How to Start Talking about Postnatal Mental Health

Talking about postnatal mental health can feel surprisingly hard.

You may know, theoretically, that many women and birthing parents struggle after birth, yet still hesitate to put words to your own experience. You might worry about being judged or dismissed, or simply told that what you’re feeling is “normal” and therefore not worth support. Or you may simply not know where to begin.

Today is Time to Talk Day; the UK’s largest annual campaign dedicated to encouraging open conversations about mental health.  And at Hesta Health, we want to take the opportunity to talk about something important: how conversations about postnatal mental health start, and what makes them safe, useful, and effective.

Because talking is not just about speaking. It’s about being heard in the right way, at the right time, with the right support.

Why postnatal mental health conversations matter

The postnatal period brings profound change, and it takes time and work to adjust to this new period. Bodies are changed and still changing. Hormones shift. Sleep is disrupted. Identity, relationships, work, and expectations all shift.

Emotional responses during this time exist on a wide spectrum. Some women and birthing parents feel low, anxious, detached, overwhelmed, or unlike themselves. Others feel “fine” for months and then notice things changing later. Many don’t recognise their experience in public narratives of postnatal depression or anxiety, and therefore assume they don’t qualify for help.

What we know clinically is this: early conversations matter. Not because every difficult feeling signals illness, but because unaddressed distress can accumulate, become entrenched, or escalate over time.

Talking is not a diagnosis. It is a doorway to understanding.

Mental health exists on a spectrum, not a threshold

One of the biggest barriers to speaking up is the belief that you must be “unwell enough” to justify concern.

In reality, postnatal mental health does not operate in neat categories. While diagnostic frameworks (such as postnatal depression or anxiety) are important for treatment planning and access to services, they do not capture the full range of experiences that may benefit from support.

You can:

• feel persistently overwhelmed

• feel emotionally numb rather than low

• feel anxious without panic attacks

• feel functional but not yourself

• feel distressed but still able to care for your baby

…and still benefit from being heard and supported.

Not meeting diagnostic criteria does not mean that your experience is insignificant, that you should “wait it out”, or that support wouldn’t help. Early, lower-level support can be protective. It can prevent distress from becoming acute, and help women and birthing parents feel steadier before crisis points are reached.

The importance of a trauma-informed response

How someone responds when you speak matters as much as the act of speaking itself.

A trauma-informed approach recognises that many women and birthing parents enter the postnatal period with prior trauma. This might include trauma related to birth, pregnancy complications, previous mental health difficulties, loss, or experiences unrelated to pregnancy altogether.

Trauma-informed care does not assume trauma, but it assumes vulnerability. It prioritises:

• emotional safety

• choice and control

• being believed

• avoiding blame or minimisation

This means responses such as:

• “Lots of women feel like this”

• “At least your baby is healthy”

• “This is just hormones”

can feel dismissive or silencing, even if well-intentioned.

A trauma-informed response sounds more like:

• “Thank you for telling me”

• “That sounds really hard”

• “We don’t have to label this, let’s just talk about what’s going on”

  
  

Whether the listener is a friend, partner, GP, midwife, or mental health professional, feeling safe enough to continue the conversation is critical.

Why being proactive matters

Postnatal mental health difficulties do not always arrive dramatically. More often, they develop quietly.

Women may:

• normalise distress because they are “coping”

• delay speaking because they fear being seen as incapable

• prioritise everyone else’s needs first

• wait for a clear “breaking point” before seeking help

From a clinical perspective, this is where opportunities are often missed.

Being proactive does not mean pathologising normal adjustment. It means:

• noticing changes over time

• checking in before distress becomes overwhelming

• creating space for conversation even when symptoms feel vague or manageable

This is as true for healthcare systems as it is for individuals and families. Postnatal mental health care should not rely solely on women reaching crisis thresholds in order to be taken seriously.

When postnatal mental health difficulties can appear

Another common misconception is that postnatal mental health issues are confined to the first few weeks after birth. In reality, difficulties can emerge months, or even well over a year, after delivery. Research and clinical services consistently show that there is a second peak in postnatal depression symptoms around the 12–18 month mark, a time when many women and birthing parents believe they should not even consider themselves to be “postnatal” anymore.

Challenges that arise after the first few months after birth can coincide with:

• the cumulative effects of long-term sleep disruption

• returning to work or childcare transitions

• weaning or changes in feeding

• shifts in identity, relationships, and expectations

• the delayed emotional processing of pregnancy or birth experiences

• relationship strain, or subsequent life stress

• the reappearance of previous trauma or cumulative stress

Because this phase sits outside the traditional “postnatal window,” many women and birthing parents are surprised to find themselves struggling, and may be less likely to recognise their symptoms as postnatal or to seek support.  But a decline in mental wellbeing after months or years does not mean something was “missed” or that a woman or birthing parent has failed to recover. It reflects the fact that the postnatal period is not a single moment, but an extended transition.

Understanding that postnatal mental health difficulties can surface well beyond the newborn stage is an important part of reducing shame and ensuring women and birthing parents feel justified in asking for help whenever they need it.

How to start the conversation (practically)

Starting to talk doesn’t require a full explanation or the “right” language. It can begin in small, contained ways.

Some examples:

• “I don’t feel like myself, and I don’t know why”

• “I’m managing, but it feels harder than it should”

• “I’m not in crisis, but I could use some support”

• “Something feels off, even though I can’t name it”

You might choose to speak first to:

• a trusted friend or partner

• another mother or birthing parent

• A community group or group on social media

• A helpline

• your GP

• your health visitor or midwife

• a mental health professional

Peer support can offer validation and relief from isolation. Professional support brings clinical perspective, continuity, and access to care pathways. These are not competing options; they are complementary.

If you’re supporting someone else

If you’re listening to a postnatal woman talk about her mental health, your response matters.

You don’t need to fix it.You don’t need to diagnose.You don’t need perfect words.

You can:

• listen without interruption

• reflect what you hear

• avoid minimising or reassuring too quickly

• encourage further support when appropriate

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Sometimes the most protective response is simply staying with the conversation rather than closing it down.

Time to Talk Day

Time to Talk Day exists to remind us that talking about mental health can reduce stigma and isolation. For postnatal women and birthing parents, this message is particularly important.

Talking is not a one-off event. It is an ongoing process that may start quietly, stop, and start again. It may involve peers, professionals, or both. And it may happen long after the newborn phase has passed.

At Hesta Health, we believe postnatal mental health deserves:

• early attention

• trauma-informed responses

• support across the full spectrum of need

• and conversations that continue beyond the first weeks after birth

If this piece helps one woman feel more justified in speaking, or one listener respond more thoughtfully, it has done its job.

Where to find support

If reading this has brought up difficult feelings, or if you recognise yourself in any of the experiences described, you don’t have to manage this alone. Support is available, and you don’t need to be at breaking point to reach out.

NHS support

• Your GP, midwife or health visitor  These professionals are often the first step into support. They can listen, offer guidance, and refer you to local services, including NHS Perinatal Mental Health Services. These support women experiencing moderate to severe mental health difficulties during pregnancy and the postnatal period, including those that emerge months after birth.

• NHS Talking Therapies (England)  You can self-refer in many areas for evidence-based psychological therapies, without needing a GP referral.  https://www.nhs.uk/service-search/mental-health/find-an-NHS-talking-therapies-service/
  

Specialist perinatal mental health support

• Make Birth Better Make Birth Better is a UK-based non-profit organisation and collective founded in 2018 by Dr. Rebecca Moore and Dr. Emma Svanberg, dedicated to reducing the impact of birth trauma and improving maternity care.  It offers support and information around birth trauma, including a free download that can be used to start these conversations with a list of common symptoms and feelings. https://www.makebirthbetter.org/step-1

• PANDAS Foundation  Offers support, information and helplines for perinatal mental health difficulties, for mothers and families. https://pandasfoundation.org.uk/

Peer support and listening services

• Mind Provides information, local support options and helplines for mental health concerns. https://www.mind.org.uk/

• Samaritans If you’re feeling overwhelmed or unable to cope, Samaritans offer confidential listening support, 24 hours a day. Call free on 116 123 or visit https://www.samaritans.org/

If you need urgent help

If you feel at risk of harming yourself, unable to keep yourself safe, or in immediate distress:

• Contact your local NHS urgent mental health helpline (available 24/7 in England)

• Go to A&E

• Or call 999 in an emergency

A link to accessing urgent NHS services is here: https://www.nhs.uk/nhs-services/mental-health-services/where-to-get-urgent-help-for-mental-health/

Seeking urgent help is a protective step, not a failure.

A final word

If you are postnatal and thinking about talking, but unsure whether your feelings are “serious enough", please be reassured that you don’t need a diagnosis to deserve care. You don’t need the right words to begin. You don’t need to wait until things fall apart.

Starting the conversation is the intervention.

Written by Hesta Health, and validated by Dr Rebecca Moore, a perinatal psychiatrist and a founder of Make Birth Better.