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Pregnancy and Postnatal Mental Health for Expat mums

Updated: May 20, 2022



In honour of World Mental Health Week (and before that Maternal Mental Health Week) Lynette of Baby On Board Spain interviewed Therapist Amy Temple on the very important subject of pregnancy and postnatal mental health for expats. To give some context - around 10% of new mums suffer from postnatal anxiety and depression within the first 6 months of their baby’s life. These numbers are likely much higher as at least 20% more women don’t report their symptoms. So we are potentially looking at at least a third of new mums suffering with depression and anxiety after their babies arrive. We asked Amy the following questions:

So what is postnatal depression and when can it start? Well, to understand this we need to backtrack a few steps to pregnancy and realise that it is very normal that women experience mental health changes in pregnancy, which then continue to after having their baby. These changes are due to massive hormonal shifts and periods of exhaustion and adjustment in growing your baby, birthing, and then managing the many unfamiliar challenges of the newborn period (especially in first-time mums). Symptoms of anxiety and depression in pregnancy can be exacerbated if we are away from our usual home-country support systems, have had any periods of previous mental health issues (including in previous pregnancies), have suffered past losses, have suffered infertility, are in a high risk pregnancy, have had previous traumatic birth experiences, are in unstable or unsafe relationships or with unsettled home environments. And the list goes on... What are ‘normal’ mental health signs in pregnancy and postpartum and what isn’t? Amy explained that it is very ‘normal’ that we may become emotional, angry, act unpredictably and have mood swings in pregnancy, and this can begin from as soon as we become pregnant. These emotional highs and lows usually continue into postpartum with the ‘baby blues’ period (seen in the first 2 weeks postpartum) and are entirely expected. Postpartum depression (PPD) is a severe, intense form of “baby blues” that usually lasts for longer than baby blues, and can go on for months (or even years) if untreated.

PPD is characterised by intense anxiety, sadness, despair, thoughts of self harm or of harming the baby.

Amy said when any of these feelings become a problem is when they are there more than they aren’t, they start impacting our ability to function day-to-day (appetite, sleep, not wanting to go out at all), or they risk the wellbeing of ourselves or our baby. What lifestyle factors can contribute to PPD? Amy explained that the biggest contributing factors to feelings of not coping postpartum are: 1) Most of us have become used to doing everything ourselves and are not good at asking for help. When we suddenly have to manage all our usual daily tasks, plus are recovering from birth, plus are in charge of a brand new human being this can become overwhelming. 2) We are bombarded with images in the media (mainstream and social) of women who seem to have immediately bounced back after birth. Their houses are clean, their makeup done, they are back in their skinny jeans days post-birth, and everything looks blissfully in order in their new lives as mothers. 3) We are increasingly living isolated lives (exacerbated by the recent pandemic and with further loneliness for expat mums without family support nearby).

So what can we do?

  • Connect with people you trust, ideally who are at a similar life stage. They will be the best example for how real motherhood looks!

  • Start practising asking for help. Start with the physical chores - shopping, cleaning etc... You will be surprised that most people love feeling useful and will not mind helping you at all! We (mammals) are pack animals, after all.

  • Shut out the noise (social media, family members or friends who don’t get it) and learn to listen to our own bodies for what we can manage (and what we can’t), how we feel, and how we should be parenting our babies. That isn’t to say don’t take external advice, but seek it from people you trust. Watching reels of immaculate ‘Insta' mums is not going to help your fragile postpartum mental state at this time!

  • Slow down. Take time to assess how YOU feel, what YOU need. Even if just for 5 minutes. Tune in to yourself. You will be able to be your best self to your baby when your needs are also being met.

  • Get educated on what to expect mentally in new motherhood by reliable sources, and preferably while still pregnant.

And if it’s all getting too much and you feel you can’t cope?

It’s important to TELL SOMEONE. It can just be one person. It can be a friend, family member, partner, therapist, your doctor. We were not meant to do this (motherhood) alone!

In our group antenatal course we cover maternal mental health in the Pregnancy and Labour Session, and again in Caring for yourself Postnatally. And we connect you to a peer support group who are the same life stage!


Further info on Amy and how she supports expats.

Source: ConSalud Watch the full interview:





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