Working with new mothers experiencing post-natal depression and distress has alerted me to the pressures that can contribute to their low mood and anxious state.  What a complex time this is for women - adjusting to how it feels to be central to another human being’s existence whilst possibly recovering from the physical impact and exhaustion of the delivery as well as learning the tasks of motherhood on diminished sleep.

Along with the very personal stories of difficult births and feeding issues, mothers almost all talk about the internal and external measures that come along with having given birth. First there are the ideals set out in a birth plan. This might be for a drug and intervention-free labour in which both bodies and babies collaborate to achieve a straightforward and stress-free arrival. Then there are the expectations one might have of breast-feeding our babies without difficulty or pain. Some may have decided not to breast feed but find people are only too ready to comment on this choice without considering that each mother has to make the right choice for herself.

Imagine the disappointment when medical intervention prevents the ideal birth and any power you feel you had over events disappears. In addition, many women are left feeling that their bodies have let them down and this too can create feelings of maternal inadequacy. Then there are the struggles to establish feeding, or settling the newborn, and the efforts to respond to or manage the moods of infants whose cries you don’t yet recognise and fully understand. Every choice, often made in a blur of exhaustion, is put under the microscope of ‘what’s best for baby’ and female relatives and friends might unknowingly increase the discomfort by questioning or commenting on how things are being done or by simply saying it was different for them.

In this information age, new mothers are bombarded with opinion from media bloggers to well-meaning friends and can lose sight of the fact that they are in the unique position to have the expertise about their own baby and that their decisions have to be made in the context of their individual or family situation. Space, support, health and household income all exert an influence over how mothers survive this early period. When babies appear to be fractious or unwell, of course mothers look around for reassurance and answers. There will be any number of more experienced friends or relatives ready to give advice based on their own possibly rose-tinted memories of the post-partum period. But the new mother’s best friend is her intuition and knowledge of her own child and herself.

Over 50 years ago, Donald Winnicott wrote about the ‘good enough mother’ a concept that suggested that babies needed mothers to be less than perfect in order to grow into resilient and robust children and adults. Of course striving to keep a baby from harm is a primary task but attempting to get everything ‘right’ can lead a mother to self-judgement and consequent feelings of failure that can impede her ability to be available to herself and possibly therefore to her child. Winnicott knew from his own therapeutic work that this was a really compelling state for many mothers, thrown as they are into completely uncharted territory and prepared throughout pregnancy for something that is almost universally accepted as a uniquely fulfilling experience.

So women who seek counselling support express the ambivalence they experience as mothers and, with support, begin to acknowledge and make sense of feelings that appear to be contradictory. Moments of intense joy are matched by moments of acute anger. Feelings of huge contentment contrast with feelings of fear and helplessness. In one way their baby might elicit a feeling of being complete but at other times they might feel the loss of their former life and the simplicity and rest it afforded them. Having negative feelings at this time can be a source of enormous distress and guilt that with therapeutic help, it is possible to relieve.

Women seeking counselling want the best for their babies and can easily feel that by doing things without conviction or by compromising on previously strongly held ideals they are ‘doing harm.’ The media and our social context can be condemnatory of parents and has heightened our awareness of how parental actions or inaction might contribute adversely to child health and wellbeing. The Internet offers a myriad of opposing views on how mothering should be done and can present an airbrushed illusion that someone somewhere is doing it all perfectly. Naturally this can easily feed post-partum anxiety and create a powerful persecutory dynamic in mothers who already feel overwhelmed by responsibility and self-judgement.

Therapeutic work seeks to help women to hold their judgements lightly; to believe in their own choices; to seek knowledge but to adapt it as needed and to give themselves as much care and compassion as they offer their infants. This is often effective in lessening maternal distress. The therapist offers a holding place for a new mother who is engaged in holding her child and with luck therapy can also model the imperfection of this holding task by carefully adjusting to the changing needs of the mother and working with fragility in the way that mothers need to do with their babies.

If you are feeling low after the birth of your baby these simple things might help:

  • Talk to a trusted friend or family member and ask for any practical help you need - pick up the phone
  • Seek help from your GP if you feel that your low mood is affecting your ability to cope
  • Try to give yourself small breaks in the day – sit down to listen to or watch a favourite programme, read a magazine, have a cup of tea or a warm bath
  • Don’t expect too much too soon. Quiet days with small moments of self-nurture will be beneficial to both you and your baby
  • Getting out in the fresh air and making time for gentle exercise when you feel ready will connect you to yourself again