Postnatal depression (PND) affects almost 16% of new mothers in Australiam according to beyondblue, a non-profit organisation helping people with depression and anxiety. Women with PDD can experience a prolonged period of low mood, reduced interest in activities, tiredness, sleep disturbance and appetite and negative thoughts and feelings, See http://www.beyondblue.org.au/index.aspx?link_id=94 for more information.
Please welcome guest blogger, Jo Williams, who has some great ideas on how mothers can avoid postnatal depression. Jo is married to Neil and lives in Surrey, United Kingdom, with their 19 month old son. Jo and Neil are expecting their second baby in July. A member of Jo’s mum’s family (Jo is not sure exactly who, as it is never talked about) suffered from increasingly severe and untreated PND with each of her babies, eventually committing suicide after having her fourth child. Jo says that she feels the reason she never got PND herself is because she took the threat of it seriously, did her reading, thinking and preparation before her son was born and continued to watch for the early warning signs, nipping them in the bud, for many months after the birth.
Idea no. 1 – Co-sleep and breastfeed
Depression (in general) has been linked in various studies (and I can see it in my own sister’s depression) to a lack of sleep (see http://www.nationalpost.com/life/health/story.html?id=1492104). And who, having a small baby, doesn’t suffer to some extent from a lack of sleep?! The obvious answer to me on this is to;
- co-sleep, and
To my mind, rolling over, latching the baby on and then going back to sleep has got to be more restful than the baby waking up crying in its cot down the hall, me dragging my arse out of bed, going to the kitchen, boiling the kettle, finding I have no sterilised bottles, washing one up, sterilising it in the microwave, making the bottle of formula, cooling it down to a drinkable temperature (all while the baby is shrieking) and then having to stay awake while they baby calms down and takes the bottle because I have to make sure it doesn’t choke on the bottle. Call me lazy, but that is just a recipe for depression!
This link leads to a good guide on ‘A Breastfeeding-Friendly Approach to Depression in New Mothers’ http://www.nhbreastfeedingtaskforce.org/nhbftf-ppd-curriculum.pdf
Idea no. 2 – Take breaks from the baby if needed, or not!
I think the advice about ‘have plenty of breaks from the baby’, is as unhelpful as ‘don’t put the baby down for one minute’. If mum WANTS to be with baby pretty much all the time, MAKING her have a break will cause her anxiety, just as HAVING to be with the baby all the time would cause anxiety if she WANTS to have a break. The main thing is to have the possibility of taking a break if you want one and not beating yourself up either way.
Idea no. 3 – Get out of the house
I think having breaks from being stuck in the house on your own with the baby is important. Maybe finding something to do or someone to see each day so the mother isn’t on her own, for instance, mother’s groups, playgroups or story times at the library. Just something to get out of the house and give a purpose to the day. Also, a walk in the park is not only free, but also a good workout when you’re babywearing, and we now know exercise helps combat depression (see http://www.mayoclinic.com/health/depression-and-exercise/MH00043).
Idea no. 4 – Wear your baby
One of the benefits of babywearing (and this is going to sound a bit odd) is that you don’t have to look at your baby. When I say that’s a benefit, I mean to mums with PND, as I’ll explain. When your baby isn’t in contact with your body, it needs to reassure itself in other ways that it hasn’t been (and isn’t going to be) abandoned. So the baby tries to make eye contact with you and tries to get you to interact with it. For mums with PND, it can sometimes be very hard to make encouraging eye contact with a baby in this way and if the baby is met with a blank or indifferent face that is a problem. If, however, you are holding or wearing your baby, the baby is already reassured that everything is OK and doesn’t need to rely on your smiling face. As a result, the baby continues to form a good attachment with you, even at times when you perhaps couldn’t care less about the baby, so once the PND has subsided the baby hasn’t been harmed and you can get on with enjoying one another.
According to the US National Women’s Health Information Center website (http://www.womenshealth.gov/faq/depression-pregnancy.cfm), babies whose mother’s have PND may cry more. Fortunately for babywearers, studies show that ‘Increased Carrying Reduces Infant Crying’ (see http://www.portareipiccoli.it/trial_hunziker.htm), which has got to be good if you’re depressed. Crying babies often provoke a feeling in mums (and those around them) of, ‘what am I doing wrong?’ leading to ‘I can’t cope,’ whereas mums are always praised for having quiet, contented babies (why do you think Gina Ford sells so many books – it’s the word ‘contented’ on the cover) and feel, ‘I CAN meet my baby’s needs’.
For me, one of the hardest things was, ‘can I meet my own needs’. I found that very hard to deal with when my son was small and feeding ALL the time (this was at a time before I discovered babywearing). Being stuck on the sofa for weeks on end, not able to get up and make a cup of tea or sandwich, was really tough, let alone having a shower or brushing my hair. The benefits of babywearing are obvious if you’re having ‘who the hell am I?’ issues, because you can fool yourself that your bump has just moved out of your tummy and up onto your chest, but you’re still an independent person with, yes, two hands free!
Other articles on the benefits of babywearing can be found at http://www.thebabywearer.com/index.php?page=bwbenefits
Idea no. 5 – Find support or attend counselling
The US National Women’s Health Information Center website (http://www.womenshealth.gov/faq/depression-pregnancy.cfm) has some useful information and shows that antidepressants aren’t necessarily the automatic answer, when support and counselling can also help. The website also has some tips, like ‘don’t try to do too much’, which I was certainly guilty of when my son was born. Next time I’m having a fortnight in bed with the baby while my husband runs around looking after everything else!
I do think you have to have the right help – having my mother-in-law helping would give me PND and a divorce, quite frankly, whereas having my cousin with me would be bliss! I have told my husband that if we’re ever expecting twins, I’m having a post-natal doula to help out.
Also, if anyone came to visit they had to bring food (except my mother-in-law, who brought champagne – how useful is that when you’re breastfeeding and on prescription medication?!). My aunt, on the other hand, is a professional cake maker (I know, what a burden!) and when my mum came to visit she came with three different sorts of home-made cake, complete with instructions on freezing. Maybe they should replace anti-depressants with home-made cake…yum!
Idea no. 6 – Sort everything out before your baby is born
I think good preparation on practical things is important, as it gives you a break when you’re at your busiest. When we were expecting our son I made sure all the washing was done, the mountain of ironing was finished, the house was tidy, we had set up our login and shopping list for online grocery ordering and home delivery, the nappies and baby clothes were washed (we had a pack of disposables in case we couldn’t keep up with the washing – we never needed them), the freezer was full, the bills were paid etc. That way, when I did every feed standing up for the first four days following an extensive episiotomy (not something I recommend), couldn’t sit down for twelve days, the baby was losing weight, etc we still had something decent to eat and had clean clothes to wear. Even if I wasn’t sure I was coping with being a mum and having a baby, the practicalities of life weren’t also demanding my attention and energy.
Idea no. 7 – Expect the worst, hope for the best!
One thing that helped me was going into the first two weeks of motherhood with an attitude of, ‘this is going to be absolutely awful’. That helped because the first two weeks WERE absolutely awful! I’m sure that if I had thought, ‘oh, this is going to be a breeze, breastfeeding will be easy, I’ll be a goddess etc,’ the reality of what happened would have been much harder to deal with and I would have felt like I was failing. As it was, I pitched it just about right – it was hard work and extremely tiring, and there was a point when I nearly collapsed emotionally, but we stuck together and got through the first two weeks, then we got through the first six weeks and by then we were old hands. But reality bites when you have a new baby and it isn’t lovely and the baby isn’t cooing. The reality is your boobs ache, you can’t get a decent latch for love or money, you don’t know what day of the week it is, you’ve only had two hours of sleep at a stretch, day or night, the baby’s losing weight, your husband’s losing weight (oh yes!), you haven’t had a shower in four days (yuck!) and the thought of stepping into the garden feels like a foreign country because you’ve become so housebound. And that’s the first five days! But if you know that’s normal and it won’t always be like that and celebrity mums such as Posh Spice with her size zero dresses are an absolute fiction, then makes the hard work more bearable and, for me, eventually, a privilege.