When to ask for help?
Although it’s normal to have periods of feeling worried or low when you’re pregnant or after birth, some women have feelings that don’t go away and this can be a sign of something more serious. It’s not uncommon for pregnant women and new mothers to suffer from depression or anxiety and sometimes from other mental health problems.
"My manager at work got me counselling under an employee assistance scheme. It was six sessions...It made a huge difference to me and how I felt. I felt a lot less angry." Theresa, mum of one. Read more...
Your midwife will ask you some questions to see if you need support with mental health during your booking appointment.
However, it is not uncommon for mental health problems to start at other points during pregnancy, so if you have the symptoms below at any point during your pregnancy, speak your midwife, doctor or health visitor about how you are feeling as soon as possible. If you are unwell they can arrange treatment to help.
- You feel low or anxious most of the time for more than two weeks.
- You lose interest in things you normally like.
- You have panic attacks.
- You feel worthless or guilty.
- You lose your appetite.
- You have unpleasant thoughts that keep coming back and you can’t control them.
- You find yourself repeating an action (like washing, checking, counting) to feel better.
- Your thoughts race and you become extremely energetic and happy.
- You are so afraid of giving birth that you don’t want to go through with it.
- You have thoughts about suicide.
You should also tell your midwife or doctor if you have (or have had) an eating disorder, as you may need special support to deal with your body’s changes through pregnancy and beyond.
If you aren’t happy with how the midwife, health visitor or doctor responds to what you tell them, don’t be afraid to ask to see a different health professional. Trust yourself – you are the best judge of whether your feelings are normal for you. If you don’t feel right, or if you have some of the signs of depression and they last for more than two weeks, push for help if necessary.
If you feel that your midwife is not listening to you, you can ask to see another member of the team.
If you are still worried that no one is listening to your concerns, contact the day assessment unit (DAU) within the maternity unit or alternatively seek advice by contacting a supervisor of midwives (SoM) through your maternity unit. The SoM is available 24 hours a day.
"If you don't get the reaction you need when you speak to the first person, find someone else because every person who you ask is different and you will find the person who can help you." Stephanie, mum of two. Read more...
Mental wellbeing and the booking appointment
At your booking appointment, the midwife will ask you many questions about your mental and physical health so that they can find out whether you need any extra support. Every woman is asked these questions. Your midwife will ask you how you’re feeling and whether you or anyone in your family has a mental health problem (or had one in the past). Even if you don’t have a specific mental health issue, it’s a good idea to talk to the midwife if you’re feeling anxious or feel like you are isolated and do not have support.
The midwife will ask some questions to see if you are at risk of having depression or anxiety. They could include the following:
- whether you often been bothered by feeling down, depressed or hopeless during the past month
- whether you have often been bothered by having little interest or pleasure in doing things during the past month
- whether you have been feeling nervous, anxious or on edge during the past month
- whether you have not been able to stop or control worrying during the past month.
The midwife will also ask you:
- whether you have or have ever had mental health difficulties
- whether you have ever been treated by a specialist mental health service
- whether a close relative has ever had severe mental illness during pregnancy or after birth.
If the midwife thinks you need more support after talking to you, she’ll refer you to your GP who may refer you on to a specialist mental health service.
It’s important to be honest with the midwife about how you feel. She won’t criticise you, and she can help you get support or treatment if you need it.
“That was all I needed, to get it out, to speak to somebody and to feel that I wasn’t completely alone."
Sarah, mum of one. Read more...
Organisations that can support you
There are many organisations that can offer you information and support. Some have online forums and local support groups where you can share your feelings with other women. Others are national charities that specialise in improving mental health.
“At that point I’d try anything they had to offer. At first I thought the CBT would be a load of rubbish, but I’d definitely recommend it now."Katie, mum of one. Read more...
The Wellbeing Plan
The Wellbeing Plan is a two-page plan, endorsed by NICE, that helps you start thinking about how you feel and what support you might need in your pregnancy and after the birth. Download the Wellbeing Plan and fill it out. If you find it hard to talk to your partner, family, friends or midwife about how you are feeling, you could use the Wellbeing Plan to help start the conversation. Or you can keep it private if you prefer.
- NICE (2014) Antenatal and postnatal mental health: clinical and service management guidance, clinical guideline 192, National Institute for Health and Care Excellence. London, P 4: Available at: http://www.nice.org.uk/guidance/cg192
- London Parliamentary and Health Service Ombudsman, Midwifery supervision and regulation: recommendations for change, London The Stationery office, 2013. Also available from: http://www.ombudsman.org.uk/__data/assets/pdf_file/0003/23484/Midwifery-supervision-and-regulation_-recommendations-for-change.pdf (accessed 6 May 2014)
- NICE (2014) Antenatal and postnatal mental health: clinical and service management guidance, clinical guideline 192, National Institute for Health and Care Excellence. London, P 28. Available at: http://www.nice.org.uk/guidance/cg192
Further help and information on mental health in pregnancy
Some mums expect, or perhaps feel pressured, to feel excited and happy throughout their pregnancy. But unfortunately this isn't always the case.
We all dream of floating serenely through pregnancy, channelling a sense of calm for the growing baby inside us. But, often, the reality is somewhat different. Try our practical tips to help you relax in pregnancy.
Stress in pregnancy is not unusual. Here are some ideas for how you can relax and look after your emotional wellbeing when you’re pregnant.
If you need help and support with your emotional health, there are a number of different options.
Pregnancy and having a baby can be an exciting and demanding time for women. If you have an existing or past mental health condition it brings extra challenges and you are at higher risk of relapse during this time than at others.
Myths and facts about mental health
ℹLast reviewed on February 1st, 2015. Next review date February 1st, 2018.
By Anonymous (not verified) on 2 Sep 2016 - 14:44
my doctor wont acknowledge it
By Midwife @Tommys on 8 Sep 2016 - 09:48
I am so sorry if you feel you are not being listened to by your doctor. Please do ask for help, you can see another doctor or talk to your midwife. Also please do know we are hear to help and support you, you can call us on 0800 0147 800 or email [email protected]