How to grow your village and look after your mental health during pregnancy, birth and postpartum.

This year’s theme for Mental Health Awareness Week, which runs from 23 to 29 September 2024, is: “Community is… what we create together”.

Here at Helensville Birthing Centre, and at our drop-in clinic, Te Hā Tama Ariki, we’re big on creating spaces for community and for nurturing your mental wellbeing. We’re here to support you from pregnancy to birth and postpartum.

Why is this so important to us?

The World Health Organisation (WHO) estimates roughly 10% of pregnant and 13% of postpartum māmā experience mental distress, most commonly depression.

In New Zealand, our Ministry of Health estimate a higher 12-18% of māmā will develop depression, anxiety or another form of mental distress post birth. While not commonly talked about, postnatal depression also affects 10% of fathers and is more common among those who have been depressed before, or whose partners are suffering from it.

Sadly, these numbers are even higher for Māori, and Pacific and Asian peoples.

Who’s at higher risk of being affected by mental distress?

You’re at higher risk of being in the 12-18% of women who struggle with their mental health during pregnancy and postpartum if you have:

• a history of mental distress/illness

• had recent stressful life events, like moving cities or grieving a loved one

• have a lack of social support, and people to chat to about your situation
• if you’re having a difficult pregnancy or you had a traumatic birth experience.

Look out for these signs:

It’s normal to have mood changes during pregnancy, like feeling irritable and exhausted. If you’re sad and tearful most of the time, getting easily angered, or losing interest in the world around you and the people you love, these can be signs of antenatal depression.

Feeling down in the 3-5 days after childbirth is expected and known as the “baby blues”. It’s caused by a rush of hormones along with the expected overwhelm and tiredness after birth. However, if these sad feelings persist for more than the first week, it may be a sign of postnatal depression.

Here’s the signs to watch out for:

• low mood

• change in appetite, eating much more or much less than you used to

• loss of joy, or an absence of pleasure in your daily life

• feelings of worthlessness

• inability to concentrate

• not feeling interested in your baby or other members of your whānau

• intrusive thoughts about harming yourself or your pēpi

Keep in mind that it’s completely normal (and expected!) to feel some of these things, some of the time. After all, you’re going through a big life change bringing your pēpi into the world, and you’re likely sleep deprived.

But if you start seeing these signs consistently – or if they’re worsening – please seek professional help.

Your midwife will check in on you during the first six weeks and after that your GP will look after you. You may lose insight into how well you’re coping – especially with serious mental distress like bipolar and postpartum psychosis – and you might downplay the severity of your personal experiences or symptoms. That’s why medical professionals and your midwife are trained to use a variety of screening tools and know what to look out for.

You can also find some helpful resources on the Perinatal Anxiety & Depression Aotearoa’s website.

How you can take small, positive steps for your mental health.   

Try taking moments for yourself by reflecting on your current thoughts and feelings in a journal, talking about your struggles and wins with a loved one, or enjoying a few minutes of fresh air and gentle exercise around the block.

The book, Dear Mummy, You’re Important Too by Tui Fleming has some great guided journal prompts which you can work through gently at your own pace.

If books or journals are not your thing, there are lots of apps which allow you to track your moods and thoughts. You can see if you notice any patterns or if your difficult days are one-offs.

Hobbies like crocheting, drawing, writing, and painting can be wonderful for the small snippets of time you have to yourself and will leave you more relaxed than a few minutes of social media would.

Ask friends and family for book recommendations, local walks or mother and baby groups. Check them out and see what suits you. You’re not obligated to go back but trying them out when you’re feeling strong means it’s easier to go back if you’re feeling low.

A few ways to prepare before giving birth: 

• Stress has a huge influence on mental health, so being prepared for your birth (as best you can be) is a way to decrease your chances of distress. We’ve created a checklist of items to have prepared for labour, so you’ve got peace of mind that you’re packed and ready to go when you need to be.

• Chat with your support network on the symptoms to look out for. Both you and your partner need to have others you can lean on, so encourage them to talk to their friends, too.

• While you’re chatting with your support network, let them know you may ask for extra help over the coming months. Giving them a heads up on what you might need makes it easier for them to jump into action. Things like dropping off pre-made meals, helping with childcare for your other tamariki, or regular mental health check-ins help lighten your load and leave you more time and capacity to recover.

• Join our free pregnancy and parenting classes to be more prepared for the early days with your baby. You’ll also meet other local expectant parents, which is great for growing your village with others on the same journey. Having people going through the same life stage helps you to feel less alone and gives you an extended community of people to reach out to if times get rough.

Feel awkward about asking for help? Here’s a couple of things you could consider:

If you’re planning a baby shower, perhaps your friends could print off a calendar of the three months after your due date, so your guests can write their name next to a date (or dates) of when they can cook for your whānau.

We know someone who did this, and her family didn’t have to think about meals for a whole 90 days! People also love knowing they’re helping you in a very practical way.

Have a list of household chores on the fridge. When someone comes round to visit you and baby, and they ask you how they can help, simply point to the fridge and they can choose a job.

Other ways you can prepare and ask for help post birth: 

• Keep a copy of the signs and symptoms nearby and remember it’s normal to feel some of these things some of the time.

At the same time, know what constitutes a medical emergency – especially if you’re worried you might hurt yourself or your baby.

• Have a list of contact details on your fridge or somewhere else within easy reach. The Mental Health Foundation has a list of contact details on their website.

• Talk to your nurse, midwife or doctor straightaway if you start to feel low for more than a week. They will talk to you about treatment, including medication, and share resources in your area to help.

• Keep in regular contact with your support network. It can help to make a Facebook or WhatsApp group chat before birth, so you can send updates and ask for help through this channel. It also means your friends and family can coordinate their visits and help, so you don’t end up getting 5 casseroles and surprise visits all in one morning.
• It’s okay to ask for help with even the smaller tasks around the house. It can ease your mental load by accepting help with cooking, tidying or running errands.
• Remember you can cancel or reschedule visitors anytime. You have a very valid – and cute – excuse to not host.

• It might feel like you’re the only one who’s ever had these low thoughts or feelings. But lots of people around you have been where you are and can help you feel less alone in the process. Talking to others about their experiences can lift some of the isolation, and in turn, lift your mood.

How Helensville Birthing Centre supports you and your pēpi during birth and your postnatal stay.

Your partner can stay with you for your entire postnatal stay. Along with our excellent staff to parent ratios you’ll have the support you need during this time.

Our experienced postnatal nurses, midwives and lactation consultants are available around the clock to help and answer your questions.

Your LMC will visit you within the first day of heading home, so you can feel comfortable settling in and ask any questions to feel more relaxed. They’ll continue to visit you for 4-6 weeks after your baby is born, and you can speak to them about your mental health during this time too.

Other ways we can help (and grow your community)

• Join our Facebook page for support and advice from other mothers who have been through a similar journey to you.

• Connect with our Helensville Birthing Centre peer supporters, volunteers trained by lactation consultants who are also māmā. They provide support and guidance on breastfeeding.

• Our midwifery-led drop-in clinic runs on Mondays, Wednesdays and Fridays from 9am-3pm. No need to book, simply drop by for a friendly chat and cuppa, along with midwifery and breastfeeding support.

• Parent Aid North – This is a free at-home service for first time māmā if you need  extra support while looking after your newborn and recovering from childbirth.

Remember; to keep you and your pēpi safe during pregnancy and beyond:

• Prepare what you need for your birth
• Keep an eye on the symptoms of you and your partner
• Stay in touch with your friends and family
• Don’t be afraid to ask for help when you need it

All of us at Helensville Birthing Centre are here to support you. If you have any questions about what to expect from any of our services, please do get in touch. We love to hear from you!