What causes perinatal mental health problems?
There are many reasons that you might develop a mental health problem. Nobody knows exactly why they happen. This includes mental health problems you develop while pregnant or after giving birth, known as ‘perinatal’ mental health problems.
Some perinatal mental health problems have clearer causes. For example, difficult experiences while giving birth can cause postnatal PTSD.
But for many people, it can be a combination of factors that cause a perinatal mental health problem.
These factors might include:
- previous experience of mental health problems
- biological causes
- lack of support
- difficult childhood experiences
- experience of abuse
- low self-esteem
- stressful living conditions
- major life events
- Obstetric trauma or complications
Previous experience of mental health problems
Your experience of mental health will be personal to you, as will your experience of being pregnant and having a child.
But if you’ve had mental health problems in the past, being pregnant or having a baby can increase the risk of those problems happening again. This includes any previous perinatal mental health problems.
It is important to understand what might trigger another episode of any previous problems, as well as what support you may need during this time. You can speak to your doctor about this.
See our page on types of mental health problems for more information about any specific problems you have experienced.
Some people think it is likely that perinatal mental health problems have a biological cause. This includes changes in your body during and after pregnancy, such as changes to your hormones.
Some studies show that changes to your hormones during pregnancy and after giving birth can cause differences in your mood. But not everyone who gets pregnant and experiences these changes goes on to develop a perinatal mental health problem. So changes in hormones are unlikely to be the only cause if you do develop a problem.
Lack of support
Having a baby is a major life event and can be stressful, exhausting and overwhelming. If you don’t have people around who can help, like a partner or family members, this can affect how well you cope. It may mean that you are more likely to develop a mental health problem during this time.
HK Family Welfare Society (HKFWS) provides advice and practical support for single parent families. And our page of useful contacts has details of other organisations who can help you find support.
Difficult childhood experiences
Some of us have difficult experiences in our childhood, such as:
- physical, sexual or emotional abuse
- the loss of someone close to you
- traumatic events
- an unstable family situation.
Some research shows that these experiences could make you more vulnerable to mental health problems later in life.
These experiences can have a big effect on how you feel about becoming a parent. For example, if you experienced abuse while growing up, you may now struggle to relate to other people. This may include finding it difficult to relate to your baby.
If your own parents did not have good parenting skills, you may find it hard to adapt to your new role as a parent. For example, you may feel unsure of how to interpret your baby’s needs. You may even fear that you are going to harm your baby somehow, because you aren’t sure how to take care of them.
HK FamilyLink Mental Health Advocacy Association and Talk Hong Kong offer support services for individuals who have experienced abuse in childhood, including sexual, physical or emotional abuse, and neglect.
“I have PTSD due to trauma experienced in childhood… I worked so hard to fight my anxiety and accept my experiences, and to realise that these were very different to the circumstances in which I would be bringing up my daughter.”
Experience of abuse
Experiencing abuse can sometimes cause:
- low self-esteem
- post-traumatic stress disorder (PTSD).
So if you have experience of abuse, you may be more likely to develop perinatal mental health problems.
Different types of abuse include:
- domestic violence
- verbal abuse
- emotional abuse
- sexual assault and rape
- violent assault
- financial abuse – for example, if a partner tries to have power over you by stopping you having control over your own money.
If your self-esteem is low, you may doubt your ability to cope as a parent. For example, when your baby cries you may think it is because of something you’ve done wrong, or because of something important you haven’t done.
The way you think about yourself can put you at risk of developing perinatal mental health problems like depression and anxiety.
See our pages on self-esteem for more information, including ways to improve your self- esteem. Some of these tips might feel difficult while you are pregnant or have a new baby, but even small changes can make a big difference to how you feel.
“I was angry, sad, irrational, indifferent towards my husband… I lied and said things were better than the reality out of fear of being laughed at and being judged as a bad mother.”
Stressful living conditions
It can be difficult for anyone to deal with stressful living conditions. If you are pregnant or recently had a baby, this may feel even harder. These conditions can make you more likely to develop a perinatal mental health problem.
For example, you may be struggling with:
- money problems
- insecure or poor housing
- insecure employment.
These problems can be even more difficult if you live alone, with little or no support from other people.
Living with these conditions might make you worry that you are unable to provide your baby with everything that they need. Or you might feel like you are failing your baby.
We have information on money and mental health which you may find helpful.
“I had a difficult labour with my first baby and many significant life changes, which I can now see all contributed to my depression.”
Major life events
Major life events can be difficult to deal with, and may increase the level of stress in your life.
Examples of major life events include:
- an illness or death in the family
- the break-up of a relationship
- moving house
- losing your job.
If you experience any of these events while you are pregnant or after having a baby, you may be more likely to develop a perinatal mental health problem.
Having a baby is also a major life event in itself, and is likely to involve many changes in your life. It may cause you to leave your job and lose your financial independence.
Or you may need to give up social activities, and find it difficult to spend time with friends. Being responsible for a baby means that your day is likely to revolve around your child’s needs rather than yours.
These changes to your life might mean you are more likely to develop a mental health problem.
Infant loss and mental health
Experiencing infant loss can be extremely traumatic and can have a big effect on your mental health. This includes losing your baby through miscarriage, still birth or sudden infant death syndrome (SIDS).
It’s important to remember that you don’t have to cope alone, and there is support out there. You can talk about your mental health or fertility concerns with your family doctor or Obsetrician. You can also find more information about infant loss from our webpage on women’s mental health or from links below: :
- Family Health Service Information on Sudden Infant Death Syndrome (SIDS)
- Social Welfare Department Tel (24-hr hotline): 2343 2255 (People in need, including women who have suffered a miscarriage, may call the 24-hour Social Welfare Department SWD hotline at 2343 2255 to seek immediate counselling or referral to appropriate service units for support, consultation and follow-up services.)
- Comfort Care Concern Child Bereavement Service 2361 6606