Thinking ahead: early days with a newborn

What happens after the birth?

After you have had your baby, the doctors and midwives will do what they can to help you recover from the birth and reduce the chance of your mental illness symptoms coming back or getting worse. For example, they may offer you an individual room if one is available, so you can sleep and rest more easily. Your partner or a family member may be able to stay overnight with you if this would help you.

Someone from the perinatal mental health team may visit you in hospital after the birth to check you’re well enough to go home and discuss your mental health medication needs. 

You may stay in hospital longer if your baby needs treatment in the newborn (neonatal) care unit, for example if they need help to withdraw from medicines they have been exposed to in the womb.

My mental health after the birth

Baby blues

You’re likely to feel emotional after the birth and this is true for all women. The first few weeks can feel overwhelming but try to look after yourself and take up offers of help from friends and family. Many women have the ‘baby blues’ in the first few days. This is normal and is caused by hormone changes as your body gets used to not being pregnant anymore.

Postnatal depression

Some women develop postnatal depression, which can cause feelings of sadness, hopelessness, guilt or self-blame. Talk to your GP, midwife, health visitor, family nurse or perinatal mental health team if these feelings last for more than a couple of weeks or if you’re worried about how you’re feeling.

Postnatal depression is a mental illness – it’s not your fault and your healthcare team won’t judge you for how you’re feeling. There’s more information about postnatal depression here.

Mental illness symptoms coming back or getting worse

Once you are home, you will have support from your community mental health team, home treatment team or specialist community perinatal mental health team. They will help you spot any early signs that your mental illness may be relapsing.

If you or someone close to you notices that your mental illness symptoms are coming back or getting worse, you or they can contact your GP or perinatal mental health team. The health professionals looking after you will check what support you have at home and may offer you treatment or change the treatment you’re currently taking.

If you’re worried that you may harm yourself or your baby, don’t be afraid to ask your GP, health visitor, family nurse or perinatal mental health team for help straight away. They know that you will want the best for your baby so asking for help is always the right thing to do. They may have given you a crisis helpline number to call or you can get help from other support services.

If your symptoms are severe and can’t be treated in the community, you and your baby may go to a mother and baby unit while you have treatment.

‘I was lucky enough to be taken to a mother and baby unit, which allowed me to spend time with my baby, daughter and husband, while having 24-hour support. This was invaluable! I couldn't have survived without it.’ 

Mental health forum user  

You will also have postnatal (after the birth) support from your midwife and health visitor and, if you are a young parent, from the family nurse. You will see your midwife up until 14 days after the birth but this can be extended to 28 days if you need more support. Your health visitor will visit you 10 to 14 days after the birth, then you will have regular appointments either at home or in a clinic.

Practical support

Looking after a new baby is a 24 hour a day job. You may want to do everything yourself but asking for help can really make a difference to you and your baby’s wellbeing. You could talk to family and friends now about how they might help you after your baby is born, for example, by:

• looking after the baby while you have a nap or a shower
• taking the baby for a walk
• helping with night feeds if you’re expressing milk or using formula
• doing a few chores in your home, such as cooking or cleaning
• taking older children to school.

Your perinatal mental health team can help you bond with your baby and become confident in your role as a mum. They can also tell you what services and support networks are in your local area.

Your health visitor or family nurse can offer advice on practical issues, such as feeding and routines, and can put you in touch with local support groups. They work together with other health professionals to provide mental health support but will only do this with your consent.

Sometimes, you may want to chat to someone when you’re at home or during the night and that’s when online and social media groups can be helpful:

• The mental health charity Mind has the Elefriends community online and as a mobile app.
• Use #PND hour on twitter to talk to others about postnatal depression.
• Bipolar UK has an e-community
• Action on Postpartum Psychosis has an online forum

What if I don’t have a partner or family to help?

If you are a single parent, it’s very important to think about who you can ask for emotional and practical support in the months after your baby is born. Your midwife or health visitor may be able to help you plan this.

Make sure your care plan has details of the professionals you can contact if you need extra help after the baby is born. Asking for help if you need it is always a positive step.

You can get more information and support from single parent’s charity Gingerbread.

Bonding with your baby

You may be worried about how your mental illness will affect your relationship with your baby. If you feel this way, talk to your health visitor, family nurse or perinatal mental health team about your concerns. Getting help early on will mean you can get the right treatment for your mental illness as well as help to bond with your baby.

Here are some ideas that can help you bond with your baby.

Asking for help does not mean that you’re not able to look after your baby. It shows that you’re doing your best for your baby.

Therapies that may help you include:

• mother-infant therapy
• couple and family therapy
• video feedback – showing you short video clips of you interacting with your baby to help strengthen your bond
• cognitive behavioural therapy (CBT).

The health professionals you see can tell you what services are available in your area.

Breastfeeding

Breastfeeding has many benefits for your baby and health professionals will encourage you to do it if you can. When you’re thinking about whether to breastfeed your baby, speak to your psychiatrist or perinatal mental health professional about how any medications you’re taking may affect your breastmilk. 

The most important thing for your baby is that you are well.

You may choose not to breastfeed, for example if your medication affects your baby or you’re worried about a lack of sleep affecting your mental health. Or you may decide to mix breast and formula feeding so that your partner or family can do some of the feeds, giving you time to rest, which is important for you to be well. 

Your healthcare team will support you whatever you decide is best for you and your baby.

For some women, not breastfeeding can be a source of stress and anxiety and you may feel guilty if you can’t breastfeed your baby. Try not to feel guilty or to worry about what other people think. Remind yourself that the important thing is that you have made the best decision for you and your baby.

If you are not breastfeeding, skin-to-skin contact with your baby when you or your partner are formula feeding can help with bonding.

On the other hand, if you do want to breastfeed and are struggling with it, don’t be afraid to ask your midwife or health visitor for support.

We have more information about breastfeeding here.

Smoking, alcohol and recreational drugs

If you smoked or used recreational drugs or alcohol while you were pregnant, your healthcare team will continue to offer you support and treatment. They may monitor your baby to check for any effects of smoking, drugs or alcohol.

If anyone in your home smokes, your baby may be more likely to have breathing problems. Smoking is also linked to sudden infant death syndrome (SIDS). Giving up smoking is good for the health of the whole family and makes it less likely that your children will grow up to smoke.

If you have given up smoking, alcohol or drugs, you may still need support to help you stay off them. Your GP can tell you what support is available and can put you in touch with organisations who can help. You can also find a list of support organisations at the bottom of this page.

Your GP may also refer you to early help services, which bring together support from several organisations, such as healthcare, housing and education.

We have more support here for quitting smoking, alcohol and recreational drugs.

More information and support

Best Beginnings has the ‘out of the blue’ series of videos for parents with mental illness as well as the baby buddy app.

Family nurse Partnership
Home visiting programme for first-time young mums and families.

Gingerbread

National Breastfeeding Helpline

NHS stop smoking services in:

• England
• Wales
• Northern Ireland
• Scotland

NHS Smokefree

The Breastfeeding Network