Perinatal Mental Health: How to spot the signs, start the conversations and get help
- Dr Natalie Hutchins
- Sep 16
- 4 min read
Updated: Sep 17
Dr. Natalie Hutchins (Host) with Dr. Kamini Rajaratnam (Guest)
Guest Bio:
Dr. Kamini Rajaratnam (MBBS, MRCPsych) is a passionate and patient-centered psychiatrist with 17 years of experience. She is committed to providing compassionate, holistic and evidence-based care to her patients. She graduated with an MBBS degree from the National University of Singapore and obtained the Membership of the Royal College of Psychiatrists (UK). She is an accredited psychiatrist with the Specialist Accreditation Board, Ministry of Health Singapore and a registered psychiatrist with the Singapore Medical Council. She is trained in Mindfulness Based Stress Reduction (MBSR), Mindfulness-based Cognitive Therapy(MBCT), Mindful Motherhood program, Cognitive Behavioural Therapy for Insomnia (CBT-i), the Bringing Baby Home program by the Gottman Institute and is a member of Postpartum Support International.
She trained in mindfulness-based therapies, nutritional psychiatry and nutritional and environmental medicine and learned that a plethora of other issues can contribute to and perpetuate mental illness.
She is especially passionate about women’s mental health and loves to work with women facing emotional issues throughout the different phases of life from adolescents through pregnancy and postpartum, perimenopause and menopause. She also advocates strongly for preventive psychiatry, which is a branch of psychiatry aimed at early interventions, modifying risk exposures and strengthening the coping mechanisms of the individual.
Episode Show Notes:
Perinatal mental health—the emotional well-being of women during pregnancy and after birth—remains one of the most under-discussed and misunderstood aspects of motherhood.
In a recent episode of the Women's Handbook podcast, Dr. Natalie Hutchins and perinatal psychiatrist Dr. Kamini Rajaratnam tackled the realities of these struggles, highlighting the crucial need for more open conversations, earlier recognition, and accessible support.
If you're pregnant, have recently given birth, or are supporting someone who has, understanding perinatal mental health can save lives. Here’s what every woman and her support network need to know, straight from the experts.
What Is Perinatal Mental Health?
“Perinatal” refers to the period spanning pregnancy through the first year after childbirth. It’s a time of tremendous physical, emotional, and social change. While some degree of adjustment is normal, Dr. Hutchins and Dr. Rajaratnam caution that significant mental health challenges often get dismissed as just “part of being a new mother.”
Rather than being “hormonal” or “just emotional,” perinatal mental health disorders are real medical conditions requiring attention and care.
What Does Perinatal Mental Illness Look Like?
Many women, and those around them, expect motherhood to be “100% positive.” That myth fuels guilt and prevents women from speaking up. In reality, perinatal mental health struggles are common—one in five women will experience them.
Here are some of the signs to watch out for, whether in yourself or someone close to you:
Red Flags and Symptoms
Persistent Low Mood: Feeling sad, hopeless, or unable to enjoy things, nearly all the time.
Difficulty Bonding with the Baby: Struggling to feel connected or repeatedly expressing doubts about being a good mother.
Thoughts of Escaping: Wanting to give the baby up for adoption, or fantasies of running away.
Intrusive, Distressing Thoughts: Recurrent thoughts or images about harming the baby, oneself, or fear that something dreadful will happen.
Sleep Disturbance: Not being able to sleep even when the baby is sleeping, or racing thoughts that prevent rest.
Anxiety and Panic: Constantly worrying something terrible will happen, unable to be reassured even after checking or being told things are okay.
Loss of Interest: Not enjoying activities or people previously enjoyed.
Withdrawal: Becoming isolated, avoiding social contacts or support.
Dr. Rajaratnam notes that these struggles can go far beyond what’s often called “baby blues,” which is common and usually resolves within two weeks. If symptoms are persistent, severe, or worsening, they may signal depression, anxiety, OCD, or even (rarely) postnatal psychosis—a serious mental health emergency.
Risk Factors
Some women are at higher risk, including those who have:
A previous mental health condition (depression, anxiety, OCD, bipolar disorder)
Experienced previous pregnancy loss or trauma (miscarriage, stillbirth, birth trauma, or medical terminations)
Little social support, or feel isolated from family/friends
Pre-existing sensitivity to hormonal fluctuations (e.g., severe PMS/PMDD)
Ongoing relationship or financial stress
However, perinatal mental health disorders can affect ANY woman, regardless of her background or history.
When to Get Help
The podcast’s message is clear: You are not alone, you are not to blame, and help is available.
Seek professional help if you notice:
Symptoms lasting more than two weeks
Thoughts of self-harm, suicide, or harming your baby
Persistent inability to bond with your baby
Severe anxiety or intrusive, distressing thoughts
Withdrawal from daily life or support networks
Partners, family, and friends: if you spot these signs, encourage her to talk to a doctor, therapist, or health visitor—don’t wait.
There are validated screening tools doctors can use, but they’re not always offered, so don’t hesitate to ask for one.
What Happens If You Reach Out?
Many women worry about being judged or having their babies taken away. Dr. Rajaratnam reassures: “Coming forward is about getting you better so you can enjoy motherhood. It’s not about punishment or separation, but supporting your recovery.” The vast majority of women get better—and sooner, with treatment.
Treatment may involve therapy, medication (which can be safe in pregnancy/breastfeeding with specialist advice), support groups, or lifestyle adjustments. Your wishes and concerns matter—treatment is not “one size fits all”—and saying you don’t want medication doesn’t mean help isn’t available!
Self-Care Isn’t Selfish
Rest, support, social connection, daylight, and self-compassion are crucial for prevention and recovery. Communicate your needs, ask for help, and don't hesitate to accept it.
Even five minutes alone, a walk in the sun, or a trusted friend’s ear can make a difference.
The Takeaway
Perinatal mental health disorders are real, common, and treatable.
Persistent sadness, anxiety, withdrawal, sleep problems, or thoughts of escaping are NOT just “normal new mum feelings.”
It is never too early (or too late) to ask for help.
Reaching out is an act of strength and love—for yourself, and your baby.
If you, or someone you care about, is struggling: You are not alone and support is here.
Resources:
Remember: this is not medical advice—see your doctor or a qualified professional if any of these symptoms sound familiar. Your mental health matters.
