to think that having high expectations for childbirth and breast feeding contributes to PND?

[Alizzle]

just wondering as my DH seems to think so and I'm beginning to think he's right.

Totally agree Cherries. What really stick in my mind was the bit about forceps birth. A photo of a baby who had been delivered by forceps was passed found. He had red welts on his head, quite a shocking image for a load of heavily pregnant first time mums. Then a photo of a baby born without intervention. We were asked 'which of these would you prefer for your baby?'. I think the sensible answer would be 'one which doesn't remain stuck in my vagina please!'.

Re birth the only external pressure I felt was from NCT classes. The rest was internal, wanting to be a hero, trying for no pain relief. I was intervention-free but not drug-free. I'm cool with that. A friend who is a bit of an earth mother and who put complete faith in her body to do what she perceived as its job (natural birth) had an EMCS when she didn't dilate and suffered PND. Two years on she can't go near the maternity hospital without a panic attack and is scared of having any more kids. Possible PTSD? Maybe. She won't seek more help, sadly.

It would be great to see some more research which identifies how women can best prepare for labour in order to reduce the likelihood of these awful conditions. Then there's the whole can of worms that is women's treatment and involvement in decision-making during labour.

Anyway, long post. Sorry...

I don't think that high expectations are the problem so much as lack of support. The women I know who have had long/difficult/very medical births where they were attended by the same people sensitively the whole way through have all been fine afterwards. The same goes for breastfeeding - with good support, a woman will either be able to breastfeed or be able to stop knowing that stopping is absolutely, definitely the right choice in her individual circumstances.

Alizzle, I remember emotionally rejecting DD when she started on formula in the hospital. When I held her, she smelt different. Like a different baby. It's a shock to feel like that. I haven't told anyone this in RL. It did pass though.

I find looking through photos helps me. I do them in chronological order to help me build the narrative of her life.

I agree with Shagmunds points.

I can see that having a high expectation and then having a disappointing reality is going to be very difficult, but is it difficult because of what actually happened or because of the expectation before hand? Surely any depression is more likely to be related directly to recovering from a traumatic birth or real struggles with breastfeeding?

I don't think having low expectations can be a good thing for anyone, it could too easily become a self fulfilling prophecy.

If a woman is convinced that she isn't going to be able to cope without pain relief, then she is likely to take it at the earliest opportunity, which is going to lead to an increased likelihood of interventions. Likewise, if a mother starts out believing that breastfeeding is going to be really difficult and that she probably won't be able to do it, then she is going to be less likely to seek out support and advice when she's having difficulty, and so will be quicker to give up.

High expectations are not a bad thing I don't think.

I go to one baby group when I am off on that one day (I work different days each week but ft) though that's not very often. DH and MIL have been urging me to get out more and I've slowly been trying on good days but on bad days there's no chance of me wanting to be in the same room as him. Sometimes I just feel so guilty that some people have had a 'worse' (for want of a better word) time of it and seem to manage it all just brilliantly. Generally since giving birth to my son I'm now in awe of all mum's and wish I could send every mum a card on the 10th.
I am very very grateful for all the opinions and stories shared here. it puts things in perspective and generally makes me feel a bit less alone. I'll try and keep on board the advice and will speak to my gp and health visitor again.

"which identifies how women can best prepare for labour in order to reduce the likelihood of these awful conditions"

No - no more pressure on women. Other than doing those things which the evidence shows are linked to better physical/emotional outcomes: not putting on huge amounts of weight, staying active (if they can), practising yoga and relaxation. Women need to accept that they can't control the birth process. It will control them.

What we need to do is improve the care which women are getting during pregnancy, birth and afterwards.

We have good evidence that case loading care by midwives is strongly linked to better psychological and physical outcomes for birth and breastfeeding. We need to widen access to this care.

in regards to breast feeding, I had amazing support from the nhs, absolutely amazing, at home-fair to middling. I had amazing supply, perhaps over supply issues but could barely get a latch for longer than 3 minutes and for 2 days I couldn't latch at all on one boob. I completely gave up after 6 days because I was beginning to feel a bit traumatised myself.
Looking back and at my son I think he has a lip tie. So just wanted to point out in this case the bf issue wasn't lack of support.

Alizzle - if you are depressed your thinking processes are not working properly and the way you see your own and others situations will be distorted. That's what depression does. Because you are a good mother you are struggling on trying to provide loving care to your baby while this nasty illness messes with your perception of your world. I didn't get PND but I did get a nasty clinical depression when my youngest was 3, which left me in a very dark place. Really barely able to function. AD's and time passing have made me well. I only needed AD's for a few months.

You will get better and you will love your life and get huge, huge pleasure from your little one. It's all to come!

Sorry Shagmund, maybe I didn't word it very well. I'm not talking about putting additional pressure on women. We all approach it in different ways. Some women are deeply traumatised some not, yet their labours are similar. Why is that? I think a large part will be care throughout the whole process (inc before and after), but the OP was about expectations. It's completely valid to explore this. Some research has been done but PP questioned some areas of this. Further work could be useful. Doesn't mean more pressure on women.

If your ds had tongue tie which wasn't picked up on, it might have been what made bf so difficult.

Really good bf support needs to be more than just well intentioned. When bf isn't working and the normal methods aren't working, you need someone with very good clinical skills to diagnose what's going on and treat it.

My experience of PND was that it felt very biological/hormonal/linked to sleep deprivation. Came on very quickly after the birth and left me feeling crazy for a couple of weeks, but then got better fairly quickly with treatment. Having said that, birth and breastfeeding were way harder than I expected too. I certainly didn't think any of it was going to be easy - in fact before my baby arrived, the whole labour/having a baby seemed so major and so different to anything else I had experienced, it was almost too big to worry about so I just assumed/hoped that I would cope OK.

Sorry - Chair, didn't mean to sound harsh.

Just that I don't think there is much women can do to prepare for labour that might protect them emotionally from a difficult birth, other than doing all she can to access good care. I think how you feel about birth comes from the person you are and this isn't amenable to change in the antenatal period.

I am a bit of a sucker for good intentions. if you mean well I don't mind if you accidentally offend me/give me substandard care.

I found child birth and pregnancy strangely fascinating before I got pregnant but am now in the post natal side of things. I am an avid consumer of free literature and do notice a difference in the amount available on the latter. Not quite sure why that is

Alizzle - I was the same about pregnancy and birth. But I absolutely refused to read about babies or think about dd until she was born. And then I spent the first year of her life in a state of constant suprise. I was quite demented. Every single picture of me and her for the first year shows me clutching at her in a worried sort of way, looking like I was about to beat anyone who tried to touch her to death with a muslin. Very odd.

Very possibly Shagmund. Clearly though there is work to be done amity the whole process to ensure preparedness (inc preparing for lack of control which may be an issue for some) and correct support.

Alizzle my son had tongue tie which badly affected his latch. Coupled with my poor supply we got nowhere with BF. Tongue or lip tie definitely have an impact on latch and feeding. Like you I had great support from HCPs, but I just wish more was done to fix these problems quickly so feeding can be established.

I hope you're feeling stronger soon. You've been doing a great job caring for your son whilst struggling with PND. Better than those who breeze through it because of the additional challenges you have had to face.

amity?. Where did that some from?

I feel the same way. I had absolutely no idea it was so hard. one of my sisters tried to tell me but I just shrugged it off thinking, 'millions do it every day, it can't be that difficult'. I keep imagining myself going back in time and telling my pregnant self to chill the feck out and it'll be easier.

I had possibly the most set in stone birth plan ever. I spent 10 years perfecting the damn thing. I was determined. So so so determined to birth my way. For many reasons.

What actually happened was my EDD came and went. 14 days over my EDD came and went. At 20 days late he finally arrived, with a birth completely the opposite of the birth I planned and hoped for.

When I finally agreed to IOL at 40+19 I despaired. I thought that I would really regret it, I beat myself up over the decision.

He was born by forceps.

He was put on me.

The world stopped. Nothing else mattered.

Birth? I stopped caring at that moment.

I have no regrets. No PND (which I thought prior to him being born I would end up with due to being so set on how I would have him at home, no intervention etc).

I can't explain it, but when you have planned something for so long, and been so dead set on how you will do it, when you have to make a decision that flies in the face of everything you wanted, then you think you will live to regret it. I have injuries from my birth which I wouldn't wish on my enemies, but I have no regrets.

Just adding my story in as I suppose it is the opposite to the theory.

Many years ago the 'expectation' was a likely chance you or your baby would not survive. Our great great grandmothers must have been on a high to have just made it through.

Those women also had no modern concept of being able to control their lives - no reliable contraception, pain relief, antibiotics etc etc.

We can now control when we get pregnant but still cant control the birth process. Our gggms never expected to.

There is currently a LOT of research to back up this theory, OP.

DH & I have just finished out NCT Antenatal classes and our practitioner (who was lovely!) told us right off the bat that we should not in any way put pressure on ourselves to have the all-natural approach to birthing - because although every woman ideally wants that, and the NCT supports it, labour and birth is an unpredictable thing and ANYTHING can happen.

24% of ALL births end in EMCS. This is a statistic that should be made more commonly available to women, so that when they "fail", they realise that they are a QUARTER of all women in the UK, and that the only reason they "failed" is because their baby is more important than doing things the "right" way.

There is a huge pressure on women to do motherhood "right", and it's not just from the NHS but family too - I think there definitely should be more awareness of PND, and support for mothers, with an understanding that if it's right for baby, then it's right for mum, and vice versa.

I doubt that many of us understand that starting a pregnancy is the beginning of a world of guilt before we do it. It's a horrible intersection of massive external expectations and hormonal peaks and troughs that magnifiy every stage.

I always considered myself bloody minded and tough and it nearly broke me, having twins and only being able to BF for 6 weeks with top ups as I had only one functioning breast due to a prior operation that had severed milk ducts.

Apparently everyone can BF, its a demand and supply system, but the MW, NCT and HV experts don't seem to take physical scarring into account. I ended up hating them all.

Alizzle Looking back and at my son I think he has a lip tie. So just wanted to point out in this case the bf issue wasn't lack of support.

The tongue/lip tie should be picked up and dealt with, these are basic things so you got rubbish support from the NHS.

I went into birth with very low expectations - partly due to family history and also because I had a difficult pregnancy, fractured my pelvis ten years ago and general fear of birth. On the event it turned out far worse than I imagined, and although ds is a perfectly healthy 2 year old he has been left with facial scarring due to a botched forceps attempt.

I was lucky to have few problems with breastfeeding once it was established - i hadn't expected any problems (possibly because I didn't really know anything about it).

I didn't have pnd, but I have never felt guilty about the birth - I have felt very angry at the poor standard of care I received, but I never thought if it as being my fault - I wonder if the fact I felt angry at others, rather than guilty ''protected' me from pnd? Although obviously being angry is not a healthy emotional state either!

I think that the problem doesn't lie with high expectations, but rather with an unrealistic view of pregnancy and childbirth. The writing of birth plans encourages women to assume that what they want is what they will get. Nature doesn't work like that. My sister is a childcare professional and, when we were discussing problems like PND, said that there is some research that shows that the more husbands and partners have become involved in the process of childbirth, the higher the percentage of PND - not sure if I believe the research, but interesting if true.

My only experience of PND was with a family member who had an idealised view of what childbirth and child rearing would be like - and her birth plans were detailed to an amazing degree. Unfortunately nothing went to plan at all, including BF when her DD had a late diagnosis of tongue-tie. All so very sad and it took her eighteen months to be back to normal again.

Op, just give it time, I am sure you will get there in the end.

I've been re reading this thread and just wanted to say thank you to you all who talked me through a very bad time. I have actually properly bonded with my ds who is a very happy boy. I am very very happy to say I love him so much now it hurts! it did take a long time to bond though and I think working helped. I still have pnd, I'm receiving help and realise it isn't me, it's an illness.
You all gave me things to think about but the main thing was after this I stopped thinking that the emcs and not breast feeding my fault.
So again... a big fat thank you!!