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Perinatal mental health

Perinatal refers to the time from pregnancy to a year after childbirth. Antenatal refers the period during pregnancy. Postnatal, or postpartum, refers to the first year after birth.

Some women may be at risk of becoming unwell during pregnancy or after giving birth. There is a higher risk if they felt stressed recently or had mental health problems in the past.

One in five Australian women will have some sort of mental health issue during the perinatal period.

The 'baby blues'

It is normal for women who have given birth to feel out of sorts while adjusting to the changes a new baby brings.

The baby blues usually occurs between three to 10 days after the baby’s birth, due to hormonal changes, lack of sleep and other factors.

Symptoms of the baby blues

  • feeling weepy or crying over seemingly minor things
  • having mood swings or being especially irritable
  • feeling unattached or unbonded to your baby
  • missing parts of your old life, like the freedom to go out with friends
  • worrying or feeling anxious about your baby’s health and safety
  • feeling restless or experiencing insomnia, even though you’re exhausted
  • having trouble making easy decisions or thinking clearly
  • Symptoms disappear within a few days without the need for treatment other than rest and support.

If these symptoms last longer than two weeks after birth, they may be sign of an emerging mental health condition.

Perinatal mental health conditions

Perinatal anxiety

Anxiety disorders during the perinatal period includes:

  • generalised anxiety disorder
  • obsessive compulsive disorder (OCD)
  • panic disorder and
  • social phobia.

Perinatal anxiety occurs in up to 20 per cent of women. It is common to have both anxiety and depression at the same time.

Symptoms of perinatal anxiety

  • feeling restless, keyed up, on edge, panicky
  • worried about things not in your control
  • easily fatigued
  • difficulty concentrating
  • irritability
  • fearful
  • muscle tension
  • sleep disturbance
  • panic attacks
  • avoidance behaviours, for example, towards baby or social interactions.

More information about perinatal anxiety.

Perinatal depression

Depression affects up to 10 per cent of women during pregnancy, and up to 16 per cent after the birth up to the first year.

Around 10 per cent of fathers are affected by depression, and up to 20 per cent for anxiety.

Symptoms of perinatal depression

  • depressed mood or irritability
  • diminished interest or enjoyment in activities
  • significant weight or appetite change
  • sleeping problems
  • fatigue, tiredness
  • feelings of worthlessness or guilt
  • inability to think clearly or concentrate
  • recurrent thoughts of death or suicide or both.

More information

Post-traumatic stress disorder (PTSD)

Some women experience birth or pregnancy as traumatic, especially those with a history of childhood sexual abuse.

Symptoms of post-traumatic stress disorder (PTSD)

  • persistently re-experiencing thoughts or dreams or both
  • flashbacks followed by feelings of intense distress
  • persistently avoiding thoughts, feelings and situations associated with the traumatic event
  • constant state of arousal, irritability, hyper-vigilance, exaggerated startle response
  • difficulty getting to or staying asleep
  • feeling detached from others.

Bipolar affective disorder

A disorder characterised by episodes of mood swings ranging from depressive lows to manic highs. The manic episodes can include high energy, less need for sleep and a loss of reality. Depressive episodes can include low mood and energy. Episodes can last days to months.

Symptoms of manic episodes

  • increased energy
  • irritability
  • overactivity
  • increased spending
  • increased sex drive
  • racing thoughts
  • rapid speech
  • decreased sleep
  • grandiose ideas
  • hallucinations or delusions, or both.

Symptoms of depressive episodes

  • low mood
  • irritability
  • loss or change of appetite
  • lack of motivation
  • low self-esteem
  • sleep disturbance
  • suicidal thoughts
  • difficulty managing small tasks or making simple decisions

More information on biploar disorder and pregnancy.

Borderline personality disorder (BPD)

Borderline personality disorder (BPD) is a mental illness that centres on the inability to manage emotions and impulses. Having BPD makes it hard for a person to feel comfortable with themselves and relating to other people.

Symptoms of borderline personality disorder

  • frequent suicidal or self harming behaviour
  • taking risks or acting impulsively Intense anger, and being unable to control it
  • obvious emotional instability
  • feeling persistently ‘empty’ inside
  • having relationships that are unusually intense or unstable.

Postnatal psychosis

Postnatal psychosis, also known as puerperal or postpartum psychosis, is an illness that can put both mother and baby at risk. It can

  • occur after childbirth and requires urgent psychiatric care
  • be related to an underlying mental health disorder, for example bipolar disorder or schizophrenia.

People with bipolar disorder or a prior postnatal psychosis have a very high risk of postnatal psychosis.

The onset of symptoms is sudden and can include:

  • delusional beliefs
  • disorganised thinking and confusion
  • rapid mood change or irritability
  • hallucinations.
More information about postnatal psychosis.

Perinatal mental health assessment

A psychiatrist, or other qualified mental health specialist, can assess whether someone has a mental health condition. Mental health conditions include:
  • Depression
  • Anxiety
  • Post-traumatic stress disorder (PTSD)
  • Bipolar affective disorder
  • Borderline personality disorder (BPD)
  • Postnatal psychosis.

These conditions can range from mild to moderate or severe. Some severe or acute conditions require hospital care.

Severe perinatal mental illness

Severe mental illness is much less common than depressive and anxiety disorders. Hospital care at an inpatient mental health unit or mother-baby unit is often required.

A mother with severe and acute mental health conditions can negatively impact the baby’s emotional and behavioural growth.

An urgent mental health assessment is needed if there is:

  • risk of suicide
  • risk of harm or neglect to the baby
  • postnatal psychosis.

To get a mental health assessment, call the Mental Health Line on 1800 011 511.

If there is an immediate risk of harm to themselves, the baby or you, call Triple Zero (000) now or go to a hospital emergency department.

Read more about how to get free advice and services from the Perinatal and Infant Mental Health Services on Where to get help and support.

More information

For more information about perinatal mental health, refer to:


​​​Although this resource is aimed at dads, the information is helpful for all new parents and carers regardless of gender, who are coping with perinatal mental illness.

Current as at: Monday 1 February 2021
Contact page owner: Mental Health Branch