Mental health and wellbeing for hāpu wāhine and new mothers

Pregnancy brings a mix of feelings, and not all of them are good. If you’re feeling worried, you’re not alone. Worry is common, especially during a woman’s first pregnancy or an unplanned one. It can be even harder if you’re dealing with depression or anxiety.

Mental health can be greatly affected by the various stages of pregnancy, but the good news is that there are plenty of people who can help.

For your health and your baby’s, take care of yourself as much as you can. Be sure to eat well, exercise and get enough sleep.

Key points about perinatal depression or anxiety:

1. Perinatal means anything to do with pregnancy, birth and the first years of a baby’s life.
2. Perinatal depression or anxiety can happen any time during pregnancy or up to a year after pēpi (baby) is born. It can also occur after a miscarriage.
3. About 10% of fathers may also develop perinatal depression and or anxiety.
4. If you are experiencing signs of perinatal depression or anxiety, seek help as early as possible. The earlier treatment is started, the sooner you will start to feel better.
5. Perinatal depression or anxiety is usually treated with a combination of practical support and advice, talk therapy and support groups. If necessary, antidepressants may be helpful.

Sometimes emotions turn into something more serious and start to have a negative effect on everyday living and relationships with partners and families. Approximately one in ten women will experience this type of anxiety and/or depression during pregnancy. Depression can be described as feeling sad or down, while anxiety is often described as worrying about things that might happen.

Some women may have had these feelings before the pregnancy but others may be experiencing them for the first time.

“I don’t think I’m depressed or anxious, but I’m struggling – what can I do?”

It’s important to treat mental health concerns during pregnancy. Mothers who are depressed, anxious, or have another issue might not get the medical care they need. They might not take care of themselves, or they may use drugs and alcohol during the pregnancy.

If you have a mental health issue, talk with your caregiver(s) so you can get the help you need during and after your pregnancy.

Whatever the situation, it is important to talk to someone you trust if you are feeling sad, scared, low, anxious or worried. Let your midwife know how you are feeling and she will listen to your concerns, answer your questions and refer you for further support if necessary.

Postnatal or maternity ‘blues’ are very common and involve a brief period of the mother feeling down and tearful in the week after her baby is born. This feeling passes after a few days.

If there is an immediate, life-threatening danger to yourself or others, dial 111.

Self-care: “How can I look after myself if I have perinatal depression or anxiety?”

• Track your mood. You may find there are times of the day when you feel better and can get more done. Likewise, you may find triggers or activities you find more draining. Discuss these findings with your doctor or health providers.
• Keep active. Physical activity is very helpful for everyone and an excellent way to help manage anxiety and low mood, reduce stress hormones etc. 
• Establish good sleep routines. While interrupted sleep is normal once you have a baby, there are things you can do to foster good sleep routines. Try to develop a good bedtime routine which gives you time to unwind before bed and keeps bedtime and wake times relatively regular.
• Structured problem-solving. Some people are naturally good problem solvers. Most of us are not when we are tired, stressed or depressed. This is an evidence-based approach and easy to learn. View our structured problem-solving factsheet for 6 easy steps. 
• Plan activities. Plan some specific ‘you time’ activities a week ahead. Having something to look forward to, someone to catch up with, or some relaxation time while someone cares for baby are all great activities to improve balance and wellbeing. Planning ahead and writing it down also helps with getting the day to day activities done. Set yourself small goals each day you can achieve and feel good about. 
• Develop a good support system. This is so important. Reach out to friends and family, accept their offers of help and build your support network. Join a local mothers’ group, playgroup or coffee group. Ask your Plunket Nurse or contact Parent’s Centre for groups near you, or join Mothers Helpers private Facebook group – NZ PND Support and Social Group. Spend time with people who make you feel good and are emotionally supportive. 
• WRAP: Wellness recovery action plan. This is another proven strategy anyone can set up and benefit from. Write a list of things that help you when you’re having a bad day or feeling down eg, ring a friend, take the baby for a walk, play some music, dance, do something creative, put some nice clothes on and do your hair, journaling, join a class and learn something new.
• Find ways to give and help others. There is always someone worse off and better off than yourself. Look for little ways to help brighten someone else’s day and in doing so it often brightens yours.

Support groups and a range of other services are available throughout the country. A useful resource is the Perinatal Anxiety and Depression Aotearoa (PADA) website. It has information for pregnant women, new mothers, new fathers and families affected by depression or anxiety around pregnancy and a new baby. It also has a comprehensive list of support helplines and services.

Below you’ll find a range of mental health service providers you can reach out to for support and advice.