Why Becoming A New Parent Can Feel So Hard

Becoming a parent is one of life's biggest transitions. Alongside the practical changes of caring for a new baby can come profound shifts in identity, relationships, emotions and mental health.

In this episode, perinatal psychologist Julianne Boutaleb joins Dr Lee David to explore why this period can feel so challenging and why many new parents are surprised by the intensity of the experience. From changes in the brain and heightened sensitivity to uncertainty through to sleep deprivation, relationship changes and the loss of the village that once helped families raise children, the conversation explores some of the reasons life with a new baby can feel harder than expected.

Julianne explains how modern parents often place enormous pressure on themselves to get everything right. They discuss perfectionism, social comparison and the belief that we should somehow instinctively know how to care for a baby. The discussion highlights why babies do not need perfect parents and how the idea of "good enough" parenting may be more helpful than many people realise.

The episode also explores the importance of connection and support. Julianne reflects on the role of partners, family, friends and wider communities in helping parents navigate the emotional ups and downs of early parenthood. She explains why asking for help can be difficult and why many parents mistakenly believe they should be able to manage alone.

Lee and Julianne also discuss perinatal mental health, including anxiety, depression, intrusive thoughts and birth trauma. They explore how to recognise when additional support may be needed and why early support can make a meaningful difference.

This is a thoughtful conversation about the emotional realities of life with a new baby and a reminder that finding this period difficult is often a reflection of the scale of the transition rather than a sign that something has gone wrong.

And you can read Julianne's poem, Little Stranger, here in in our blog.

Key moments

00:00 The reality of becoming a parent
03:05 Why the transition feels so challenging
06:17 Uncertainty and loss of control
08:53 The support new parents need
12:07 Comparison and parenting pressure
17:00 How parenthood changes the brain
19:58 Why babies don't need perfect parents
23:58 The importance of a village
29:19 Small moments of support and kindness
31:22 Recognising perinatal mental health difficulties
36:24 Growth and change through parenthood
38:27 Choice Space takeaway

About the guest

Julianne Boutaleb is a consultant perinatal psychologist and founder and clinical director of Parenthood In Mind. With more than 24 years' experience across the NHS and private practice, she specialises in supporting parents and parents-to-be with perinatal mental health difficulties including anxiety, depression, birth trauma, PTSD, tokophobia, reproductive loss, fertility treatment, attachment difficulties and relationship challenges. Julianne has a particular interest in the impact of birth trauma on parents, couple relationships and parent-infant attachment, and has extensive experience teaching and training health professionals in perinatal mental health, attachment and early years wellbeing. She works with individuals, couples and families using a range of evidence-based approaches including CBT, ACT, compassion-focused therapy and attachment-based interventions.

You can contact her via the Parenthood in Mind Website, LinkedIn and Instagram

About the host

Dr Lee David is a GP, CBT therapist and author specialising in mental health and wellbeing. Lee has written many books on CBT, mindfulness and teen wellbeing, and speaks regularly at conferences and in the media. Away from work she enjoys running, hiking, singing in a choir and spending time outdoors with her family. You can find Lee through her website and on Instagram, TikTok (@dr.lee.david), Facebook and LinkedIn.  You can find more about her books, wellbeing courses and therapy here:  https://linktr.ee/dr.lee.david 

Transcript

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SPEAKER_01 0:00

It is not serving babies or toddlers or children well if we are doing too good mothering. What we want is to have flexibility, agility in terms of relationships and being able to move in and out of states of distress. And what I really, really want you to know is that you're allowed to get it wrong. In fact, you need to get it wrong sometimes because guess what? That will allow your baby's brain to grow in such a way that they are relationally agile, that they can move in and out of different environments and be able to cope with the uncertainty that comes with those environments.

SPEAKER_00 0:47

Welcome to the Choice Space Podcast. I'm Dr. Lee David, GE CBT therapist and author. Being a parent can turn everyday life upside down, and it often takes time to find our way. Some days may feel manageable, others more uncertain or overwhelming. And this will all happen alongside moments that feel hugely meaningful or connecting. The early stages of parenting can also bring challenges with perinatal mental health, and it's not always easy to talk about these or to know what helps. But taking time to understand can make things a little clearer and easier to handle. I'm delighted to be joined today by Julianne Bouteleb, consultant perinatal psychologist and founder of Parenthood in Mind. Julianne, welcome. Could you start by telling us a little about your work and what drew you to this area?

SPEAKER_01 1:37

Absolutely. Thank you so much for inviting me on, Lee. I'm delighted to be here this morning. I'm a consultant perinatal psychologist, and essentially perinatal is the period from conception through to usually one year post-birth. My career stretches over 25 years now, and I was one of the first psychologists in the country to set up sure start psychology services. So my passion has been about preemptive care, about really helping people, I guess, to use Bishop Desmond Tutu's idea of being able to pick people up further stream rather than when they're downstream and really struggling. Now my career has moved on, and in the last 25 years, what we've seen is a whole range of alternative routes to parenthood, including more open access to IBF, to donor conception, surrogacy, and indeed adoption. And so part of what I'm also specializing in is helping families with a perhaps a longer or more alternate route to parenthood as well.

SPEAKER_00 2:34

Thank you so much. And so what I'm hearing there is that parenthood is really diverse and it looks different for different families, for different individuals. The route to parenthood can be very different. And it's so important to understand that when we're thinking about what parenting involves. I think something that may be universal though is that the transition to parenthood for all of us can feel really quite challenging, although what those challenges are may be very different for different individuals. Why is it such a challenging transition, do you think?

SPEAKER_01 3:05

I I think that's a great question. So the tagline of Parenthood in Mind is whatever your path to parenthood, wherever you are in the journey. And I think what we're ill-prepared for as individuals in this time and space of civilization is the huge upheaval that comes with becoming a parent. For some, the upheaval starts at the point when they're trying to conceive. Perhaps there's a desire to conceive, but there's soon a realization that that's going to need some sort of medical assistance, or indeed somebody may go through a miscarriage or other pregnancy loss. But even if the path to parenthood is easier, what most of them are unprepared for is what having a small baby, having a small pre-verbal person in the house is actually about. There is usually a sense of preparing practically. So we can paint the room, we can look out for a nursery place, we can get the right buggy, for example. But often what people aren't doing so well is really thinking, what's going to happen to my relationship with my partner if you're doing this partnered? How are we going to have a relationship if we're tag teaming with a little one over a course of a few nights? What is my career going to look like if I've come through a very difficult birth and realise I can't quite go back to work when I thought I would and how I thought I would. I think there's also the wider implications where most people don't have the village, I guess, that sense of there being aunties and other mothers in the area that you could perhaps go to because you know your mum had gone to the hospital to have a baby. That village is missing for many of the people that I see in clinical practice. And I guess that's the added burden where they're trying to manage all of these huge emotional, relational, and practical changes, but they're often trying to manage that between two of them, which is really not the way that we've been parenting and being hardwired to parent across the ages, really.

SPEAKER_00 5:05

So I'm just hearing there how that lack of support can be a huge impact. So there's this massive transition, and there's lots of changes that may need to be made, and there's adaptation to how we do care for, as you say, uh a non-verbal little one that we care for so deeply and want to promote their well-being, but not always sure how exactly to do that. And then we're doing that without anywhere near as much support. One of the things that often stands out to me when I'm working with people around parenting changes is about uncertainty because there's a lot of lack of control, I think, around fertility, for example. We can't choose exactly when we might fall pregnant, we might be able to sort of uh sort of improve our chances and be healthy and make healthy choices, but we can't really control that as an outcome. And we can't always control the outcome of a pregnancy, which is so wanted and loved, and and as you mentioned, sometimes people experience things like miscarriage, which can be hugely devastating. And then with a a new little one in our life, we can't necessarily control their personality, how they interact with us, and how we're feeling about it, our our mental or physical health. So there's an awful lot of things that feel quite out of control in a in a world where we're perhaps very used to being able to control things. And I wondered if that's something that comes up for you.

SPEAKER_01 6:25

Absolutely. So there are two very key points. And again, I think we have to think within perhaps a sort of a westernized model that, you know, we're often raising young people to be very individualistic. We often have these messages of if you work hard and you know, pass your exams, you'll do well and you'll get the results that you want. And of course, what happens then is you come to this point in your life where actually those same messages, those same beliefs are really challenged. You know, you're not necessarily going to be able to try harder to get pregnant or indeed maintain a pregnancy. You know, suddenly you're faced with this sense of, gosh, I can't control the outcome here. How do I manage my vulnerability around this? And I think what often then happens, and I think one of the huge shifts in parenthood is how relational we are and how much we require relationships. So one of the key sort of shocks I often find with parents is the degree to which the baby's feelings and the baby's lack of sleep or not being able to feed or not being able to soothe them can really, really throw them into a sense of overwhelm, into this sense, as you say, of not having any control. And the reasons for that are are multiple. But one is, of course, that babies can't talk. So we're often thrown into our pre-verbal, non-verbal, at the right side of our brains, where we're trying to understand what our babies are communicating to us. We're trying to do that, of course, when hormonally lots of shifts have occurred. Perhaps we've also been through lots of medical procedures to get pregnant and then through birth. Our partners then are trying to also be alongside and understand what's happening. And they may also be finding the baby's cries or the baby's, you know, not sleeping very overwhelming as well. And so what we have often is a sense of trying to learn huge things. What do our baby's cues mean? How much can I rely on the fact that when I've fed the baby that she's had enough? But we're doing this at a time when our hormones, you know, have hugely changed, our bodies have changed, our relationships have changed. And I think what's often fallen away when I listen to older women talk about how they raised children and, you know, the support they had was that we're doing this often in silos. Often the only advice or wisdom that people can avail of is Dr. Google or the internet. And that isn't what new parents need. New parents need regulated, wiser grandmothers, grandfathers who've done this before, who can calm them and show them perhaps and give them ways of doing things that have worked for them. Now I know somebody's probably listening, going, oh gosh, no, that's my worst nightmare. I don't want to have that sort of support. But actually, one of the things across 40 years now, Lee, of perinatal studies in terms of anxiety and depression, particularly postnatal anxiety and depression, the key most robust variable is to what degree do you have a supportive partner? And by supportive partner is somebody who can get into the trenches with you, who is tag teaming you with the sleep, with the feeding, with the household chores, and to what degree do you have a support network around you? Where people have those two things, the outcomes for perinatal mental health can be vastly different. And so I would say, along with checking out what sort of buggy you're going to have and taking a trip to John Lewis to check out, you know, your breastfeeding pump and so on, I would also start to do a little bit of a list of who is there in your support network. And we don't need them all to be doing the same thing, Lee. Sometimes it is about somebody dropping over a big pot of, in my case, Irish stew, or it might be somebody else knowing that you really want to breastfeed and they've been there and done that and have, you know, been really happy with their breastfeeding journey. Can they come along and sit with you and hold your hand and pour you the water and encourage you? And again, we're talking about this at a timely where really unfortunately the sort of more professional village that used to exist, i.e., the community midwives and the health visitors, they are not there in the same ways that they used to be when I started my career. And so we really need to think in advance about the sorts of supports that we need before we're faced with a crying baby and you know not having slept for five days.

SPEAKER_00 10:54

Yeah, I couldn't agree more. And, you know, I'm really thinking about this idea about the importance of connection and relationship. And actually, that's a predictor of mental health and well-being across life at all ages, and it's probably the strongest predictor. I think it's got the best evidence for well-being in every aspect of our lives. And so it's so important that we are seeking ways to connect. It strikes me that there's a lot of levels at which support can be helpful because support can give us that practical advice. It can give us somebody who can maybe give us a suggestion, oh, this worked for me, and you know, perhaps you could try this or this. Maybe it gives us a sense of validation. Actually, yeah, I found that hard too, and you're not the only person. Because I think when we do get siloed, there's a risk that we start to blame ourselves when things, when our baby's perhaps not sleeping, and particularly when we're tired, our hormones are changing, we may have increased anxiety, we may be lower in mood than we normally would, and we'll then interpret our baby's messages in quite a negative way. I think our self-esteem can be knocked, and we end up thinking, I'm not doing well enough, I'm failing somehow, and I'm not good enough. And then we get this cycle where we feel very isolated and we're blaming ourselves and we feel less able to reach out because then we think, oh, I'll be exposed because other people will see that I'm failing and everyone else looks like they're doing okay. And so we end up being really isolated.

SPEAKER_01 12:21

Absolutely. You have really brought that to life. If I had £50 for every parent that comes to me and very convinced says to me, everybody else is doing this better than me, I would be a very wealthy woman. And it really breaks my heart because I feel, and don't get me wrong, Instagram is a wonderful resource for many, many things. But I think what it's also given rise to is this sort of belief, you know, it's putting your best face forward. And a lot of people are taken in by these images that they see. They're convinced that that person with the hair blown, you know, the beautiful makeup and the beautiful house is the epitome of what motherhood should be. But what they're not seeing is what she looked like at 3 a.m. in the morning, you know, when the baby wasn't sleeping. What they're not seeing is the levels of support that she has in order to create and curate this image of motherhood. One of the ways in which I feel we're going backward is this belief that we should be doing this on our own. We should not. What happens, and this is the amazing work since 2016 of El Celine Huxima. She is a researcher and she led almost an all-female team in 2016 to show what actually happens to the maternal brain in early pregnancy and throughout postpartum. And what she was able to see on fMRI scans was the difference between brains of women who had not yet become mothers and those who had. And there were two key points in the in the brain structure that had changed. One was the amygdala, which is a tiny almond-shaped part of the brain, which is to do with risk, became more active. And that again makes sense. If you think of one of the first jobs we have as a new parent, it is matter-of-factly to keep our babies alive. And so that part of the brain became very active. And the other part was the frontal cortex, the part of the brain that links in with being able to see emotion, interpret emotion, think about emotion. And of course, that is also very salient when we think of what we have to do with our babies, trying to take in, interpret, and make sense of the baby's cues. Now, what that also means, unfortunately, is that we develop heightened sensitivity for our own feelings. So often people will say to me, you know, most of my life I've been a very calm person. Yes, I've had challenges. Yes, I've got a busy work environment. Yes, I've had illness in the family, but I've always been able to cope. What I'm really, really shocked by is the level of anger I feel sometimes, or the level of sometimes I feel like I'm wanting to run away from this scenario. It's so out of my control. And again, what I often have to explain to them is yes, you're not only having to deal with your own emotions, but you're also taking in your baby's emotions. And what that might mean at times, in order for us to make sense of those emotions, is that we may be thrown back to earlier pre-verbal or non-verbal memories of our own experiences of being parented. And many people aren't prepared for that. A beautiful example I heard recently of a woman I'm working with, she was speaking to me about seeing her little one slide down a slide on a very hot day. And she remembered, it just came into her mind, the little one's about two, her own sense of sliding down a slide when it was very hot. And she didn't I felt this tingling in my fingertips. And it was the extent to which it wasn't just that she'd connected with her daughter's experience, but that she was able to find herself almost in her daughter's experience. And a lot of that is not expressly explained to parents that at times you will feel as if you're the crying baby or you're the one that needs to be scooped up and held and looked after. And again, I often feel that when that's not explained in a couple relationship, that can feel very overwhelming also. Sometimes I work with couples where the male or the non-gestational parent will say to me, I don't recognize this person. She was always so on it, she was always very capable. And again, what that means is that the other person has to move into a different way of being in relationship. So I would say I would really like some of those factors to be spelled out for people. How you will change in relationship, how you might need different things in relationship as you move across this transition, how others around you may be more or less able to move into a different relational space with you, but that none of this is you doing it wrong. This is exactly what we expect. And I guess the word we now are using for this is matrescence. It's understanding that as you move into becoming a parent, and the male equivalent is patrescence, that there is a whole shift, a seismic shift in all of these different ways, and particularly relationally. And I would love to prepare people more for that so they don't feel so frightened by it when it happens.

SPEAKER_00 17:19

That is so interesting to hear about the changes to the brain affected through parenthood and the fact that our amygdala, the threat system, it makes so much sense that that would be alert. And obviously, the positive side is that it makes us more aware of risk and helps us keep our baby safe. The downside is that when we're in a relatively safe world, that it can leave us hyper-vigilant and aware of every minor risk and perhaps feeling really overwhelmed by risk because actually the world just starts to feel hugely threatening and we then start to feel overwhelmed and feel like, I don't know if I can keep my baby safe. It feels like there's so many threats out there, and I have to get it absolutely right. So then we put ourselves under pressure. And I see a lot of women who'll be overthinking, they'll be thinking, thinking, thinking, I just need to get it right. I need to read more, I need to check more, I need to think about this. And we've got all these checking devices in the modern world as well now, haven't we? Where we're able to monitor and we've got comparisons. And so it feels like the gap between expectation and and the messy reality of having a baby where babies don't follow schedules and where our emotions are actually, as you say, we're experiencing our own younger selves. And so that idea about what we really need at that point is is co-regulation. We need a way to soothe ourselves, to feel connected, to take a breath and not react immediately, but create a sense of I've got support, I'm not alone. Yes, there are things that are difficult, and yes, I do want to get it right. I love my baby, but I just need to turn down that pressure and that amygdala-driven do it now, but actually just think about it in a more subtle, soothed way. And it feels like that's where the connection might help us a little bit.

SPEAKER_01 19:05

Absolutely. And and I think if you imagine then, let's say you've had a very difficult time to conception, and then you've had a very difficult pregnancy where again the hypervigilance has been there the whole way across being pregnant. And then let's say you have a birth that is less than ideal, so you come to caregiving and parenting with all of that hypervigilance as well. And that you add in then perhaps a predisposition to perfectionism or you know, needing to get things right, then of course, what you're seeing and what I'm seeing is intrusive thoughts, ideas around failing as a mother because you're not getting it right. And again, what I love to do, because I love research, is I always say to people, so Ed Tronick, who is the godfather of parent-infant psychotherapy, he was responsible for doing what we call the still face experiments, where mothers interact with their toddlers and stay still, don't respond to them, and he was able to show the distress, but also the expectation that babies and toddlers have that their parents will respond and interact with them. Now, why is this important? It's important because one of his key theories is what we call the power of the third. And this is probably 30 years worth of observation and research into mother infant and father-infant dyads. And what he said was the reality is not that we have to get it 100%. That's not it at all. Instead, what he saw and what his team were able to plot over time was that a third of the time you are beautifully attuned to your baby. You're having this lovely, you know, your brain is full of oxytocin, which is the bonding hormone, their brain is full of oxytocin. You might even be getting, you know, a couple of shots of dopamine in the frontal brain. So it's all beautiful and lovely and snuggly and warm. But a third of the time you won't be in sync. You'll be trying to work out what's going on. We're not in sync. You've woken up and I've just fallen asleep. And the other third of the time will be you trying to work out, take in and understand your baby's experience. And his message is we need all three of these things. Now, why? If you think about parenting as preparation for a little one to go out into the world and survive, you know, on pure anthropological terms. That's what parenting is, caregiving is. It is not serving babies or toddlers or children well if we are doing what we also call in psychoanalysis too good mothering. In other words, we have got it down to a T and perfection, but you take that little one and put them into a different environment, and suddenly they will experience that environment as very uncertain. What we want is to have flexibility, agility in terms of relationships and being able to move in and out of states of distress. And so that's one of the ways often that I speak to mothers. Say, I know this is what your brain is telling you. I think what you're wanting is to remedy or repair something from your own childhood. And yet, what I really, really want you to know is that you're allowed to get it wrong. In fact, you need to get it wrong sometimes because guess what? That will allow your baby's brain to grow in such a way that they are relationally agile, that they can move in and out of different environments and be able to cope with the uncertainty that comes with those environments. And that often flicks a switch for many of the women that I see and allows them to understand how they can move out of perfectionism.

SPEAKER_00 22:39

So what I'm hearing there is that it's not only okay, it's actually better to not be perfect because our babies need us to have a bit of flexibility to not be perfect. And actually they will learn from us about recognizing when things aren't working and actually being okay with that and having a sense of stability that actually doesn't have to be completely controlled in order to be safe. It's okay for there to be changes, it's okay to have maybe some rupture of our relationship a little bit, and then as long as it's repaired again, then that's also really important part of learning how to be in a real relationship with a real person rather than a perfectionist relationship on Instagram version where it's always shiny and happy. And so I'm hearing something about the importance of self-compassion, being kinder to ourselves and being a bit more accepting that I'm doing my best actually, and that's okay. I don't have to live up to some unrealistic standard. I sometimes use an analogy with people thinking about my children had some very loved Teddies. So we had a rabbit who was just so loved that his arm was kind of hanging down, his stuffing had come out, he wasn't really that rabbit-shaped anymore. But he was absolutely beloved. And if we try to change him for a brand new perfect one, he wouldn't have been wanted. And I think he's loved because he's not perfect, he's loved because of all the time he's been spent being held and sucked and and he's pretty grubby. But actually, we're aspiring to be the loved version. We're not trying to be the flashy toy in the toy box who's never been played with and yes, may look perfect, but isn't actually a real human being.

SPEAKER_01 24:16

Exactly. That's a beautiful, beautiful example of what I'm talking about. And I think there's two things in this, what I would call toxic mothering idea. One, that it's all on you. No, we mother best in groups. In other words, that might be a group that you go out to at 11 o'clock in the morning where you're able to say, I've had a really difficult night, and someone goes, Yeah, me too. And suddenly you get that connection, you get that sense of validation of that feeling. We also need to mother intergenerationally if that's possible. And that may not be your own mother, but it may be a mother who is slightly ahead of you. And again, why is that important? Because they're likely to be more regulated, they're not in the trenches with you, they're not meant to be, but they're walking alongside you saying, you know what, you can get there. I can see some of the lovely things that you're doing, I can see the way that your baby is looking at you, I can see the way, since I last saw you four weeks ago, that your baby has come on a leaps and bounds. And without those, so we call this the maternal gaze, and it's the gaze of other mothers or others who mother, and that can be men and women, who are able to see you in your mothering role and go, you know what, you're fine, you're doing really well, or hang on a second, you're looking a bit down today. What's going on? And without that, what we're doing is we're constantly turning inwards to check how we are. Self-compassion is usually something that happens when others have shown us compassion. And I really feel for a lot of the younger mothers that I see coming up who are really beating themselves up with a stick that they don't even need to have in their hands. This is for the long term. It is an ongoing relationship with your little one. And I often say to them, imagine it from the baby's point of view. What if your baby were able to talk? What if I was able to talk to your baby? What would they tell me you'd done really well last night when you're describing to me a really difficult night when they're teething and you didn't sleep and they didn't sleep? And often what they're able to get to is, yeah, mummy held me. Mummy was there for me, just like that rabbit, as you're saying, you know, we're battered and stained and we've got bruises, and our arm is probably hanging to one side, just like that bunny rabbit you described. But therein lies the whole point. We're known and loved and safe because our babies are able to do those things with us over time.

SPEAKER_00 26:46

This is the choice pause, a short tool you'll hear in every episode, drawn from my books and therapy practice. Each time it offers a different way to pause, notice, and choose your next step. Today's pause is about letting go of pressure as a parent. Take a slow breath in and a longer breath out. Notice your feet on the ground, let your shoulders feel a little heavier, and soften any tension you may be carrying in your face or jaw. Many parents carry an internal pressure to somehow get everything right. We care so deeply about our children and the responsibility can feel huge. Yet much of parenting involves living with uncertainty, doing our best without any guarantee that we'll always get things right, or that we won't need to change course or change our minds at times. And when stress and pressure build, it can make it harder to think clearly or make decisions. Take a moment to pause and ask yourself what pressures or worries am I carrying today? Perhaps it's a pressure to be more patient, to know all the answers, to keep everyone happy, or to carry everything and cope by ourselves. Take another slow breath. Notice the colours around you, a background sound. Perhaps take a sip of water or gently stretch your arms. Remind yourself parenting is hard. No one has all the answers. It's okay to not be sure. Now ask yourself what is one small helpful next step? Perhaps it's letting go of an expectation, just a little, finding some information, but not too much, reaching out to someone else who understands, or taking a moment to nourish yourself with food, fluids, or some gentle movement. As you continue with your day, remember that even a brief pause can create a little more space to think clearly, respond thoughtfully, and care for yourself along with your baby. Do you think there's value in us as a society also offering light touch moments of support and compassion? Because I quite often see it's often a mum, it's not always, but it's often a mum, maybe in the supermarket or a shop, and maybe they've got a baby and a toddler, and there's a little bit of perhaps the toddler's challenging in some way, and and mum's looking a bit fraught and overwhelmed. And I always try and just make eye contact and smile and say, You're doing a great job. I know how hard it is. I remember from my time, and you know, keep going, you're doing amazing. Because I always think people are just assuming that everyone is judging them in those moments, and I want to try and counter that idea. And do you think those things matter, those sort of little moments?

SPEAKER_01 29:42

Yeah, oh, amazingly so. I I have worked with women, you know, really in the depths of depressive episodes or not being able to get out of the house for fear that others will see them. And often there is exactly as you described, that sense of they will see how bad a mother I am. They'll see I'm not able to soothe my baby. And it's for somebody to see and go, don't worry, you're doing a great job, or even to offer practical help. The number of mothers I see struggling with buggies up a flight of stairs or onto the tube, maybe just say, Would you like me to take the little one? And the relief, you can see the shoulders drop. And I do think, and and I am very passionate about this because I've worked in parent infant work for many, many years and was once for a time a trustee of the Association of Infant Mental Health. And so, what I would really like to have happen is for us as society to really understand that children are our children. We have to encourage parents, we have to campaign for better maternity settings and better maternity experiences. I really feel we have to get back to somewhere where the mothering and the parenting definitely happened in groups. It's always been done in groups, not alone.

SPEAKER_00 30:55

It's so important to recognise, I think it's a period of vulnerability for mental health challenges, is a parenting period, and that's that's for everybody. And perinatal mental health affects mothers, but also fathers and non-birthing partners can have an impact on everybody. So when we talk about perinatal mental health, we're not just talking about mothers, and it's important to sort of acknowledge that. I think sometimes we may notice it ourselves, sometimes it might be our partner, or sometimes it may be someone we care about, either a friend, or it may be that we're a grandparent. And how can we identify the difference between baby blues, which is kind of normalized, and people who expect it to feel a bit blue? And it's it's pretty common, but it is quite different where we really do need to take notice and actually seek additional support. How can people start to recognise that?

SPEAKER_01 31:44

So I guess what I want to say is there's a whole spectrum here, and baby blues is that very normal, mostly hormonal, hormonally driven impact post-birth, and that lasts up to, you know, a week, usually seven to ten days. And that's about huge levels of pregnancy hormones leaving your body. It may also be to do with the impact of the birth and the letdown reflex happening where prolactin causes surges in breast milk. So there's a lot of things happening hormonally in the first seven to ten days. You have to also factor in. There's going to be some time to adjust. And so, again, in terms of actually diagnosing postnatal depression or postnatal anxiety, we're usually looking at a six to eight weeks point, which is why that time, either meeting with your GP or another health professional, such as a health visitor, it is really important that you say to them, if you're still not feeling that you're getting the hang of things or that you're having intrusive thoughts, or indeed that you're really not feeling like yourself. And it's really important, we will have dips. It will be normal to have good days, bad days. But when we come to diagnosis, and we we normally use things like the PHQ and GAD, we're looking at what's happening across a two-week period. So if in a two-week period you're saying to me actually, the majority of the days and really consistently over a number of days, I'm really feeling very low. I'm really not enjoying it when my baby smiles, I'm sitting watching the clock, waiting for my partner to come home, or indeed I'm dreading having to put the baby down or feed the baby. Then we're looking at possibly looking at more support. And again, I think what's really important here is people go into a shame spiral. One in four, it used to be one in five, it is now one in four, is the latest research of parents and parents to be will have some sort of mental health impact in this transition to parenthood. And again, I know how much people beat themselves up, I shouldn't be, I should be, etc. What we know is if you have had earlier experiences of depression and anxiety, it is likely that you'll be more predisposed. If you've had a very difficult pregnancy or indeed very difficult time becoming pregnant and a difficult birth, that might also be a factor in what's happening. And none of that is your fault. These are all different things that may have been outside of your control. But what's really important is that the sooner you can get the help that you need, whether that's talking therapies via your GP or a support group with women similarly impacted by whatever your issue is, or indeed also using medication alongside that, or maybe calling in a grandparent to perhaps take the caregiving load off you, whatever those range of factors might be, and indeed a full range of factors is usually needed. Take it that the earlier you can put those things in, the more likely it is that you will come through this difficult period and move on into parenthood in the ways that you'd imagined. Again, what I really want people to hear is don't let this drag on. Don't imagine this is unique to you. It's not. Many of us go through it. We expect a lot of things of ourselves as new parents, but it is really important to understand that if you're not able to put your own oxygen mask on and ask for the help that you need, there will be a knock-on effect. And what that usually means is there's usually a severity in symptoms, and also the longer it goes on, greater knock-on effects on your relationships, your relationship with your baby, your feelings about yourself as a parent, and so on. So I would say if you are feeling some of these things right now, do try and speak to somebody that you trust about how you're feeling. Take the next step. That might be the next step today. Just talking to someone and saying, Yeah, I'm not really where I thought it would be by now. And then tomorrow take another step. You don't have to do it all on your own.

SPEAKER_00 35:49

Yeah, absolutely. And over the years in my career, I think there's been a greater recognition of that range of perinatal illness that can affect mental health. And I think in the past we used to see it as depression was the common one, and we'd look for low mood. But I think I'm also seeing a huge amount of anxiety in perinatal period and maybe features of OCD, for example, and and that again can be incredibly difficult with lots of intrusive thoughts, all motivated by love and wanting to keep our baby safe, but it gets a bit out of control where we're having to do perhaps some repetitive behaviours in order to try and stay safe, that they're actually getting in the way of living or of our values in in parenting. And so it's so important to seek support because I think all of these things are treatable. You will be so familiar with this that people can come feeling really overwhelmed, and actually, with some time and support and recognition, self-acceptance and skills that how to work through some of these things can change hugely, can't they?

SPEAKER_01 36:56

And very quickly, and that's why I love my job. Sometimes people say to me, gosh, is it not difficult to see, you know, new parents? No, because what's amazing is that sometimes because of this neuroplasticity, because of the agility in the brain structure and the hormones and the wonderful agility in your baby, these things can change very, very quickly. And that's what's amazing as well. And and I often say to people, sometimes these things turn up in parenting because we've put them somewhere, we've put them in the deep freeze, we've said, I'll come back to that at a later date. And what's happening with all of the hormonal changes, brain changes, relational changes is suddenly that thing pops out and it's about maybe breaking the cycle on your perfectionism. Maybe it's about breaking the cycle on imagining this is all on me. No, it's not. Maybe it's also about breaking the cycle on what parenting means. Maybe it is just about sitting in a messy room with the baby on your breast and watching daytime TV. If we're able to grab hold of some of these really difficult experiences, Lee, what I see happening, and yes, we have a word for it in the literature, which is post-traumatic or post-perinatal growth, it's about saying, I can put that to one side. I don't need that anymore. We can grow through the perinatal period. We can become different people because what we're finally often facing are those sorts of experiences or beliefs about ourselves that finally have to be looked at face on. And I really want people to understand that whilst many go through these difficulties and there is a range of difficulties that will be experienced, the vast majority, I mean the vast majority, come through and talk about leading much more meaningful, much more balanced lives. And that's what having a baby can truly, really, truly mean for many of the women and men that I see.

SPEAKER_00 38:55

That's so amazing. So just to finish, we always do a choice space takeaway. And I think if we're to speak to new parents who are listening, who may be struggling a little, but perhaps looking for some strategies that they can use themselves in their day-to-day lives that will help them move forwards. And obviously, we've talked about the seeking support, and that is hugely important. Are there any other practical tips that might be quite quick that people can do even when they're fatigued, even when life is tough and they're feeling a little bit unsure? What can we do that could make a difference, Julianne?

SPEAKER_01 39:32

I would say one thing is just to pause. And I know people say, Oh no, but I can't, I've got to get out. No, just pause, breathe, take a deep breath in, and exhale. That very long exhale signals to your brain that there is no risk. There is no saber-toothed tiger going to jump through the window. Your brain is telling you that there is, but that sort of exhale will allow your brain just to pause, sit down, take a breath, make yourself a cup of tea. Again, that's a very mindful activity. These moments throughout your day in parenting are really important. They're the equivalent of the break in the car when your brain is on acceleration. Try that, put the baby down, let them sleep, and just exhale. Leave everything else to one side, and hopefully that will make the difference in your day. If you're finding that's not enough, then it might be about reaching out for more help.

SPEAKER_00 40:28

I I love that. And I think pauses are important again across the board, and our sense of urgency are growing amygdala will tell us you can't, you mustn't have a pause, there's no time for a pause. And actually, it's trying to say it's okay, these things are important and safety is important, but not so important that I need to be frantic all day. And that isn't actually making us safer, it's just making me stressed and tired and undermining my sense of competence in parenting. So I I love the idea about having a pause. I think for my one, I'm going to go back to what you said about the one-third rule, which is about a third of the time we're going to be thinking and what's going on and planning. We don't want that to end up being three-quarters of the time that we're spent worrying and planning and trying to figure out what's wrong, that we spent all our time thinking and overthinking, and actually we're missing out on that one-third, which is so important when we're just present, engaged, we're making the eye contact, we're making faces, and they're making faces back at us, and we're interacting. And I think that's so important for our regulation, for that baby's regulation, and for that little bit of joy about finding those moments where it's not about achievement, it's about just being present and being engaged. And the other thing that I think can draw us out of attention is things like social media where we're scrolling or we're checking or we're thinking or we're planning. So I would just encourage people to think about putting a boundary around the time spent thinking and planning or scrolling and making sure that we've got enough of the time, not perfectionist, but just a good chunk of time where we're present, engaged, and just being with our baby.

SPEAKER_01 42:12

Yeah, absolutely. And there's something that we talk more about in the last 10 years, which is delight, delighting in the baby. Babies do these amazing things, like they wriggle their legs, they they have a whole body experience of all of the emotions. And delighting in our babies is also what they need in order to allow all these little synaptic pathways to grow.

SPEAKER_00 42:34

So maybe we need to be engaging in our younger self a little bit, but not the younger self who feels vulnerable, but the younger self who also delighted in kicking our legs and being a bit more present and actually allow ourselves to be not always this adult who's always on guard, but actually just have a moment of joy and connection.

SPEAKER_01 42:52

Yes, absolutely.

SPEAKER_00 42:53

Thanks for listening to the Choice Face podcast. I hope this conversation has offered a little room to pause and choose your next step. We've included links to the Parenthood in Mind website and Julianne's Instagram links in the show notes. And there's a lovely poem called Little Stranger about what we need as parents and what our babies need and how we can find some of that delight and joy of parenting. If this episode's been helpful, please download, follow us, and share with someone else you might value the conversation too. And please do leave a rating or review on your podcast platform. This really does help more people discover our show.