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Pregnancy and childbirth are traditionally regarded as a time for happiness and celebration. But when postnatal depression strikes, the whole family can be affected and they should seek help, according to the head of new treatment centre in Perth.

Perinatal and infant psychiatrist Beate Harrison, the clinical director of the newly established Raphael Centre at St John of God Murdoch, said childbirth could be a period of great upheaval and mental and physical challenges such as adjusting to altered routines, sleep patterns and roles.

She said it was now well-established that unaddressed maternal anxiety and depression had a detrimental effect on the long-term social, emotional and cognitive development of their infants as well as on the parents' relationship.

It was also understood that partners of mothers who were depressed were at a higher risk of emotional problems than the rest of the population.

"It really has moved from just being an issue for the mum to being an issue more generally for the whole family and infant," Dr Harrison said.

Early and comprehensive treatment of postnatal depression was very effective and beneficial for the whole family.

"These mothers need our help and support in the challenges they face," she said. Unresolved maternal mental health issues could affect the quality of the mother-infant relationship and deny babies the warm interactions with their mother that were important for developing good emotional regulation and security.

"Mothers can have a range of issues, including poor self-esteem, indecisiveness and feeling withdrawn during this period which can make it very difficult for them to have the warm responsive interaction with their baby that we know is optimal for their development," Dr Harrison said.

"They can have less eye contact and be less attuned which can result in less affirming or responsive interactions with their infant.

"Development of emotional regulation in the baby, for example, requires sensitivity of the mother to the infant so immediate and appropriate responses, stimulation and soothing are given as required."

If the mother was not able to help their baby develop an optimal repertoire of coping skills at an early stage, babies could become fussy or irritable and difficult to settle to sleep or feed, Dr Harrison said.

"In terms of early attachment relationships they will generally be a bit more disorganised or insecure when we are really aiming for secure attachment for optimal social and emotional development," she said.

While research had shown that an infant's "inbuilt" temperament and other social and family supports could affect how they responded to a depressed mother, it had also shown they generally tended to be less sociable and likely to be anxious or clingy when separated from their main caregiver.

In the toddler years, cognitive and language development could be affected, particularly in boys, and some studies had suggested attention, concentration and behavioural disorders could persist to at least school age.

Although there was some debate about the contribution of genetic and other risk factors, Dr Harrison said some studies suggested that children of mothers who had been withdrawn when they were infants were at higher risk of emotional problems when teenagers and young adults.

Other studies had shown that adults who had depressed mothers had three times the rate of depression of the normal population.

Recognising that early treatment of postnatal depression and anxiety is vital for the long-term emotional wellbeing of children as well as their parents, St John of God Murdoch Hospital opened the perinatal and infant mental health service in Fremantle.

Part of the hospital's community outreach program, the centre will offer specialist ante and postnatal support at minimal cost to all families in the south metropolitan area - not just those giving birth at Murdoch.

Information, counselling and psychological therapies will be available to help women and their partners manage anxiety, depression and lifestyle changes during pregnancy through to the first four years after the birth of their child.

"Murdoch is a large maternity hospital, delivering a number of babies in the growth corridor and we have a number of families needing services down that way," Dr Harrison said. "There is very much a paucity of services in the pre-conception to the perinatal period."

·St John of God Raphael Centre Murdoch is at Ferns House counselling centre, 62 Pakenham Street, Fremantle. Phone 6226 9455 or email raphael.murdoch@sjog.org.au for more information.

·Referral to the service is via your GP through the Better Access scheme.

The West Australian

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