Angst

A Womb With A View: Antenatal depression

By Jude Rogers

Read the first in Jude Roger’s series, A Womb With a View: The Anti-Medicine Brigade.

Thirty-five weeks in, I am enjoying lots of things about pregnancy. Watching my stomach doing a John Hurt in Alien. Getting seats on trains (when people aren’t cocooned in their technological bubbles, anyway). Waddling. Napping. And my favourite: not holding my belly in.

But then there are the other things, of course: the niggles, the concerns. The guilt about what food and drink you can eat. The worries about whether baby is moving enough. Random pains. Itchy skin. Recently, I’ve been physically monitored to check some of these out (and I’m fine, all is well), but I’ve been surprised how rarely their psychological repercussions are acknowledged by health professionals.

The thing is, everyone knows about post-natal depression. It’s a regular headline on women’s magazine covers and something addressed, very rightly, in many birth preparation courses. Antenatal depression, however, is a fairly unknown term. Perhaps, once again, it’s because pregnancy is meant to be a blooming, beautiful time, when an ordinary woman becomes a walking, talking miracle. For many of those people, pregnancy is not the easiest draw, though. The pregnancy may have been unexpected or unwanted. It might bring up difficult emotions from the past. It might feel uncontrollable.

According to pre- and post-natal charity PANDAS (Pre and Postnatal Depression Advice and Support), one in ten women will experience antenatal depression. In the UK, it’s meant to be on the health agenda too. In 2007, NICE [the National Institute for Clinical Excellence] published guidance to help women at risk from the condition, and encouraged healthcare professionals to ask women at risk of it three simple questions: if they had felt down or hopeless, found it hard to find pleasure in doing things, and whether they wanted help with these feelings. Even if these women didn’t have specific mental illnesses, NICE advice continued, they should be encouraged to get support from professionals or voluntary organisations.

From my experiences, and those of others I’ve talked to, this isn’t always the case. At 19 weeks, I texted one of my healthcare contacts in desperation, worrying madly about having felt the baby move a few weeks previously, but not since. I felt bleak and couldn’t stop crying, I said. She replied to say sometimes movement changes happen, but didn’t address my state of mind.

At my next appointment, she had forgotten our exchange entirely. Ah, everyone gets anxious, she said, when I reminded her. Worry is normal. Which is all correct, of course, but that wasn’t the point.

A lot of anxiety in pregnancy is put down to hormones – and yep, there’s a lot of them, swirling and rollercoastering around. But bring up slight concerns about your state of mind and most health professionals plump for the “don’t worry, dear” response. A friend of a friend of mine who felt very low during her pregnancy was asked if she wanted to be monitored on machines more often for reassurance. She was never offered what she really wanted: services to help her emotionally.

In October 2012, Netmums, in association with the Royal College of Midwives, published more research about antenatal depression. Their findings reinforced a causal link between antenatal and postnatal conditions. Press headlines at the time had a specific focus, as a result: ITV’s typical example was “Report reveals antenatal depression affects relationship with baby.”

There’s something missing from that headline, of course – the mother herself, and her initial experiences. Once again, the individual growing a new life inside her doesn’t have her own taken seriously. This makes me wonder, dispiritingly, if post-natal depression is given more time because there are two people involved by that point. Still, in so much rhetoric and care, the woman alone, the mere vessel, doesn’t matter as much.

What this comes down to is how psychological illness is treated in healthcare, of course. This requires resources and money, but more importantly the communication of guidelines to all staff working within the system – something that should make the treatment of these issues frustratingly simple. After all, sometimes all that pregnant women want is a listening ear, and a mouth that responds. They want the opportunity to tell someone, “this is how I feel when I wake up in the morning… this is how unmanageable things feel when I think that’s something’s wrong”, and then be given some leaflets, or website addresses, rather than flail around in the dark.

Only then can pregnant women start getting on with the business of enjoying their strange, pregnant lives – something we can only do if we can feel happy with ourselves.

Jude Rogers is a writer, broadcaster, journalist, romantic, Welsh woman and geek. Follow her @juderogers

For more useful information on antenatal depression, go to:

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One thought on “A Womb With A View: Antenatal depression

  1. Katherine

    I felt suicidal during my second pregnancy and although I only got a ‘don’t worry dear’ from my GP, googling it and finding ante-natal depression existed helped a lot! Once I knew it wasn’t just me it somehow made things easier.

    Reply

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