Going through the ‘baby blues’ before the baby is born

For women experiencing low moods throughout pregnancy, it is important to get help early

Having a baby is a joy and privilege for many women, though for some the thought of motherhood brings on anxiety, stress and depression.

While up to 15 per cent of new mothers can suffer postnatal depression, some women go through the “baby blues” before they have given birth.

Rachel Harraghy (26) was overjoyed to welcome a baby in 2019 with partner Jason (who has since died) she also suffered with low moods throughout her pregnancy. “Although we had talked a lot about having kids, it was still a shock and worry when I became pregnant,” she says. “I’m sure many couples feel the same, but our case is a little different as Jason had recently been diagnosed with motor neuron disease and was unfortunately in a wheelchair at 29, so we had a lot to think about.

“I began feeling very low when I was about seven weeks pregnant and when the sickness started, it all became too much. Trying to figure out if I would be able for everything just hit me and really brought me down. I also feared other people’s opinions so I couldn’t talk about it — then when my mood was at its lowest point ever, I had very bad [suicidal] thoughts.”

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Rachel, who is from Mayo, confided in a relative who encouraged her to seek medical advice. She went to her GP who advised her to go straight to hospital as there was a very lengthy wait for mental health services. “Even though the news [about the pregnancy] was very exciting, I had very bad thoughts with nothing but sadness and negativity,” she says. “When I was in A & , I explained that if I didn’t get some serious help in the next few days, I wouldn’t be here by the next week.

“But after a long discussion with the psychiatrist I was referred to the local mental health services and told I would get a phone call for an appointment — basically I was just sent home to wait.”

Following this appointment, Rachel tried to keep positive but found it very difficult and it wasn’t long before she visited hospital again. She was told the only thing she could do was wait for an appointment as being pregnant she didn’t want to take any medication.

She went back to A & twice before she received counselling. Despite this intervention, however, depression and anxiety continued throughout her pregnancy.

She vowed to keep herself strong for the sake of her unborn baby and after months of depression, her daughter, Myla, who is now 21 months, arrived and she began to feel better. “I had no major postnatal depression but, although it wasn’t as bad as when I was pregnant, my mood wasn’t great after the birth as my hormones were all over the place,” she says. “My form is still a bit touch and go, but I have got used to feeling like this and have not linked in with the mental health services since my experience when pregnant — and to be honest, I probably never will after what I went through with them.

“These days my daughter is my focus and the really bad thoughts haven’t come back, even though my partner, who turned 30 in February, unfortunately passed away in March from the cruel illness which is motor neuron disease. Now I like to think he is looking out for us, watching over us all the time and helping me to get through these difficult days.”

Rachel has been through a tough time and it is hardly surprising that she has experienced issues with low mood. But midwife and founder of gentlebirth.ie Tracy Donegan says post and perinatal depression is more commonplace than we think. “There is still a stigma surrounding maternal depression, particularly during pregnancy so there’s a lot of under-reporting,” she says. “And numbers are likely to have increased thanks to the social-distancing restrictions during the various lockdowns.

“My advice to pregnant women would be, if it has been a few weeks since your baby’s birth or if you’re pregnant and feel like you’re having more bad days than good and are not enjoying this time as much as you thought you would, have a chat with your midwife, GP or PHN for screening. Untreated mood challenges can impact your baby’s development and your emotional wellbeing, so don’t wait.

“Getting help early is important and there are several effective treatments other than medication, if that’s a concern.”

Aine McDonagh, from Dublin, also experienced perinatal depression before the birth of her daughter three years ago. While she says her “low mood was illogical”, she just couldn’t shake the feeling.

“When I was pregnant with my daughter, Keela, I was over the moon,” she says. “My husband and I had been trying for a baby for a good few years, so the news was really welcome. I didn’t have any problems during the pregnancy but when I got towards the beginning of my third trimester, I began to feel really low all the time.

“I think it started when I realised that I had put on a lot of weight — I felt fat and horrible and really annoyed with myself for allowing the pounds to creep on. I knew it wasn’t logical to think like that, but I couldn’t help it. I also began to worry that I wouldn’t be a good mother and instead of thinking of all the good things that a baby would bring to our lives, I started obsessing about all the things we would have to give up like spontaneous weekend breaks and nights out.

“I knew it didn’t make sense to be thinking like that but I really felt like I had made a terrible mistake by becoming pregnant. And on days when I didn’t have to work [as a hairdresser], I would just stay in bed until lunchtime every day as I had no desire to get up and get dressed. Martin was worried about me and said that I should talk to someone about how I was feeling.”

During a routine check-up her midwife asked how she was feeling and she opened up. “There was a really lovely midwife at the doctor’s surgery and one day when I went to for the usual examination, she asked me how my mood was and I just burst out crying,” says Aine (36). “I felt like a complete idiot as I know there are many women out there who would give anything to have a baby and here was I crying about getting fat and missing out on a social life. I regretted it immediately but she was so nice and said that many women feel like that and it’s completely natural.

“She encouraged me to open up about how I felt and to do a list of all of the things I felt that were negative and compare them with all the positive aspects. She told me that she would be in the clinic every week and that if I wanted to come in and talk, that I could just make an appointment and she would listen. I availed of her offer whenever I could and as the weeks went on, I began to feel less negative and more excited about seeing my baby.

“Then when Keela finally arrived, I was overjoyed and although I still haven’t lost all the baby weight and don’t get to go out for cocktails whenever I want, she is worth the world to me.”

Dr Margo Wrigley, specialist in perinatal mental health, says suicide is one of the most common causes of maternal death so women should always seek help if they feel depressed. “When women attend their maternity booking and review appointments, they should mention any mental health difficulties they are experiencing,” she advises. “We hope in time in all sites, women will be proactively asked about their mental health, so no one is missed.

“And where necessary, women in need of further mental health assessment and care will be referred to the service’s mental health midwife and further advice or assessment can be sought by the mental health midwife as clinically indicated.

“In areas where the service hasn’t been established as yet, women should discuss their mental health problems with their GP who will arrange referral to the local Adult Community Mental Health Team.”

ABOUT PERINATAL MENTAL HEALTH

  • As many as one in five women have mental health problems before, during or after pregnancy.
  • It is important to note that babies will not be taken away if mothers (or fathers) ask for help with their mental health.
  • Suicide is one of the leading causes of maternal deaths.
  • Antenatal mental illness (untreated) is a strong risk factor for postnatal illness, so it is important to seek help during pregnancy.
  • At least 70 per cent of women experience unwanted, intrusive thoughts about their baby.
  • Post-traumatic Stress Disorder is estimated to occur in 6 per cent of maternities following an emergency C-section.
  • Women are routinely asked about their mental health at booking clinics in maternity units/hospitals.
  • Mental health midwives and perinatal mental health teams provide specialist support for women.
  • Any woman who feels as though they are suffering from low mood before, during or after pregnancy should seek advice from their GP or public health nurse
  • If further help is needed, they will be referred to a perinatal mental health service, which is usually located in maternity units and hospitals.

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Arlene Harris

Arlene Harris

Arlene Harris is a contributor to The Irish Times specialising in health, lifestyle, parenting, travel and human interest stories