by Dr Rachel Upperton
A move to Singapore as an expat may signal a great opportunity for many women to consider motherhood. Particularly if you have taken a break from your career to support your husbands by relocating. The opportunity for additional domestic help may make this idea even more attractive. However, one factor that can be overlooked is separation from key supports such as family and old good friends. Such supports can contribute greatly to our mental well being and are known to be one of the contributors to resilience. The birth of a new baby marks a time in life when the presence of key supports can make the adjustment to a new family member more joyous.
In my own experience as a new mother in Australia I found that there was increasing amounts of discussion and resources regarding peri-natal depression. However, it was often still a point of shame for many mothers creating a reluctance to access support. Peri-natal depression and anxiety is often unexpected, with many women not considering that they could be at risk and therefore not preparing for the possibility. Peri-natal depression can also come as a greater shock when it occurs following a second or third birth and was not present following previous births. As reported by the Black Dog Institute the reality is that 1 in 7 women will experience peri-natal depression or anxiety. Knowledge definitely is power in this case, knowing the risk factors, symptoms, and treatment options can empower women to acknowledge that they may be struggling or at risk and seek appropriate support early. There are a range of psychosocial risk factors to be aware of when preparing for the birth of a baby, some of which are particularly pertinent to expat women.
According to the Black Dog Institute in Australia a stressful life event during the last 12 months is a risk factor for peri-natal depression. Among other things this can include loss of employment, relocation or relationship issues. Many expat women may be able to go tick, tick, tick when looking at this list. All of these life events feature highly among the expat community. Other risk factors include insufficient family and social support, events that impact self esteem, previous history of mood disorders and pregnancy loss. Acknowledging that some or all of these may be relevant to your situation can help you to plan well for life post birth.
It is much harder to muster the courage, strength or motivation to seek out support once depression has set in so planning is crucial. Below are a list of steps you can consider to maximise your mental health post birth.
Enlist Professionals Early – begin discussing the possibility of peri-natal depression (PND) with your GP, midwife or obstetrician during you pregnancy. They can administer simple assessments that will determine your level of risk. Discuss with them symptoms to be aware of and potential treatment options.
Enlist Family Support – consider the possibility of having a close family member come for an extended visit after your partner returns to work. This person may be able to provide practical and emotional support. In addition you will feel less isolated if you are able to share the joys of your new baby with family. Also discuss the possibility of PND with your partner.
Join a Pregnancy Exercise Group – commonly there are yoga groups for pregnancy which are very beneficial. In addition to the physical benefits they also provide the opportunity to connect with other expectant mothers and the chance to develop friendships pre-birth.
Connect with Support Groups and Mother and Baby Clinics – other mothers are often the greatest source of support and mothers’ groups can lead to lasting connections and friendships. Having a common shared experience can facilitate strong bonds. Singapore has some wonderful clinics and support groups, the links are provided below. Have a look at these prior to birth perhaps dropping in or making a phone call so you know when and where you can access these.
Invest in Relationship Health – when expecting the birth of a child couples can feel very connected, excited and scared. This is a good time to discuss what your expectations of each other are and how you view your roles as parents. What were your own experiences of being parented and what will your approach to parenting be. Often couples may have differing views, if this is the case it can be a good time to access some couples counselling to explore these issues further.
Consider a Counsellor for Yourself – if you think you may be at risk of developing PND it may be useful to engage in counselling prior to the birth. A psychologist or counsellor can help you to identify and challenge thinking patterns that can contribute to depression and anxiety. In addition they can help you process any concerns you may have about how you were parented. Already having a relationship established with a counsellor means that they will be able to detect shifts or changes in your mood and behaviours that may be of concern post birth.
Below is a comprehensive list of resources and supports. Keeping in line with the knowledge is power theme I really recommend that everyone at least becomes familiar with the symptoms of PND as early intervention can lead to rapid symptom reduction. Symptom reduction increases levels of satisfaction and joy that can come from mothering. PND is a very real illness but treatment options are effective and available, make sure you do not suffer alone.
SACAC Counselling – has a diverse range of psychologists and counsellors from a variety of cultural groups. SACAC has practitioners who can assist with peri-natal counselling, adjustment to motherhood and couples counselling.
- Mindful Mums – “Whatever you are struggling with, the Mindful Mums Support Group is a confidential and supportive space where you can truly be honest about what is going on in you and around you. This is a free, open group for anyone to attend, with or without your child. We will incorporate some mindfulness techniques, but the group is mainly about supportive listening and sharing – not advice giving or parenting training. If you have a sense of struggling with the feelings and thoughts brought on by motherhood then come and join us.” This group is affiliated with Postpartum Support International.
- KKH Monthly Support Group (Open to clinic patients only). For enquiries: 6394 2205 (Mon-Fri: 8am – 6pm)
- Social Support: New Mothers Support Group Singapore (NMSG) – http://www.nmsg-singapore.com/
Further Information – Helpful Websites
Postpartum Progress: excellent source of support with real mums sharing their story as well as articles by mental health professionals.
Postpartum Support International: International association dedicated to helping women suffering from perinatal mood and anxiety disorders, including postpartum depression.
Mother and Child Centre, Tanglin Mall – This centre offers a range of pre and post natal classes, clinics and support groups covering all things mother and baby related.
Tel: 6836 0063
- KKH: Care for women with psychological disorders related to pregnancy and childbirth. First consultation will be with a psychiatrist.
For appointments: 6294 4050
For enquiries: 6394 2205 (Mon-Fri: 8am – 6pm)
- NUH: Women’s Emotional Health Service. Emotional assessment and support during and after pregnancy; Counselling; Education on parenting and emotional attachment. First consultation will be with a psychiatrist.
Tel: 6772 2037 (Mondays – Fridays: 8.30am to 5.30pm)