Mental Health in Pregnancy and After Birth

“Perinatal mental health” is the emotional health and well-being during pregnancy and the first year after childbirth.  

Pregnancy, birth and early parenthood are often seen as times of excitement and great joy for the parents to be. They are also times of tremendous change and stress. You may find your mood changes quickly from being excited or happy to sad or feeling overwhelmed. Taking care of your mental health is important because: 

  • You are more able to develop a secure attachment with your baby.
  • It helps build your resilience and ability to cope with stress.
  • You are more able to reach your potential as an individual, parent and caregiver. 
Ideas to take care of your perinatal mental health

While eating healthy, being active and learning about pregnancy promote physical health, they also build your mental health and resilience. Here are some other ideas to promote your mental health in pregnancy and after birth:

Building support
  • Think about the people who you trust to give you positive emotional and practical support, such as a partner, friend, or neighbour. Talk with them as to how they can help you, such as: 
    • Listening and accepting how you feel. 
    • Providing comfort and support.  
    • Cooking a meal to have in your freezer.
    • Caring for your baby while you take a shower, eat a meal, and catch up on your sleep.
  • Explore places where you can make social connections and develop friendships, such as getting involved in your faith or cultural community, joining a prenatal yoga class, or connecting with a community service, such as the EarlyOn Child and Family Centres. 
  • Calling or speaking to family and friends online can bring support too, especially if you are living away from loved ones. 
  • Practice ways to relax:
    • Switch off your screens and take time each day to breathe deeply, relax and still your mind.
    • Take some time to go for a walk and enjoy nature. 
    • Meet a friend to talk and to have fun. 
    • Listen to some music you enjoy. 

Learning how to cope with stress and challenges 

Stress can be a healthy and normal part of life. A certain level of stress helps you cope with the many demands of work, family, caring for others and living from day-to-day. However, stress can become overwhelming and can lead to poor mental health and increase the risk of perinatal mental illness. It is important to think about how you can reduce and cope with stress, and where to find help when you need it. Here are some examples of ways to cope with stress that you can start to practice: 

  • Talk to your support person or group about how you are feeling and thinking. It is good to have someone who listens, encourages, and comforts you. 

  • Challenge negative thoughts as they can affect how you see yourself, how you parent, care for and relate to your baby. 

  • Try to keep life simple, and know it is okay to say “no” and not take on more than you can handle. You need time to recover from childbirth and take care of your baby. 

  • Think about and try to understand the problem you are facing and plan simple steps to solve your challenge. An example is to call a friend or family member to provide extra help while you feed your baby.  

Asking for help opens the door to support, treatment, and services. 

If you are in crisis, please contact the Mental Health Crisis Line (24 hours a day/7 days a week) at 613-722-6914 or if outside Ottawa toll-free at 1-866-996-0991. 
 How can I help as a partner or support person?

If you are a partner or support person, you can help by: 

  • Listening and accepting their feelings and thoughts. 

  • Being aware of changes in their mental health or mood. 

  • Comforting and making them feel safe to talk to you. 

  • Taking care of the baby while they rest. 

  • Helping them call their health professional and find the resources they need.  

If your loved one is in crisis, please contact the Mental Health Crisis Line (24 hours a day/7days a week) at 613-722-6914 or if outside Ottawa toll-free at 1-866-996-0991. 
 Who is more likely to experience poor mental health and mental illness during the perinatal period? 
Some individuals may experience poor mental health and mental illness in pregnancy and following childbirth. Here are some of the life challenges that may increase the risk: 

  • History of mental illness before or during pregnancy 

  • Health challenges during pregnancy 

  • Difficult childbirth 

  • Unplanned pregnancy  

  • Stressful life event, such as the death of a loved one 

  • Lack of social support 

  • Past and present experience of violence and abuse 

  • Living with poverty and/or unstable housing 

  • Living with a substance use health challenge 

  • Having trouble sleeping 

However, it is important to know that not everyone who has these risks will develop poor mental health or a mental illness. A person can reduce their risks by developing good social support, being aware of any changes in their mental health or mood and talking to a health professional to find the help they need. 
 What are the symptoms of baby blues, perinatal depression and/or anxiety?  

New parents experience many emotional changes. It is important to care for yourself. It's also important to know about the postpartum baby blues as well as the signs and symptoms of perinatal depression and anxiety and where to get help. Below is what to watch for:

Baby Blues Perinatal Depression and/or Anxiety  Postpartum Psychosis

The baby blues are common and happen three to four days after childbirth as your body recovers and heals, and as you adjust to a new baby. When you have baby blues, you may feel: 

  • Restless 

  • Irritable 

  • Tired 

  • Discouraged 

  • Sad and tearful. 

  • You may also have trouble eating and/or sleeping.  

  

All of these feelings are normal and do not usually need treatment other than understanding, rest and support. If they last longer than two weeks, it is important to talk to a health care provider.

 

While the cause of perinatal depression and or anxiety is not fully known, it can happen in pregnancy, shortly after childbirth or months later. Depression can occur in about 10-25% of birthing parents and anxiety can be more common. Partners can also experience depression. It can start during pregnancy and/or after the baby is born.   

  

You may experience or feel: 

  • Sad, lonely, and hopeless 

  • Guilty or ashamed 

  • Restless or irritable 

  • Frustrated or angry 

  • Anxious and/or panic attacks 

  • Overwhelmed 

  • Frequent crying 

  • Trouble sleeping 

  • Loss of appetite 

  • Find it hard to focus or make decisions 

  • Loss interest in activities you used to enjoy 

  • Have scary or upsetting thoughts 

  • Have thoughts of self-harm or suicide 

  

If you are experiencing any of these symptoms, you should get help as soon as possible.  Call a health care provider to talk about your concerns and to access the resources you need. Symptoms can last for many months and could lead to:  

  • Baby being born too early 

  • Low birth weight 

  • Miscarriage 

  • Not getting enough prenatal care 

  • Perinatal depression or anxiety disorders 

  • Difficulty building a positive relationship with your baby 

  • Problems forming a secure attachment with your baby

Postpartum psychosis is very rare, occurring to1 in 1,000 people. Seek help immediately if you are experiencing any of the following symptoms: 

  • Hearing and seeing things that are not there 

  • Feeling extremely confused 

  • Out of touch with reality 

  • Thoughts of harming yourself or your baby 

  

Call a health care provider or go to your local emergency department.

If you are in crisis, please contact the Mental Health Crisis Line (24 hours a day/7 days a week) at 613-722-6914 or if outside Ottawa toll-free at 1-866-996-0991. 

*NEW* Steps To Wellness, Before and After Baby     

CBT For Perinatal Depression 9 Week Group Session

FREE, 9-week group-based Cognitive Behavioral Therapy (CBT) program for women who are expecting or have a child (birth or adoption) and who have been feeling one or more of the following: depressed, sad, anxious, worried, angry or overwhelmed.  

During a nine-week series, participants meet in a virtual group setting with a public health nurse and learn skills to help reduce symptoms of depression and anxiety by changing thoughts, feelings, and behaviors.

The program is offered in English and French.

Some of the eligibility criteria for this program includes: 

  • 18 years of age and older  
  • Having a baby less than 18 months or is expecting  
  • Having access to technology and data to participate in the virtual group  
  • Willing and able to participate in the virtual group platform  
  • Having access to a private space to ensure group members’ privacy 
  • Able to read and communicate in English or French

Groups run for 9 weeks, with a maximum of 15 participants.

Registration for the January 2025 sessions is now open.

The English group will start on Tuesday January 7th from 10am-noon, and the French group will start on Wednesday January 8th from 10am-noon.

If you are interested, please register using the link below. A nurse will contact you by the end of December to determine if this program is suitable for you.

CBT-Referral - Ottawa Public Health
 More Resources and Services

You can refer yourself to these services:  

The Healthy Babies, Healthy Children program provides home visiting, to expectant individuals and families with children from birth to their transition to school. This program is designed to help parents who need more support to give their children a healthy start. 

Perinatal Support Groups
Parenting Support Groups
Accessing Counselling and Mental Health Services

  • Counselling Connect provides access to a same-day or next-day phone or video counselling session. This service is for children, youth, adults and families in Ottawa and the surrounding area.  

  • AccessMHA.ca is a new way to find mental health and addictions support, services, and care in Eastern Ontario. You will be paired with a professional who will connect you to the services you need from a network of partner organizations. For individuals aged 16 years and older.  

  • 1Call1Click provides supportive, coordinated access and navigation services in a way that integrates the exceptional, trusted and safe mental health and addiction care offered by Kids Come First Health Team organizations in the Eastern region of Ontario. For individuals who are up to 21 years of age. 

  • Walk-in Counselling Clinic offers in person sessions, as well as video or phone (613-755-2277) counselling sessions in English, French, Arabic, Spanish, Somali, Cantonese, and Mandarin at a variety of different locations. 

  • Life with a Baby offers mental health counselling and psychotherapy services for parents in Ontario. 

  • eMentalHealth.ca offers a searchable directory of local mental health support and services. 

  • Connex Ontario call, text, chat or email to find resources and services in your community.  

  • Wellness Together Canada offers mental health and substance use support for people in Canada and Canadians abroad. Always free and virtual, 24/7. 
Workbooks, Guides and Self-Directed Resources

Do you have more questions about parenting?

  • Connect with a registered nurse from Health811 for free, secure, and confidential health advice. Service is available 24/7 in English and French, with translation support also offered in other languages. Call 8-1-1 or visit Health811.ontario.ca.
  • Connect with a Community Navigator from 2-1-1 for information about community programs and resources across Eastern Ontario. Helpline service is available 24/7 and in many different languages. Call 2-1-1 or visit 211ontario.ca.
  • Connect with other parents on the Parenting in Ottawa Facebook page.
  • There are a variety of services to make it easier for your child to grow up healthy in Ottawa.
  • You can update your child's immunization record using either the Immunization Connect Ontario (ICON) Tool or the CANImmunize App. 
  • If you have received a message from Ottawa Public Health such as a letter or a call regarding immunization, an infectious disease, or infection control lapse, please call 613-580-6744 and listen to the menu options carefully.

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