Understanding postpartum mood disorders and How to prepare for the days, weeks and months after Bub has arrived.

The day has arrived when your new bundle of joy has made it from the warmth of your womb to the startling busy outside world and into your arms.
First of all, well done!
Know matter how your baby was born you’ve just accomplished an incredible achievement!

You deserve MORE than a pat on the back, in fact you deserve a TOOL kit, full of hints, tips and tricks plus loads of positive affirmations to help you through the difficult times ahead.

After the third stage of labour, when your placenta is birthed, your hormones change dramatically, this mixed with exhaustion from pregnancy, labour and birth, not to mention trying to find your feet as a new parent, can all attribute to postnatal difficulties. Some of these are common and some not so much, some are dealt with easily and without the need for intervention and some can have devastating effects if not taken note of and acted on. So what are these difficulties?  The proper term would be postpartum mood disorders these include:

• baby blues
• obsessive compulsive disorder

• panic disorder
• psychosis and
• depression

(1)

Let’s start with baby blues or (BB). BB is normal, once the placenta is birthed hormones change dramatically and it is speculated that this is the reason behind baby blues; which consists of moodiness, being weepy and feeling lost. Baby blues tends to set in around day 3 and can last up to 10 days, on average. Baby blues does not require treatment. Don’t be afraid if you have these symptoms, 80% of new mums experience this and overcome it within 2 weeks of giving birth. It may help to think of this time as your adjustment period, life is different now and that’s ok, you may be mourning your old life and that is normal, heck it is necessary.(1) (2)

Postpartum psychosis is more serious. Common symptoms of pp psychosis include hyperactivity, insomnia, paranoia and suspicion, manic mood swings and irritability.  Women who experience pp psychosis tend to have a history of bipolar disorder. The serious concern for mothers suffering from pp psychosis is when mothers hallucinate and experience verbal hallucinations where they hear ‘something’ telling them to harm themselves or their baby, this is when action must be taken. Only a small percentage of women are affected by pp psychosis but it's still important to be aware of the warning signs and to reach out for help if you are the Mother or you know a Mum going through this. There is no shame in seeking help. It’s important to remember that pp psychosis is temporary and that treatment is available in the form of medication and counselling. (1)(3)

Postpartum obsessive compulsion is when you do things unnecessarily again and again, for example every nappy change you change your child’s clothes even if they aren’t soiled. Or you constantly rearrange the baby’s room or empty the draws and re fold the clothes again and again. The most concerning obsession is visualising harming your child, the difference between pp obsessive compulsion and pp psychosis is the Mother is aware that her thoughts aren’t normal.
Some other obsessions may include:

• Fear of accidentally harming by the baby by dropping them from a height or giving them a disease and
• Unwanted thoughts or impulses about harming the baby such as shaking them, drowning them, yelling at them or stabbing them.

Some compulsions may appear as:

• Repeatedly checking on the baby to ensure they are well,  
• Repeatedly reviewing daily tasks to ensure that one has not harmed the baby and
• Avoidance of child for fear of harming them

Postpartum obsessive compulsion can be treated with medication and counselling. (1)(4)

Postpartum panic disorders affect 10% of mothers. Symptoms include panic attacks and extreme anxiety, shortness of breath, chest pain and heart palpitations. Seeking help in the form of counselling or cognitive behavioural therapy can help greatly and in some cases medications can too.(1)

Postpartum depression(ppd) affects up to 20% of postpartum women, and can also affect partners!  The onset of ppd is anytime within the first year of giving birth. PPD is constant feelings of anxiety, guilt, shame, unhappiness, sadness, weepiness, mood swings, loss of appetite and insomnia. Some women also become suicidal. Treatment comes as therapy and or medication. Women who are at more risk of experiencing ppd are those in unstable relationships, have had previous forms of depression and are lacking in support. (1)(5)(6)(7)(8)


This article has covered the basics of postpartum mood disorders. It is always good to be informed about things you may encounter on your journey into parenthood, so that you may be prepared if the time comes when you find yourself, partner or loved one struggling. The best way to try and prevent experiencing any of the above postpartum mood disorders is by looking after yourself, asking for help and setting up a good support network and even a mental health plan, just in case. A mental health plan can be as simple as, “if I start to feel like this (x,y,z) I will try one or all of the following (x,y,z) things to help me get back on track, these things can range from going for a walk, ignoring the house work for a day or two, asking for help, booking in to see a counsellor just for a chat, organising a play date or catch up, etc. the list is endless, all that matters is that you have a list of things you enjoy doing and a list of contacts in case you need help. First point of call is usually is your GP, they can refer you on, or else the Internet is a wealth of knowledge with many contacts for local help. Please also see the “other resources tab" on this website for helpful contacts AND check the blog to see a long list of ideas for how to look after and give back to yourself to ensure you cup s full.
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References:

1. http://psychotherapy.com/mom.html
2. https://www.fitpregnancy.com/parenting/postnatal-health/difference-between-baby-blues-and-postpartum-depression
3. https://healthyfamilies.beyondblue.org.au/pregnancy-and-new-parents/maternal-mental-health-and-wellbeing/postnatal-psychosis
4. http://www.ocdclinicbrisbane.com.au/post-partum-ocd/
5. https://cmha.ca/documents/postpartum-depression/#.VCuCGfmwLa5
6. https://web.archive.org/web/20120608115600/http://www.health.harvard.edu/newsletters/
7. Harvard_Mental_Health_Letter/2011/September/beyond-the-baby-blues
8. https://www.panda.org.au/news-media/perinatal-depression-and-anxiety-in-men-when-and-how-to-seek-help

Firstly what is a self love kit and why do I neeeed it?
A SLK as we'll call it is simply a box or bag filled with some of your favourite treats that you can use whenever you are in need of some self love and positive reminders.

What you'll need:
A pretty box {or even a bag would work}, I recommend going to the dollar store and buying a gift box to keep the cost low or you can buy any box you fancy!
*You can even buy a box and decorate it however you like to truly make it your own you can use anything eg: paint/stickers/jewels/glue..
GLITTER (who doesn't like glitter!)

What goes in the box?
Check the video below to see what's in my Self Love Kit!




Here are some other ideas of what to keep in your kit:

• Movie Gift Card
• Favourite photos
• A love letter to yourself
• Ticket stubs/wristband from a favourite concert or festival
• Your bucketlist!! to tick off regularly
• A list of things that you enjoying doing *for quick reference
• A face or hair mask
• Photos
• Tea bags
• Eye pillow
• Shawl
• New undies or socks
• Chocolate

Creating your kit should be fun and it may even be a little emotional. Giving back to yourself can be a hard thing to learn to do, just remember you are truly worth it and you can't pour from an empty cup.

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​I will upload the list of self care activities so you can print it to help you if you're stumped for ideas.
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Here are some things to consider and that may help you navigate your way through the early days with a new baby and beyond.

Support Team:
Who can you turn to if you need?
People who respect your wishes, listen, and help.
A Doula, midwife, partner, friends, family, Dr, Australian breastfeeding association, lactation consultant, etc?

Nourishing Foods:
Warm and hearty whole foods. Who can prepare and deliver some meals for you in the first few weeks postpartum? If you don't have someone to do this maybe you could set up a regular delivery or stock up on freezer meals. Another option is contacting your local meals on wheels and seeing if they support local mums too.

Your Nest:
Do you want to be undisturbed and do you have a message you can place on your door, on your social media or that you can send via text,(eg, to call ahead instead of popping in, to not expect 5 star service etc)? Or will you have someone stay with you for a few days or weeks to keep you company and help you out? Do you need to get out of the house? Can you organise some gentle catch ups? A walk, a coffee, a meal or movie.

Self care:
You've just had a baby and that baby is relying on you to sustain it's precious life, just typing that is exhausting.. You are deserving of down time. It's excruciatingly hard to do everything and not have a break, tell mum guilt to gtfo, you're worth it mumma. Ideas.. Massage, Yoni steaming, closing the bones ceremony, meditation, placenta encapsulation, placenta burial, a bath by yourself- undisturbed, a regular catch up can give you something to look forward to each week, having someone take bus for a walk around the block.

New routine:
Now you're a parent, it can be hard finding your feet, let's face it, you're still you, just.. different, kind of new, with a fresh little sidekick or two! (or 3/4/5/6+!)
It can be hard to find your feet, especially if you are the first in your friendship group to have a babe, or if you don't have much support.

Here are some ideas you can do with your new babe to help you get out of the house and meet other parents.

Playgroup, mothers group, library activities (playtime,story time, rhyme time) mums and bubs yoga, coffee dates, social exercise, play dates, volunteering.

Partnership:
It's also a really good idea to organise date nights too or even a dinner with a friend regularly, in the early days this may be difficult to arrange a more manageable idea could be setting 10 minutes out of your day, every day to check in with your partner and take 5 minutes each to talk about your days without interrupting each other. then have a response round.

Practical side:
Breast pads for leaking boobies, comfy clothes, adult nappies or post partum pads[nappies are just way easier and comfier and more leak proof~ there is the option of reusable cloth maternity pads also]your going to bleed a lot and for quite a few weeks.
Have you got the cupboard stocked with snacks? [and by cupboard I mean the bedside table) what about a good sized water bottle? breastfeeding and healing is thirsty work.
​Some of the best advice is to sleep when your baby sleep, including during the day and especially in the first few weeks and even months, don't try to continue your old ways of being, you simply won't be able to keep up and you will burn out.

Premature or sick babies
Sometimes not everything goes to plan, its important to be aware of this. Why? because if you have a baby in intensive care or special care it can be a hell of a shock even if you were expecting it.
First things first get rid of the guilt that somehow this is your fault, that's got to go because your baby needs you and you need them. Whats happened has happened and all that can be done now is to work through it.
If you are going to breastfeed its important to express regularly- every 2 hours to get your supply going and to maintain it so that you can store milk and also so that you are prepared for when your baby does come home.
Many women have been left in the dark about pumping frequency and struggle to establish breastfeeding when the time comes because of not producing enough milk. IMPORTANT the more you take the more you make. The production of breast milk is completely a supply and demand relationship.

Personally, I found the medela hospital pumps to be the best and you can hire such pumps from different chemists and through the Australian breastfeeding association.
*In the RBWH intensive care and special care unit there is a designated pumping room, they also have a shower and a tea room where you can prepare food for parents who will be spending lengthy periods at the hospital visiting their babies.

​There is support in the hospital, so if you find yourself struggling you can reach out to the social workers and ask for help.

Respect:
Sadly yet not surprisingly in every work place you may find a handful of people who are there because of a wage instead of passion.
​If you find yourself in a position where you don't believe you are being taken seriously or that your wishes aren't being heard please speak up. You are entitled to request a new nurse, doctor or midwife. Remember this is your health and your babies health, don't disregard your maternal or paternal instincts.