Nine months of glowing skin and a small protruding bump, followed by a life-changing, drug-free labour.
An instant bond, deepened by the natural process of breastfeeding. The newborn baby bubble is blissful. You've never felt love like this, or more connected to your partner.
At least that's the expectation. But pregnancy, birth and early parenthood is far from easy and rarely goes to plan.
Silje Andersen-Cooke expected she would be welcoming a new baby to the family - not three. She became consumed by anxiety when told she was having triplets.
The mother already had a toddler, and lived in a two-bedroom rental. How could her body and finances possibly cope, especially during COVID and a cost-of-living crisis?
The missed signs
Ms Andersen-Cooke did not meet her babies until nine hours after giving birth. Her partner stayed with the triplets at Royal Prince Alfred Hospital's neonatal intensive care unit, leaving Ms Andersen-Cooke alone because of COVID restrictions.
"I was by myself in a single room and I was in so much pain, just pressing the button, trying to get someone to come see me. I was curled up and I couldn't even talk," she said.
"I'm just in so much pain, all by myself in a room and I haven't met my babies yet and I would not wish that upon anybody. It was awful. It's traumatising to even think about it again."
After only five days, Ms Andersen-Cooke and her partner were sent home, leaving their babies in intensive care.
"It's the most unnatural feeling leaving your babies in somebody else's care if you've just given birth to them. They're so vulnerable," she said.
"You cannot ever prepare yourself to do that, to walk away, and I wish there was more support to help me through that time."
Lost chances
Once the triplets were home, Ms Andersen-Cooke's anxiety peaked - especially at night.
"Any time a baby would cry during the night, I'd get really panicked and my body would just freeze," she said.
"I had lots of really intrusive thoughts, like just letting go of the pram."
She was visited by a public health nurse, but not screened for signs of postnatal depression or anxiety.
Eventually, Ms Andersen-Cooke was able to see a psychologist, but still struggled to make appointments because leaving the house with three babies was so hard.
A 2019 study found one in five mothers and one in 10 fathers struggled with their mental health from conception to a year after birth, Perinatal Wellbeing Centre chief executive Dr Yvonne Luxford said.
Since COVID and the bushfires, anxiety has skyrocketed in young people and so has demand for the perinatal centre, Dr Luxford said.
Canberra's strengths
Ms Andersen-Cooke, her partner and four children have since moved to Canberra.
An ACT Health spokesperson said birth parents in the public system were formally screened multiple times before and after giving birth for mental health problems.
"I think all of my mental health challenges would have been entirely preventable with the right support," Ms Anderson-Cooke said.
Of the data available to ACT Health, 7 per cent of patients screened were at a high risk of developing postnatal depression and 8 per cent were at a moderate risk.
Private hospitals are not required to report their mental health screening data to Canberra Health Services or ACT Health.
Screening is not a way to diagnose mental illness, but can indicate someone needs support, Dr Luxford said.
"Screening is absolutely fantastic, but we need to make sure that we're also funding the referral pathway [and services]," she said.
Progress to be made
As part of Perinatal Mental Health Week 2023, a group of Australian organisations have launched a service finder, allowing parents to search for help in their area.
Dr Luxford said there were ways to improve perinatal mental health in the ACT.
Pre-birth classes for all parents that focus on wellbeing, mental health, and how to care for a newborn when you get home, not just labour and breastfeeding, would help.
"There's sometimes unrealistic expectations about what it's like when you have the baby and when you get back home," Dr Luxford said.
Allowing midwives to have time to debrief parents after birth, and explain why things happened the way they did, can also reduce birth trauma.
Suicide was reported as the third most common cause of maternal death from 2011 to 2020.
However, there are no inpatient public mental health beds for ACT parents in which they can bring a child with them.
A scoping study on a residential mental health unit for parents and babies is due in mid-December, an ACT government spokesperson said.
This commitment follows a 2020 inquiry.
- Perinatal mental health support finder
- Perinatal Wellbeing Centre: 6288 1936
- Maternity in Focus: The Public System Maternity Plan 2022 - 2032
- Report on Inquiry into Maternity Services in the ACT
If you or someone you know needs support:
- Lifeline 13 11 14
- PANDA (national helpline Monday to Saturday) on 1300 726 306
- Red Nose Australia (24/7 bereavement support) on 1300 308 307
- SMS4Dads (free text support for fathers)
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