29 Apr Social Isolation, the Perinatal Period and Postnatal Depression.
Postnatal depression, or PND, refers to depressed mood, or major depression, during first year after birth. However, symptoms usually appear between 6-weeks and 6-months after birth. PND can persist for years if untreated and may be difficult for people to disentangle from “normal” adjustment difficulties.
All women are vulnerable to PND, but some more than others. Research suggests there are multiple factors that underly depression, each varying from woman to women. These include physiological causes, fatigue/sleep disturbance, pain, reproductive hormones, birth trauma and childbirth related PTSD, infant characteristics, psychological factors, and social factors (Kendall-Tackett, 2015).
Not all new mothers will be exposed to these factors, however, the current climate of social isolation and COVID-19 risk places new parents under extra stress, and vulnerable to social risk factors- factors which are further emphasised in isolation. This includes facing stressful life events during the perinatal period (e.g., living through a pandemic, not experiencing the birth you had planned), not being able to show off your new baby, missing the nurturing of friends and family, as well as facing new relationship and/or additional financial stressors (Milgrom et al., 2008; Schmied et al. 2013). All of these situations can contribute to a difficult adjustment for new mums (i.e., making us feel displaced or vulnerable).
It is normal to be grieving for the experience of parenthood that we imagined.
Am I depressed or just exhausted? Distinguishing between enervation (drained of energy) and PND
- Sleep disturbance
- Loss of concentration
- Feeling you can’t cope
- Inability to sleep even when baby is sleeping
- Loss of pleasure
- Morbid/ suicidal thoughts
- Low self-esteem
- Loss of interest in eating (EPDS, Cox et al., 1989)
How can we help counter social risk factors whilst in isolation?
Nurture each other and your relationship.
Take this time to build on curating the bond of your new family and getting to know one-another. Nurture your new family as a whole with nice words, kind actions, individual self-care (e.g., bubble baths), and skin-to-skin with baby for both parents
New-borns really love skin-to-skin (i.e. Kangaroo Care).
Try this out when in the shower together or feeding- whenever possible- as we know skin-to-skin assists with low mood by lowering physiological stress, assisting the release of oxytocin (the love hormone) enhancing feelings of attachment, and improving milk production
Embrace and receive social support in unorthodox ways to assist with lack of expected social support.
Reframe the thought as ‘physical isolation’ rather than social. This may include getting family and friends to nurture and support you by allowing them to drop off food and ready-made meals. You may also decide to show off your new bundle through FaceTime, Skype, and Zoom (or similar apps)
Eat healthy nourishing food.
Let people bring you things if this is on offer. If asked how family and friends can help, this could be their way of assisting you when cuddles aren’t available,
Exercise every day.
The benefit of exercise for low mood has been shown in population studies and randomised control trials. If you are worried about contact with other people, try using a baby carrier, taking back streets and walking during unpopulated times. Some research also suggests efficacy of vitamin D and light improving mood…
Sleep when baby sleeps.
Research is rife regarding the correlation between sleep and low mood- housework can and will wait until later, and
Try to let go of the small stuff.
Your role during this time is not to be a domestic goddess (despite being at home 24/7). Prioritise what really needs to be clean, such as the kitchen and bathroom. If you have a partner, share the load.
It’s hard enough being a new mum, particularly without the usual support of friends and family that you may have expected to have.
On the plus side, you may have your partner working from home allowing more special time as a new family, without the interruption of revolving visitors. This gives you time to curate bonds as a new family. Further, you can use this uninterrupted time to build a secure attachment with your baby, something that is essential for baby’s development.
Sometimes it is all about perspective and reframing.
Feeling like you’re can’t cope- put baby in the pram and go for a walk- pyjamas allowed. Call a supportive friend or family member. Reach out to your GP, midwife and family health nurse. Call the PANDA hotline.
You may be saying “I’m not depressed”, “It’s the baby, If I could just get some sleep”. “I don’t hate my baby”. This may be true. It’s also okay, not to be okay and reaching out is not failure. Rather, reaching out is bravery and a sign of strength. Although in isolation, people are still available to listen and assist you. Talk to someone. Make an appointment with your GP. Ask for a referral.
Need someone to talk to in the meantime? Call or visit the following sites:
- Karitane | 1300 227 464
- Tresillian | 1300 272 736
- Perinatal Anxiety and Depression Australia | 1300 726 306
- Pregnancy Births & Baby | 1800 882 436
- Parent Line NSW | 1300 1300 52
- Australian Breastfeeding Association | 1800 686 268
For emergency assistance:
- Triple Zero | (000) | or go to your local hospital emergency department.
- Lifeline | 13 11 14 | They also offer online chat and a text messaging service
- Suicide callback service | 1300 659 467 | They also offer online chat and video chat
By reaching out and putting your own oxygen mask on first, you are in a much better position to care for the needs of yourself and your baby.