Relationships and support networks

Your support network is very important when you are planning a pregnancy with a serious mental illness. The people around and close to you can support you and this can have a big effect on how you manage pregnancy and after.

Having good support around you is important before, during and after a pregnancy.

What is a support network?

A support network can be made up of parents, siblings, spouses or partners, extended families, close friends and others who care about us like neighbours and co-workers. Some people have larger networks than others, but most of us have at least a few people who are there for us when we need them.

You may have a partner, family or friends who you trust and who understand your mental illness.

‘My mum has been amazing and in fact three days after I’d had the baby, she turned up at our house. I’d been advised not to wake up for night feeds because there was a fear that I might tip over into illness. So she actually did the night feeds and stayed on a camp bed in the front room. She’s been a huge source of support.’

This support network can give practical and emotional help, which is important at this time of your life.

If you don’t have a partner, family or other supportive people around you, your GP can tell you about support services and groups in your area.

‘I don’t have any family around me. I have some friends but having the support of the perinatal mental health team was crucial to me in ways I didn’t really understand until afterwards’. 

How can my partner, family or friends support me?

Often family and friends will want to offer support but they may not know what you need. Some people will worry about being seen as interfering. Others who have not been through pregnancy will not realise that you need support.

For these reasons, it’s good to ask for help instead of waiting for it to come to you.

‘When I had my last baby I had my mum here so I had my sleep. She’s not coming this time because I have a good friend here and she’s coming to cook and iron. She’s my best friend, she’s a good support.’

You could talk to the people you trust about how they can help, for example by:

Practical support with general living also helps you with your general mental wellbeing. Friends and family can help with this during and after your pregnancy, for example by:

  • cooking healthy meals
  • taking the baby or other children out so you can get some sleep
  • doing household chores, such as cleaning or laundry
  • spending time entertaining the baby while you take a break – even if it’s just to have a bath or shower
  • being there for you to talk to or to go for a walk with.

Support for your partner or family

Your partner or family may feel they need support or advice as well.

These websites have information that can help them support you:

Action on Post-Partum Psychosis: Resources for Partners

Birth Trauma Association: Fathers/Partners Page

Royal College of Psychiatry: information for carers on postpartum psychosispostnatal depression and perinatal obsessive compulsive disorder (OCD)

Association for Postnatal Illness: Advice for Carers

NCT information on postnatal depression in fathers

Building networks for after the birth

Pregnancy and afterwards is a time when people can find it easier to build new friendships with people who are at the same stage of life.

Starting this early by joining local pregnancy or antenatal groups once you are pregnant can mean you have a group of people who live near you to talk to when your baby is born.

After you’ve had your baby (or even beforehand), you can ask your health visitor for details of local mum and baby groups. You can also find out about these on library or children’s centre noticeboards or on local online area forums.

Many of these sessions are free or have a small fee. For example, many libraries and cafes hold singing and story-reading sessions. You may have a local children’s centre, that runs parenting courses, play groups and other family activities where you can chat to other new mums.

You don’t need to tell anyone about your mental illness – just having people to talk to about your pregnancy and baby helps. Once you build trust you can decide whether you want to talk about it.

What if I’m having relationship problems?

Mental health problems can affect your relationship with your partner. Planning a pregnancy can make things even harder for some couples.

If there are any difficulties in your relationship it’s important to get help as early as possible, ideally before you get pregnant.

If problems start during pregnancy then ask for help before your baby is born. Getting the support you need will help you and your baby.

Speak to your GP, mental health professional or family nurse if you feel unsupported at home. They can tell you about support services in your area.

These may include:

  • relationship counselling
  • general counselling, which may cover mental health as well as relationships
  • child and family services
  • helplines and online support

You can contact your local IAPT (Improving Access to Psychological Therapies) service directly, but this service is only available in England at the moment. IAPT services often offer relationship counselling.

Read more about relationship problems and pregnancy.

Domestic abuse

More than 1 in 4 women experience domestic abuse or violence at some point in their lives. The abuse may be from a partner or other family member. It doesn’t have to be physical abuse, it can be sexual, emotional, psychological or financial. Controlling and bullying (coercive) behaviour is also a form of abuse.

Physical abuse may include slapping, hitting, punching, holding you down or throwing things.

You may be being sexually abused if someone:

  • touches you in a way that makes you feel uncomfortable
  • pressures you into having sex
  • pressures you into not using contraception
  • hurts you during sex
  • stops you breastfeeding.

Signs of emotional abuse may include someone:

  • blaming you for the abuse
  • accusing you of flirting or having an affair
  • telling you what to wear or what to do
  • calling you names
  • making racist or sexist comments about you.

Psychological abuse may include someone:

  • threatening to harm your children or take them away
  • isolating you from friends and family
  • belittling you or putting you down
  • questioning your memory or sanity
  • reading your emails, texts or letters.

Financial abuse may involve someone:

  • not letting you work
  • not letting you access your own money
  • making you explain what you’ve spent money on
  • not giving you enough money to buy essential items, such as food
  • making you beg for money.

Controlling and bullying behaviour may include someone:

  • making you depend on them by cutting you off from friends and family
  • stopping you getting support, for example from health professionals
  • controlling your daily life, such as what you wear, who you can see or where you can go
  • monitoring you online or using spyware
  • repeatedly threatening, humiliating or hurting you so you do what they want.

Many women with a mental illness have experienced some form of domestic abuse. Some abuse starts when women become pregnant. Other times the abuse gets worse during or after pregnancy. The person may try to stop you going to your pregnancy or mental health appointments.

Domestic abuse doesn’t just affect you but also the unborn baby and other children. During pregnancy, it increases the risk of miscarriage, premature birth, low birth weight, infection, physical injury to the baby and even death.

It may be very difficult to recognise or admit what’s happening. Remember that domestic violence or abuse can happen to anyone and you’re not alone.

Where can I get help for domestic abuse?

If you’re being abused, you can talk to a health professional or a domestic abuse advocate or advisor. Nobody will judge you or tell you what to do, but it’s important that you get support.

Your GP or mental health professional can give you details of organisations who can support you, as well as phone numbers of local and national helplines. If you’re pregnant, you could speak to your midwife or family nurse. Women’s Aid have an online directory of local support services.

Your domestic violence advocate and healthcare team will give you information on how to keep safe. They may be able to change the length and timing of your appointments to make it easier for you to get to them and to give you more time to talk about the abuse. It will be kept confidential and won’t appear in your hand-held pregnancy notes or in any letters sent to your address. Let the team know if you have a particular phone number that is safe for them to contact you on.

You can also call the Women’s Aid 24-hour domestic violence helpline on 0808 2000 247. They will give you confidential advice and support. They have a survivor’s handbook with practical support and information for women experiencing domestic abuse as well as advice on how to cover your tracks online.

False beliefs about domestic abuse

  • It’s a ‘one off’
  • An act of domestic abuse is rarely a ‘one off’ incident. It is often a build-up of controlling and bullying behaviour, which can gradually increase over time.
  • My baby will be taken away by social services if I tell anyone about it
  • This doesn’t happen very often and is always a last resort if the baby is at risk from the abuser.
  • If your healthcare team think you should see social services, they will explain the reasons why. This doesn’t mean that your baby will be taken from you. The social worker is there to make sure you and your baby are safe and they will support you to make sure you get the advice and help you need. 
  • Only a court can decide to remove a baby from the parents and this is a last resort when all other options have been explored. Talking to someone about domestic abuse and getting help so you can keep your baby safe will be seen as evidence that you are doing what you can to protect your baby.
  • The most important thing is that you are trying to make your home as safe as possible for your baby and you are making sure that they are not at risk of harm.
  • I am in a same sex relationship so there can’t be domestic abuse
  • Domestic abuse can happen in all types of relationships, whatever your gender or sexual orientation.The LGBT+ charity GALOP has a domestic abuse helpline providing emotional and practical support.

More information and support

GALOP
National LGBT+ Domestic Abuse Helpline 0800 999 5428 / [email protected]

Refuge
Helpline 0808 2000 247

Women’s Aid
24-hour domestic violence helpline on 0808 2000 247

Sources

[1] Early Intervention Foundation. Reducing Parental Conflict Hub https://reducingparentalconflict.eif.org.uk/

[2] Early Intervention Foundation (2017) Types of relationship support services https://reducingparentalconflict.eif.org.uk/

[3] Office for National Statistics (2018) Domestic abuse: findings from the Crime Survey for England and Wales: year ending March 2018 https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice/articles/domesticabusefindingsfromthecrimesurveyforenglandandwales/yearendingmarch2018#the-long-term-trends-in-domestic-abuse

[4] Gov.uk (2018) Domestic abuse: how to get helpwww.gov.uk/guidance/domestic-abuse-how-to-get-help

[5] National Institute for Health and Care Excellence (2018) Clinical Knowledge Summary: Domestic violence and abuse. https://cks.nice.org.uk/domestic-violence-and-abuse

[6] Gov.uk (2018) Domestic abuse: how to get helpwww.gov.uk/guidance/domestic-abuse-how-to-get-help

[7] National Institute for Health and Care Excellence (2018) Clinical Knowledge Summary: Domestic violence and abuse. https://cks.nice.org.uk/domestic-violence-and-abuse

[8] Gov.uk (2018) Domestic abuse: how to get helpwww.gov.uk/guidance/domestic-abuse-how-to-get-help

[9] National Institute for Health and Care Excellence (2018) Clinical Knowledge Summary: Domestic violence and abuse. https://cks.nice.org.uk/domestic-violence-and-abuse

[10] Gov.uk (2018) Domestic abuse: how to get helpwww.gov.uk/guidance/domestic-abuse-how-to-get-help

[11] National Institute for Health and Care Excellence (2018) Clinical Knowledge Summary: Domestic violence and abuse. https://cks.nice.org.uk/domestic-violence-and-abuse

[12] Gov.uk (2018) Domestic abuse: how to get helpwww.gov.uk/guidance/domestic-abuse-how-to-get-help

[13] National Institute for Health and Care Excellence (2018) Clinical Knowledge Summary: Domestic violence and abuse. https://cks.nice.org.uk/domestic-violence-and-abuse

[14] National Institute for Health and Care Excellence (2018) Clinical Knowledge Summary: Domestic violence and abuse. https://cks.nice.org.uk/domestic-violence-and-abuse

[15] Women’s Aid (accessed 2020) What is coercive control? www.womensaid.org.uk/information-support/what-is-domestic-abuse/coercive-control/

[16] Howard LM et al (2013) Domestic Violence and Perinatal Mental Disorders: A Systematic Review and Meta-Analysis. PLOS Medicine 10(5): e1001452.

[17] National Institute for Health and Care Excellence (2010) Pregnancy and complex social factors: a model for service provision for pregnant women with complex social factors. Clinical guideline [CG110]

[18] Jahanfar  S, Howard  LM, Medley  N. (2014) Interventions for preventing or reducing domestic violence against pregnant women. Cochrane Database of Systematic Reviews 11: CD009414.

[19] National Institute for Health and Care Excellence (2010) Pregnancy and complex social factors: a model for service provision for pregnant women with complex social factors. Clinical guideline [CG110]

[20] National Institute for Health and Care Excellence (2018) Clinical Knowledge Summary: Domestic violence and abuse. https://cks.nice.org.uk/domestic-violence-and-abuse

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    Last reviewed on July 24th, 2020. Next review date July 24th, 2023.

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