Beyond Baby Blues

Pregnancy sickness is a spectrum: while most women experience some degree of pregnancy sickness, hyperemesis gravidarum (HG) is a severe form at the extreme end of the spectrum. It affects about 3% of pregnancies and it can involve serious physical and psychological complications. 

In this episode we think about HG from our perspective as perinatal psychiatrists: what do mental health professionals need to know about HG? how does it affect mental health? and what can we do to support women with this condition?

Useful links:

• Pregnancy Sickness Support
• The ObsPod episode on HG
• Pregnancy Unique Quantification of Emesis (PUQE) score
• RCOG Green Top Guideline
• Psychological morbidity associated with HG: a systematic review and meta-analysis (Mitchell-Jones et al, 2017)
• Understanding the support needs of women with HG (Challacombe et al, 2025)

If you or someone you know is struggling with mental health difficulties, there is lots of help available. You can contact your primary care provider in the first instance, or if you are based in the UK the NHS perinatal mental health website will help you to find support in your local area.

Whether we are delivering clinical care or designing and improving healthcare services, the voice of lived experience should be at the heart of everything that we do.

In this episode we speak to Sakina Ballard (trustee for Make Birth Better and Maternal Mental Health Alliance) about peer support and experts by experience in perinatal mental health. 

If you or someone you know is struggling with mental health difficulties, there is lots of help available. You can contact your primary care provider in the first instance, or if you are based in the UK the NHS perinatal mental health website will help you to find support in your local area.

Infant feeding is an intrinsic part of parenthood. When it goes well it can be incredibly rewarding, but it's not always straightforward and many parents experience difficulties.

In this episode, Lynsey and Chrissy discuss the different factors that influence feeding decisions, the intricate relationship between infant feeding and mental health, and the challenges around medication and breastfeeding. 

References and resources:

• Supporting positive conversations about feeding choice and mental health (The Breastfeeding Network, 2017)
• Guilt, shame, and postpartum feeding outcomes: a systematic review (Jackson et al., 2021)
• The Breastfeeding Network
• First Steps Nutrition Trust
• GP Infant Feeding Network
• World Health Organisation factsheets
• The politics of breastfeeding - Gabriel Palmer
• Why formula feeding matters - Shel Banks
• Why breastfeeding matters - Charlotte Young

If you or someone you know is struggling with mental health difficulties, there is lots of help available. You can contact your primary care provider in the first instance, or if you are based in the UK the NHS perinatal mental health website will help you to find support in your local area.

There is a strong social narrative that pregnancy and parenthood should be a time filled with new connection, a strong sense of community, and abundant social support. In reality many parents can feel incredibly lonely and disconnected. 

In this episode, Lynsey and Chrissy are joined by Dr Kate Adlington to discuss the emotional, social, and existential facets of loneliness and the specific issue of loneliness in the perinatal period. What drives it? What is the relationship between loneliness and mental illness? And what can be done about it?

Key references and resources:

• Loneliness Conceptual Review (What Works Centre for Wellbeing, 2019)
• “Juts snap out of it” - the experience of loneliness in women with perinatal depression: a meta synthesis of qualitative studies (Adlington et al, 2023)
• Solutions to perinatal loneliness (Naughton-Doe, 2024)
• Video - Where is the village that was promised? (Naughton-Doe, 2024) *content warning - reference to perinatal loss*
• Guardian article - It felt shameful: the profound loneliness of modern motherhood (Jones, 2024)

If you or someone you know is struggling with mental health difficulties, there is lots of help available. You can contact your primary care provider in the first instance, or if you are based in the UK the NHS perinatal mental health website will help you to find support in your local area.

Attention deficit hyperactivity disorder (ADHD) affects up to 4% of the adult population although it is under-recognised and under-diagnosed in women and girls. 

In this episode we are joined by Dr Shevonne Matheiken, who shares her own lived and learned experience of ADHD and parenthood. We discuss the medical and social models of ADHD, the different ways that it can manifest, the challenges that can arise during major life transitions such as pregnancy and parenthood, and the implications for perinatal mental health. 

Resources and references for this episode:

• Adult ADHD: time for a rethink? - Matheiken et al 2024
• ADHD & autism: before, during, and after pregnancy - Tommy’s Pregnancy Hub
• Females with ADHD: an expert consensus statement - Young et al 2020
• Obstetric complications in mothers with ADHD - Walsh et al 2022
• ADHD medication use trajectories among women in the perinatal period - Bang Madsen et al 2024
• In utero exposure to ADHD medication and long-term offspring outcomes - Bang Madsen et al 2023

If you or someone you know is struggling with mental health difficulties, there is lots of help available. You can contact your primary care provider in the first instance, or if you are based in the UK the NHS perinatal mental health website will help you to find support in your local area.

Sleep is absolutely vital for the body and brain to function properly, but sleep disruption is almost universal in the perinatal period. This can have a huge impact on parenting and on mental health. 

In this episode we talk to Dr Chiara Petrosellini about the complicated relationship between sleep and perinatal mental health. Tune in to hear about the science of sleep, the specific challenges in the perinatal period, and evidence-based strategies for improving sleep during this crucial time. 

Recommended resources:

• The Sleep Foundation
• BMJ visual summary on optimising sleep for night shifts
• Maternal sleeping problems before and after childbirth: a systematic review (open access paper)

If you or someone you know is struggling with mental health difficulties, there is lots of help available. You can contact your primary care provider in the first instance, or if you are based in the UK the NHS perinatal mental health website will help you to find support in your local area.

“Is it a boy or a girl!?” 

Some parents experience sadness, distress, and feelings of shame when their baby’s gender does not match their preferences and expectations. In this episode, Lynsey and Chrissy discuss the individual, social, and cultural aspects of gender preference and gender disappointment. 

If you would like to learn more about this topic, you can read Chrissy’s open-access paper here: ‘It's a girl!’ Is gender disappointment a mental health or sociocultural issue? | BJPsych Bulletin

If you or someone you know is struggling with mental health difficulties, there is lots of help available. You can contact your primary care provider in the first instance, or if you are based in the UK the NHS perinatal mental health website will help you to find support in your local area.

• Tommy’s: depression in pregnancy
• RCPsych: postnatal depression - info for patients
• RCPsych: postnatal depression - info for family and carers
• Mind: coping with suicidal thoughts
• PANDAS: PND awareness and support

If you or someone you know is struggling with mental health difficulties, there is lots of help available. You can contact your primary care provider in the first instance, or if you are based in the UK the NHS perinatal mental health website will help you to find support in your local area.

Donald Winnicott was a paediatrician and psychoanalyst whose work had a profound influence on our understanding of psychological development. In today’s episode, Lynsey and Chrissy discuss Winnicott’s concept of the good enough mother and the importance of parent-infant relationships for healthy psychological development.

If you would like to learn more about Winnicott’s work, we wholeheartedly recommend reading some of his original work: The Child, the Family, and the Outside World  is a great place to start. 

If you or someone you know is struggling with mental health difficulties, there is lots of help available. You can contact your primary care provider in the first instance, or if you are based in the UK the NHS perinatal mental health website will help you to find support in your local area.

Postpartum psychosis is a psychiatric emergency that can start very suddenly in the days or weeks after having a baby. It can happen to anyone and often occurs completely out of the blue.

In this episode we are joined by Sally Wilson from Action on Postpartum Psychosis to talk about her experience of postpartum psychosis and the work that she is doing with APP to support and advocate for women and families who have been affected by this serious but treatable condition.

If you would like to learn more about this topic, you can follow APP on twitter @ActionOnPP and check out the resources on their website. 

If you or someone you know is struggling with mental health difficulties, there is lots of help available. You can contact your primary care provider in the first instance, or if you are based in the UK the NHS perinatal mental health website will help you to find support in your local area.