Experiences of hospitalisation for postnatal depression

Several mothers were admitted to a specialist mother and baby unit for postnatal depression or anxiety. One father of twins talked about his wife's stay in a mother and baby unit, and one mother was contemplating a hospital stay. Parents talked about their or their partners' experiences of being admitted, the treatment and support received in hospital, and their feelings about their experience.

How quickly mothers were admitted to hospital depended on how severe their symptoms were seen to be. Some women were admitted quickly while others waited several weeks for a referral and the offer of a hospital bed. Michelle, a mother of one, said her husband began researching a private hospital with a mother and baby unit after she had a 'breakdown' one night, and she talked to both her GP and her maternal and child health nurse about a referral. About a month later the hospital contacted her and Michelle underwent an 'interview' and 'screening process' before being admitted. In contrast, Anna's admission was very fast. Some women found the admission process itself challenging.

Anna described how a rapid change in her 'psychological state' led to her immediate admission to a Mother and Baby Unit after she tried to 'self-harm'.

Chelsea found the interview for admission to a mother and baby unit 'very, very confronting' but understood the reasoning behind the questions she was asked.

Mothers commented on the treatment and support they received in hospital. This involved several elements including being given the opportunity to sleep, medication, being taught how to settle their babies, and group sessions (for mothers as well as fathers).

Most described being encouraged at the start of their stay to sleep, as they were typically 'exhausted' or 'sleep-deprived' on admission. As Melissa, who spent one week in a mother and baby unit when her second child was four months old, explained: 'the first thing they do is they look after your child and you get as much sleep, rest, whatever you need'. Michelle commented on how her hospital stay also benefited her husband: 'He was there every day but didn't stay with us and it was really hard to be away from him but I realised that he needed a break as well because he wasn't sleeping... even though he was coping with it better'.

Medication for depression, anxiety or sleeping difficulties was prescribed if women were not already taking any. Due to the time needed for antidepressants to take effect, this meant the initial period in hospital could be difficult, as was the case for Anna, who spent three weeks in the unit: the antidepressants did take a few weeks to start working, so those few weeks were really tough'. For mothers already taking medication, their doses were reviewed and adjusted.

A few women said they appreciated learning how to settle their babies. This was particularly valued by mothers of babies with reflux or colic who cried frequently and didn't sleep well. Michelle said learning settling techniques made her hospital stay 'the best thing' she did and was grateful for the nurses' reassurance that her baby was particularly challenging: 'they said, "Look, he's a difficult baby - he's sick, he's got reflux, he's got [a cows' milk protein] allergy ... all these pains for him to deal with"'.

Melissa was 'comfortable' with the new settling techniques she learned in hospital, as well as the fact that the staff 'altered' these to suit her baby.

Group therapy, for both mothers as well as fathers, was mentioned by a few parents.

Michelle said the group sessions she participated in hospital made her realise her feelings were 'all normal' and she was 'not a bad mother'. Similarly, the group her husband attended helped him understand what Michelle had been going through.

Some mothers found aspects of being in hospital 'confronting', including the loss of freedom and the 'very structured' nature of the hospital routine. As Chelsea, who spent a month in the unit, commented: 'Your freedom - yeah, it's gone. You need to do what they tell you to do, which is different when you've lived out of home for 10 years, been very independent, to just be within this room, with your child, being told when it was breakfast, when it was lunch, when you needed to do everything basically. It was a real shock to the system'.

However, all women who spent time in a mother and baby unit were appreciative of their experience. In addition to being able to sleep and rest, mothers particularly appreciated being supported while learning to settle their babies and adjust to early parenthood.

Andrew described the benefits of his wife's stay in a mother and baby unit.

Chelsea said the 'tough love' she experienced in hospital taught her how to 'cope' with early parenthood, as well as to 'enjoy' her baby.

A few said hospitalisation helped them 'feel connected' to their children, particularly once they had mastered settling techniques. Michelle described having been 'scared' she would repeat with her son the anger she experienced from her father as a child, explaining: 'When I learnt how to cope with settling him and understood what babies were like, it got so much easier. The bond grew from there and my love for my son just got that much more intense and now it's all good'.

Several parents portrayed hospital as part of a spectrum of treatment for postnatal depression. Melissa felt hospitalisation helped her get into a routine with her baby, allowing her to then 'concentrate on sorting [herself] out' through counselling and adjusting her medication. In contrast, after realising she and her son were not 'bonded', Melanie managed to rebuild their relationship but was not confident she could 'recover' from postnatal depression with counselling and medication alone.

Melanie had tried medication and counselling but felt these weren't 'really helping'. She was contemplating a hospital stay to 'focus uninterrupted' on recovering from postnatal depression.

A final benefit of hospital was meeting other parents going through similar difficulties. Chelsea said she developed an enduring friendship with someone she met in hospital, while Andrew commented in relation to his wife's hospital stay: 'Just seeing that other people are in the same situation as you makes it a bit easier to accept that, yeah, you are human, and it is hard'.

Further information:

Victorian Government (Department of Health): Mother and baby mental health services