Reflection: Supporting a Mother with Postnatal Depression

Submitted by: K.S. - Community Midwife

What was the nature of the CPD activity and what did you hope to learn from it?

During a routine postnatal home visit to Emma (pseudonym), a first-time mother with a three-week-old baby, I noticed she seemed withdrawn and tearful. When I asked how she was coping, she broke down and said she felt like a 'terrible mother' because she wasn't enjoying motherhood and sometimes felt overwhelmed by her baby's needs.

Emma scored 14 on the Edinburgh Postnatal Depression Scale, indicating likely postnatal depression. She was reluctant to seek help, saying she felt ashamed and worried that social services would take her baby away if she admitted she was struggling.

This was one of my first experiences supporting a mother with postnatal depression, and I hoped to learn how to have sensitive conversations about mental health, provide appropriate support and signposting, and help reduce the stigma that prevents many women from seeking help.

What did you learn from the CPD activity?

I learned the importance of creating a non-judgmental space where mothers feel safe to share their true feelings. By normalising Emma's experience—explaining that postnatal depression affects 1 in 10 women and doesn't mean she's a bad mother—I helped reduce her shame and opened the door for honest conversation.

I learned to listen without immediately jumping to solutions. Emma needed to feel heard and validated before she could consider accepting help. I used reflective listening, acknowledging how difficult things must be for her, rather than minimising her feelings or offering quick fixes.

I also learned the importance of clear, accurate information to address misconceptions. Emma's fear that her baby would be taken away was preventing her from seeking help. I explained that postnatal depression is a health condition, not a safeguarding issue, and that asking for help shows strength and good parenting, not weakness.

The experience taught me about the range of support available for postnatal mental health, including GP referrals, perinatal mental health services, talking therapies, and peer support groups. I learned to present these options collaboratively, empowering Emma to choose what felt right for her rather than telling her what to do.

How did you change or improve my practice as a result?

I now approach mental health screening more thoughtfully. Rather than just completing the Edinburgh scale as a tick-box exercise, I use it as a conversation starter, asking open questions about how the mother is really feeling and coping.

I've improved my communication about postnatal depression by normalising it from the start. During antenatal contacts, I now proactively discuss postnatal mental health, explain the signs to look out for, and emphasise that it's common and treatable. This helps reduce stigma before problems arise.

I've also developed a better understanding of the support pathways available in my area. I now carry information about local services, including peer support groups and mental health helplines, so I can provide immediate, practical signposting when needed.

Following this experience, I completed additional training in perinatal mental health and now feel much more confident in identifying and supporting women experiencing postnatal depression. I've also become an advocate for routine mental health screening at all postnatal contacts, not just the initial visits.

How is this relevant to the Code?

This reflection relates to several aspects of the NMC Code:

Prioritise people (1.1): I treated Emma with kindness, respect and compassion during a vulnerable time, putting her dignity and wellbeing at the centre of my care.

Work in partnership (2.1): I worked with Emma to identify her needs and preferences, empowering her to make informed decisions about her care rather than imposing solutions.

Maintain knowledge and skills (22.3): I recognised a gap in my knowledge about perinatal mental health and undertook additional training to improve my practice.

Practise effectively (6.2): I maintained accurate records of Emma's mental health assessment and the support I provided, ensuring continuity of care.

Preserve safety (13.3): I appropriately signposted Emma to specialist mental health services when her needs exceeded my scope of practice as a community midwife.

Do you have any further comments?

Emma accessed support from her GP and was referred to the perinatal mental health team. With treatment and support, her symptoms improved significantly. At her six-week check, she thanked me for 'not judging her' and said that our conversation had given her the courage to ask for help.

This experience reinforced for me that midwifery care extends beyond physical health—supporting maternal mental health is equally important for the wellbeing of both mother and baby. I'm now passionate about reducing the stigma around postnatal depression and ensuring all mothers know that help is available and that struggling doesn't make them a bad parent.