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
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.
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.
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 your 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 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.
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.
- 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 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.
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.
More information and support
Family nurse Partnership
Home visiting programme for first-time young mums and families.
NHS stop smoking services in:
Symptoms and management of ADHD or autism (ASD) when planning a pregnancy
Healthy food and regular activity can improve mental wellbeing as well as being very important for the development of a future baby.
Having a baby is a positive and exciting experience for many women. But if you have had a traumatic experience in the past, you may find some of the difficult feelings come back when you’re planning a pregnancy or become pregnant.
When you have a serious mental illness the earlier you start planning your pregnancy the better
There is a higher chance that your mental illness will come back or get worse at this time than at other times of your life.
When you are managing a serious mental illness there’s lots of support to help you through pregnancy and beyond. Find out about the people and teams that help you here.
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.
The 5 most important things you could do before you get pregnant if you are managing a serious mental illness and are planning a pregnancy
Information for you about different types of treatment for mental health illness if you have a serious mental illness and are planning to become pregnant.
Information about when to try for a baby and fertility when you have a serious mental illness
If you have bipolar disorder and want to get pregnant it’s important to talk to your doctor before you start trying.
If you take drugs regularly it can be really tough to stop, but now that you are planning a pregnancy you have a big chance to stop safely.
It’s safest to not drink at all while you’re planning a pregnancy but if you’re finding this hard, there’s lots of help available.
Information about giving up smoking while on mental health medication
Other organisations and resources who can give support if you are planning a pregnancy with a serious mental illness
It’s hard to describe childbirth. Labour is different for everyone and your experience and feelings about the birth can depend on what you expect compared to what happens.
Life becomes busier and more chaotic when there is a baby involved. Returning to work is a challenge for most new parents, but it can be harder if you have a mental illness. Being prepared and having support can help.
- Green L, Miele M, Protti O (2015) Perinatal mental health care pathways. Pan London Perinatal Mental Health Network www.londonscn.nhs.uk/wp-content/uploads/2015/10/mh-care-pathway-231015.pdf
- NHS England, NHS Improvement, National Collaborating Centre for Mental Health (2018) The Perinatal Mental Health Care Pathways. www.england.nhs.uk/wp-content/uploads/2018/05/perinatal-mental-health-care-pathway.pdf
- Pan-London Perinatal Mental Health Networks (2019) Pre-birth planning: Best Practice Toolkit for Perinatal Mental Health Services. www.healthylondon.org/wp-content/uploads/2019/01/Pre-birth-planning-guidance-for-Perinatal-Mental-Health-Networks.pdf
- Royal College of Psychiatrists (accessed April 2020) What are Perinatal Mental Health Services? https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/what-are-perinatal-mental-health-services?searchTerms=perinatal%20mental%20health%20team
- Scatliffe N et al (2019) Oxytocin and early parent-infant interactions: A systematic review. Int J Nurs Sci. 6(4): 445–453.
- National Institute for Health and Care Excellence (2014, updated 2020) Antenatal and postnatal mental health: clinical management and service guidance Clinical guideline [CG192].
- National Institute for Health Research (2017) Better beginnings. Improving health for pregnancy. www.uhs.nhs.uk/Media/SUHTInternet/Services/Maternity/Better-beginnings-Improving-health-for-pregnancy.pdf
- Department for Education (2018) Working Together to Safeguard Children A guide to inter-agency working to safeguard and promote the welfare of children London: HM Government https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/779401/Working_Together_to_Safeguard-Children.pdf