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As many as one in 10 women experience postnatal depression. So what happens when you’re in the midst of it, or recovering, and you’re due to return to work? We look at your options and share tips on handling the transition

Staying in touch

As difficult as it may be when you’re going through PND, you may find that keeping in touch with your employer and colleagues helps you feel less anxious about returning to work.

Sybille Raphael is Head of Legal Advice Services at Working Families, an organisation specialising in work-life balance, and she has the following advice:

‘It usually helps to have regular contact with your employer, allowing you to explain your worries and your wishes, so you can prepare for your return to work together.’

You can come to work – and be paid – for up to 10 Keeping in Touch (KIT) days without maternity leave or pay ending.

There’s also no substitute for talking. ‘Emails, or what feels like a suspiciously long silence, can be misinterpreted.’

‘So it’s often better to take the bull by the horns and suggest a quick chat, in person or by phone,’ says Sybille.

Keeping your employer informed

It’s completely up to you whether or not you want to disclose your PND to your employer. You are not legally obliged to do so.

However, informing them might mean they’re better able to understand and support you.

‘It might also help you negotiate whatever you think might help, or diffuse any tensions before they arise,’ says Sybille.

Laura Clark is mum to Edward and founder of The Butterfly Mother blog about mental health, emotional wellbeing and self care for parents. Because she was starting a new job she didn’t feel able to disclose her PND, but in hindsight she says it might have helped.

"You’re not obliged to tell anyone about your PND if you don’t want to"

‘When I had a relapse of anxiety around two years later I was forced to tell my boss and she was absolutely incredible. Most companies have a mental health policy and sometimes mental health champions to support you.’

She adds: ‘If you’re returning to your previous job, and feel comfortable doing so, try to have a frank discussion with your manager – maybe they can find a way to ease you back in, such as a phased return.’

Talking it through

If you’ve decided to disclose your PND, telling your employer or colleagues something so personal can feel very daunting.

So it’s worth working out what you’re going to say. You can tell them as much or as little about your experiences as you feel comfortable with.

Also think about how you’d like them to respond – are you asking for any specific help or support when you return to work, or do you need to delay your return to work?

Write it down and bring notes with you if you feel it will help.

Presenting solutions, not problems

Sybille advises: ‘Consider your situation and try to put forward the best proposal you can. So, instead of arriving with a problem, you will be a problem-solver.’

Being proactive and trying to plan for your return to work is always sensible – and hopefully it will make the process smoother.

‘If there’s anything specific that you’re worried about, face the problem head-on and try to find solutions,’ says Sybille.

‘Be positive. Try to plan ahead and be prepared to suggest ideas to get around any issues. For instance, if you think you’ll find it difficult to leave your baby, suggest a phased return to work or that you start work a bit later so that mornings aren’t so hectic.’

‘Or, if you’re worried about having to do overnight travel, think carefully about how your manager could reallocate your responsibilities.’

Sybille’s advice is to prepare thoroughly before all meetings with your employer.

‘Think about what you need from the discussion with your boss or colleague. Make sure you know what you’re asking for and make sure to ask for it.’

She adds: ‘It’s a good idea to keep notes of your meetings and of anything that is agreed along the way.’

What if you’re unable to return to work?

  • You don’t have to return to work straight after your maternity leave. You can ask for parental leave. It’s unpaid and lasts a limited time (statutory is four weeks maximum).
  • PND is an illness and you should be treated like any other sick employee if you’re not well enough to return to work at the end of your maternity leave.
  • This means you may get statutory sick pay.
  • But you’ll also be subject to your employer’s sick policy and could potentially be dismissed for long-term absence just as another long-term sick employee would be.

Weighing up your options

You may feel like the clock is ticking and your return to work is looming, yet you’re just not ready because of your PND.

If this is the case, try to have a discussion with your partner about what options might be open to you as a family. For example, would your finances allow you to request a change in working hours? It may help you cope emotionally if you know you’ll be working fewer hours.

Or, would it be financially viable to delay your return to work? You are legally entitled to 52 weeks of maternity leave (although the last 13 weeks are unpaid) and some further time off might help your recovery.

Many women don’t realise that they accrue holidays while on maternity leave so you could ask if this can be added onto the end of your maternity leave to buy you some more time to recover.

It can help to figure out what your options are – so you don’t feel like you’re pressured into following a path that could set your recovery back.

Managing expectations

"Be realistic in your goals and don’t be afraid to ask for help and support"

It’s very tricky when you have lots going on in your personal life but you’re still expected to perform at work.

Sybille has the following tips: ‘Think of the resources you need and ask for them. Clarify mutual expectations and priorities.’

She adds: ‘Communication is key. If you’re going to miss deadlines, raise your hand early on.’

‘Come prepared to present your boss with potential solutions to show that you have the same sense of urgency as they do about projects. And be sure to flag your successes for your boss.’

Resolving conflict at work

Many employers prove understanding and sympathetic towards women experiencing PND, but unfortunately this isn’t always the case.

Sybille says: ‘If your manager does not support you, the next step is probably to seek help elsewhere. Raise the matter with HR or a superior informally first. If this does not get you anywhere, ultimately you can complain about it in writing through a grievance.’

However, Sybille does caution about raising a grievance before you’ve explored other options.

‘It is almost always better to be clear about what you need in terms of support and raise it informally first.’

Taking it one day at a time

"Try to take it slow and give yourself time to get used to the new routines and arrangements"

Returning to work after having a baby is difficult enough, even without PND thrown into the mix.

Laura says: ‘This is not just a tip for returning to work but for handling PND in general. During those first few weeks I had several moments when I felt completely overwhelmed and I questioned whether I could do it at all.’

‘This usually occurred when I let my mind run away with me and focused too much on the future. If you take your job literally one task at a time everything feels a lot more manageable.’

Finding the right childcare

Laura explains how important it is to feel happy with the childcare arrangements you’ve put in place.

‘Focusing at work can be challenging when you’re still in recovery – even without the distraction of worrying about your little one.’

‘So finding childcare that you’re comfortable with is vital and it’s the first step you should take especially since some nurseries and childminders have waiting lists.’

You’re not alone

PND affects 10 to 15 in every 100 women having a baby*.
In a study by the Royal College of Obstetricians and Gynaecologists 81% of women surveyed had experienced at least one episode of a mental health problem during or after their pregnancy**.

Remember there are so many other people in the same boat as you.

You are far from alone. PND can happen to anyone and it does not mean you’re a failure, a bad parent or that your child will be taken away from you.

Don’t suffer in silence – talk to your partner, family, friends, other new parents, your GP or health visitor.

There is so much help available for you. And, with the right support, you can and will recover.

Focus on the positives

When you’re recovering from PND and feeling fragile, a big change might feel like the last thing you need.

But actually it’s worth thinking about the benefits of work and what you enjoyed about your career before your maternity leave.

Laura says: ‘I craved the normality that had been missing since my son’s arrival but at the same time I was utterly terrified.’

‘But you may end up finding your return to work is really helpful to your recovery.’

"Going back to work may help you establish your new identity"

She explains: ‘It may help you build your confidence back up as you transition into familiar tasks; it might help combat isolation and loneliness; and it helps to focus your mind or distract you from intrusive thoughts’.

Most importantly of all, keep in mind that you can and you will recover. And that no matter how overwhelming returning to work and handling PND might seem, with the right help and support, you will get through this.

Your rights

  • You can ask for a phased return to work or put in a request for flexible working. Your employer does not have to agree your request but must respond in a reasonable way (for example, properly investigating it and responding in a timely way).
  • PND does not necessarily give you additional protection against dismissal but your employer must not treat you less favourably than they would treat a man who is absent from work for the same length of time due to sickness.
  • Severe depression can amount to a disability. So, if you have told your employer that you are suffering from PND, you may potentially have rights under the Equality Act 2010. This would depend on the severity and length of your PND.
  • To qualify, your PND needs to have lasted, or be expected to last, at least 12 months and it must also have a substantial impact on your day-to-day activities. While most women suffering from PND are not likely to meet this test at the point when they are due to return to work, in some circumstances, individuals may qualify.
  • If you meet the criteria, you may be able to ask for reasonable adjustments if your current working conditions would disadvantage you because of your PND. These adjustments may include being able to work reduced hours, on a part-time basis or returning to a less stressful role.

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700. 

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby. To find out when an NCT nearly new sale is happening near you, search here.

You might find attending one of our NCT New Baby courses helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Related articles

Released on: 09 May 2017

How does a local branch help local mums have good perinatal mental health with the help of peer supporters? Michele Xenophontos, Branch Coordinator in Widnes and Runcorn talks about her experience.

Tell us a bit about your branch and your area.

Being just on the outskirts of Liverpool our area is often overlooked for things including funding. If we were to live in the bigger towns or cities around us the support available in is much more extensive. Our branch was set up 18 months ago so that we didn't have to travel out of town. I personally wanted to find an NCT group and our nearest one was a long journey on three buses away. Our branch is small but intimate and I think every single member has made at least two or three friends for life

What is Parents in Mind?

Parents in Mind is a project focusing on perinatal mental health. Perinatal mental health focuses on those issues when pregnant or just after baby is born. It helps highlight that no matter what your age or background anyone at any time can have mental health problems. Parents in Mind trains peer supporters in our area that have lived experience of perinatal mental illness to go out and help those who are struggling. Offering them a trained listening ear and a friendly face.

Why did you want to get involved?

I suffered with postpartum psychosis after the birth of my first son. I was lucky that it was recognised and I was able to get a place in a mother and baby unit but not everyone is that lucky. Fast forward 12 years to when my second son was born. I was in desperate need of help. I approached my health ;visitor for help who put me on the waiting list for a talking therapy. The waiting list was 56 weeks long so I contacted the mental health services direct. I explained my situation to them and that I needed help, and because I was already known to the mental health service I was seen the same week as an emergency. Not everybody is this lucky, I know, so if I had a service like Parents in Mind I would have had support to get through those tough times.

What are peer supporters?

Peer supporters are a highly-trained listening ear with lived experience. They have important personal life experiences and can offer practical support. Peer supporters have received training in listening skills but are not medically trained. They are able to draw on their own experiences but won't be prescribing medications. They will be there to support parents through the difficult times and help them get whatever help they need if just a friendly ear isn't enough.

How are people going to hear about Parents in Mind?

We as an NCT branch are already talking to mums and dads about Parents in Mind and all the amazing things to come. We are active on social media and in the local press. We have leaflets and posters in local children centres, nurseries, doctors, midwives, and libraries. Health professionals will be able to refer mums and dads to Parents in Mind so not only will it be word of mouth and media coverage, your local doctor, midwife, or health visitor will have all the information to hand too. They can refer or give information on how to self-refer.

We have also been chosen as the Co-op local charity. So our name is out there for all to see. Being the local charity chosen by Co-op means that people locally can choose to support us and help raise extra funds. By clicking on our page on the Co-op website it helps people know that we are there and what we do. Since being chosen as one of the local charities we have had lots of messages asking how to find out more.

What difference do you think Parents in Mind will make to mums?

I personally think it will make a huge difference to mums and dads. Without long waiting lists our peer supporters will be able to see mums and dads who need help much quicker than many other services. As we all know cuts to services are being made all the time which is why Parents in Mind will see a huge change in our area. No longer will parents-to-be and new parents be put to the bottom of the list. We’ll make them a priority. We want mums to enjoy being a mum, dads to enjoy being a dad and be able to bond with their babies. We want to help them understand that these feelings are often normal and there are other people out there that feel just the same. Sometimes all it takes is a friendly ear and a cup of tea and a problem shared really does help

Released on: 19 November 2015

NCT launches its #BeyondBabyBlues campaign which aims to encourage people to talk more openly about maternal mental health,

Half of new mothers are concerned about their mental health and many are suffering in silence, according to new research released today by NCT as it launches its #BeyondBabyBlues campaign supported by celebrities. 

 The UK’s largest charity for parents also says that almost one in five (18%) callers to their helpline had a mental health issue to discuss and over a third (35%) had not spoken to a healthcare professional about it. 

 The #BeyondBabyBlues campaign aims to encourage people to talk more openly about maternal mental health, to avoid the mistake of dismissing potentially serious mental health issues in themselves, friends or family and to seek help. NCT is asking people to show their support for the campaign and for each other on social media by sharing pictures of themselves linking hands with someone else, or even with themselves, under the hashtag #BeyondBabyBlues. 

 Some women are affected by the ‘baby blues’ which can leave mums feeling emotional, irritable and depressed within the first few days or weeks after giving birth. This is thought to be triggered by hormonal, psychological and social changes associated with childbirth, but the feelings of low mood typically reduce after a few days. If symptoms persist or worsen, begin at a later stage, or even in pregnancy, it can be something more serious such as antenatal depression, postnatal depression or post-traumatic stress disorder. However there’s a danger this can be dismissed as the ‘baby blues’, therefore many mums don’t seek help. 

 NCT’s new research¹ found 50% of mothers were still worried about feeling low or depressed when their babies were eight months old and almost three quarters (73%) of fathers were concerned about their partner’s mental health. 

 Research² by the charity last year found a staggering lack of support services for mothers’ mental health. NCT is calling for further funding from central Government for improved services for women’s mental health during pregnancy and early parenthood and better access to support and treatment. The charity is also calling on the Government to name and shame Clinical Commissioning Groups (CCGs) who don’t have a maternal mental health strategy in place and hold them to account. 

 Dr Sarah McMullen, Head of Research, NCT, said: 

“We know many women’s mental health can be affected during pregnancy or in the early weeks and months of motherhood and a lot find it incredibly hard to talk about how they're feeling and also worry about not being a good enough mum. It's really important they know they're not alone and feel supported at this crucial time in their lives. Our #BeyondBabyBlues campaign is asking everyone to be more open about maternal mental health, to take it more seriously and to ask for help. 

 “We are very concerned that over a third of mothers who called our helpline about their mental health are suffering in silence and have not spoken to a health professional about it. There currently isn’t enough support for new mothers and much more investment is needed to provide support services and train enough GPs, midwives and health visitors to recognise vulnerable new mums and give them the help they need by offering treatment options and referral if necessary. Early intervention could prevent devastating problems later down the line.” 

 NCT’s #BeyondBabyBlues campaign is being supported by celebrities including comedian Jo Brand, a former psychiatric nurse and Coronation Street actress Jennie McAlpine, a patron of Mood Swings (a mental health charity). 

 Jo Brand said: 

“The time before and after giving birth can be really stressful for women. For many of us, it is not the straightforward, happy time we associate with the arrival of a new baby. This is why it’s essential for new mothers to have the right support at the right time. NCT’s research shows a huge number of mums are affected in some way by perinatal mental health issues and it’s no laughing matter. NCT’s longstanding experience and investment in research means they are an essential part of the fabric of childbirth in the UK from education to support and campaigning for improved services. This is why I’m supporting their #BeyondBabyBlues campaign.” 

 Jennie McAlpine said: 

“Since becoming a mother myself, I know just what an amazing job mums do. I'm in awe of all of us! I can also see that so much more needs to be done to support mums whose mental health is suffering, for their own wellbeing and the wellbeing of their families. If you need help - please ask someone. I’ve seen myself how support can make all the difference.” 

 ¹ During 2013-2014, NCT’s Research and Evaluation Department conducted a mixed-methods longitudinal research study of first-time mothers’ and fathers’ experiences and attitudes during the first two years following the birth of their baby. To understand more about life as a new first-time parent, NCT invited men and women to complete online questionnaires at two time-points: one during their baby’s first year (6-9 months), the other one year later (18-21 months), following eight focus groups to inform the survey design. In total, 869 first-time mothers and 296 first-time fathers responded in full to the first questionnaire when their babies were on average eight months old. 

 ² Research by the charity last year found that 29% of women said their GP did not ask them about any emotional or mental health issues in their six week postnatal check-up. Shockingly only 3% of Clinical Commissioning Groups (CCG’S) had a perinatal mental health strategy in place and over half (54%) of NHS trusts said they did not provide any perinatal mental health services at all. 

 The helpline figures are based on 903 calls to NCT’s Postnatal helpline between 2010 and 2015. 

Released on: 17 June 2015

New research from NCT finds that more than a third of new dads are worried about their mental health

More than 1 in 3 new fathers (38%)* are concerned about their mental health, according to new research from NCT released to coincide with Father’s Day.

Caring for a baby can be challenging and it is now increasingly recognised that postnatal depression and other perinatal mental health issues can be experienced by men as well as women. The increased pressures of fatherhood, more financial responsibility, changes in relationships and lifestyle, combined with a lack of sleep and an increased workload at home, may all affect a new dad’s mental wellbeing.

Concern about their partner is another worry for new fathers. NCT found that almost three quarters (73%) of dads were worried about their partner’s mental health.

Mark Williams, founder of education and support group Dads Matter UK, whose mental health suffered after he became a dad said: “There are all sorts of reasons why men suffer mental health problems after the birth of a child. Some suffer from postnatal depression themselves whilst others get downcast because their partners have mental health troubles. I suffered from post-traumatic stress disorder after seeing my wife’s distressing birth.”

Whatever the cause, NCT says it’s important that men are encouraged and supported to speak up about their experiences, if not to their partner, then to their family, friends or GP. The parent charity has information and tips on its website (www.nct.org.uk) to help men find the support they need.

Dr Sarah McMullen, Head of Research, NCT, said: “We recognise the huge impact having a baby can have on dads as well as mums. Perinatal mental health issues can affect men or women so raising awareness of the specific concerns and questions that dads-to-be or new dads have is crucial. Dads sometimes feel uncomfortable about opening up about their feelings but we would encourage them to do so and seek the support they need.”

The following suggestions might be useful to support positive mental wellbeing for all dads:

  • Share your feelings with people you trust. This could be your family or friends, a health professional or a counsellor.
  • Try to take some time for yourself by maintaining involvement in hobbies, exercise, or social activities, even an hour here or there can make a difference.
  • Take some exercise each day, like a walk with the buggy or swimming. Exercise can have a positive effect on mood and sense of wellbeing.
  • Although many new parents experience mood changes or feel down some of the time, you may find that feelings of anxiety or low mood persist. If you have concerns about your own or your partner’s mental health, it’s best to seek help from your GP who can help you to access support services.

Read more in our article Postnatal depression in dads: 10 things you should know.

Dads Matter UK, a website offering education and support for dads with perinatal mental health issues will launch on Father’s Day, Sunday 21st June.

*During 2013-2014, NCT’s Research and Evaluation Department conducted a mixed-methods longitudinal research study of first-time mothers’ and fathers’ experiences and attitudes during the first two years following the birth of their baby. To understand more about life as a new first-time parent, NCT invited men and women to complete online questionnaires at two time-points: one during their baby’s first year (6-9 months), the other one year later (18-21 months), following eight focus groups to inform the survey design. In total, 869 first-time mothers and 296 first-time fathers responded in full to the first questionnaire when their babies were on average eight months old.

 

 

 

 

 

 

 

 

 

 

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