Mama Matters sat down and spoke to Julia Röder about the beautiful yet challenging time after giving birth. Julia is a psychotherapist and certified mediator. The focus of her work is on support, counseling and therapy for fertility, pregnancy, birth experiences and the postpartum time. She provides a non-judgmental space so that women can talk openly about their feelings, thoughts and ideas.   MM: From your personal experience as a mother and also from working with other mothers in your practice, how do you see the postpartum time? JR: The first time with a newborn is magical, incredibly emotional and exhausting at the same time. It can include blue-sky moments as well as rainy days. It certainly needs a dose of self-sacrifice.  Every mum has probably heard phrases like ‘We hope you have a lovely cuddle time!’ or ‘You must be so happy with this wonderful baby!’. However, these phrases are not very helpful as they can create expectations that may not be fulfilled. For many women, the first period with their baby can be an enormous burden and a turning point in their lives. They experience excessive demands, exhaustion, or sadness, even though they were looking forward to having a baby. The spectrum ranges from unfulfilled expectations to severe depression. Moreover, they might hear phrases such as ‘Don't be like that, you have a wonderful baby’ from those around them, which immediately leads to shame and guilt. Almost 80% of all mothers experience psychological stress around the birth. Nevertheless, the topic is still taboo and there is little support. Self-optimisation, perfectionism and the images conveyed on social media do the rest. I believe we need a more honest education and open dialogue about what it means to become a mother. At the same time, we need more professional support service for women before and after birth that does not focus exclusively on the well-being of the newborn baby. A beneficial holistic approach would take into account both the body and the mind.  MM: How can women recognize that they have postpartum depression – and not ‘just’ the baby blues? JR: The baby blues describes the first few days after birth, when women experience themselves as particularly open to emotions and feelings, almost as if they were permeable. This applies to both joy and sadness - the emotions flood the body. It subsides after a short time without treatment.  Up to three-quarters of all mothers experience this phase, with a peak around the third to fifth day after the birth. Typical signs include sadness, anxiety, irritability, exhaustion, strong emotional fluctuations, and lack of sleep. These are normal reactions to the physical and emotional changes after a birth. It is important to have an attentive, supportive environment and to be aware of whether more help is needed. In contrast to the baby blues, postpartum depression is more severe, lasts longer, and requires treatment. Around 15-20% of women develop postpartum depression after giving birth, which can occur in the first year after giving birth. The symptoms do not differ from depressive disorders that occur independently of the birth of a child. These include, for example: - Persistent sadness or the feeling of being emotionally numb - States of exhaustion and/or constant tiredness - Sleep disorders, insomnia, loss of appetite - Irritability and mood swings - Overwhelmed by the new situation - thoughts of withdrawal - Loss of interest in activities that used to be enjoyable   Postpartum depression also has the following characteristics: - Inability to develop positive feelings for one's child to the point of numbness - Excessive anxiety and worry about the child's well-being - Pronounced thoughts and doubts about their own abilities as a mother as well as fears of failure: ‘I am a bad mother’, ‘I can't look after my child’ - Obsessive thoughts (e.g. harming the child) - Breastfeeding problems   Screening with the Edinburgh Postnatal Depression Scale (EPDS)* - also attached below - can facilitate early detection. What counts here is your personal observation and the result can be helpful if you want to get an idea of how you are doing.  Postpartum psychosis, which rarely occurs and affects around 1 to 2 in 1,000 women after the birth of their child, must be distinguished from this. MM: Where can women go if they have more than 10 points and live in Vienna? JR:FEM-Elternambulanz als Zuweisungsdrehscheibe für niedergelassene PPD-ExpertInnen: & (+43) 650/546 30 66 (Mo, Di, Mi, Fr 8.30–12.30 Uhr) Spezialambulanz für perinatale Psychiatrie in der Klinik Ottakring: https://klinik-ottakring.gesundheitsverbund.at/leistung/spezialambulanz-fuer-peripartale-psychiatrie/ Frühe Hilfen –Familienbegleitung: www.fruehehilfen.at Psychotherapists with expert knowledge - such as myself: juliaroeder.com MM: What can women do before giving birth to prepare for postpartum? JR: It is important to know already during pregnancy what postpartum could feel like, realistically, to manage expectations. How wonderful, yet challenging and scary this time can be. The series Motherhood (Un)seen that Mama Matters produced is a great start or Vemina Association in Vienna. It can also be helpful to establish a network of helpers during pregnancy to ensure that you are well looked after. This could include a trusted midwife, an empathetic gynecologist, a specialized therapist and a supportive environment of friends and family.  MM: How do you work with new mothers when they come to you with postpartum depression? JR: It is important for me that the women feel understood here so that they can talk freely about their feelings, experiences, and thoughts at their own pace, in their own form of expression, in a non-judgmental space. Every story is different and requires a mindful and professional approach.  MM: Is there a tip that you can give mums for them to do at home in their everyday lives when they feel overwhelmed? JR: Breathe!  in through the nose - preferably in front of an open window - and out through the mouth. This can help to calm down within minutes. It can also be helpful if small rituals from your life before becoming a mum are carried over into your new life - so that you don't lose yourself.  MM: What else do you think it is important for women to know? JR: Every story, every experience, every woman is special. There is no ‘this is the way it has to be, this is the right way.’ There are individual stories that all stand for themselves and are not subject to judgment.  Take good care of yourselves and get support if it can be helpful.   Many thanks, Julia for your time and valuable insights! You can follow Julia Röder @julia_roeder_psychotherapie on IG or juliaroeder.com