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Risk Factors

Perinatal depression and anxiety can strike anyone: first-time parents, experienced parents, older parents, younger parents, and parents from all socioeconomic backgrounds and cultures.

Some of the following background factors and circumstances can increase the risk of PNDA:

–  A personal history of mental illness

–  A family history of mental illness

–  Pre-existing misuse of alcohol or other drugs

–  Vulnerable personality factors such as low self-esteem or perfectionism

–  A personal history of trauma, abuse or other adverse experiences

–  Having settled in Australia from another country

–  Financial difficulties

–  Lack of social and/or practical support network

–  LGBTQI+ parents, who can face discrimination and have their family or parenting questioned

–  An unsupportive employer e.g. pressure to return to work or lack of flexible options

–  Relationship difficulties with partner, mother, father or another key person

–  Previous pregnancy, baby or child loss

–  Birth of twins or multiples

–  Pregnancy or birth complications

–  Unplanned pregnancy

–  Birth mother younger than 18 years old

–  Fertility issues, including IVF or surrogacy

–  A rural and remote location

–  Culturally or linguistically diverse background

–  Aboriginal or Torres Strait Islander background

–  Birth mother older than 35

–  A recent or significant bereavement

–  Other stressful life events

The difference between the baby blues and PNDA

With the many changes occurring during the transition to parenthood, it is hard to know whether your feelings are “normal”. There is so much to take in and process after a birth.

The ‘baby blues’ are so common that they are considered a normal part of the inevitable adjustment that mums experience in the early days after birth. Usually, they start a few days after birth and resolve within two weeks. The ‘blues’ implies low mood, although the mood is probably labile, while irritability and tearfulness are common.

Some women may have an elevated mood rather than feeling blue. The exact cause is largely unknown, although hormonal changes are thought to play a part. It could be a normal reaction to the birth process and what that brings up for women. Acknowledgment of the situation along with social and emotional support is usually all that is required.

If the symptoms interfere with day-to-day functioning or persist beyond 14 days specialist assessment and advice are essential as more serious illness is likely.

Some key markers for the baby blues, compared with more serious perinatal mental health issues, include the following:

–  These mood changes usually emerge within three to four days of birth and resolve within two weeks. If they persist for longer, it is helpful for a parent to talk to someone about how they are feeling and seek professional advice.

–  Symptoms are usually mild and do not significantly affect a woman’s day-to-day functioning and will usually settle, although they can feel very intense at times.

–  The baby blues alone don’t include thoughts of suicide, self-harm or disturbing and intrusive thoughts or images about harm to baby, self or family

–  They are short-lived and temporary emotional responses

These are not signs of more serious mental health issues unless they persist beyond 14 days or include other signs and symptoms.

Date of Last Review: April 2021