
A doula supports women and those that birth through pregnancy, birth and the postnatal period. How do we do that…. well, to start with we are non-judgemental and incredibly open in our approach. We appreciate that everyone makes decisions that are right for them…..
To doula or not to doula…that is the question!
Ever heard of a doula? Wondered what one is, what they do and how they can help? Is it all witchcraft and incense? Hopefully, I can dispel a few myths here!
What is a doula?
A doula supports women and those that birth through pregnancy, birth and the postnatal period. How do we do that…. well, to start with we are non-judgemental and incredibly open in our approach. We appreciate that everyone makes decisions that are right for them at any given moment and our aim is to make sure that you feel fully informed and supported to make the choices that suit you.
We can help by signposting good evidenced-based research (no opinions, judgement or advice here, we want you to explore what feels right for YOU) and by exploring the emotional and practical needs a doula can bring, it means we will respond to the individual needs of each pregnant person…with the idea that you feel confident and empowered, and that any gaps in knowledge, care, understanding or communication is bridged.
You can read more about the role of the doula here and this is a great source of evidence-based information.
Are we just for the mother to be/birthing person?
No! As doulas we often support the partner, whoever that may be, so they too are informed and relaxed. By offering continuity of care, we build relationships with whoever needs that support so that when the day of birth arrives, everyone is as positive and included as they can be.
Are we clinical and can we give medical advice?
In short, no. We are not medics but fully appreciate there are roles we all play when supporting birthing women/people… although we have different roles, doulas keep the needs of those they support, at the forefront of their minds always. We want that oxytocin flowing so work hard to make your birth space as calm as possible!
Are there statistics to show the benefits of having a doula?
Yes! There is evidence to show that having a doula can:
Reduce risk of caesarean birth.
Reduce risk of instrumental birth.
Reduce need for painkillers or epidural during birth.
Reduce risk of induction of labour.
Shorten labour.
Increase parental satisfaction with the birth experience.
Increase the likelihood of initiating breastfeeding.
Increase the likelihood of successfully establishing breastfeeding and breastfeeding at six weeks.
Lower incidence of depressive symptomology.
Improve equity and provide culturally responsive care
(Brigstocke S. MIDIRS Midwifery Digest, vol 24, no 2, 2014, pp157-160)
The best doula for you?
Chat to a few! See who you connect with... when the rapport flows and you know you could chat about anything with ease…you’re on the right track!
You can download a FREE PDF of this piece and many other useful resources HERE.
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Sam is a married mum of two, has a cat, dog & bearded dragon & has lived in Essex all her life.
After training in 2008 with Nurturing Birth she dipped her toe further into the birth world (also attending the training & facilitating for Mindful Doulas) and went on to explore mental wellbeing, Birth Trauma (3 step rewind technique), infant massage, hypnobirthing and many other workshops and study days that caught her eye! Finding community, supporting those who need it and embracing who you are is at the heart of Sam’s drive and is why you’ll find her as ‘the unapologetic doula’ on social media!
She’s been a doula mentor for seven years and at the end of 2019 was overjoyed to be asked to join the Nurturing Birth team where she has branched out to facilitate the new doula courses 😊
Contact Sam via email – samshepp4@yahoo.com or call 07793970367 for a free chat on how a doula can benefit you, or check out the links on this guide for her FB page, more info and reviews/testimonials.
A Free Guide to Postnatal Healing
When Nissa asked me to write an article about postnatal healing, I jumped at the chance. It’s a subject I am truly passionate about and this stems from the knowledge that huge changes can be brought about physically, emotionally and spiritually by focusing on postnatal healing. This is something that I see happen on a daily basis in my clinic.
In this short article, I will introduce some key areas to think about:
Physical healing:
Rest - This is the essential first step for physical healing. It’s very easy to underestimate the need to rest and nourish yourself. But I have seen enough women who have suffered from a vaginal prolapse a few weeks after delivery to know this has got to be a priority….
When Nissa asked me to write an article about postnatal healing, I jumped at the chance. It’s a subject I am truly passionate about and this stems from the knowledge that huge changes can be brought about physically, emotionally and spiritually by focusing on postnatal healing. This is something that I see happen on a daily basis in my clinic.
In this short article, I will introduce some key areas to think about:
Physical healing:
Rest - This is the essential first step for physical healing. It’s very easy to underestimate the need to rest and nourish yourself. But I have seen enough women who have suffered from a vaginal prolapse a few weeks after delivery to know this has got to be a priority.
Scar tissue - If you’ve had a c-section, episiotomy or vaginal tearing, then doing scar tissue release work is super important. Many women are scared to touch their scar tissue but in fact, scar tissue responds beautifully to touch and research suggests that it has a hugely beneficial effect on the healing process. There are some simple techniques you can do yourself (you can find videos on my website for these with links below) and you can also see a women’s health specialist trained in scar tissue work to help with this.
Emotional healing:
Almost universally, we women tend to blame and judge ourselves - this can take many forms, such as ‘My birth went the way it did because I didn’t do enough,’ or ‘I’m not a real woman/mother because I didn’t do this...’ Honestly, it is rare to find a woman who is not blaming herself in some way. So, for emotional healing, the number one decision is to forgive ourselves. Think of the judgement you are making about yourself in relation to your pregnancy, birth, breastfeeding. Would you judge your friend for that? Now forgive yourself for judging yourself in that way. It’s powerful to say this out loud and notice how you feel after saying this.
Spiritual healing:
Once we have done this emotional healing and are no longer blaming ourselves for the way things are, we are free to let the healing energy flow through us. I use a concept called the Birthing Field in my work - a loving energetic field which flows through us as mothers to our children. This is an incredibly powerful tool (which can be used even years after your delivery) to shift from numbness/disconnect/trauma within your body into a feeling a loving connection with your birth experience and your body.
If you have experienced any sort of birth trauma then know that this can be healed and we can reconnect with our bodies in a beautiful way. In my experience, it often doesn’t take much to do so, and you do not need to live with these effects. To find out more about postnatal healing check out the free resources on my website.
You can find a FREE shareable PDF of this piece here.
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Rebecca is an experienced osteopath who works with you at the level which is appropriate – for some this will mean pure physical support, for others mental, emotional or spiritual support.
She uses osteopathy in its fullest sense using structural, visceral and cranial approaches. Rebecca works with everyone (men, women and babies) but is particularly interested in supporting those with women’s health issues. She treats many women who have not been able to find help elsewhere and welcomes complex cases.
Rebecca also works energetically helping to shift trauma patterns, frequently using this work to help women recover from difficult births and help with chronic pain patterns. She offers this support face to face and virtually. For more information visit her website.
What I’ve learnt... About My Feminine Power
I graduated as a yoga teacher just a few short weeks before I fell pregnant with my son. I was fresh from the ashram in India and full of the teachings of Shakti…the powerful female energy that resides within all of us. The experience had been transformative, a shedding of unwanted negativity and a boost to my vital life-force energy. I was clear-headed, full of direction and ready to take on a new path in London….
I graduated as a yoga teacher just a few short weeks before I fell pregnant with my son. I was fresh from the ashram in India and full of the teachings of Shakti…the powerful female energy that resides within all of us. The experience had been transformative, a shedding of unwanted negativity and a boost to my vital life-force energy. I was clear-headed, full of direction and ready to take on a new path in London.
Then boom, I was pregnant! Of course I was elated. If I’m really honest with myself I went to India to shift things that I felt were hindering me in falling pregnant. I knew I had work to do.
I experienced strange happenings whilst on my training. I had dreams about the word Shakti, I had dreams of dances connected to this word, I had stirrings in a place in my lower abdomen (my fertility chakra). I didn’t understand it, nor did I know what it meant, it felt kind of weird. But slowly it unfurled for me and its been a journey that’s taught me so much about myself ever since.
I had a really magical pregnancy with Hari, I also had the home birth I had been dreaming of. I used my yogic breath to birth calmly and without pain relief and I felt like a warrior goddess. I met incredible women on my journey and started to build my community. Then, without notice or warning… I was floored.
I was floored by the fourth trimester, we struggled with feeding issues that nearly sent me to a very dark place. I was exhausted but determined to breastfeed, I was not kind to myself at all. My instinct to nurture Hari was fierce and unyielding but the instinct to nurture myself as I had done before totally vanished.
I felt lost. I disconnected from myself and from others and at times I felt very alone. I had worked so hard at childbirth, I was so proud at myself. But I had so naively forgotten the part when the baby arrives, the struggles that can come, the lack of time for yourself.
After a period of drifting through a haze that still makes me feel emotional and a bit sad, I started to reconnect to my yoga. I practiced with my son on my lap and discovered small techniques that I as a Mama could use to enable me to piece myself back together.
I learnt that I had to work with my body and with my emotional state. I had to reconcile that I was working in a new space and time and that was ok. It was tiny steps and those steps still take place today. I had to be really kind to myself.
As I write this I am navigating my way through early pregnancy with my second child. I am feeling all of the feels! It’s a reflective time, a time where I have to almost force myself to pause and use the tools I know so well to find my power and my center. I still forget at times.
Being a warrior goddess is not just about being strong, it’s about being lost and then coming back. Not just once but most probably on many occasions. It’s about realising that self-care is a real thing, essential for survival.
I also now understand the importance of connectedness, of finding your circle and building your community. When women come together the magic really happens….that’s the biggest learning that I want to take through this new chapter of motherhood.
5 Tips for Positive Birth
Here are my top five tips to have a positive birth experience no matter which way you decide to birth your baby
Being a dreamy 25 year old student I went for the stereotypical hippy option, a pain-relief free homebirth on the living room floor. Using hypnobirthing breathing techniques and plenty of youthful naivety I had an incredibly powerful and positive birth experience. It put me on the road to where I am now, somewhat older, slightly wiser and considerably more grounded. What I learned from giving birth is that women are shape-shifting superheroes and are much tougher than we seem! Our bodies completely transform in birth and open up like blooming technicolour flowers.
These days I am a midwife working in a busy South London birth centre and a hypnobirthing teacher. I love my work passionately and feel lucky to have found what feels like a calling, something I never imagined I would find. A large part of my job is preparing parents and especially first time mums for their births. Now if you have had a baby or been with a birthing woman you will have your own take on what birth is, how it feels and what advice you will give to your friends when it’s their turn. From what I’ve seen every woman will have a strikingly individual experience and what would be a heavenly natural homebirth for one can be painful and traumatic for another.
Here are my TOP FIVE TIPS to have a positive birth experience, no matter which way you decide to birth your baby:
1. I’ve noticed that the women who stay active in their pregnancies tend to have easier births and quicker recoveries. This seems pretty obvious - of course if you are fit and healthy your body will work more efficiently. But this isn’t so easy when you are nine weeks pregnant with raging morning sickness that lasts all day and all you want to do is lie on the sofa with your duvet eating malted milk biscuits! When you get to your second trimester and have a little more energy get active again. Walking, swimming, pregnancy yoga and pilates are all fantastic.
2. Stay relaxed. Easier said than done when you have a two year old causing all kinds of crazy in the kitchen cupboards! Especially now that she has just figured out how to climb up and open the ones you didn’t think you would need to child proof. If you already have little people who need your constant attention, relaxation may mean you take ten minutes out at the end of the day to lie down quietly and do some breathing. Or find an obliging chap to give you a good long foot rub. Make time for yourself you deserve it!
3. Many of the women I see are very anxious and fearful about birth and pain. They are often very well informed and have definitely watched plenty of ‘One Born Every Minute’. To a certain extent you can choose what you fill your life up with so immerse yourselves with healthy, happy birth. Watch some beautiful water births on YouTube, talk to your friends who have had good experiences and read anything by Sheila Kitzinger, Ina-May Gaskin or Michel Odent.
4. These days most women will make a birth plan, a long wish list cherry picking all the best bits. I think it’s great to be well informed and know what you want! I have also noticed that from time to time babies don’t read the plan and have ideas of their own. How dare they! I recommend that you also write a ‘birth tweet’ (not that this should be published of course). A tweet has space for only 140 characters which is about two sentences. This enables you to condense down the essence of what is really important to you. This would be mine ‘We want our baby to be born in a calm, peaceful and loving environment’. Give it a go!
5. Can you guess my last top tip? Of course it’s hypnobirth. Having supported hundreds of birthing women and used hypnobirthing myself I know how well it works. Hypnobirthing provides the knowledge and understanding of normal birth, combined with relaxation techniques to keep you calm and in control no matter what happens. I have supported a couple who used hypnobirthing during an elective caesarian, the calmest I have ever attended!
Once you have had a baby you may suddenly realise how epic every woman who has ever gone before you really is. Something that your children may also realise about you when they finally grow up and stop climbing up the kitchen cupboards!