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'.
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And so this went on for a few days where - not eating but exhaustion plus some of these other physical symptoms really started to take their toll and at that point my psychological state started to fall apart. [Pause] It's - went from feelings of I guess grief and loss of my old life, to me coming down the stairs one morning and saying, "I want to give her up for adoption". And of course my partner responded with, "What are you talking about?" And realised at this point that, hang on, things are really - things are going wrong.
I often tell friends or whoever I'm speaking to that I was lucky in the sense that over - just a couple of days my emotions and my - the way I was thinking went from quite stressed to obviously not right. Because what that meant is that immediate action was taken by those around me. It was obvious something was wrong and it was obvious very quickly. Not very long after I told my husband that I wanted to give my daughter up for adoption, and his response of, "Well that's not going to happen", I started to think of other ways to change my situation. And because my thoughts by this stage were very confused - the only other options I could think of was running away or suicide.
And one morning I was in the kitchen and I was trying something that - what made it obvious that I was thinking about self-harm and I got bundled into the car and taken to a local emergency room where the staff were able to find me a spot in a mother and baby unit, which is a unit where new mums are treated with their children. So the babies still get the opportunity to bond with the mother. The problem was that in my case I actually wanted to get, get as far away as possible, so I fought the idea of going into a mother and baby unit for a few hours before I was convinced that that's really the best option for both myself and my daughter.
And I eventually agreed to go. It was on the other side of town, so there was a lot of stress for me about that and the - the sort of pressure that that will put on my family and my husband in terms of obviously my daughter was going to be with me, so away from him and that that that was unfair. But by the time I was admitted into the unit, which was that evening, I can honestly say I don't remember the next 48 hours at all.
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.
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I remember on admission the psychiatrist that you sort of get allocated to sort of goes through - runs through like a million questions, that they have, all, I guess, the standard stuff that they need to ask you. And it was very, very confronting, and a lot of stuff, like a lot of probably feelings that I didn't think were even an issue for me sort of were getting brought up and that sort of thing, with my family and that sort of thing. My mum having schizophrenia, my dad having bipolar. Brothers having substance abuse issues, and all this sort of stuff got brought up and I just didn't understand why it was being brought up in my situation, and I guess they were just trying to get the foundation of it. Because it all contributes, so you know, some people I guess are lucky and have postnatal - I shouldn't say lucky, but some people don't have the existing medical history so therefore their experience is different. So yeah that sort of opened up a whole other can of worms, which was fine.
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.
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So I went into the mother and baby unit, spent five days in there, five nights and the first two nights, the first thing they do is they look after your child and you get as much sleep, rest, whatever you need, if you just want to read a magazine, that's possible. So it's not for everyone. It is - there is a part of self-settling in there. They do a little bit of controlled crying, but I was at my wits' end. I would have taken anything at the time, but the controlled crying is with you there. You are letting them cry, you are just trying to settle them and they were left no more than two minutes at any time. So I was comfortable with that. I looked into all that before I went in and he took to it really well.
So I had lots of rest. You were seen by a GP. The GP will give you sleeping pills if you feel you need them. I was exhausted, I didn't need sleeping pills. You are also seen by a psychiatrist if the GP thinks you need it.
After the two days you were then shown the technique for settling your baby. So of course my son was the terrible baby that couldn't do the standard - he would constantly - because you lay them on their side and as they're laying there you're patting them and you do a double pat and he would constantly try and turn around to look for me. So he had to be held on the shoulder and just one pat. So there was just a slight change, but I liked the fact that they altered it to suit the child.
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.
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They were really good. They - they just helped me so much and being amongst people as well that were going through the same thing. And we had a group session a day where we went in and sort of shared with the group what we were going through and I sort of heard all these different stories from the other girls and they were going through it and the same thing. And it was just so beneficial for me to sort of be in that environment.
Like I still have my days but yeah, it's - I think the main things I've got out of the stay in hospital is that yes this is all normal. I'm not a bad mother for having these thoughts and feelings towards him because every par - parent goes through it and that was really good to get that reassurance but also it's brought me closer to my son because at first I was afraid of him and I mean I love him to death, didn't know what to do with him though.
There was a good thing about the hospital, they actually involved the husbands a lot. They had like group meetings and with a psychologist and my husband went to one of the meetings and they just talked about how he felt. Like how he sort of felt about the whole experience and just involved them a lot as well. Not all the husbands went but yeah. It was good for him. Good for him to sort of get that information, have a little bit more of an idea of what's going on in my head I guess.
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.
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I know my wife struggled with breastfeeding. And the whole stigma of, you're only a good mother if you breastfeed. And she stuck it out for quite a while. A good six months of twins with different cycles of their own. So no sooner than feeding one and getting it off to sleep, then the other one would wake up and you'd feed that one, and then the next one's woken up again.
So she had about six months of pretty much zero sleep before it started getting a bit dire at home. And she actually checked into a maternity psychiatric ward. And we got some help there.
It was good for her to have the time out at the psych ward, and have a break. I think it was actually my suggestion at the time. I had some leave owing, and I took one of the twins home with me. And like had a fortnight off work. And I was just raising one of them at home so she could have just one-on-one in the ward and get some help that she needed, and not have the double the workload.
So that was certainly good. And then... it was either a month or six weeks that she was in there altogether, and had some help. And I was going, I was going there quite a lot too, and seeing her, and sort of taking some real food in occasionally [laughs]. But certainly after that, we came back and I had a deeper understanding of what the problem, you know, like what the whole lack of sleep does. And certainly it is, it is an easier option just to head off to work and earn the bread and come back. And it is very hard raising children.
Chelsea said the 'tough love' she experienced in hospital taught her how to 'cope' with early parenthood, as well as to 'enjoy' her baby.
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And I guess at the hospital they just teach you how to cope. Change your mindset.
Because a lot of it - well from my experience, a lot of the postnatal depression and anxiety I think being mindful, learning about being mindful, and I guess sort of just thinking of things differently. You know, you get so exhausted, so - so tired, so emotional, that you just don't think straight, and I guess they taught me how to think straight again, which was a very basic way of sort of explaining it.
Yeah, so it was just - it was quite a difficult time, very scary, very stressful, confronting, there was good - obviously there was good elements to it as well. They got me sleeping - like I wasn't sleeping, like it was just ridiculous. They got me sleeping again with the help of medication, and just sort of helped me get back in balance.
And I guess sometimes I felt like it was a bit of tough love in there. And a couple of times, you know, they would say things like, "Well that's what being a mum is" - because I think I had a bit of trouble adjusting to, my new role in life [laughs], which I definitely did have some trouble adjusting to that and you know, because I was unwell I think it was all magnified as well.
So, yeah - there was a few times that the nurses were just, 'You know what, well that's just life and you need to suck that up'. But it was relevant to what I was complaining about, like I was complaining about the fact that it takes five times as long to get out of the house with a child than - you know, if you want to do something you just get up and walk out of the house. So that was relative to the situation. But they were also there when I was feeling very miserable and confronted by my situation, and out of control, and they were able to just help me get back into control and work through things.
And actually they even had classes there about how do you actually enjoy your child, which sounds a bit ridiculous. You should be able to enjoy your child but there was nothing - I loved him. There was no question of - like and I would have done anything for him. But I didn't know how to just be with him without feeling anxious or tired or angry, at feeling suffocated, sort of thing. So they kind of probably taught me how to relax and sort of just be in the moment and who gives a crap if the dishes aren't done and the washing's not done and [sighs] your place is a mess, or anything like that.
All that matters is just stopping and finding something good in your situation, like the fact that he was - you know - he was - you could see him changing, growing and changing and learning like right in front of me and I'd been completely oblivious to that. Like I shouldn't say oblivious. I was aware, but I wasn't in the moment. I wasn't enjoying it. So I think during that period of time, like I don't know how long it sort of went on for because like I said before I don't know when I was sick versus what's just normal, because that was my sort of experience. But yeah, I didn't enjoy a big chunk of it and so I didn't - it wasn't until I went through that experience with the hospital that I learnt to stop and enjoy him and be - I'm kind of comforted by him in a way.
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.
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And my counsellor's father recently passed away so I haven't seen her for a number of weeks. So yeah, I've stepped up my medication, I'm on the 20 milligrams now but I just don't think it's really helping me. So I mean I'm certainly better than when I went off it that time when I got pregnant but I mean there's probably a lot of things that play there with my hormones and all of that. So anyway, so we've - my partner and I have decided that a hospital stay might do me good. So we're in the process of arranging that at the moment.
Just because when I have become very distressed, like in the last few weeks, I've probably thought some very negative thoughts that, I probably shouldn't - I've just - I just feel that it's hard for me to get to appointments with my son just because of the - I mean, I'm better at getting organised and going out but just the age he's at it's hard, it's hard to expect him to sit still somewhere while you talk to someone for an hour, and money's a factor as well, but we have health insurance that covers everything.
So we just feel that it would be good for me to be able to just really focus on this sort of stuff, uninterrupted. And I suppose I feel I've never really recovered from - well the birth and the first year, I suppose. You know, he's in a great routine and he sleeps now but I don't sleep that well. So yeah, I just feel like I haven't had any rest. And I think I just need to just take a step out of the world and just, you know, reorganise myself and come back a bit stronger.
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