Understanding Perinatal Mental Health

Perinatal depression is a common and serious condition that can affect people during pregnancy or in the first year after birth. Around 1 in 7 parents experience this mood disorder, which arises from a mix of hormonal changes, genetic factors, and life stresses. Despite how common it is, up to half of all cases are never diagnosed. This is often because of stigma or because parents feel hesitant to talk about their symptoms.

It’s important to know that perinatal depression is different from the “baby blues.” While the blues are usually short-lived, perinatal depression is more persistent and can include ongoing sadness, low self-worth, anxiety, trouble sleeping, and difficulty bonding with the baby.

Recognising and treating perinatal depression early makes a big difference. With the right support, parents can recover and both parent and baby can thrive.

Physical Well-being and Perinatal Mental Health

Perinatal depression and anxiety don’t just affect emotions — they can have a significant impact on the body as well. Understanding the physical side of perinatal mental health helps parents, families, and health professionals recognise early warning signs and provide more holistic care.

Common physical impacts include:

• Sleep disturbance: Difficulty falling asleep, staying asleep, or experiencing restful sleep is one of the most common signs. Poor sleep can worsen mood symptoms and make day-to-day life more challenging.

• Chronic fatigue and low energy: Ongoing tiredness that doesn’t improve with rest is often reported, leaving parents struggling with daily responsibilities.

• Appetite and weight changes: Some people experience loss of appetite and weight loss, while others may eat more than usual and gain weight. These changes often reflect the body’s stress response.

• Cardiovascular effects: Stress and depression can increase heart rate and blood pressure, adding strain to the cardiovascular system during a time when the body is already under extra demand.

• Muscle tension and body pain: Anxiety and stress often lead to tight muscles, headaches, or generalised aches and pains, which can reduce mobility and comfort.

• Hormonal and reproductive system impacts: Shifts in reproductive hormones, combined with the stress response, may disrupt menstrual cycles post-birth or impact recovery after pregnancy.

• Weakened immune system: Ongoing stress and fatigue can reduce the body’s ability to fight infections, leaving new parents more vulnerable to illness.

• Respiratory symptoms: Shallow breathing, chest tightness, or frequent sighing are common when anxiety is present alongside depression.

• Gastrointestinal issues: Nausea, constipation, diarrhoea, or irritable bowel symptoms may appear or worsen due to the gut–brain connection.

• Psychomotor changes: Some parents notice slowed movements and speech, while others feel restless or unable to sit still — both can be signs of depression.

• Long-term physical health risks: Without treatment, ongoing depression and anxiety increase the risk of chronic conditions such as heart disease, diabetes, and persistent pain disorders later in life.

Why it matters: Addressing the physical aspects of perinatal depression is just as important as supporting emotional wellbeing. By recognising these symptoms early and seeking care, parents can improve their recovery, protect their long-term health, and create a healthier environment for their baby.

Nutrition

• "Eat for you, not for two"—extra serves are mainly needed in 2nd/3rd trimester. Focus on veg, fruit, wholegrains, lean proteins, dairy/alternatives. See Eat for Health (Aust. Gov.).
• Key nutrients: folic acid, iodine, iron, calcium, vitamin D & omega‑3 (DHA). Discuss supplements with your GP/midwife. See FSANZ: Pregnancy & healthy eating.
• Food safety: avoid high‑risk foods for listeria and mercury; follow safe storage and reheating guidance from NSW Food Authority.

Exercise & movement

• Aim to be active most days—150+ minutes/week of moderate activity (talk‑test level), plus 2 sessions of light strength, as tolerated. See Australian pregnancy exercise guidelines.
• Break up long sitting; include pelvic floor exercises; adjust intensity as pregnancy progresses. Consider postnatal gradual return—check with your care team.

Food security (and what to do if food is tight)

• Food insecurity affects many Australian households and can impact perinatal health. See latest ABS overview of food insecurity rates and risk factors (ABS 2024).
• Practical help: Foodbank & local charities can provide rapid support—see Foodbank and talk to your midwife/GP for referrals. AIFS explains service responses: AIFS.

Oral health

• Gingivitis is common in pregnancy; dental care is safe. Brush twice daily with fluoride toothpaste, floss, and book a check‑up. See ADA: Teeth.org.au and DHSV fact sheet.

Regular GP/antenatal visits

• Keep routine checks (blood pressure, blood tests, vaccinations, mental health screens). Share any mood/sleep/appetite changes early. National perinatal screening & care guidance: COPE 2023 Guideline.

Sexual health & contraception

• STIs can impact pregnancy—testing is recommended as per risk and local guidelines. See STI Guidelines Australia.
• Postnatal contraception: options from 21 days (varies by method and breastfeeding). See Sexual Health Victoria and Family Planning NSW.

Social Wellbeing

Education, employment & community

• Ask your antenatal team about parent education (birth, breastfeeding, safe sleep), community courses, and return‑to‑work planning.
• Community and playgroups reduce isolation and boost confidence—check council/community centre listings.

Personal interests & social activities

• Keep (or adapt) hobbies for rest and joy—short, regular social contact improves mood and buffers stress.
• Use low‑cost ideas (library story time, walking groups, online peer forums).

Why Education and Awareness Matter

The American College of Nurse-Midwives, in its position statement “Mental Health During Childbirth and Across the Lifespan,” highlights that many people face barriers when trying to access mental health support. These barriers can include:

• lack of services,
• cultural stigma,
• fear of not being taken seriously, or even
• worry that their baby could be removed from their care. These challenges are even greater for people in minority groups or those who experience multiple forms of stigma. 

Because of this, education is vital. Information about perinatal depression should start during pregnancy, with health professionals talking to parents and families about the warning signs, possible risks, and the differences between normal “baby blues” and more serious depression. Families should also be encouraged to plan for support and rest after the birth. Education can be provided through prenatal classes, brochures, or during regular health visits, and routine mental health screening at both antenatal and postnatal appointments can help identify issues early. 

Support options—such as counselling, peer groups, and community programs—need to be easy to access. When families feel supported and informed, stigma decreases and more people are likely to seek help.

Pearls and Key Points

• People at higher risk of perinatal depression can often be identified during pregnancy. Education should be given to both parents and reinforced after birth, including in hospital and at follow-up visits. 

• Antenatal classes can prepare families to seek support if symptoms develop.

• Screening for depressive symptoms during pregnancy helps detect risks early. 

• Exclusive breastfeeding has been linked to reduced depressive symptoms in the first 3 months after birth.

• Promoting parent–infant bonding and providing positive parenting support can also help prevent perinatal depression.

• Social factors such as racism, discrimination, and financial disadvantage can increase the risk of poor outcomes. Transgender and gender-diverse parents may face additional barriers and need more inclusive care.

• Fathers can also experience “postpartum blues,” which can affect bonding with their infants and should not be overlooked. 

Source: Perinatal Depression, Karen Carlson; Saba Mughal; Yusra Azhar; Waquar Siddiqui., Last Update: January 22, 2025.

https://www.ncbi.nlm.nih.gov/books/NBK519070/# 

In Australia, perinatal mental health support is available through PANDA – Perinatal Anxiety & Depression Australia, which runs a free national helpline for expecting and new parents: 1300 726 306 (Monday–Saturday) — www.panda.org.au

In Queensland, specialist services include:

• the Queensland Centre for Perinatal and Infant Mental Health (QCPIMH) (childrens.health.qld.gov.au), which develops state-wide programs and resources, and

• Catherine’s House for Mothers, Babies and Families in Brisbane (mater.org.au), a dedicated centre offering inpatient and outpatient care while keeping mothers and infants together.

• In some regions (e.g. Logan/Beaudesert, Redlands), the nurse-led Perinatal Wellbeing Service provides community-based assessment and support for families and clinicians (Clinical Excellence Queensland).

• Families and clinicians can also access crisis support at any time by calling

  Lifeline on 13 11 14 or Beyond Blue on 1300 22 4636.

Education – What This Means for Parents

A large study looked at how education and simple depression screening can help new mums understand their mental health and know when to reach out for support.

What was done: Over 1,300 women after birth were asked about their thoughts and experiences. Some had been part of a screening program that used the Edinburgh Postnatal Depression Scale (EPDS) — a short questionnaire designed to spot early signs of depression. They also received easy-to-read booklets about perinatal depression. Others had not done the program.

What was found:
• Women who had been screened and given information were better at recognising when someone might be experiencing depression — both in a case example and in themselves.
• Those who had the booklet felt more confident, and when they did seek help, they were more satisfied with the care they received.
• Having the information early made it easier to plan for support and rest after birth.

Why it matters: Simple education and screening don’t just raise awareness — they can help parents notice symptoms sooner, reduce worry, and encourage timely support. This means healthier outcomes for both parents and babies.

💡 The EPDS is not a diagnosis, but it’s a helpful tool to flag when a parent might be struggling and needs extra support.

Source: Impact of education on women with perinatal depression

1. Buist,C. Speelman,B. Hayes,R. Reay,J. Milgrom,D. Meyer

Pages 49-54 | Received 20 Mar 2006, Accepted 23 Nov 2006, Published online: 07 Jul 2009

https://www.tandfonline.com/doi/abs/10.1080/01674820601143187# 

Early Discharge and Postnatal Depression – What Parents Should Know

A study in Sydney looked at whether mums who leave hospital soon after giving birth (within 3 days) are more likely to develop postnatal depression.

What they found:
• Women who went home early had about twice the risk of developing postnatal depression compared with those who stayed longer.
• This increased risk was still present even after taking into account things like age, medical history, and social factors.

Why this matters:
• Going home early can be convenient and many families prefer it, but it may also increase stress and reduce support at a time when mothers are adjusting physically and emotionally.
• Careful checks before leaving hospital, and strong follow-up afterwards, can make a big difference.

Takeaway:
If you’re thinking about an early discharge, talk with your midwife or doctor about the possible risks and make sure you have support in place at home. Knowing the signs of postnatal depression — low mood, loss of interest, changes in sleep or appetite, or feelings of hopelessness — means you can reach out for help sooner. Hickey et al., Med J Aust, 1997

💡 Early discharge doesn’t cause depression on its own, but planning for extra support at home is important to protect your wellbeing.

Source: Early discharge and risk for postnatal depression

Anthea R Hickey, David Ellwood FRACOG, DPhil(Oxon), Philip M Boyce MD, FRANZCP, Allen D Morris-Yates BA(Hons)

First published: 01 September 1997 https://doi.org/10.5694/j.1326-5377.1997.tb125047.x

Emotional Well-being  and Perinatal Mental Health

Postnatal depression is the most common mental health challenge after childbirth, and its impact often extends beyond mood alone. Research shows that emotional wellbeing during the first year after birth is closely linked with both intimate relationships and overall relationship satisfaction.

A study of Australian women found that:

• Around one in four women (24%) reported symptoms of postnatal depression within the first year after giving birth.

• Women with a lower level of education were more than twice as likely to experience depressive symptoms.

• Sexual dysfunction increased the risk by 2.5 times.

• Relationship dissatisfaction carried the greatest risk, making women almost four times more likely to report symptoms of depression.

• Other factors, such as not initiating sexual activity or having a previous diagnosis of depression, were also associated with higher risk.

(Khajehei M, Doherty M. Exploring postnatal depression, sexual dysfunction and relationship dissatisfaction in Australian women. British Journal of Midwifery. 2017;25(3):162. doi:10.12968/bjom.2017.25.3.162)

What this means for parents:

Emotional wellbeing after birth is shaped not only by individual mental health but also by the quality of relationships and intimacy. Open communication with partners, access to counselling or therapy, and seeking early support for both depression and sexual health concerns can reduce the risk of relationship breakdown and improve recovery. Recognising the link between mood, intimacy, and relationships is a vital step in supporting both parents and strengthening family wellbeing.

Self-care: Practical Strategies

Looking after your emotional health starts with simple daily practices. While self-care won’t “cure” postnatal depression on its own, it can ease symptoms and build resilience.

• Mindfulness and relaxation: Techniques such as deep breathing, guided meditation, or gentle yoga can help reduce stress and calm racing thoughts. Even 5–10 minutes a day can make a difference.

• Coping strategies: Break tasks into smaller steps, ask for help with household chores, and try not to put pressure on yourself to “do it all.”

• Rest where possible: Sleep can be unpredictable with a newborn, so focus on rest when you can — even short naps or lying down while your baby sleeps can help.

• Healthy routines: Regular meals, fresh air, and light exercise (like walking with your baby in the pram) support both mood and physical health.

Support Systems: Natural and Professional

Having a support network around you is one of the most powerful protections against perinatal depression.

• Natural supports include your partner, family, close friends, or trusted community members. Talking openly about how you’re feeling helps reduce isolation.

• Professional supports include your GP, midwife, child health nurse, or a psychologist. These professionals can provide screening, counselling, or referrals to specialist services.

• Peer support groups (in-person or online) allow you to connect with other parents who are going through similar experiences — helping you feel less alone.

• If symptoms persist, treatments such as counselling, cognitive behavioural therapy (CBT), or medication (when recommended by a doctor) can be highly effective.

Healthy Relationships

Your relationships — especially with your partner — play an important role in emotional wellbeing after birth. Challenges like sleep deprivation, new responsibilities, and changes in intimacy can put strain on even the strongest relationships.

• Open communication: Talk honestly about your feelings and listen to each other without judgment.

• Share responsibilities: Agree on rest times, share tasks, set kind boundaries, and dividing baby care and household tasks fairly helps reduce stress and resentment.

• Stay connected: Make time, even in small ways, to nurture your bond — whether it’s a short walk together, a meal, or a simple check-in conversation.

• Seek support early: If conflict, dissatisfaction, or loss of intimacy is ongoing, couples counselling or relationship support services can help.

•  Seek help for conflict or family violence (contact 1800RESPECT: 1800 737 732).

💡 Healthy, supportive relationships are not only important for parents, but also create a stable and nurturing environment for your baby to grow.