Perinatal Mental Health Team - Experiences

[Mournae]

I have been referred by my midwife to the perinatal mental health team due to a worsening depression in pregnancy and was just wondering what other peoples experience of these had been as I really don't know what to expect.

I've had depression on and off since my teens and used medication at times. I had PND following the birth of my son (27 months old) after a traumatic birth that brought up things from my past that I felt I'd moved on from. I ended up on medication again but stopped due to this pregnancy, I'm reluctant to go back on medication whilst pregnant as I'm already on codeine for severe SPD and don't want anything else affecting the baby.

I have also requested a c-section due to mental health / past experience, is this something the perinatal mental health teams can support with or are they more focused on getting you to have a vaginal birth?

It would be really helpful to hear of others experiences/advice if you've been in similar situations as I'm feeling a bit on my own at the moment.

Many Thanks

Hey Mournae soor to hear you're feeling low. I referred myself to community mental health towards the end of my last pregnancy and they were very helpful. I also have depression, which worsened considerably during the pregnancy despite medication. How many weeks pregnant are you.
There are a few things that might be offered to you. You'll probably be offered sertraline or another antidepressant (I've taken prozac and sertraline throughout 2 pregnancies and have had 2 100% healthy babies, so please don't beat yourself up if you need meds.)

I also requested a c section as I didn't think I could cope with the trauma of labour and birth in the state I was in. I asked the psychiatrist to speak to my consultant and he explained why I wanted one. The thing is, a psychiatrist cannot advise a obs/gyne about obs/gyne issues, but he can certainly say that you have good reason to want one, and I got one. It was definitely the right decision, and it went really smoothly.

They (mental health) might be able to put a word in with the health visiting team to organise some free childcare for your son while you rest. There's also mother + baby units, but hopefully you won't need one.

Feel free to pm me for support. My little one is now 5 months old but I vividly recall how frightening and isolating it was to be in such a bad way mentally during a pregnancy. Be gentle with yourself, and I promise you won't always feel this bad.x

Hi madmomma
Thank you for your kind reply. I'm 32 weeks pregnant now and have just received my appointment for the perinatal mental health team in a week and a half. I'm glad you got the birth you wanted and that it was a positive experience for you. I'm seeing a consultant this week so hopefully she will be understanding of my situation. I'm starting to come round to the idea that medication may be a necessity and I'm pleased your babies were healthy as it's always a worry.
Do you mind me asking what kind of things the mental health team asked you about? I'm not really much of a talker and find it hard to express things as I'm really quite private.
Thanks again for your reply and support.
Mournae.

Of course I don't mind
They just asked me about how I felt really. I can't remember the exact questions but I've had a few psychiatric assessments (sound scary, aren't) before so I knew what to expect. They ask about how your appetite and sleep have been affected by the depression, if you've had any suicidal thoughts, if you hear voices - that kind of thing. They have to check that it is just common or garden depression so they ask you stuff to eliminate nastier things.
They're bound to ask you how you manage with your child, what support you have, if you can talk to anyone; that kind of thing. Of course when we're questioned about anything as a Mother it's natural to clam up and panic that they're going to take your child off you! This is far, far from the truth. They have to ask every single person who has a child at home the same questions. It's their job and it does not mean at all that they are suspicious. The fact that you have confided in your midwife and accepted support are ample evidence that you are a very caring Mother.
They will not ask you anything 'deep' like what you regard to be the origin of your depression or anything like that. You'll find it easier than you think to express yourself because the questions are designed to draw you out IYSWIM.
They're only interested in your symptoms and in what would help, so there's no reason for you to bare your soul at all.
Take heart from the fact that (as you know)at 32 weeks, all your baby's organs are fully formed and so a lot of the risk factor (which is beyond tiny anyway)is gone. The only concern at this stage would be the baby having withdrawls when born (if bottlefeeding) or when weaned (if breastfeeding).
This sounds a hell of a lot worse than it is! If your baby did have some withdrawls, the effects are temporary (no longer than a week)and they will forget. They are not medically dangerous, just unpleasant. We're not talking crack withdrawls here! (My son withdrew from prozac at 3 weeks when I stopped breastfeeding and he was kind of tense and a bit jittery for a bout 3 days. We just cuddled him all the time and he was fine - didn't cry or anything, just a bit jumpy if there was a noise: a bit like you'd be if you'd had too much coffee.)
Whereas the benefits to you and your baby if the medication works are huge, as I'm sure you know. Things can only get better from today, and this hard time will pass. Loads of love to you, Heather x

I ended up seeing the perinatal team before and after recent birth, as a drug I was on is now old enough that the new GP and MWs were ignorant of it and wanted an expert opinion.

I was reluctant as had bad experiences with psych types before, but both guys were really lovely and kind and reassuring, and ensured my notes highlighted important points. They also knew everything about drug effects and risks - they were able to confirm that my codeine for SPD should not be an issue after a full term birth and is OK with breastfeeding, for example, citing all the research.

Incidentally, they were both amazingly gorgeous...

funny you should mention that notcitrus - my psychiatrist is also v hot!

I have been seeing perinatal mh team since 28 weeks and have found them very helpful - totally up on the research with meds as above and very understanding and empathetic. I can't say the same for anyone else involved in my care. I have perinatal OCD and had moderate depression early on in pregnancy which has mostly lifted with CBT and mindfulness therapy I paid for privately.

I chose not to take the meds when prescribed at 28 weeks because I was afraid of risks but to be honest, I've been sorry I made that decision several times since as I have had some bad times in the last few weeks (it's my due date today). If I had my time over I would just take them and I will go on the medication as soon as I deliver: anxiety/depression/mh carry their own risks to the baby and really the risks of sertraline etc are so minimal as to be non-existent.

Good looking psych here too

Thanks for your replies. It's good to hear from those who have been there or are currently supported by a perinatal MH team. I have my appointment on Wednesday so I'll just be as honest as I can with them and see what they advise.

Thanks again.

Mournae

I was referred at 12 weeks and saw a lovely CPN every 1-2 weeks, and psych monthly. I went into the mother & baby unit when baby was 2 weeks, for a short stay (because of the trauma following my c sec, the effect on the baby and my recovery was horrific). Then I went back in early march this year for 3 months, during which time I was really poorly.

I also saw a specialist mental health midwife whilst preg. I was discharged from the ward last Monday, still seeing my team until baby turns 1.

12 weeks pregnant, that is.

Sorry to be a downer, but whilst in MBU I saw quite a few other babies who were very, very damaged from mums medication. One with 2 holes in her heart, another born at 23 weeks, permanently disabled/blind/unable to breathe independantly. But Tbf the mums were on heavy duty anti psychotic meds, not ADs. I'd speak to your team.

I came off my meds whilst preg as they are v high risk, stayed off as determined to bf as long as possible. Stopped and went back on whilst in hosp as they sectioned me and were going to forcibly inject me.