Life feels hard. You’re feeling anxious, stressed, overwhelmed. You’re feeling flat, lost, unhappy. You’ve been through difficult life experiences that are weighing you down. Perhaps you’re not functioning as well as you’d like to. 

Let’s face it, we all struggle at times in our lives, especially when it comes to becoming parents, and everything that goes with this tumultuous life stage.
 
You might be contemplating talking to someone, but also wondering “what would be the point?” “How could talking to a psychologist help me?”  
 
Nowadays we rely on reviews to find out about other people’s experiences. As  psychologists, we are prohibited from eliciting and publishing client testimonials, making it difficult for people to find out how therapy works for others. 
 
However, the psychologists at the Antenatal & Postnatal Psychology Network constantly receive feedback from our clients about their experiences of therapy. So we decided to pull together feedback we’ve received over the years, to bring to light the commonly reported benefits of therapy. 
 
Please note that no identities have been revealed in the compilation of this list. The headings are written in the first person and are in no particular order.
 
Feeling heard, accepted and validated
 
Some people come to therapy reporting that when they were growing up, their feelings were not heard. With the best of intentions, parents can minimize or dismiss the feelings of their children, sending messages that their feelings are a sign of weakness, that they should just get on with things, or that their feelings signal catastrophe. 
 
Clients have reported that therapy provides them with a safe environment in which to identify and share their feelings. Once a good relationship and rapport has been established with their therapist, clients value that their feelings are accepted, are encouraged to be ‘felt’ (rather than shied away from or feared), and that their feelings are valid (“it makes sense that you feel that way”).
 
Feeling ‘lighter’ by getting things off my chest
 
In some instances, a client’s therapist is the first person to whom they have disclosed past experiences, distressing thoughts, or shameful feelings. By simply getting this information out, clients report feeling lighter – less consumed by their self-criticism, shame or fear of being judged. Within a trusted client-therapist relationship, repair can begin with the acceptance, validation and non-judgement the therapist brings.
 
Learning that all feelings pass
 
Interestingly, many clients report that being allowed to feel and express their feelings, along with having their feelings accepted and validated, provides an environment within which they learn that feelings evolve and change over time. By talking things through, feelings shift, and the intensity of the original feelings (often shame) diminishes.
 
Understanding why I think and react the way I do
 
In exploring the past, people learn about the ways in which they experience, and deal with their feelings – both internally and in relationships with other people. With insight into why they think and feel the way they do, their responses can be de-automated, giving them more choice and capacity to respond more adaptively. Clients learn to bring self-compassion to what was once habitual self-criticism.
 
Recognising that my expectations and assumptions underlie my feelings and behaviours.
            
In exploring the past, people learn about how their expectations were formed and how their expectations cause them to feel and react in certain ways. In therapy, clients learn to challenge their expectations, and to defer to their values as their guide, rather than to their habitual internal narratives.

Examples of unhelpful beliefs:
 
As a mother, I should know exactly what my baby needs at all times.
If I can’t exercise 3 times per week, I won’t exercise at all.
Everything I do should be done perfectly otherwise I’ve failed.
If I don’t get enough sleep tonight, I won’t be able to function tomorrow.
I am uninteresting to others, so I avoid meeting new people.
My child should know to behave well when we go out.
 
Examples of assumptions:
 
She thinks I’m a terrible mum because she uses cloth nappies, and I don’t.
My partner won’t know what to do if I leave the baby with him.
The mothers at mothers’ group think I’m a bad mum because my baby cries more than the other babies.
No one cares about my grief after my miscarriage.
I’m a bad person because I had that awful thought.
 
Learning to see another person’s point of view /emotional experience
 
It can be enlightening when people realize that they have been making assumptions about other people’s behavior or responses to them. They learn that there are many potential explanations other than the ones they were subscribing to. When people learn about their own projections onto other people, they also learn that other people project their fears too. When clients see that everyone sees things from their own perspective, they can come to recognize that trying to please others is futile, and that even if theyarejudged by another person, this is tolerable.
 
Learning how to live in the present and not engage in ‘what if’ thoughts
 
Clients learn the value of living in the present moment, of asking themselves “what’s required of me now”, rather than entertaining a litany of catastrophic thoughts about what could go wrong in the future. With practise, recognizing and stopping “what if” thoughts can liberate clients from worry.
 
Learning to accept what I can’t control
 
Clients can become practised at recognizing what’s not in their control. As a result, they can develop more confidence about acting on what isin their control, and accepting what is not controllable. 
 
Learning of skills
 
Skills learnt in therapy include 

• becoming more assertive in relationships 
• learning better ways of communicating and listening 
• learning to self-regulate when triggered
• learning coping strategies for when things get hard
• facing fears (in a supported environment), and becoming less fearful and anxious
• learning how to survive loss and rebuild life
• learning how to set goals and commit to achieving them
• accessing compassion for self and others in place of criticism and judgement 
• identifying values, and making decisions based on these
• understanding and responding to baby’s cues, thereby becoming a more confident parent
• becoming a better parent by hearing, accepting and validating children, while being clear on boundaries and limits

 
Overall, clients have reported becoming better versions of themselves - more tolerant of their own and others’ imperfections, feeling worthy of being cared for and seeing the value in caring for themselves. And, as a result, clients have reported an improvement in their moods and relationships, and a strengthening in their sense of selves and their meaning in life.
 
Written by Dr Renée Miller
​Principal Clinical Psychologist
Antenatal & Postnatal Psychology Network 

Helping to soothe your child’s anxious feelings is one of the most precious gifts you can give them. Every time you help soothe your child’s big feelings, your child develops a trust that their difficult feelings can subside. Over time (a long time), and with your help, children eventually learn to regulate their own emotions. 
 
The reality is that parents don’t always know this. They often find themselves at a loss about how to manage or change their child’s “difficult” behaviour (e.g. tantrums, defiance, not listening, refusing to participate,  bed-time struggles). The problem with the behavioural management approach is that it may not consider the feelings that the child is experiencing – the feelings that underly their challenging behaviours. 
 
Behaviour is communication 
When children ‘act out’, ‘misbehave’, ‘don’t listen’, withdraw, what are they actually communicating? Usually, young children don’t have words for the overwhelming feelings inside them. And they certainly don’t know how to make sense of them.
Children’s challenging behaviour may be a result of major life changes or experiences.
 
Examples of such experiences include:

• Adjustment to having a new sibling.
• Loss of a sibling during pregnancy or after birth
• Parents grieving
• Having a sibling with special needs who requires a lot of the parent’s focus
• Having a parent who is experiencing depression or anxiety for various reasons
• The loss of someone close to a child 
• Separation from a parent
• Illness and surgery
• Starting daycare or kindergarten
• Moving house, city or country
• Having a previous bad experience that evoked fear such as dogs, aeroplanes, the dark
• Feeling pressure to toilet train when not yet ready

• Unexpected life events

 
These are just a few examples of experiences that can impact children and result in them feeling emotionally disorganised or overwhelmed. What we may see, is their challenging behaviour.
 
Take for example the child who gets a new sibling. While many children delight in the experience of having a new sibling, others can struggle. Often, it’s a mixed bag of feelings. An emotional storm may be brewing in even the most excited of siblings.
 
When a new baby comes into the family, the older child has typically been through the pregnancy that may have resulted sickness and/or reduced energy levels in their mum. Then there’s the anticipation of the baby being born and the child being separated from his/her parents at the time of the birth. Although seemingly excited to be an older sibling, the child may be affected by these changes, and may feel insecure and displaced.
 
Often there is a regression in the older sibling’s behaviour - this is normal. What we may see, is their challenging behaviour.
 
Suddenly, a mum and dad who were exclusively theirs are shared by a newcomer to the family that everyone is cooing over. He/she might feel pushed aside. The child might feel angry that the new baby is needy and has access to mum’s body in a way that the he/she no longer does. Watching mum breastfeed might bring up feelings of envy that are hard for the older sibling to understand. 
 
Mum and dad are likely to be exhausted and the older sibling may not be able to make sense of this. The older sibling may tantrum, regress (needing parents more), and unhelpfully, be labelled as “difficult”.
 
This storm inside the child needs to be processed and understood. For this to happen, parents need to see the feelings that lie beneath the behaviours, and help the child put words to them.
 
Are you feeling angry because Mummy has to feed the baby again and you really wanted to play?
 
Are you feeling sad that baby won’t stop crying?
 
You so wanted to read your book with me, then baby started fussing?
 
Are you feeling a bit cranky that baby needs me so much?
 
It doesn’t seem fair does it?
 
The first step in helping children to process their feelings is showing them that their big feelings don’t scare or upset you. That you are there for them is all of their emotional chaos. Then, children need to be heard and validated. With kindness, understanding, and patience, big feelings can settle.
 
When the big feelings settle, there can be a space to come up with a solution.
 
How about I read your book to you while I’m feeding baby?
 
When I’ve changed baby’s nappy, I’ll put him in the carrier and sit down on the floor with you to play leggo.
 
How about when Daddy gets home, you and I have a bath together and play with your dinosaurs?
 
To have empathy for your child’s emotional world, it might be useful to think about a time in your life when you felt like you had a storm going on inside you. Certain experiences leave us feeling anxious or unsettled, and in these moments, it can feel as if we are falling to pieces on the inside. You may feel like nobody else can see this, but you feel awful. You might not even know what you need at such times and may find yourself withdrawing, getting angry or feeling quite tearful. These overwhelming feelings can impact how you function, as well as your capacity to think clearly and make sense of things. 
 
What can help is having a trusted friend or therapist sit with you and tune into your emotions, show they understand you (without judgement), and help you to disentangle the knots of overwhelm that you are feeling inside yourself. With this, you might find yourself breathing deeper, and thinking clearer. Overall, feeling calmer.
 
The same applies to children. They don’t have words to say what they are feeling, but their behaviours reveal something to us – that there is a storm inside them. 
 
A word from the author
In my psychology practice, I often encounter parents who have trouble when it comes to helping their children manage their anxiety and other difficult feelings. This prompted me to write a psychologically based children’s book drawing from both theory and clinical experience. The book is titled The Storm Inside Katie with characters that are easy to relate to and identify with for both children and parents. 
 
My aim was to provide an accessible resource that reads like a story for children but helps parents understand the impact of overwhelming feelings and the various ways in which parents mays respond to children when they are feeling afraid or unsettled for various reasons. The book also provides an opportunity for meaningful conversations between parents and their children
 
These communications may coincide with parents trying to deal with their own difficult feelings and experiences, which can all feel quite overwhelming. It can be extremely difficult to organise your child’s feelings if you are feeling emotionally unsettled yourself. If you are struggling, it may be helpful to consult with a psychologist to address the storm inside you, and to receive guidance in making sense of and responding to your child’s storms.
 
Written by Clinical Psychologist, Beverley Marcus 

Copies of The storm Inside Katie are available to purchase by emailing beverleymarcus@gmail.com to place your order. 

Miscarriage is commonly dismissed as the 'loss of a pregnancy'. For happily expectant parents, miscarriage is the loss of their baby. It represents a loss of parents' hopes, dreams, and future plans. For many people, the idea of parenthood is conceived some time in their early lives. Although the timing of these inklings differ for different people, there are unconscious stories people amass as they themselves were parented, and as their developing selves evolve over time. A kind of knowing that one day, they too will become parents. For some people, an opportunity to rectify or better the less-than-ideal parenting they received.

Often the work lives and the intimate relationships of hopeful parents have come to a point where there is an existential readiness for children. A baby becomes nurtured in their minds. The woman's body is primed to create and protect a precious new life.

Once pregnant, a woman (and couple) typically begin to imagine their new lives. Anchored by the due date of their baby and alongside the lifestyle sacrifices made for optimal gestation, they begin to integrate their baby into their decision-making, into their future plans, into their homes, and into their families. Once announced, the broader family narrative may begin to incorporate the baby.

When a pregnancy ends in miscarriage, the physical and emotional ramifications can be devastating. The baby conceived of in body and mind, has died. The process of miscarrying can be painful, protracted and traumatic. The woman may have felt or seen her tiny baby, and she may regret where her baby ended up. Most people are unaware of what a woman might have experienced in the midst of miscarrying, and may have no idea about the depths of her grief over the loss of her child.

When miscarriage happens repeatedly, hopes are raised and dashed time and time again. The accumulation of loss and grief can be crippling, with plummeting self-worth, and for some women, increased self-blame, hopelessness and depression.

​Women often remark that they observe other women seemingly 'popping out' babies with little effort. Pregnancy and babies everywhere. There is no escape from the enthusiastic pregnancy and birth announcements. And even worse, the unplanned, 'surprise' pregnancies that can engender a silent rage in the bereaved parent, who is acutely aware of the inequities of parenthood.

How easy it seems for others. How alone the woman feels. So desperately wanting to settle into the next phase of life. Wanting what everyone else seems to have. Feeling guilty for her envy. Avoiding her usual supporters, for fear of her inability to conceal her grief. Questioning what she is doing wrong, and why this is happening to her. 

The staggering truth is that at least one in four pregnancies end in miscarriage. The sad reality is that many women don't talk about it. The secrecy surrounding miscarriage is in part due to the convergence of women's perceived shame (as if in some way it is their fault), and society's minimisation of the loss not being as valid as the loss of a living child.

As a result, isolation can accompany the pits of grief, maintaining the illusion that other women and couples - seemingly unaffected by loss - conceive easily, and give birth to healthy babies. This misguided belief ultimately reinforces the perceived shame, and renders the bereaved parent alone in their mourning, believing that no one really understands what they are going through.

​Interestingly, when women open up about miscarriage, they are often surprised, and comforted by the number of other women who have also experienced loss. Women can find some solace in online support groups, but the supportive nature of these groups is time limited, as people's situations change.

Miscarriage brings emotional implications for subsequent pregnancies. Although relieved to be pregnant, the woman no longer feels the unbridled joy she may have once felt. Instead, there can be questions, doubts, fears and anxieties. Thoughts and feelings that need to be managed, milestones that need to be passed, uncertainty that needs to be endured, and hopes and dreams that need to be quelled.

This is the devastation of miscarriage. 

If you are reading this because you have experienced miscarriage, we are so sorry for your loss. 

If you are interesting in supporting research into miscarriage, find out more here. 

Written by Dr Renée Miller
Principal Perinatal Clinical Psychologist
Perinatal Loss Educator
Co-founder The Perinatal Loss Centre, Melbourne, Australia
Founder Antenatal & Postnatal Psychology Network, Melbourne, Australia

Perfection is like infinity.  There is no end.  We can keep striving to be better, yet the goal posts keep moving, and perfection eludes us. Time and time again, I see new mums who with the best of intentions for their babies and families, are striving to be  ‘perfect’ mothers – to parent in the ‘perfect’ way.  The reason they are in therapy, is often because this bottomless pit of striving sets them up to fail, and this perceived failure feels intolerable.  There is typically a lifetime of layers beneath the surface of this striving, which is certainly worthy of exploration.

Striving for perfection can seriously limit our capacity to enjoy life.  Perfection-striving is often associated with all or nothing or black and whitethinking.  For example, the mum who won’t go to mother’s group if she is going to be late, misses out on the building of relationships with other mums (who are often late themselves). The mum who won’t exercise if she can’t exercise three times per week, misses out on the benefits of some exercise and a little time-out.  The mum who won’t invite people over unless she gets the time to make the house look immaculate, misses out on the fun and spontaneity of having other new mums and babies around for her own and her baby’s social well-being.  The mum who won’t let her partner settle the baby because he/she won’t do it like she does, misses out on her partner’s support and her partner's growing bond with the baby.

The bottom line is that there is no one way, and there is no right way.  When your hard and fast rules about how things should be, get in the way of the things that give your life meaning (i.e. the things that you really value) ask yourself if there is a middle ground?

The middle ground is a place where we strive for being ‘good-enough’ mothers.  Perfectionists usually see this term “good enough” as meaning mediocre.  However, ‘good-enough’ means good enough.  For example, getting to mothers group late is better than not going at all.  It can be a good laugh and a supportive environment.  Exercising whenever possible (despite wishing to achieve three exercise sessions per week) is better than nothing, and is likely to become easier to achieve over time.  Inviting friends over, even if the house is untidy, shows them that you are human after all (very comforting for most people), and demonstrates that you value friendships more than your domestic high standards.  Letting your partner settle the baby even if he/she does it differently to you, knowing that this is their chance to discover what works, and to establish a good bond.

The middle ground is a much kinder place – a place of acceptance, and openness to experience.  Try it.  You’ll see. You might even find that not only can you be a 'good-enough' mum, you can be a great mum!

If these tips are not enough, and your need for perfection is causing you distress, it may be worthwhile to seek help.

Written by Dr Renée Miller
Principal Perinatal Clinical Psychologist
Founder Antenatal & Postnatal Psychology Network
Co-founder The Perinatal Loss Centre

The birth of a baby brings about significant changes to new parents - changes to their identities, their life-responsibilities and their relationships. The same can be said for new grandparents. At a time when they may be appreciating a new-found freedom, new grandparents face a re-orientation towards participating in their children’s and now grandchildren’s lives.

New parents are often exhausted, vulnerable, and desperate for practical and emotional support. They can hold expectations of their families based on assumptions they haven’t verbalised. As a result, new parents can feel disappointed when these expectations are not met.

Similarly, when a baby is born, new grandparents can hold their own ideas about their grandparenting roles and about the involvement they wish to have in the lives of their children’s offspring. Some grandparents can feel shut out of their grandchildren’s lives, and others can feel overly responsible to be available at all times.
 
What about when there are no grandparents?
Although family dynamics can be complicated, some new parents have no family support and can feel alone and isolated. For these families, the charity organisation, Caring Mums, trains older mums who volunteer their time to make weekly visits to families needing practical and emotional support. As part of their training, these volunteers learn to withhold their opinions, and to focus on fostering confidence in new parents, by supporting them to find their own way with their babies.
 
I was invited by Caring Mums to give a fundraising talk, entitled “Grandparenting in the 21st Century”. Drawing from many years as a perinatal (pregnancy and postnatal) psychologist, I had heard many stories about the ways in which grandparents become involved in families’ lives – in some cases providing invaluable support and fostering beautiful relationships with their grandchildren, and in other cases being uninvolved or even undermining the parents’ wishes. Needless to say, I had much to draw upon.
 
However, prior to the talk, I decided to do a little additional research. I posted a question on a mother-baby social media site asking mums to share their experiences regarding the “Dos and Don’ts” of grandparenting - "...what helps and what hinders?". Many mums responded, both publicly and privately. I collated their responses and shared this list with the grandparents who attended the talk.
 
•   Call before coming over
•   Only give advice when asked
•   Ask what support is needed
•   Just help, don’t offer
•   Help with practical tasks such as cooking, shopping, washing
•   Never do our washing
•   When visiting, bring a meal
•   Just do what needs to be done
•   Ask before you do things around the house
•   Don’t take the baby unless asked to. Let the new parents learn about their baby and develop good bonds
•   When you come over, offer to take baby and let Mum shower
•   Turn visitors away in the first 3 weeks
•   If you had a similar problem, tell the parents what you did, not what they should do
•   Get your vaccines done
•   Give predictable times when helping with grandchildren
•   Don’t compete with the other grandparents
•   Remember things have changed since you had children
•   Don’t say “we survived without….”, “we never did…..”
•   Don’t stay all day or expect to be waited on
•   Don’t force children to kiss/hug you
•   Babysitting is a privilege not a right
•   Listen without trying to solve problems
•   Don’t criticize without giving a solution
•   Don’t criticize!
•   When we do things differently to you, don’t take it as a personal criticism
•   Don’t judge a messy house
•   Don’t talk about mum’s pregnancy or post-baby weight
•   Don’t say “my baby”
•   Stick to the same rules as the parents
•   Don’t undermine the parents’ rules
•   Don’t give junk food to children if parents have asked you not to
•   Don’t say to the child “I’ll get into trouble if I give you that”
•   Do special things with the grandchildren
•   Tell the parents they are doing a good job
 
Two things struck me
1. There were obvious differences among mums about what constitutes support. Largely, the differences around asking about what can be done versus just doing it. Differences were evident between mums regarding the things they feel comfortable about grandparents doing for them. What is helpful and non-judgemental to one woman can be considered to be intrusive and laden with judgement to another.
 
2. When I shared the list of “Dos and Don’ts” to the grandparents who attended the talk, it was met with a resounding applause. The grandparents in the group agreed wholeheartedly with these requests. I was surprised. I was expecting to be met with some defensive responses about grandparents feeling used or misunderstood. But this was not the case. These grandparents agreed that the requests were reasonable.
 
Now it could be argued that the grandparents who chose to attend this talk were a group who had put a lot of thought into their grandparenting roles already - a group who had considered carefully how to best support their offspring and grandchildren. A group interested in doing the best they could as grandparents, hence their attendance at a talk such as this.
 
What I discovered
Notwithstanding that I may have struck a particularly supportive group of grandparents, a number of things became evident from my informal research across both groups:

• Some parents don’t know how to ask for help, or feel inadequate if they need help. This leaves grandparents uncertain as to whether the parents want them around. Not wanting to be intrusive, grandparents might hold back and wait to be asked. Parents can then assume that the grandparents aren’t interested in being involved, and can feel resentful or unsupported. Grandparents can feel under-valued, and unwanted.
• Some grandparents want so desperately to help or to forge relationships with their grandchildren that they become over-involved, giving unsolicited advice in their efforts to spare the parents (or themselves) distress. This can feel intrusive for the parents, who - especially in a vulnerable state - can receive grandparents’ actions or advice as criticism of the job they are doing.
• Some grandparents struggle with saying “no” to endless requests for help, to the extent that one grandparent in the group questioned whether it was ok to take a holiday.

 
Take home messages
There is an intrinsic complexity in these relationships, given the shared histories (joys and hurts) between grandparents and their children (the new parents).  But what can we learn from what parents and grandparents told me?
 
1.   Don’t assume
 
As was evident in the list, what is helpful for one person might not be helpful for another. Everyone is different. Similarly for grandparents, the role and the extent to which grandparents want to be involved differs from one grandparent to the next. It is not helpful for either party to assume that they know what the other is thinking, expecting or wanting.
 
2   Communicate
 
It is vital to talk to one another. When grandparents ask the new parents what they can do to help, this communicates not only a willingness to offer practical support, but it allows grandparents to tune in to their adult children’s needs and to really be there for them at this challenging time. It is ok for grandparents to express their desires to help as well as their conflicts around not wanting to interfere. This may be better for new parents to know as opposed to grandparents holding back, leaving new parents to make assumptions (e.g. “they don’t care”).  
 
Similarly, it is ok for grandparents to put limits on their time. In fact, many new parents have told me that they appreciate knowing what the grandparents feel is a reasonable amount of time spent with the grandchildren. Many new parents appreciate a predictable commitment of time so they can schedule breaks or time to get things done. And this can give grandparents precious time alone with their grandchildren.
 
Parents crave respect for their parenting choices, particularly when parenting opinions and judgements are rife in their everyday lives. They may ask for the grandparents’ opinions and they may not. This is their time to discover what works and what doesn’t. Remember, parents want to do what they believe is best for their child.
 
Summary
Sleep-deprived new parents can feel sensitive to well-intentioned comments or perceived judgements by grandparents. Many new parents grapple with defining the kinds of parents they want to be to their child. Their values come in part from what worked and what didn’t work for them in their childhoods. As this unfolds, closeness, differences, unresolved issues and stress can be triggered between new parents and grandparents.
 
Parents, tell grandparents what is helpful. More often than not they are wanting to do what helps, but they get can get it wrong when their actions are based on assumptions. Show them that you appreciate their efforts. Encourage them to forge special relationships with their grandchildren. Let them have some autonomy in their grandparenting without compromising the things that are really important to you. When you are not happy with something they are doing or not doing, express it in a calm, respectful way.
 
Parents, remember that grandparents have done their hard yards in parenting and working. Check in on how involved they want to be with the grandchildren. Respect this time in their lives by asking for help, not expecting it, and by showing your appreciation when you receive it. Indeed it could be argued that grandparents' care of your children is a “privilege not a right” - your privilege.
 
Grandparents, remember that parents won’t get it all right (they are human, just like you). They will be stretched physically and emotionally as parents. They need to know that you are there, and that you care. If they want your advice, let them ask for it. If you want to give advice, ask them if they would like to hear it.
 
Conclusion
Parenting and grandparenting are profound roles that shape families and leave enduring memories in children’s lives. Consider how you would like your children and grandchildren to remember family life. Share these goals with one another, express yourselves respectfully, show gratitude, and look after one another.
 
Written by Dr Renée Miller (Perinatal Clinical Psychologist)
Founder of the Antenatal & Postnatal Psychology Network 
 
Thank you to the mums who generously shared their experiences on Babies Toddlers Kids Melbourne.
Thank you to the grandparents who attended the fundraising talk for Caring Mums, who shared their compassion and wisdom.
 
Further information about Caring Mums and donations to this important charity can be made here.
​​ ​

ORIGINALLY POSTED JULY 2020. When we imagine having a baby, our minds create narratives about the hoped-for child. Along with the child we envisage raising, we hold scripts about the kind of parents we hope to be.

Then we become pregnant, and these fantasies intensify.

The narratives we hold are formed by our past, and by the meaning we derived from the relationships we’ve experienced and observed. We unconsciously amass information and draw conclusions about parents and children, family compositions, siblings, and the meaning of gender within these relationships.

When we find out the sex of our baby (whether in utero or after birth), this intricate web of preconceived ideas springs to the surface. Stories about ourselves, our relationships, our fears, our regrets, and our desires. Some or all of these things can be wrapped up in our perceptions about the sex of our baby. 

Not everyone has a strong preference for the sex of their baby, but for some women (and less commonly, men), the gender of their baby is steeped in personal meaning. When the baby is not the hoped-for daughter or son, some people experience mild to extreme disappointment, grief, and even depression.

Before you judge with “surely a healthy baby is all that matters”, let’s make it clear that a healthy baby is the wish of all parents. But for some parents, the meaning of their baby’s sex is so deeply-rooted in their psyches that the loss of their hoped-for child can be devastating.

To truly understand gender disappointment and the grief women can experience, we need to respectfully understand the particular meaning for the individual. People’s reasons and stories differ uniquely. However, there are some common themes.

The themes
From the vast response I received to my Facebook post (both publicly and privately), there were some noteworthy themes.

1. Gender disappointment appeared to be more commonly experienced by women. A small proportion of women spoke about their male partners’ gender disappointment (equally in relation to wished-for boys as compared to wished-for girls). 
2. The majority of women’s gender disappointment was in relation to the preference for a girl. This was followed by the preference for one of each sex. And less commonly, by the preference for a boy.

The wish for a girl was associated with the following narratives:

• I grew up with sisters. It’s what I know.
• I never had a sister, and always longed for one.
• From a young child, I imagined having a daughter.
• I had a close relationship with my sister but not my brother.
• I have a close relationship with my mum and want to replicate this.
• I have a poor relationship with my mum and want to repair this.
• My brother has a terrible relationship with my parents.
• I am a feminist and work in a female dominated industry. Being a woman is a strong part of my identity.
• I lost a boy, and I want a girl so that I don’t feel like the next baby replaces the baby who died.
• I’ve seen families where the sons have poor relationships with their parents as adults, and I’m fearful this could happen with boys.
• We only want one child, and I want a girl so we can be close. 
• I identified very much as a ‘girlie girl’ when I was growing up, and I want to share this with a daughter.
• I feel like a female will look after me when I’m old, much more so than a male.
• I want to be part of a daughter having her own family (rather than being the mother-in-law who might struggle with a daughter-in-law who prefers her own mum).

The wish for one of each was associated with the following narratives:

• I desperately want the experience of being a parent to both sexes.
• I want my partner to have a boy/girl.
• I have a picture of what each child would share/experience differently with each parent.
• I have a brother, and I loved that.
• I had a competitive relationship with my sister so I want there to be one of each.

The wish for a boy was associated with the following narratives:

• I’d always seen myself as a ‘boy mum’.
• I had an awful relationship with my mum and always hoped for boys because of this.
• I grew up having male friends. I was sporty and not a ‘girlie girl’.
• I didn’t want my child to go through what I went through as a teenager, and I thought a boy would have less social issues.
• Life is simpler with boys. Girls are more complex, especially in the teenage years.
• I had a very close relationship with my brother.
• I am close to my dad, and we are very alike.
• I lost a boy and want another boy.
• I lost a girl and want the opposite sex to the baby I lost.
• I wanted a brother for my son.
• For cultural reasons.

 “Why can’t you just be happy to have a healthy baby?” (A common judgement)
As indicated by the women who responded to my post, gender disappointment does not negate their appreciation and gratitude for a healthy baby. Nor does it (in most cases) preclude loving the baby who was born. 

The disappointment and grief is about the baby who was not born, the baby who had been yearned for and mentalized, in some cases from as far back as a woman can remember.

Extrapolating from the many reasons women offered for their gender disappointment, I propose that these feelings can be understood by three types of projections:

1. REPLICATION
Women seek to replicate what they experienced or witnessed, because it was positive.
2. REPAIR
Women seek to repair what they experienced or witnessed, because it was negative.
3. REFLECTION OF SELF
The wished-for child is a reflection of the woman’s perceptions of self (identity, regrets, hopes, fears, dreams).

The grief associated with gender disappointment is real, and can run deep.

The grief
When the sex of one’s child is opposite to that of the wished-for child, and the family composition differs from the imagined picture, there is a loss of a strongly held ideal. An ideal that may sit alongside one’s self-identity (including one’s cultural identity) and one’s amalgamated past. When this is the case, the depth of grief may be intense.

Sadly this grief tends to be disenfranchised. Most women believe that other people don’t understand their distress (and indeed, many people do not), so they grieve alone or minimise their feelings to reduce cognitive dissonance.

Women often feel ashamed and guilty for their feelings of disappointment. They judge their feelings as unjustified because they haven’t lost a ‘real’ baby. And when they have lost a baby or have experienced fertility difficulties, the guilt and shame can be worse.

Beneath their shame there may be questions like these: 

• “Shouldn’t I just be happy to be pregnant?”
• “If I feel sad that I’m not having the gender I wanted, does this mean I won’t love my baby?” 
• “If I express my feelings to other people, will they think I’m a horrible mother?” 
• “If I express my feelings to others, will they be offended thinking that I’m judging the sex of their child?” 
• “Do these feelings make me an awful person?”

The grief from gender disappointment needs time for reflective processing to acknowledge and work through the feelings and layers of loss. 

How does therapy help?
In some cases, the feelings can be overwhelming and may affect a woman’s mental health and her capacity to bond with her baby. Therapy can be a helpful way to learn to see and appreciate the arrived baby for the unique individual they are, whilst recognising that it’s okay to mourn the loss of the idealised baby.

Therapy can also help women to examine their assumptions and biases about gender, and the meaning they’ve attributed to it through the lens of their past.

The truth of the matter
The truth is that our narratives are not truths. Our narratives are stories we’ve compiled over the course of our lives. These stories are based on subjective conclusions we’ve drawn about boys and girls, sons and daughters, sisters and brothers, in the context of our own history.

As we parent the children we have, we grieve many idealised images or expectations along the way. There are all sorts of things parents wish for in their children that may not come to fruition. Who they are, how they think, what they do, can differ considerably from what we had hoped for and from who we are.

Once again, our unconscious wishes to replicate, repair and reflect ourselves, stem from the experiences and meaning derived from our pasts. 

In essence, parenting is a constant process of recalibrating what we wished for in accordance with what we have. Ultimately, when we are not blinded by our projections, we free ourselves to accept and cherish our children for the unique individuals they are.  

This doesn’t mean we don’t have pangs of sadness, wondering what life would be like with that dreamed for little girl or little boy. But when we acknowledge our grief and accept our reality, we can more readily foster the kinds of relationships and experiences we value with our children, irrespective of their assigned sex.

This article was written with stories shared both publicly and privately on the Facebook page of the Antenatal & Postnatal Psychology Network.

Compiled and written by Dr Renée Miller, with gratitude to the many women who shared their feelings and experiences on this deeply personal topic.
Principal Perinatal Clinical Psychologist
Antenatal & Postnatal Psychology Network

Worry strikes us all, particularly in the childbearing years.

Women who are trying to conceive can find the two-week wait interminable. A time when worry and fear can ramp up, out of control. The mind can become consumed by fearful thoughts. "What if I'm not pregnant?", "What if I'm going to need IVF?" "What if we can't have the family we've always dreamed of?"

When pregnant, waiting for a scan, can mess with your mind. "What if there's something wrong with the baby?" "How would we cope?"

Women (especially those who have experienced a previous loss) can find themselves agonising over fears about something being wrong with the baby, of losing the baby, or of having a negative birth outcome.

Then, when we become parents, the worries can be endless. "What if he doesn't sleep tonight?" "What if there's a developmental problem with my toddler?" "What if my child doesn't have friends?" What if my child becomes a bully?"

The fact is that any thought that begins with "what if" is by its very nature, not true. That doesn't mean that bad things don't happen. They do. But more often than not, our worries don't end up manifesting. And when bad things happen, we attend to the situation, drawing from our internal and external resources to cope, and we deal with what is actually happening. 

Worrying endlessly about things that could go wrong, is mentally exhausting. What people often don't realise is that we can manage our minds better than we think we can.

The first step is to recognise that our thoughts are not truths. When we worry about a future scenario that hasn't happened, we remove ourselves from the life we have right now. "What if" thoughts make us feel anxious and stressed. People typically look back at their worries and wish they hadn't wasted all that time fretting. 

So how do we manage fear and worry? What do we do when "what if" thoughts (or fears about the future) intrude?

This short video uses a Mindfulness-based, visual approach to help you to manage your worry and tame your mind. It takes practice, but you can do it!

Click on this link: https://www.youtube.com/watch?v=QWrTcLmj6yI

Written by Dr Renée Miller
Perinatal Clinical Psychologist
​Antenatal & Postnatal Psychology Network

Parenthood is stressful. The responsibilities and demands of a baby, toddler (or both), the sleep deprivation, the loss of freedom, the loss of control, and the never-ending 'to do list' can be overwhelming and stress inducing. Not to mention the emotional investment in wanting to parent a child who will feel safe and secure in the world, with a high emotional intelligence and a resilience to facing life's challenges. It's a big gig!

The Coronavirus Pandemic has added further stress and uncertainty for new parents. Fear of the virus itself. Lockdowns. Border closures with families elsewhere. Isolation. Working from home. Job loss. Financial pressure. 

Some new parents seek help to manage postnatal depression and/or postnatal anxiety. However many new parents seek help  simply to manage stress. Often motivated by wanting to be the best parents they can be, parents recognise when they are operating in a revved up state. Their sleep can be affected, and they may notice symptoms of irritability, being overly touchy or sensitive, snappy, and generally not being able to wind down. Parents often report that their stress is most apparent in their relationship with their spouse, and/or in an increasing impatience with their children.

There is a vast literature and much media attention educating the public on postnatal depression and more recently, postnatal anxiety. However for parents who are stressed this focus on depression and anxiety can result in a hesitation towards help-seeking in the absence of a depressed mood or an anxiety disorder. Postnatal stress can cause significant upset in families, and evidence-based treatments for stress can bring about welcomed symptom relief. 

So what is the difference between depression, anxiety and stress? According to the authors and researchers of the Depression, Anxiety Stress Scales (Lovibond & Lovibond, 1995) depression, anxiety and stress can co-occur, however each state has its unique symptoms. Depression symptoms include feeling negative, down-hearted, gloomy, unmotivated, dispirited, and a loss of enjoyment in things once pleasurable. Anxiety includes physiological symptoms of panic, pounding heart, shakiness, fear of losing control, and apprehension. Stress includes nervousness, jumpiness, tension, getting easily upset or irritated, and difficulty relaxing.

The Psychologists at the Antenatal & Postnatal Psychology Network (APPN) commonly use the Depression Anxiety Stress Scales (DASS-21) - a well validated screening tool that helps new parents to understand their particular symptoms. In our experience, new parents like to understand their symptoms using the DASS-21, and they find it useful to track their symptoms over time to see how they are progressing with therapy. Although scores on the DASS can delineate symptom severity and a measure of progress over time, clinical diagnoses (if relevant) require further assessment by the psychologist to ensure that appropriate treatment strategies are implemented in therapy.

Treatment for stress typically involves a combination of Cognitive-Behavioural Therapy and Mindfulness based therapies. These approaches give parents tools for understanding how their thinking - expectations, appraisals and worry - contribute to their difficulties (thinking being a modifiable component in managing stress). In addition parents learn to manage their responses (physical and behavioural) in relation to life stressors and to their own fears. Practical strategies for managing daily routines can form part of the work, as well as sorting through family of origin dynamics that may underly one's problematic thinking and stress levels in the early parenting years. Learning how to wind down and relax is fundamental to this therapy for stressed new parents and parents of young children.

Written by Dr Renée Miller
Principal Clinical Psychologist
​Antenatal & Postnatal Psychology Network

​

Conception, pregnancy, childbirth, the postnatal period, and the early parenting years can pose difficulties for many people. Researchers and practitioners need to stay abreast of the experiences people face to continue to update their understanding of how best to support people with such challenges.
 
Back in 2001, over 300 new mothers participated in my research study - for which I will be eternally grateful. As a result, the findings of this research furthered our understanding of postnatal anxiety, at a time when postnatal depression had received the preponderance of postnatal research, and anxiety was conspicuously lacking in research attention. 
 
Ongoing research is vital for practitioners and policy makers to integrate people’s lived experiences into the work and support they provide. 

The psychologists at the Antenatal & Postnatal Psychology Network are passionate about facilitating the collection of data for researchers whose research studies support the mental health of perinatal women, men, couples and ultimately, children. 

How you can help
Do you have some time to participate in a research study that could further inform practitioners who work with hopeful parents, pregnant women, birthing women, women and partners in the postnatal period, and early parenthood?
 
The Antenatal & Postnatal Psychology Network provides an online research portal for academic researchers (in the perinatal field) to post their studies, giving visitors to the APPN site the option of supporting research, and striving for further meaning from their personal experiences. 

Studies requiring participation
 
Under each listed study, you will see the participants being sought. If you meet the criteria for participation, you will find links to the study on our website here.

RMIT Perinatal Well-being Study investigating challenges in pregnancy and the postnatal period.
Participants required: Women who are pregnant to 24 months postnatal.

Griffith University investigating the acceptability and outcome of an exercise intervention using a telehealth app for mothers with Postpartum Depression (PPD).  
Participants required: Women in the postnatal period who have been diagnosed with PPD or who are willing to seek a diagnosis.

University of Tasmania investigating women's experience of pregnancy and the postnatal period.
Participants required: Pregnant women living in Australia.

University of Adelaide investigating the experience of culturally and linguistically diverse (CALD) men who have experienced the loss of a baby.
Participants required: 1) Culturally and Linguistically Diverse (CALD) men with experience of perinatal death. 2) Healthcare professionals who have worked with CALD men following perinatal death. 3) Community Leaders from a CALD community.

Monash University investigating how a music-based intervention supports the quality of parent- and caregiver-toddler relationships and toddler and parent/caregiver mental health.Participants required: Parents or primary care-givers of toddlers.

Latrobe University investigating the effectiveness of a new program that aims to enhance parents’ support and understanding of their baby’s early social and language developments.
​Participants required: Pregnant women with a family history of autism, ADHD or intellectual disability

Parent-Infant Research Institute investigating the benefits of psychological treatment for depression in pregnancy, for both mother and baby.
Participants required: Women up to 30 weeks pregnant who are feeling low.

Charles Sturt University investigating childbirth experiences and trauma in first time mothers.
Participants required: First time mothers over 18, who have given birth over one month ago at 37+ weeks gestation.

University of Queensland investigating resilience to stress, in families following preterm birth.
Participants required: Parent of a preterm infant, child, or adolescent who is now 0-18 years of age.
 
QUT Investigating how mothers use social media and what effects social media use can have on mothers. Participants required​: Mothers of children aged between 0-4 years. 
 
Melbourne University undertaking Delphi expert consensus study: Establishing expert consensus about interventions for preventing and ameliorating the impact of Adverse Childhood Experiences.
Participants required: Health practitioners, educators, policy makers, researchers or program managers whose work relates to family or child health and well-being in Australia. 
 
Royal Women’s Hospital & Monash University evaluating different approaches to improving sleep for first-time mothers who currently experience sleeping difficulties.
Participants required: First-time mothers who are less than 32 weeks pregnant and currently experiencing sleep difficulties.  

University of Adelaide investigating experiences of Secondary Infertility: Emotions, Support and Coping Strategies.
Participants required: Women and/or their partners who have tried unsuccessfully to conceive for at least 12 months after having had a successful pregnancy/pregnancies. 
 
University of Adelaide LGBTQI+ Experiences of Pregnancy Loss: Perceptions of Formal and Informal Support and the Impact on Mental Health.
Participants required: People who identify as LGBTQIA+ who have experienced pregnancy loss more than 6 months and less than 10 years ago. 
 
University of Melbourne investigating women’s and men’s experiences of miscarriage, with the ultimate goal of ending the silence around miscarriage.
Participants required: Women, partners and family members affected by miscarriage more than 3 months ago but within 2 years. 
 
Monash University. This study aims to understand how the brain changes in the transition to motherhood. Participants required: First-time mothers 10-14 months postpartum with or without a diagnosis of postnatal depression. 
 
University of the Sunshine Coast exploring the impact that fertility issues have on Australian's women's quality of life whilst trying to conceive.
 Participants required: Women currently trying to conceive, experiencing fertility difficulties. 

Deakin University investigating whether late pregnancy affects women's cognitive functioning.
Participants required: 20 women in their third trimester of pregnancy and 20 women who are not pregnant, have never been pregnant and are not planning to become pregnant in the next 12 months. 
 
Latrobe University aiming to understand factors associated with well-being in same-sex attracted women during the perinatal period, to improve services for this group.
Participants required: Same sex attracted pregnant women and new mums​. 
 
Curtain University aims to establish a set of clinical guidelines for health professionals on the assessment, treatment, and management of individuals with perinatal OCD.
Participants required: Parents with personal experience of perinatal OCD, and clinicians/researchers with expertise in perinatal OCD. 
  
Swinburne University explores the potentially different postnatal experiences of First-Time and Experienced Mothers, including well-being, feelings about motherhood and perceptions of Maternal and Child Health Nurse support.
Participants required: All mothers who have had a baby within the last 2 years, are over 18 years of age, living in Australia, and speak fluent English. 
 
University of Liverpool is looking at how infant feeding attitudes change from pregnancy to the postpartum period. 
Participants required: Women in the third trimester of pregnancy (over 35 weeks). 
 
University of South Australia is looking at whether what you eat in pregnancy affects your mood during pregnancy and after.
Participants required: Women who are 8-15 weeks pregnant at the start of the study (now). 
 
Bond University is conducting research on couples experiencing infertility in order to contribute to the development of helpful fertility related psychological support programs.
Participants required: Couples experiencing infertility. 
 
CQ University's study Experiences of Pregnancy and the Year After Birth, is being conducted to further improve screening and treatments for perinatal mood disorders.
Participants required: Women over the age of 18, who are currently pregnant or have given birth in the last 12 months. 

Please click here to check your eligibility to participate in one of the listed studies.

Your experience could make an enormous difference to the experiences of others.

Thank you for your consideration and potential contribution towards these important research studies.

Dr Renée Miller
Principal Clinical Psychologist
​Antenatal & Postnatal Psychology Network and The Perinatal Loss Centre