Reflections – Pregnancy Mental Health and Beyond

So much has happened since 2003, when in my third pregnancy I first started to experience signs of depression and anxiety in pregnancy. Back then, people didn’t talk about their mental health, or if they did they were ridiculed or chastised for it. They certainly didn’t speak of it during a time when society expected you to be ‘glowing’ and happy. Now, much more than a decade later, and the world has changed. But have we come far enough?

Since I started writing and sharing my story, I’ve spoken to hundreds of women who have told me that knowing they weren’t alone brought them such relief. Many of them said that being able to talk to their midwife or doctor knowing the National Institute for Health and Care Excellence had specific guidelines in place to make sure they were cared for, enabled – and empowered – them to feel held and supported. We also know now that fathers can suffer with poor mental health during the ante-natal period and beyond too, and more services are starting to appreciate this.

The peer support group I established at the local hospital, which ran for two years, provided a much needed outlet for people who were pregnant – and their families – to talk about how they felt. But this, and the accompanying website, was unique in its time and it’s only now, as I write this in 2020, that we are starting to recognise the need for such support across the country. Many will argue it’s a ‘postcode lottery’ in terms of the quality or availability of care that a person may receive.

It matters that mental health services are recognising the need for perinatal mental health services for both mothers and fathers, and I applaud the efforts of local community mental health teams and people participation networks to ensure that the reach is far and wider than it used to be. But there is still much to be done.

We need to remember that maternal mental health is so much more than stress, depression and anxiety. We need to acknowledge that some of what people experience when they’re pregnant is normal, and not pathologise their fears and frustrations. Rather than viewing people as if they need “fixing”, speaking only of “treatment”, meet them where they are and ask them what they need. And whilst we can advocate that good mental health is possible, when people are struggling they need to know they haven’t failed, and that help is available.

We still need to see a higher standard of fair access to services, along with a rang of options (not just ‘CBT’ or medication) for people to get the help that they feel they need. The COVID-19 outbreak has also highlighted inequalities in standards of health care that particularly affect, for example, Black women in pregnancy and childbirth, which still need to be addressed. And there is still a stigma associated with talking about mental health, especially for those who are pregnant, in the way expectant mothers and fathers are treated by healthcare professionals.

So yes, we’ve come a long way. Even I have changed the way that I work and speak about mental health, making sure I work with people in a more trauma informed way – my experience is one of the reason I do the work I do today. But those pregnant in these times – and their families – still need the right help at the right time.

Copyright Delphi Ellis 2020 – updated 2021


Mental Health Awareness – Useful Links and Contacts

If you’re worried about your physical or mental health, speak to your doctor as soon as possible. If you are in need of urgent medical assistance please call 999, or 111 if you’re concerned for you’re well-being.

This page contains some links for the U.K. which may be useful; if you’re outside of the U.K. you may find equivalents in your area. This is not an exhaustive list, and a link doesn’t mean we endorse the content, just that you may find it useful:

If you’re struggling with your mental health, and need someone to talk to, remember Samaritans: are available 24/7 on 116 123 – http://Samaritans.org

Search local Crisis Support

How to help someone you’re worried about – article

Victim Services during Coronavirus

Domestic Abuse: Government Guidance During Coronavirus

Safety advice for survivors of domestic abuse during COVID-19 (Womens Aid)> https://www.womensaid.org.uk/covid-19-coronavirus-safety-advice-for-survivors/

Talking to Young People about Coronavirus via Young Minds > https://youngminds.org.uk/find-help/looking-after-yourself/coronavirus-and-mental-health/

Trouble Accessing Your GP


Visiting the doctor in difficult times (article)

For latest public information on COVID-19 click here  For help with anxiety connected to hand hygiene click here (NHS page on OCD)

Mental Health

If you’re worried about a young person:

Papyrus: (preventing suicide in young people) 0800 068 41 41 https://www.papyrus-uk.org/help-advice

Young Minds: https://youngminds.org.uk/find-help/looking-after-yourself/

Powher provide an advocacy service particularly around mental health and work.

Help for those who recognise the symptoms of obsessive compulsive disorder.  Contains a perinatal OCD information leaflet. http://www.ocdaction.org.uk

Combat Stress (UK Veterans Mental Health Charity): http://combatstress.org.uk 0800 138 1619

Mind information leaflets on different types of mental health condition: http://mind.org.uk

Heads Together’s Tips for Talking: http://headstogether.org.uk/tipsfortalking

“Finding the words to ask for help” video by Mind

Autism Awareness

Eating Disorders – Beat Eating Disorders

Seasonal Affective Disorder – Mind Leaflet

Pregnancy Mental Health

Maternity Action is a UK charity committed to improving the health and well-being of pregnant women, partners and young children. www.maternityaction.org.uk

Refuge – Information about Pregnancy and Domestic Abuse http://www.refuge.org.uk/get-help-now/what-is-domestic-violence/domestic-violence-and-pregnancy

Talk Mum – A community for Mums and Mums to Be

Elaine Hanzak is a speaker and author of two books around post-natal depression.

Raising awareness of post-natal depression The Joanne (Joe) Bingley Memorial Foundation

Tommy’s Premature Baby Charity Tommy’s

Frequently Asked Questions: https://pregnancymentalhealth.net/frequently-asked-questions/

NHS Choices – pregnancy and mental health: http://www.nhs.uk/Conditions/pregnancy-and-baby/pages/mental-health-problems-pregnant.aspx

NHS Choices – post-natal depression: http://www.nhs.uk/Conditions/Postnataldepression/Pages/Introduction.aspx

Mind information leaflet: http://www.mind.org.uk/information-support/types-of-mental-health-problems/postnatal-depression-and-perinatal-mental-health/

Calm Zone (specifically for men): https://www.thecalmzone.net/help/get-help/


Financial or Legal

Citizens Advice


National Bereavement Partnership ; The National Bereavement Partnership COVID-19 Hub provides a platform for associated practical advice services, support assistance and information to all those affected by the COVID-19 pandemic

At a Loss

Cruse Bereavement Care

National Bereavement Service includes guides on Registering a Death and Coroner’s Inquests

Chums (for children)

Dying Matters

Milton Keynes Bereavement Service

Child Bereavement UK

SOBS (for those bereaved by suicide)

Stillbirth and Neonatal Death Society

Miscarriage Association

National Homicide Service (Bereaved Families affected by Homicide)

21 Things You Might Need to Do When Someone Dies (UK Care Guide)

Domestic Abuse


Mankind Initiative

Survivors of Rape and Sexual Assault

Rape Crisis U.K.

Survivors U.K. – Male Rape and Abuse

Male Survivors Helpline

Relationship counselling


More useful links

This is not an exhaustive list. Remember, always speak to your doctor or midwife, if you have concerns about your mental or physical health. Links to sites or services doesn’t mean we endorse their content, just that the information may be of interest.


Mental Wellness for Parents

I was delighted to read in The Guardian recently that a new initiative by the NSPCC has been established to support parents’ mental health during pregnancy and the year following the birth of their child.

Recent research reported in The Telegraph suggests that as many as one in three mums-to-be will experience depression in pregnancy.  When I originally established this website in 2004, the figure was believed to be around 1 in ten, although from the hundreds of women that contacted me from then on, I had a feeling those figures weren’t the full picture.  Even when I spoke about my experience in The Guardian in 2008, the figures reported were relatively low compared to now, although at last depression in pregnancy was showing up on the healthcare radar.

Of  course the causes of poor mental health in pregnancy vary from woman to woman; a history of miscarriage or still birth may be just one of the many reasons, for others the baby may be unplanned or unwanted. Finding ways to support women and their partners or families when they’re suffering has got to be a step in the right direction.

The NSPCC’s initiative is called Pregnancy in Mind, and at the moment from what I can see it’s only available in Swindon at the time of writing, but it’s a start. Hopefully the programme will be rolled out across the country and more parents can benefit soon. As I am a qualified therapist  trained in Mindfulness, based on the evidence of how this I am now offering mindfulness sessions to support parents locally at my practice in and around Milton Keynes.


You are not alone.

My name is Delphi. When I found out I was expecting in 2003, it was a huge shock when my midwife, Zoe, told me she thought I was suffering with poor mental health in pregnancy.

It was a shock, because I would have described myself as a cheerful and positive person, delighted to be pregnant.  But it was fair to say I was miserable at the same time.  The words ‘poor mental health’ filled me with panic, because of what this might mean for my baby and me.

Thankfully, Zoe reassured me I wasn’t alone.  At the time, the research identified at least one in ten women experienced poor mental health in pregnancy.  These days the figures are even higher.

The last thing you may expect when you’re expecting is to feel depressed, anxious or stressed, and those closest to you may find it hard to understand.

This is why, when you’re feeling low, it’s important to surround yourself with people who can support you.  Your doctor and midwife are the obvious choice to support any health concerns you may have – physically or mentally; and nationally recognised healthcare guidelines are now in place to make sure they look after you.

Your family and friends can also play an important part in being there for you during your pregnancy and beyond.  Encouraging them to keep comments helpful and ask you how they can help, can make all the difference.  This updated website, originally written just for depression in pregnancy, is  with both you and them in mind, with links to other resources available.

This website must not replace any medical advice you will be receiving from your health care team.  It is designed to help you consider positive ways to manage your mental health during and after your pregnancy.  If you have any concerns about your mental health, please speak to your doctor or midwife as soon as possible.

The original website has featured in: The Guardian, Pregnancy & Birth, Prima Baby, Daily Express and many more as well as BBC Radio 4 Woman’s Hour.  To find out more about me and the work I do, click here.


The importance of breath

A lot of work is being done to raise awareness of better mental health, but depression continues to carry a stigma with it.  Which is why, when the words depression and pregnancy are mentioned in the same sentence, people find it hard to understand.

And yet the growing number of people reporting anxiety, depression and stress-like symptoms whilst pregnant seems to be growing, overtaking the original figures (around 1 in ten) suggested by research carried out by Dr Jonathan Evans from Bristol University in 2001.

I have received emails from pregnant women from all over the world, to say how relieved they are to know they are not alone.  When I set up this website in 2004, following my own experience of depression and anxiety in pregnancy, I did it with one view in mind – if it helped one person I had achieved my goal, and it continues to help hundreds of women every week.

The signs and causes of poor mental health in pregnancy are still hard to define and can vary from person to person. You may have a history of a previous miscarriage, stillbirth or difficult labour or you may have not planned this pregnancy at all.  The most important thing, once you have spoken to your midwife or doctor about how you feel, is to plan how you will look after yourself in the forthcoming days, weeks and months.

Relaxation techniques are one of the most effective ways of coping with stress, depression and anxiety whether you are pregnant or not.  Knowing how to breathe is key to managing tension which is starting to build.

When you are tense, your breathing can become shallow or you may even hold your breath for short periods without realising.  Bringing your attention to a steady flow of breathing can bring calm back in to the moment and (without even realising it) giving you an effective skill to prepare you for labour.

Effective Breathing Techniques

Observing the flow of breathing is an ancient technique which has been used effectively as a tool for health and relaxation for thousands of years.  Mindfulness is a way of relaxing the mind – of paying attention without tension.  To do this, you could try the following:

  • Switch off your mobile ‘phone and ask not to be disturbed.  You may wish to practice this breathing exercise with your midwife, friend or your labour partner.
  • Sit comfortably and as upright as possible in a chair with both feet on the floor.  Rest your hands in your lap and tilt your head slightly forward.
  • Try to breathe through your nose if possible, but not in deep breaths – just concentrate on the steady natural flow of your breathing.  If you notice you are breathing very quickly, try to slow your breathing to a more natural and comfortable pace.
  • Listen and pay attention to your breath (breathing naturally) for five minutes.  Don’t worry if your mind wanders (this usually happens after a few seconds!) – just bring your attention back to your breath and continue the exercise as planned.
  • When you have finished the exercise, sit quietly and bring your attention back to the environment around you, and return to your day feeling refreshed and relaxed.

If you find it difficult to manage five minutes to begin with, try just one minute and work your way up to five minutes from there.

You may wish to ask your doctor or midwife if they know of any other breathing techniques suitable for pregnancy or consider joining a pregnancy yoga class in your area.

The information provided in this article is open to individual interpretation and is not intended to replace the advice of your healthcare team.  Please speak to your doctor or midwife before deciding upon any form of action which may affect your pregnancy or if you have any concerns about your health and wellbeing.  

Copyright Delphi Ellis – updated 2020

What people expect when you’re expecting

Most people expect you to be happy when you announce you’re pregnant – and probably assume you are absolutely thrilled. I think it’s one of the reasons they don’t ask about your mental health.

If they do ask how you’re doing, it can feel like they’re only asking to compare notes. They expect to hear all the gory details of your morning sickness (sugar puffs don’t flush, incidentally) and your frequent urges to pee as the pregnancy progresses, so that they can tell you how they had it worse. That includes the horror stories they share about childbirth.

They expect you to be “blooming” and “glowing”, when honestly the only time I ever glowed in pregnancy was when I was heavily pregnant, sweating, trying to walk home from dropping my daughter off at school.

And then there’s the friends – even strangers – who expect to touch your growing belly, as if they now have the right to do that; I never understood this. I wouldn’t dream of going up to someone in the street and leaning in for a belly rub.

And most of all, they expect you to be excited about your pending new arrival, and that you are carrying on as normal.

Which is why they seem so surprised when you say “Actually, I’m not sure I’m coping. I feel quite low”.

And this is where my story began.

In the summer of 2003, I miraculously fell pregnant having been told to “think beyond having children” following a miscarriage and diagnosis of extensive endometriosis. My son was born safely and happily, by Caesarian in Spring 2004. But the journey between those dates was honestly terrifying.

I can look back now and say I had suffered with anxiety before my pregnancy on and off, and my earliest memory of having Obsessive Compulsive Disorder (OCD) was when I was a young teen. But during the nine months I was pregnant with my son, the OCD was the worst it’s ever been.  I would wash my hands repeatedly, so much so they would split and bleed – feeling contaminated if someone even accidentally bumped into me in a shop. (You can see now why someone touching my belly was bad).

I spent weeks crying.

I stayed in bed for days.

I had persistent negative thoughts that something awful would happen to my precious cargo.

And the weird thing I about it all? I was desperately happy to be pregnant. But I was miserable at the same time. So desperate in fact, it fleetingly crossed my mind to throw myself down the stairs. Not because I wanted anything bad to happen, but because I just wanted the fear to go away.

When those terrifying thoughts happened, I plucked up the courage to speak to my midwife and she explained what was going on. It was the best thing I could have done – and as it turned out, I wasn’t alone.

According to the Royal College of Midwives, 1 in 4 women can experience poor mental health during their pregnancy. Recognising the signs is an important step to asking for help.

But family and friends also play a big part in both helping to support good mental health and encourage recovery. Knowing what to say and what not to say (seriously “what have you got to be unhappy about?” – that’s not the one). My top tips for women, their partners and their families would be:

  • Recognise it. Acknowledge what’s going on and put the elephant in the room. It’s understandable to be nervous about disclosing how you feel, but genuinely it’s better out than in. Encourage family to give you space to say how you’re feeling, put your thoughts in the open. It’s like opening the window to the attic, it’s good to give your thoughts some air.
  • Keep talking. If you’re the one suffering try not to feel you’re a burden – people who love you want to help. If you’re a concerned partner or family member remember it’s good to talk, but just as important to listen. You don’t have to ‘fix’ anything, just listening and holding space with that person might be enough.
  • Ask for help. If you recognise the signs, speak to your doctor or midwife as soon as possible. They can offer guidance, extra support and maybe even services locally which can help.

And most of all, remember you’re not alone.

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Monday Mojo™ – feel good motivation for the week ahead, straight to your inbox.

Note to the reader: This article is produced in time for Maternal Mental Health Week. The campaign provides the opportunity to put mental health – during and after pregnancy – back on the public radar. If you are experiencing signs of poor mental Health in pregnancy please speak to your doctor or midwife as early as possible, they’re there to help. Samaritans are also available 24/7 on 116 123

©️ Copyright Delphi Ellis  – updated 2020

Maternal Mental Health Awareness 

At least 1 in 10 women will suffer from poor mental health during their pregnancy, in fact some studies say it’s many more than that.

We also know that at least the same number of women can develop post-natal depression.

If you or someone you know are worried about mental health during or after pregnancy, the following resources may be helpful:

Frequently Asked Questions: https://pregnancymentalhealth.org/frequently-asked-questions/

NHS Choices – pregnancy and mental health: http://www.nhs.uk/Conditions/pregnancy-and-baby/pages/mental-health-problems-pregnant.aspx

NHS Choices – post-natal depression: http://www.nhs.uk/Conditions/Postnataldepression/Pages/Introduction.aspx

“Finding the words to ask for help” video by Mind:

Heads Together’s Tips for Talking: http://headstogether.org.uk/tipsfortalking

Samaritans: 116 123 (UK) http://Samaritans.org

Mind information leaflet: http://www.mind.org.uk/information-support/types-of-mental-health-problems/postnatal-depression-and-perinatal-mental-health/

Copyright Delphi Ellis.  This article was written for Maternal Mental Health Awareness Week.

Pregnancy Mental Health: Depression and Anxiety in Pregnancy Awareness Week

In 2004 I started this unique website dedicated to the topic of depression in pregnancy; at the time there was almost nothing known of it.

Information by PANDA (a great resource from Australia) says up to 1 in 10 pregnant women are affected, but the research now suggests its closer to 1 in 3, and it doesn’t just affect women but their partners and family.

My good friend Elaine Hanzak also talks openly about her experience of Post-Natal Depression which inspired her books Eyes without Sparkle and Another Twinkle in the Eye – you can find out more about the amazing work she is doing at http://www.hanzak.com There are also some great resources on the Mind website.

13-19 November is Perinatal Depression and Anxiety awareness week.  Raising awareness of Maternal – and Paternal – Mental Health literally saves lives. It’s time to talk about it.
#pndawarenessweek #maternalmentalhealth #pregnancymentalhealth

Ante Natal and Post Natal Depression and Anxiety in Men

Alfie met and married his childhood sweetheart and within a year they’d had a baby girl. He hadn’t always had an easy life but said now he felt his life was complete.

Within a few days of his daughter being born, though, he noticed he felt different.  Nothing obvious at first but he was aware of a huge sense of responsibility both for his wife and their new baby girl.  He felt very protective and a fierce need to keep them both safe. He noticed he was having constant thoughts about “being a good dad” and feared disappointing his wife and new child. He rationalised this as “normal”, and something that any dad would do, but then he started to notice these feelings in his stomach, like a churning or a knot which just wouldn’t go away.  He was becoming irritable (so his wife said) and had lost his appetite.  And his biggest problem of all was that he just couldn’t sleep.

Without mentioning the sleep, Alfie went to his doctor who, after various tests, ruled out any physical causes for his problems. However, his stomach ache got worse and he started to become increasingly overwhelmed with thoughts about being a new parent. He was starting to feel trapped by what he saw as the huge responsibility of being a parent, and was becoming more and more and distant from his wife.  At a loss for what might be wrong, and becoming more and more concerned for his health – and his marriage -Alfie decided to research his symptoms and came across several articles about post-natal depression in men.  Alfie went back to see his GP, this time giving all his current symptoms and sure enough, was referred for talking therapy.

Alfie’s case has a happy ending.  He received help both privately, and with his wife.  They decided to speak with Relate so he could talk through his concerns about being a good husband and father, and his fears of letting her down. But for many dads a lot can happen before they get the help they need or even realise there’s a problem.

Depression during the perinatal and Post Natal period is recognised more in women but at least 1 in 10 fathers (some studies suggest 1 in 5) can experience depression too. There are lots of possible factors and symptoms, including tiredness, lack of libido and behaviour/risk taking which becomes unhealthy and dangerous.  Some men worry about their changing role – and that of the mum’s – in the house as well as concerns about finances and providing for those they care about.

Help is available. Speak with your doctor if you recognise any of these symptoms or others described in the links below.

For more information about perinatal mental health and post natal depression you may find this pamphlet from Mind useful.  If you or someone you know may be affected, have a chat with your healthcare team as soon as possible.  You may also find this resource useful, which gives more details about symptoms and effects of Post Natal Depression in men.  If you’re feeling overwhelmed you can also speak with the Samaritans 24 hours a day.

Treatments vary and may include medication or other interventions like Mindfulness or Cognitive Behavioural Therapy (CBT).

Any names and circumstances used in articles are changed to protect the identity of individuals they may represent.