Pregnancy and having a baby is a special and memorable time in a parent’s life, however, it can be a difficult time too.

A variety of emotions, experiences, and expectations can get in the way of how you might feel as a parent and how you feel about your baby.

It's not unusual to develop a mental health problem around the time of having a baby. This can happen to any parent, mother, father or other primary care giver.

We want you to have the support you need, so that you can feel physically and mentally well, and can get off to the best start in your relationship with your baby.
 

Perinatal is the period of time after conception up to the baby’s first birthday.

Depression is the most commonly known perinatal mental health problem. This is often referred to as postnatal depression. Depression can also happen during pregnancy - this is known as antenatal depression.

The symptoms of depression can include:

  • Low mood, such as feeling sad, empty, or tearful
  • Reduced interest and loss of pleasure
  • Decrease or increase in appetite
  • Difficulty sleeping or sleeping more than normal
  • Restlessness or slowed behaviour
  • Tiredness
  • Feelings of worthlessness, excessive guilt, or blame
  • Trouble making decisions or concentrating

Sometimes parents with depression may experience symptoms such as thoughts of harming themselves or the baby.

If you have such thoughts, it is important to seek professional help - speak to your GP, health visitor, or midwife. If you feel you or your baby are at risk from such thoughts, it is important to go to A&E. Support is available to help you keep yourself and your baby safe.

Other common mental health problems that can occur during pregnancy or when the baby arrives include: anxiety, panic, phobias, obsessive compulsive difficulties or trauma – perhaps from the birth itself.

Some expectant parents experience overwhelming fears about the birth. For some parents this can make it very difficult to participate in antenatal care and birth plans. If this is something you're experiencing, it's important to inform your midwife or GP. There's specialist help and understanding available to support you.

Postpartum psychosis can develop very suddenly after giving birth or for some women it can develop over the early days of parenthood.

Signs of postpartum psychosis may include:

  • Hallucinations
  • Being paranoid and suspicious
  • Feeling unable to settle or sleep even when baby is asleep
  • Feeling very low or very high in mood
  • Being agitated
  • Being confused
  • Having delusions (thoughts or beliefs that are unlikely to be true)
  • Acting out of character 

If you or someone you know has these symptoms, it's important to get urgent medical support through your local A&E department. Advice can also be sought by phoning the Greater Manchester specialist perinatal team at 0161 271 0188 (Mon–Fri 9am to 5pm). Outside of these hours, specialist advice can be sought from the mother and baby unit at Wythenshawe Hospital at 0161 271 0482.

Postpartum psychosis is treatable and specialist support is available.

Perinatal mental health problems can leave some parents feeling distant from their baby, and other parents feeling protective and anxious when apart from their baby.

Mental health problems affect everyone differently. Some parents may have trouble adjusting to the new routine and tasks involved in caring for a baby. They may worry a lot about the baby’s wellbeing and may not feel confident as a parent. Some parents also struggle to cope with troublesome thoughts and difficult feelings.

Perinatal mental health problems can lead to changes in thinking which may include thoughts such as, “My baby doesn’t like me, I’m a bad parent, I’m not good enough”. For some parents this can lead to frightening thoughts about harming themselves or the baby. It's important to seek immediate help if you experience such thoughts.

Having problems with your wellbeing during the perinatal period does not mean that you don’t want or love your baby. It's important to remember that mental health issues are treatable and help is available so that these distressing thoughts and feelings can pass.

If you feel you or your baby is at risk go to your closest A&E department and seek help immediately. There are trained professionals based in A&E who can help you think about what support you and your family need.

There are many factors which can lead to mental health problems occuring around the time of having a baby.

Having a baby can place great demands upon you and your body from the normal process of pregnancy, exhaustion from sleep deprivation, hormonal changes and possible complicated experiences of pregnancy and delivery. Commonly experienced emotional demands around this time can also place you at increased vulnerability in your mental health.

You may have imagined what it would like to grow your family and the reality may feel very different.

You may have an absence of feelings all together. Your feelings about yourself, your partner, your own parents and your baby may be mixed. You may not instantly love your baby or, you may feel that you aren’t in tune with your baby.

This can cause many parents to worry. Feeling like a parent and growing into parenthood can take time and attention. It does not happen automatically for some of us and that’s not our fault.

Becoming a parent involves many huge role changes and with any role change we can struggle adjusting and perhaps feel deskilled and out of our depth. We may have a longing for things to be as they used to be, and may struggle to see the new role as positive or manageable. If we do experience a struggle in accepting our new role as a parent, our wellbeing could be vulnerable.

You can be more vulnerable to developing mental health problems if you judge yourself too harshly for having mixed feelings or for struggling. This judgment and self-blame may involve negative, self-critical and other unhelpful thoughts such as worrying that other people are judging you.

It is recognised that around the time of becoming a parent it is normal for any parent to become preoccupied with a number of thoughts:

  • Can I / will I be able to care for my baby well enough?
  • Can I/ will I relate to my baby and help he/she feel loved?
  • Who can / will support me?
  • What kind of parent am I / will I be?
  • What will my baby be like?
  • Will they/ do they like me?
  • How were my parents with me as a baby? Will I be like them?
  • Who am I now?
  • What if I or my baby gets unwell?
  • How can I keep my baby safe from harm?

These worries are normal and commonly experienced by parents but we are more vulnerable to developing mental health problems, if these worries persist and do not go away.

Becoming a parent is a major stress and if we feel isolated without adequate support, we may feel naturally overwhelmed which can also put us at risk.

A complicated journey to parenthood, due to the process of assisted conception or adoption, may bring greater risk of emotional difficulties.

Our own experience of being parented, especially early on in life can have a significant impact upon how we think about our experience of becoming a parent. If we experienced a difficult relationship with our own parents, we may find that the arrival of our child stirs up thoughts and feelings which we perhaps buried away.

If we have lost a parent we may also experience the re-surfacing of grief and loss. We may find that such experiences affect our feelings and thoughts about ourselves and our baby. This can make us feel more vulnerable.

Experiencing the loss of a baby can leave parents needing extra help to support their mental health.

A lot of research has been done into how to treat perinatal mental health problems. This research has been used by NICE (National Institute of Clinical Excellence) to develop best treatment guidelines. NICE recommend that parents experiencing perinatal mental health problems are offered psychological therapy along with increased social support.

Consideration of medication is also recommended. Your doctor can think with you about how to do this safely. Specialist advice around taking medication during pregnancy and breastfeeding is available from the perinatal mental health team.

Decisions about medication are made on an individual basis by your GP, obstetrician, and sometimes a psychiatrist.

Remove self-blame

Perinatal mental health problems are diagnosable conditions and having a mental health condition is not your fault. So try to avoid blaming yourself. Self-blaming thoughts are common but will make your mood lower. People sometimes say that it can be hard to accept mental health problems as an illness that deserves support, as there are no visible symptoms. If the symptoms are not treated they can be very disabling and escalate. Remember it’s not your fault and you deserve support. 

Be flexible

Doing everyday tasks can feel like climbing a mountain when you are struggling with your mental health. Depression and anxiety can take away energy, motivation, concentration, interest, and confidence. Simply managing unpleasant symptoms can take a lot of energy. It's important to change your expectations and let go of what you don’t need to do. 

Conserve your energy for the important needs of yourself and your baby and be flexible about what you think “should” be done.

Think about particular activities which you are finding more difficult and seek support. For example, if you find it hard to get going in the morning, consider asking someone to help take your older child to school. Another example is, if you notice you are more irritable around bath time, ask your partner to take over – give yourself a break.

Become an expert in your condition

Learning from other people who have been through something similar can be really helpful. For further information you can check out the following websites:

Advice videos

Our team created these 'your baby and you' advice videos to cover a range of topics:

Be active in your recovery and involve others

Recovery is a journey which begins when we commit to doing whatever we can to heal. It requires your active participation. 

Mental health problems like depression can leave you feeling passive and helpless. You may withdraw from daily activities and other people making your world smaller. This limits opportunities for experiencing pleasant emotions and focusing your mind on pleasant thoughts. This can become a vicious cycle that maintains our mental health problems.

  • Try to gradually re-involve yourself in activities which provide positive emotions and encourage pleasant thoughts, such as physical activity, self care, better diet, meeting friends etc.
  • Think about what you used to enjoy and what may bring you pleasure.
  • Involve someone else in this goal to encourage you to share the enjoyment.
  • Talk to other people about how you are feeling. This will help them understand how to support you and will help you feel less alone.

Sharing your thoughts and feelings can help you to feel more in control and more contained. Talking to others can also help us learn that we are maybe not so different and that others may have experienced similar thoughts and feelings.

Ask for help

Mental health problems like depression can affect how you are around other people and therefore may have an effect upon those close to you, including your baby. This is not your fault and does not mean that you do not care about those close to you. By becoming more aware of your symptoms, you can ask for support from people around you to help you and your family.

If you don’t feel you have support within your own circle of friends/family you can speak to a NHS professional such as your midwife or health visitor. Alternatively you can contact one of the services below:

Greater Manchester specialist perinatal team: A service designed to support women who experience complex mental health problems during and after pregnancy, and for their infant up to the age of one to two years. Please speak to a health professional to discuss a referral. Call: 0161 271 0188.

Home Start HOST parent-infant mental health peer support: Offers support in respect to parent-infant mental health to parents with a child under the age of two years and those expecting a baby via matched volunteers who have received specialist training. This service can be accessed via referral or parents can self-refer. Email: info@homestarthost.org.uk.

Dad Matters (Home Start HOST): Offers group and individual support to fathers in their relationship with their baby and their mental health. Website: https://www.dadmatters.org.uk/.

Pregnancy and early childhood resources: A helpful start to getting the support you need. Wesbite: www.gmmh.nhs.uk/pregnancy-resources

Contact your local service: If you feel that you are in a crisis situation and unable to attend to your family’s needs or unable to keep your family safe from harm, it is important to seek urgent support from social care services. They can work with you to consider what support you need to help you and your family move forward positively. Call: 01204 331500.

Find information for your borough:

Midwifery Services: If you have any concerns, please contact your community midwife or the maternity triage unit (24 hour number, seven days a week) at the hospital which you plan to give birth. Contact numbers are on the front of your pregnancy handheld notes. Our specialist mental health midwives provide support for families who may have new or existing mental health difficulties. Please contact your midwife to discuss a referral.

Health visiting service: 

Bury health visiting service is available to support your family relationships in pregnancy and early parenthood. Please contact your health visiting team (9am to 4.30pm, Mon-Fri) on:

Bury early attachment service (parent infant mental health): Bury early attachment service works with parents to support their growing relationship with their baby. If you are worried about a relationship you can call 0161 716 1137 or email on pcn-tr.buryearlyattachmentservice@nhs.net. Website: https://www.penninecare.nhs.uk/buryeas.

Talking Therapies: Talking Therapies Bury offers psychological therapy for people experiencing depression or low mood and anxiety throughout the perinatal period. 

It includes: 

  • Silvercloud, an online cognitive behavioural therapy (CBT) programme for both parents. 
  • Telephone assessment and telephone or video therapy sessions. 
  • Parent and baby psychological wellbeing group, a popular eight week cognitive behavioural therapy based therapy group for parents and babies (up to the age of 24 months).

The group is co-facilitated by health visitors and sessions include time for interaction with baby and other parents too. Bury residents or those with a GP in Bury (aged 16+) can self refer at: https://www.penninecare.nhs.uk/burytalk. Patients who are pregnant, or those who have children under the age of 12 months will be prioritised for assessment and treatment 

Greater Manchester specialist perinatal team: Supports women who experience complex mental health problems during and after pregnancy, and for their infant up to the age of one to two years. Please speak to a health professional to discuss a referral. Call: 0161 271 0188. 

Pregnancy and early childhood resources: If you feel that you are in a crisis situation and unable to attend to your family’s needs or unable to keep your family safe from harm, it's important to seek urgent support from social care services. They can work with you to consider what support you need to help you and your family move forward positively. Call: 0161 253 5678. Email: www.gmmh.nhs.uk/pregnancy-resources

Pregnancy and early childhood resources: A helpful start to getting the support you need: www.gmmh.nhs.uk/pregnancy-resources.

Midwifery Services: If you have any concerns, please contact your community midwife or the maternity triage unit (24/7) at the hospital in which you plan to give birth. Contact numbers are on the front of your pregnancy handheld notes.

Specialist mental health midwives: Provide support for families who may have new or existing mental health difficulties. Please contact your midwife to discuss a referral.

Home-Start Rochdale - www.homestartrochdale.org.uk

Heywood, Middleton and Rochdale early attachment service - www.penninecare.nhs.uk/services/hmr-early-attachment-service 

Thinking Ahead - www.thebiglifegroup.com/service/thinkingahead

Greater Manchester specialist perinatal team: A service designed to support women who experience complex mental health problems during and after pregnancy, and for their infant up to the age of one to two years. Please speak to a health professional to discuss a referral. Call: 0161 271 0188. Website: www.gmmh.nhs.uk/perinatal-community

The following site raise awareness of the role of the father in the family. They focus mainly on mental health problems that dads may experience during the perinatal period. Facebook: @DadMattersUK Twitter: @dad_matters Website: www.dadmatters.org.uk 

Finding Rainbows: For parents affected by baby loss - www.findingrainbows.co.uk

SPOONS: For parents with babies who are premature  - www.spoons.org.uk/ 

OKE: For parents with babies who have additional needs - www.ourkidseyes.org 

Twin Trust: Support for parents having twins/multiple births - www.twinstrust.org

Proud 2B Parents: An LGBT organisation supporting parents - www.proud2bparents.co.uk 

Rochdale social care: Call: 0300 303 0440 (office hours), 0300 303 8875 (out of office hours) Address: Number One Riverside, Smith Street, Rochdale, OL16 1XU 

If you feel that you are in a crisis situation and unable to attend to your family’s needs or unable to keep your family safe from harm, it is important to seek urgent support from social care services. They can work with you to consider what support you need to help you and your family move forward positively.

Maternity: For support during your pregnancy you can contact our community midwives on 0161 6525811. Our Specialist mental health midwives provide support to mothers with moderate to severe mental health difficulties during pregnancy.

Health Visiting: Oldham ‘Right Start’ service is an integrated early years’ service including health visiting, family nurse partnership, early years specialists and additional educational needs workers. The service is offered to all families with children aged zero to five years in Oldham.

familyhubs.oldham.gov.uk

Oldham early attachment service: Provides essential support to parents and carers who are having difficulty bonding or developing their relationship with their baby from age zero to two. Call: 0161 716 2085 or email:pcn-tr.oldhameas@nhs.net 

NHS Talking Therapies Oldham: NHS talking therapy services for adults with mild to moderate depression and anxiety. There is a priority service for parents who are expecting a baby or have a baby aged zero to two years. Call: 0161 716 2777 

Home-Start Oldham, Stockport and Tameside (HOST): Volunteers providing support in the home including a parent-infant mental health (PIMH) support for families with children under two. Call: 0161 344 0669 or email: info@homestarthost.org.uk 

Greater Manchester specialist perinatal team: A service designed to support women who experience complex mental health problems during and after pregnancy, and for their infant up to the age of one to two years. Please speak to a health professional to discuss a referral. Call: 0161 271 0188 option two. 

Pregnancy and early childhood resources: You may find the resources on this page a helpful start to getting the support you need: www.gmmh.nhs.uk/pregnancy-resources

If you feel that you are in a crisis situation and unable to attend to your family’s needs or unable to keep your family safe from harm, it is important to seek urgent support from social care services. They can work with you to consider what support you need to help you and your family move forward positively. Call: 0161 770 7777 or for out of hours support: 0161 770 6936. 

Stockport Infant Parent Service (IPS): We are a team of compassionate practitioners who promote the social and emotional wellbeing and development of infants through supporting early infant-caregiver relationships.

We understand that becoming a parent can be challenging and bring up difficult feelings. We are a fully inclusive service working with mums, dads, birthing people, and partners as well as any close caregivers in the infant’s life.

We offer direct work with families through individual and group sessions from conception to second birthday. We offer consultation, supervision and training to the wider workforce in Stockport (regarding infants from conception to 5th birthday). Please contact your GP, health visitor or midwife to ask for a referral to us.

Call: 0161 716 5868 or email pcn-tr.stockportinfantparentservice@nhs.net

Health visiting and school nursing service advice line: Call: 0161 835 6789 for families of children aged zero to 16. The advice line is available Monday to Friday (excluding bank holidays) from 9am to 5pm and provides support from health visitors and school nurses on all aspects of child health, development and parenting. 

Talking Therapies: NHS talking therapy services for adults with mild to moderate depression and anxiety. There is a priority service for parents who are expecting a baby or have a baby aged zero to two years. Referral through Talking Therapies single point of access 0161 716 5640 or self-referral on https://www.penninecare.nhs.uk/talkingtherapies

Home-Start Oldham, Stockport and Tameside (HOST): Volunteers providing support in the home including a parentinfant mental health (PIMH) focus in Stockport for families with children under two. Call: 0161 344 0669 or email: info@homestarthost.org.uk 

Specialist midwives for perinatal and parent infant mental health: A service which supports and coordinates care during pregnancy up to four weeks post birth - for families who may have new or existing mental health difficulties. Please contact your midwife to discuss a referral or arrange an appointment via 0161 419 5551.

Dad Matters: A Home Start project supporting dads with their relationships and mental health. Website: https://dadmatters.org.uk/ or call: 0161 344 0669 

Greater Manchester specialist perinatal team: A service designed to support women who experience complex mental health problems during and after pregnancy, and for their infant up to the age of one to two years. Please speak to a health professional to discuss a referral. Call: 0161 271 0188 option one. 

Pregnancy and early childhood resources: A start to getting the support you need - www.gmmh.nhs.uk/pregnancy-resources

If you feel that you are in a crisis situation and unable to attend to your family’s needs or unable to keep your family safe from harm, it is important to seek urgent support from social care services. They can work with you to consider what support you need to help you and your family move forward positively. Call: 0161 217 6028 option two. 

Tameside and Glossop maternity service:

Contact details for your midwife are on the front of your pregnancy notes.

Call: 0161 922 6655 and choose from the following options :-

  • Maternity triage - pregnancy related concerns. 
  • Maternity office
  • Community midwives
  • Auntenatal clinic
  • Labour ward
  • Acorn birth centre
  • Ward 27 postnatal ward

Specialist midwives for mental health offer additional support to parents with moderate to severe mental health issues during pregnancy and the first four weeks after birth.

This service can be accessed via a referral from your midwife within maternity services.

Home Start Tameside: www.home-starthost.org.uk

Health visitors:

www.tamesideandglossopicft.nhs.uk/services/healthvisiting

Tameside and Glossop early attachment service: Supports parents and carers and their baby/young child to feel safe and secure, to manage the emotional demands of infancy and new parenthood, and to build positive relationships that all can enjoy  -www.penninecare.nhs.uk/services/tameside-and-glossop-earlyattachment-service

NHS Tameside and Glossop Talking Therapies: www.penninecare.nhs.uk/tamesidetalk

Greater Manchester specialist perinatal team: A service designed to support women who experience complex mental health problems during and after pregnancy, and for their infant up to the age of one to two years. Please speak to a health professional to discuss a referral. Call: 0161 271 0188 - www.gmmh.nhs.uk/perinatal-community/

Your Baby and You: Families and professionals have written this content together, it has information to help you to get to know and understand your baby - www.penninecare.nhs.uk/your-baby-and-you

Support for dads: Facebook - @DadMattersUK, X - @dad_matters, Website - www.dadmatters.org.uk

Grow: To help and support you with your journey, offering the most up to date advice from local health visitors, midwives, and early years workers - www.gotogrowtameside.co.uk

Tameside Children’s Social Care: Call: 0161 342 4477 (Office Hours), 0161 342 2222 (Out of Hours) - Address: The Denton Centre, Acre Street, Denton, Manchester, M34 2BW

Finding Rainbows: For parents affected by baby loss - www.findingrainbows.co.uk

Bliss: Gives every baby born premature or sick in the UK the best chance of survival and quality of life - www.bliss.org.uk

SPOONS: For parents with babies who are premature - www.spoons.org.uk/

OKE: For parents with babies who have additional needs - www.ourkidseyes.org

Twins Trust: Support for parents having twins/multiple births - www.twinstrust.org

Proud 2B Parents: An LGBT organisation supporting parents - www.proud2bparents.co.uk