Take stock of the pace in which you are operating. Does it seem like there are endless tasks on your 'to do' list? You don't have time to sit down? You are constantly rushing? Do you feel stressed by the deadline of your baby’s due date?
We can fall into the trap of just keeping on going – trying to get everything done before bubs comes along. Stop...slow down. Add "time-out" to your 'to do' list. No one can just keep going. Allow your 'to do' list to roll over each day. Slow down the pace in which you are moving. Listen to what your body needs, take breaks, and spend time tuning in to your baby.
It's important to restore our systems. Ironically, this allows us to get more done. Look realistically at what could be done after the baby is born. Does it all have to be done now? If you are feeling out of control, your sleep is disturbed from stress, or you feel that your stress levels are just too high, seek help.
Angela is a warm and caring Psychologist who is dedicated to using evidence-based treatments that can help women, men and couples through the challenges of the childbearing years. Angela is looking forward to being actively involved in providing perinatal professional development opportunities to multi-disciplinary practitioners in Ballarat. Watch this space.
We warmly welcome Angela to our team.
Posts cover topics that are of interest and of benefit to expectant and new parents, and to parents facing the common challenges associated with toddlers and young children. Out of the many topics listed below, find out which articles ranked in the top 7.
Topics our Facebook Page covers
So, out of all these topics, which articles made the top 7?
At Number 7:
The Silent Tragedy Affecting Today's Children
At Number 6:
11 Things to Say When Kids Cry
At Number 5:
Bringing Home Another Baby: Six months in, a mom reflects on double duty parenting
At Number 4:
Bereaved Mother's Day: Acknowledging mums who have lost babies
At Number 3:
How a Parent's Affection Shapes a Child's Happiness for Life
At Number 2:
Why is Mommy Tired?
At Number 1, the most popular article in 2017:
10 Rules for Visiting a New Mom
If you are interested in articles such as these, we would love you to follow our Facebook page, and to share this resource with your friends!
May you find contentment and meaning in 2018,
The psychologists from the 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!
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
What is my Role?
Some fathers question their roles in the early weeks and months, when typically mothers are the primary caregivers. As a new father it’s easy to feel a bit left out. However, research tells us that fathers’ relationships with their newborns make a significant impact right from birth. Actually, it starts long before birth, because babies begin to recognise their father’s voice at around 22 weeks of pregnancy. So when that bump starts to grow, it’s time to get talking.
The most important thing dads can do for their newborns is to simply spend time with them – cuddling, rocking, talking, singing, and settling. Getting to know each other in a hands-on way is good for everyone. For inexperienced dads, on the job training is the best confidence and relationship builder of all. And the benefits for babies are vast. Several studies suggest the quality and quantity of baby-father involvement directly impacts language development and children’s sense of security growing up. There is also research showing that babies with strong attachments to their dads tend to have fewer behavioural problems later on.
Not surprisingly, research also tells us that when mothers view their partners as competent - when they provide encouragement, and believe that parenting is a joint venture - men are more likely to be involved and value their roles as fathers. The key is mothers viewing their partners as competent. This is an issue many couples struggle with, and it comes up regularly in my work with new parents. Because mothers tend to spend more time with their newborns than their partners do, they clock up many more practice opportunities, and can feel that the way they have learnt to do things is the only way. So whether it’s changing nappies, settling a fussy baby, or managing the bath routine, dads can easily get left behind in the skill development stakes. An all too frequent result can be mums hovering on the sidelines offering unsolicited advice, or worse, taking over and doing it ‘properly’ themselves. The result? Dads can feel inadequate, resentful, and less motivated to try the next time. The impact of not letting dads learn on the job can be mums feeling unsupported.
Where has my relationship gone?
Becoming parents calls for huge adjustments in relationships. Changes in roles, workloads and finances, not to mention the sheer exhaustion of caring for a baby. These pressures can impact even rock solid partnerships. Worries about how a baby may or has changed their relationship are among the most frequent concerns voiced to me by fathers.
Some fathers experience feelings of helplessness as they watch their partners overwhelmed by tiredness, or having difficulties breastfeeding. Some women experience postnatal depression, and dads often feel at a loss as to how to ‘fix it’, feeling inadequate that they are not being able to make everything OK.
For other dads, it’s the loss of emotional connection that has been chipped away by the constant tension of tiredness and frayed patience. They can feel like they’ve lost their best friend amidst the unfamiliarity and daily grind early parenthood can bring.
Some fathers talk about feeling in competition with their babies - for time, attention, and affection. Even while understanding their partner’s all-encompassing focus on their baby, dads can feel invisible or fearful that there’s not enough love to go around.
The reality of course, is that the birth of a baby can test even the strongest relationships. Even good relationships can stumble under the weight of it all. But the good news is that the overwhelming majority tend to bounce back again once everyone is getting more sleep, things settle down, and issues like sharing the workload are resolved.
Remember, parenting is a marathon, not a sprint. It takes time and practice for both of you to adjust to being mum and dad, to learn the ropes, and to find space in there for each other. Here are some points to consider:
· Communicate with each other. It’s a vital ingredient in sharing your worries and doubts, asking for support, and working as a team
· Practice empathy which means being open to each other’s experiences and feelings, especially the ones that are different to yours
· Avoid competing about who has it tougher – nobody wins this one and it’s a certain resentment builder
· Seek professional support if worries become too big, anxiety or low mood become habitual states, or you need help adjusting to the change. Remember, dads experience postnatal depression and anxiety too.
This post was written by Dr Karola Belton
Antenatal & Postnatal Psychology Network
All new mothers experience some anxiety. Let’s face it, you're in a new role, arguably the most important one there is. You’ve never cared for an infant full-time before. This vulnerable baby depends on you for his or her physical and emotional safety (which can be particularly challenging if your own childhood was not physically or emotionally safe). And on top of all that, you are on call 24 hours a day in a body that has been through significant hormonal changes. You are sleep deprived and you are adapting to a multitude of changes in your life.
So yes, some anxiety is ‘normal’. In fact, we need a certain amount of anxiety – ‘optimal anxiety’ – to be motivated to function well, to solve problems as they arise, and in a primal sense, to keep physically safe from predators (what is known as the ‘fight-flight’ response in our biological wiring). In motherhood, this translates to having a certain amount of anxiety to be vigilant enough to keep our babies safe, to perform the many tasks involved in caring for our babies, and to prepare or plan for future possibilities (eg. an upcoming feed or nappy change).
But what happens when this vigilance turns into hyper-vigilance? What happens when a feeling of impending doom creeps in, a feeling of dread, a constant fear that something bad is around the corner? You notice a sick feeling in the stomach, a knot in the chest, heart palpitations, constant worry, exhaustion but you feel too ‘wired’ to sleep, or worse - intense panic.
These feelings are not ‘normal’. These feelings suggest that anxiety is no longer optimal, but has become a problem. And anxiety like this can be debilitating.
Most people know about postnatal depression – feelings of sadness, negative thinking, tearfulness, loss of pleasure, lack of motivation, hopelessness, and/or dark thoughts. Health practitioners are therefore more likely to ask whether you are feeling sad or blue than to ask if you are feeling unduly anxious or agitated. However, postnatal anxiety is common and can occur alongside postnatal depression or on its own.
My research showed that 10% of new mums were anxious or stressed, but were not in fact depressed. This finding means that if we focus on depression as the only mental health problem in the postnatal period, women who experience problematic levels of anxiety may not recognise the problem, and may not be helped appropriately.
It is not uncommon for postnatal anxiety to be minimised as a ‘normal’ experience of new mothers – both by health practitioners and by new mums themselves. Recognizing the extent of postnatal anxiety, PANDA recently changed its focus from postnatal depression to postnatal anxiety and depression - now known as Perinatal Anxiety and Depression Australia.
If you are feeling worried, fearful, panicky, uptight, overwhelmed, or having obsessive thoughts, you may be experiencing postnatal anxiety. If you are constantly worrying about things that could go wrong in the future (‘what if’ thoughts), you may be experiencing postnatal anxiety. If you are distressed by your anxious feelings and your symptoms are interfering with your life (eg. avoiding going out, not sleeping, obsessively checking on your baby, seeking constant reassurance from others), you may be experiencing postnatal anxiety.
It is important to talk about these feelings. You can begin by calling PANDA for free, confidential telephone counselling (ph. 1300 726 306). You can talk with your Maternal and Child Health Nurse, your GP, or a psychologist who is experienced in treating women in the postnatal period.
Everyone’s experience of postnatal anxiety differs. However generally speaking, counselling for postnatal anxiety involves:
In some cases (and in consultation with your GP or a perinatal psychiatrist) medication might be required alongside talking therapy.
Remember, not all anxiety is normal for new mums, and help is available.
Written by Dr Renée Miller for Bubba West, Edition 4
Dr Delwyn Carpenter, located in Burwood East and Boronia, brings 15 years experience to our network, Delwyn sees women (and men) with depression, anxiety, bipolar disorder, obsessive-compulsive disorder, post-traumatic stress disorder and eating disorders. Delwyn assists mothers and fathers in adjusting to parenthood, with parent/infant relationship difficulties, parenting stress, birth trauma, reproductive loss and grief, and infertility.
Rachel Watts, located in Doncaster East, brings 20 years experience working with women and families transitioning through partnering, pregnancy and the postnatal period. She works both individually with clients, and facilitates postnatal depression and anxiety groups. Rachel works with women who have a history or a perinatal onset of depression, anxiety, bipolar disorder, post-traumatic stress disorder and obsessive-compulsive disorder. Rachel assists women and couples in their adjustment to parenting, as well as supporting people through reproductive loss. Rachel enjoys mentoring and supervising early career psychologists – a role she currently undertakes in both private practice, and at the Austin Health Parent Infant Clinic and the Parent Infant Research Institute.
Yolanda Romeo, located in Kew, holds two Clinical Masters degrees – one in adult clinical psychology, and the other in child and adolescent clinical psychology. With further training in the Graduate Diploma of Parent-Infant Mental Health, Yolanda brings many years experience working with women in pregnancy and the postnatal period, as well as with parents of infants, parents of older children, and the children themselves. In her private practice, Yolanda works with perinatal depression and anxiety, birth trauma, perinatal loss, bonding and attachment issues, as well as helping parents deal with family of origin issues and mental health issues that emerged during pregnancy and the postnatal period.
Our three new Psychologists join veteran members of APPN, Hettie Dubow (Kew), Kanthi Sayers (Kew) and Vickey Annakis(Box Hill) to provide women and families in the east with psychological help during the childbearing years.
To find out about our service in other Melbourne, Peninsula and regional locations, please visit our website.
At the Antenatal & Postnatal Psychology Network, we are particular about collaborating with psychologists who possess the qualities we know women and couples value when seeking help for difficulties related to fertility, pregnancy, the postnatal period, and the early parenting years. Patients select the psychologist of their choice from our website, and the initial and ongoing contact is made directly with that psychologist. We operate this way in order to ensure new patients feel at ease from the first point of contact. You and your patients can be assured that our psychologists fulfil the criteria of the six C's:
Patients need to know that the psychologist is competent - that she/he (I will use "she") is informed of the latest perinatal research and clinical evidence-base, and that she has helped other people with similar presenting problems during pregnancy and/or the postpartum.
The psychologist has the qualifications, specific training, and experience to substantiate her expertise in the perinatal field.
The psychologist shows a genuine concern about the well-being of your patients, helping them to build their confidence and resources for managing the difficulties they face.
The psychologist is empathic, kind and non-judgemental, with a deep-seated belief in the human capacity for psychological growth.
The psychologist has the temperament, experience and ability to tolerate and manage big emotions, intense grief, and crisis situations.
The psychologist can be trusted to care responsibly for at-risk patients (including infants). She communicates well with medical and obstetric practitioners, and has good relationships with maternal & child health nurses to fully support new parents. She works collaboratively with perinatal psychiatrists (knowing when to refer patients to such psychiatrists). She is vigilant about ethics, patient confidentiality, reporting, and follow-up that is in the best interest of the patient.
Finally, for pregnant and postnatal patients, it is helpful for the psychologist to be close in proximity, so that the patient does not need to travel too far - especially if pregnant or with little ones.
These therapist qualities, along with 16 Melbourne and 2 Mornington Peninsula Clinic locations, depict the core values of the Antenatal & Postnatal Psychology Network, in our best efforts to service Melbourne's perinatal populations. Indeed, these are the qualities upon which we recently expanded our service by collaborating with three impressive perinatal psychologists located in Melbourne's East. Dr Delwyn Carpenter (Burwood East and Boronia), Rachel Watts (Doncaster East), and Yolanda Romeo (Kew).
If you are a referrer and you would like to meet the psychologist/s in your area, we are more than happy to come by your practice or centre to meet in person. This can be arranged by contacting Dr Renée Miller email@example.com
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 15 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:
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.
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.
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.
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.
These parents are usually in shock, and so grief stricken, they can barely function. They need immediate support, a soft place to land, a place where they can expel their grief in all its rawness. Some bereaved parents find it hard to talk to their families or friends in the early days. And more often than not, they are part of a peer cohort in which pregnancy and birth announcements are achingly prolific.
Platitudes such as "just have another baby, you'll feel better", "at least you have your older child", and "at least you can get pregnant", feel like painful and minimising responses to their loss. The truth is that these parents lost THIS child. The truth is that these parents now face every future milestone blighted by a sadness for what could have been, with THIS child.
Some parents find us on the internet between the time they are told that their baby has passed away, and the time the woman has to deliver her deceased baby. Why does a woman who is carrying her dead baby have to search the internet to find someone who can help her to prepare for her worst nightmare?
Some women, because of a bleak or fatal prognosis have no choice but to be active in the termination of their baby's life in utero. The processing of complex medical information associated with genetic anomalies and statistical scenarios, can be a mental and emotional minefield. Abortion is not an easy option. The trauma and guilt of this can haunt a couple despite their rational reasoning as to why this course of action was inevitable (and indeed the most loving for their child).
Bereaved parents need a place where they can express their darkest thoughts, their gut-wrenching aloneness, and their scariest fears. They need a place where platitudes are not the answer, but where a slow and gentle support of their evolving grief, can help them to rebuild their devastated lives. Grieving differences within the couple need to be normalised and addressed, and the risk of developing complicated grief (persistent complex bereavement disorder) needs to be monitored and minimised. Ongoing support for managing anxiety in a subsequent pregnancy also needs to be available.
I implore maternity hospitals, obstetricians, geneticists, ultrasonologists, midwives, gps - all medical practitioners who see women and couples at various points along the path of loss - to provide your distraught patients with appropriate information that saves them having to search for suitable therapists at this highly vulnerable time.
Perinatal psychologists specialising in reproductive loss (Melbourne): Antenatal & Postnatal Psychology Network
Order brochures: http://www.antenatalandpostnatalpsychology.com.au/for-refer…
Information and phone support for reproductive loss (Australia): SANDS order brochures: http://www.sands.org.au/brochures
Bears of Hope order brochures:
Written by Dr Renée Miller
Principal Clinical Psychologist
Antenatal & Postnatal Psychology Network
Posted by Dr Renée Miller