The Perinatal Period - with Frances Bilbao

  • Baby Care
  • November 25, 2021

Parenthood is so full of joy and love, but at the same time feels like a relentless responsibility. There are big, fulfilling rewards but little relief, and perhaps at times, little acknowledgement.

From physical to psychological, lifestyle and identity, there’s a lot going on in the perinatal period (the stage from conception until 1 year post birth). Some of these challenges and changes are spoken about widely while others aren’t so well-voiced. As with most hurdles, the key to empowerment is knowledge and understanding. 

We caught up with Frances Bilbao, clinical psychologist and founder of Mums Matter Psychology, for a healthy dose of just that.

The perinatal period is a time in a womans life of significant change; both physical, physiological and psychosocial. Can you describe the types of changes involved?

Becoming a parent touches on every aspect of a womans life. I think most people are familiar with some of the more common physical and physiological changes but may not be as aware of the huge psychological and social shifts that occur. The adjustment to becoming a parent is a complex event that doesnt happen overnight. While the baby might arrive in a day (or two!) this doesnt mean that the adjustment to becoming a mum will happen immediately. There are many parts; including learning new skills, adjusting to your new role and renegotiating your other relationships. This all takes time, with possibly a few missteps along the way.

The most common themes that arise for new parents in the early days are:

  • Trying to manage recovery after childbirth. This could be physical recovery and emotional recovery from a difficult, traumatic or any birth.
  • Feeding issues. You may grapple with breastfeeding challenges, pressure to feed a certain way or uncertainty about whether your baby is getting enough.
  • Dealing with lack of sleep, frequent night waking and times when your baby is very unsettled.
  • Bonding with your baby. There may be things that get in the way of bonding which can cause distress for some parents. We do know that bonding is an ongoing process and develops over time, but you might worry if you havent felt the overwhelming gush of love straight away.
  • Ambivalent or conflicting feelings. Managing strong but conflicting feelings about your baby can be confusing, especially if there have been difficulties trying to conceive. It is very common to grieve for your old life, worry that you have made a mistake and feel enormous love all at the same time.
  • Mental health difficulties. These may arise (or resurface) once your baby comes along. This can look like a worsening of symptoms that were there previously or new symptoms that are triggered by any aspect of a new baby including difficult labour, hormonal changes and sleep deprivation.
  • Relationship changes. Your relationship with your partner will go through major changes in how your family unit works with a new (often demanding) member. Many women report that they start the adjustment process as their body grows and develops during pregnancy. Whereas for partners, they may start their process of adjustment once the woman is showing, when they can feel the baby kicking or even once your baby arrives into the world. Additionally, family and friends go through a sort of adjustment period too as everyone is working out how this new dynamic works.
  • Dealing with other people. You might find that people close to you start offering advice, suggestions and possibly anecdotes about how they did things when they had kids. Being able to manage this advice without damaging relationships can be very difficult, especially in the early days when our lack of sleep can interfere with our tactfulness! While the advice is often well-meaning it usually undermines the parents beliefs about how they are doing in their new role.

We know that sleep deprivation can be extremely taxing on physical and emotional health. Putting strain on our close relationships can have an effect on the way we bond with our child. What strategies or advice do you have for navigating this challenging time?

A lack of sleep (sleep deprivation) can have a great effect on your mood, energy and ability to think clearly. Things can seem so much more catastrophic if you have not been getting enough sleep, and as a result you are likely to feel more overwhelmed, teary and emotional. Poor sleep and postnatal mental health disorders can be related to difficulties in the parent-infant relationship, parental confidence or coping, a higher incidence of anger towards your child, and difficulties in your relationship with your partner.

Firstly, you can take steps to improve your individual relationship with sleep by:

  • Being kind to yourself. It is easy to forget how much sleep youre missing out on. Its important to recognise the impact of sleep deprivation on the way you feel and function. Dont be too hard on yourself.
  • Practicing good sleep hygiene when possible. This includes having a consistent bedtime routine, avoiding screen time before bed which can affect the release of melatonin (the hormone we need to feel sleepy), and avoiding caffeine and alcohol which can also play havoc with our sleep biochemistry making it hard to fall and stay asleep.
  • Getting outside once a day. This can help improve our circadian rhythms and the effective release of melatonin at the right times of day for both you and your baby.
  • Napping when you can, to soak up any bit of rest available to you. This may mean some chores will need to wait.
  • Asking for help. Your partner, family or friends can make a huge difference by taking your baby even for a few hours to enable you to recharge.
    Keeping the lines of communication open with your partner during this stage is vitally important. There can become a battle about who is more tired, who is doing most, or who had the least amount of sleep and this can quickly turn to resentment and anger if each partner does not acknowledge the challenges that the other is facing. This is a great opportunity to discuss together how each of you may be involved in the babys care. If you feel as though you are unable to work through this issue alone, a couples counsellor can be very helpful. They can provide a safe space to discuss these issues in a non-judgemental way.
    If you are feeling impacted in enjoying time with your baby, try to always keep him or her as a unique little person (as opposed to simply a baby). Some very simple play, massage and talking with your baby builds a strong, positive connection between you both so dont put too much pressure on yourself to have to do too much.

We hear many mums find the perinatal period as one of a changing identity. Can you shed any light on this? How do you instil empowerment through this time of identity change?

Parenting literally changes the core of who you are in so many ways. I dont know who I am anymore” is often the catch cry of new parents! You may feel lost between the world you used to know and this strange new world where personal freedom gives way to responsibility and self-love gives way to other love. This time can be likened to the time of adolescence when we undergo a major transformation, and in fact, brings the most physical, emotional and psychological change that anyone will ever experience in their lives. The term matrescenceis being used more and more to describe this transformational time.

Given this, it is imperative you take some time to deliberately reassess yourself and embark on a little self-discovery. Becoming a parent, although exhausting at first and confusing for you personally, is an opportunity to give your life a complete makeover. The way you see the world changes, who you interact with can change and how you socialise. Your priorities have changed and what drives your decisions. What you wear, what you talk about and how you behave often changes too! Take this as an opportunity to choose your new pathway carefully and consciously. It will take time, but you can mould a new way of being around your new responsibilities. Being in touch with your values can help you find a pathway that is right for you.

Theres the old adage Put on your own oxygen mask before helping others” - how does this relate to a mothers perinatal health and what advice do you have to prioritise ones own health, particularly through times when bub is going through a leap, teething and bouts of illness?

As a new parent you may find yourself constantly putting the needs of others first – whilst your own needs and priorities can fall to the bottom of the list, or even off the list entirely! Parenting is constant work and it is easy to stop caring for yourself or to feel overwhelmed. It is important to remember though, that when you stop caring for yourself, your ability to care for your child can be impacted as well as your ability to enjoy motherhood.

It is important to prioritise, plan and schedule your own self-care. This is especially important as an anchor when things are tough and it is even harder to prioritise ourselves. This starts with the basics of sleep, eating well and keeping active even if in small ways. Try to do something pleasant or enjoyable every day or every other day and plan these for the week ahead. Access your social supports and spend time with family and friends, particularly those people who are most likely to provide comfort or boost your mood. Most importantly, try to be kind to yourself the way you would a close friend.

Life changes in more ways than one after the birth of a child. And just as your baby will grow and learn immensely in their first year, the perinatal period is an opportunity for you as a parent to grow and learn, too.

Remember to breathe in and soak up those joyful moments, and exhale and speak up through the challenges. You’ve got this.