A front door like a piece of concrete that she couldn’t get past – that’s how Irene Lowry, a Nurture Health counsellor, remembers one woman describing the impact of her postnatal anxiety.

“She just couldn’t go out,” she says. “That’s what happens. Mothers who experience anxiety after the birth of their child find that their world becomes very small.

“They don’t go out, they don’t see their friends, they don’t answer the phone. Their world shrinks, they may have panic attacks and they wake up in the morning with dread of the day that’s ahead of them.”

Irene’s women’s mental health organisation works with 32 Irish Association of Counsellors and Psychotherapists (IACP) nationwide.

She believes that there isn’t enough attention given to the issue of postnatal anxiety among mothers.

“There is stigma around saying you can’t cope with your baby or motherhood but it is an issue for many. There are 15,000 women diagnosed with postnatal depression and anxiety in Ireland every year but there are many more than that who are undiagnosed and don’t realise what’s going on or how to get support,” she says.

Irene Lowry, a Nurture Health counsellor

Feeling down

Irene points out that postnatal anxiety is not the ‘baby blues’.

“Feeling down a few days after the birth is normal because of the hormone drop in your body, but if it goes on more than the 14th day it’s time to see your GP.”

Symptoms of postnatal anxiety are similar to that of postnatal depression – crying a lot, lack of energy, worrying about everything, irritability, eating too little or too much, depending on the person.

“Fear is part of it as well,” she says, “being afraid that something bad is going to happen.

“The mother may feel unable to cope and because she is so anxious about the baby she may not be sleeping, so sleep deprivation is in there too. If they can’t sleep, the anxiety levels keep heightening.”

She also points that many women may have been anxious during their pregnancies, having been through the trials of IVF or the trauma of previous miscarriage, perhaps. In those cases, postnatal anxiety is more likely.

“Even if you want a baby desperately, it can be a shock, a massive life change and a big adjustment when the baby is born. Some mothers feel guilty about not being able to cope at a time when they thought they would be over the moon but postnatal anxiety can happen to anyone.”

Women are referred to counsellors like Irene for talk therapy by their GP or public health nurse or consultant or hospital social work team, but self-referral is also in place.

Losing it

Many feel that they are ‘losing it’. “That’s a term we often hear when women get it touch,” Irene says. “Mothers feel that they are losing it. These are very capable women who have responsible jobs who lose confidence in themselves. They feel they are letting people down by not being the perfect mother but there is no such thing as the perfect mother – or the perfect baby. They feel ashamed that they are unable to cope.

“Irrational thoughts can be part of it as well. There can be suicidal thoughts or fear that they’ll hurt their baby or that something bad will happen. That’s why seeking help early is important, so that these thoughts don’t continue going round in your head.”

Counselling for someone with postnatal anxiety can take longer than for someone with postnatal depression, she says.

“For postnatal depression, 10 weeks of counselling is generally enough but it can take 14 or 15 sessions for someone with postnatal anxiety, because with postnatal anxiety the person’s listening capacity is way down. You might come in on week one and tell your story but repeat it over several sessions. The anxiety means that you’re not able to think straight.”

What counselling involves

The humanistic talk therapy sessions focus on different aspects over the weeks, first the woman, then the baby, and then the women’s relationship with her partner and getting back to work, if that is what she is planning to do.

“Anxiety can meander around through all areas of your life, like the roots of a big oak tree going into so many aspects of our lives,” says Irene. “It can be totally debilitating, and you don’t know where to turn.

“The most important things for counsellors is to listen to the woman and get into her shoes and understand how challenging life is for her. Then you can move forward with small steps after that.

“Women are relieved to hear that they’re not ‘losing it’. We focus on the positive, reminding them of what they’ve created – a baby. There is so much going on for them that they haven’t been able to appreciate that.

“Counsellors listen very carefully to how they are feeling and slowly, slowly, get them thinking in a different way. All our counsellors are mature women with a lot of life experience with specialist training in postnatal anxiety and depression, traumatic birth, still birth and miscarriage.”

Helping the mother first

“We say ‘what would help you now, for next week, can you do one thing? They may not be out walking or able to take a shower, it might be as basic as that,” explains Irene.

“We would say ‘could you take a shower for next week’. We try to move them forward in small steps, to help them come out of this anxious time.”

Encouraging and supporting the mothers – and their partners – in this way might continue for the first six sessions.

Then the emphasis switches to the baby and getting the mother to allow someone else mind him or her for a while so that she can get a break.

“We’d encourage them to let a trusted friend or family member to take the baby for half an hour while she has a rest, and build from there. A lot of women at the start say ‘oh no, I couldn’t give the baby to anyone’.”

The mother’s relationship with her partner gets attention next, says Irene, with the woman advised and encouraged to organise couple time.

“They may not have been out together on their own as a couple for a long time so it’s about encouraging them to go out, even for a short walk together. It’s to get the mother slowly thinking in a different way, where she can trust someone to mind the baby, even for a while.”


While many woman are on anti-depressant medication at this time, for most it is a short-term strategy.

“GPs don’t hand out anti-depressants easily and women educate themselves about them too, which is a wonderful change in society. Often the combination of counselling along with short-term medication brings women through this difficult time,” Irene says.

Most new parents will feel some anxiety during the first few weeks. But if this anxiety becomes constant and affecting your daily life, you may need some help \iSotck


Loneliness and isolation can be a big part of the problem too.

“The biggest problem we’ve got, worldwide, in all generations, is people feeling lonely. If a mother is at home with her baby all day on her own it can be very difficult. If the woman has support around her – parents, friends and family to come in and help – they come back from the anxiety very fast.

“Loneliness and isolation among new mothers is not just something that happens in rural areas. I’ve seen women in cities very isolated too.”

Going back to work

If women don’t get help with their anxiety before their maternity leave is over, going back to work can be difficult.

“A lot of women go back into the workplace and because anxiety has taken a toll and their maternity leave has been a time of illness for them, they haven’t had that special time and they often don’t feel able to work.

“Some may go back but go on to actually give up their jobs because they can’t cope. That’s why professional support while out on maternity leave is so important so that they are well going back into the workplace.”

To alleviate this problem, Irene’s company is working with private medical insurers and multinational companies to set up workplace buddy systems to ease the return to work.

Buddy role

“This would involve mothers in the workplace who have been through this experience taking on the buddy role and meeting up with the woman before their return date to talk about how work might look,” Irene explains. “Also, being able to get back to work gradually, two days the first week, three the next and so on, can be helpful.

“Some women fear being demoted if they request this, but helping the woman to ease back in makes sense for the corporates. It can mean that she won’t give up her job and that they still have a productive employee.”

But what stops mothers getting help quickly enough?

“Apart from them not being signposted to services quick enough, the two main factors are money and waiting lists. If I don’t have money, I can’t get professional support. HSE waiting lists can be as long as two years and private counselling can cost between €55 and €160,” she says.

However, some private health insurance companies now reimburse clients between €25 and €40 per counselling session.

Facts and figures

• About 10-15% of all mothers experience a depression either antenatally (before birth) or postnatally (after birth). For 3% of mothers, the experience is quite severe and they may need more intensive support.

• Symptoms to watch out for include excessive worry, sleep disturbance, feeling on edge, easily fatigued, irritable and poor concentration.

• If you are struggling, speak first with your GP or public health nurse.

•See hse.ie/conditions/postnatal-depression/getting-help/ for further information.

• See nurturehealth.ie for more information related to Irene Lowry’ s company.

• To find an accredited counsellor see iacp.ie . Ask for someone specifically trained in postnatal support.

• Counselling tips: if you feel that your counsellor doesn’t suit you, ask for someone different. The client/counsellor relationship is important.

• Sessions usually last 50 minutes with exercises suggested each week.

• Partners can avail of counselling too.