Research on the impact of postpartum psychosis (PPP) on partners has concluded that healthcare professionals should receive education in involving partners, listening to them and being alert to their mental health needs. The impact of PPP on partners is substantial and needs to be addressed to secure the best clinical outcomes for all members of the new family unit.

The incidence of PPP in UK is 0.1-0.2%. PPP is typically sudden, unexpected and severe. Recovery is a long and difficult process, often involving the admission of the mother to a psychiatric ward or a Mother and Baby Unit. Earlier research has shown that partners of mothers with PPP struggle to ask for help and feel isolated and overwhelmed.

Researchers interviewed 8 fathers in Cardiff in Wales and confirmed the earlier research that fathers tend to neglect their own needs. The researchers identified a number of themes.

Sense of loss of the couple relationship:

“I had gained a child on one day and lost my partner on the next day.”

“During it all there was no husband and wife relationship, which we had been having a week or so before our baby was born.”

“You can’t get a cuddle, that sort of closeness is ripped apart.”

“I didn’t recognise her at all…It just wasn’t her. It was almost like she was possessed. I was terrified that I had lost her.”

Powerlessness:

“I had no control on the situation, no input into it. I was just holding the sick bowl.”

Exclusion:

“As a partner, I wasn’t allowed to know what was happening.”

“I didn’t know what sort of support I needed. In fact, I would say they didn’t help.” 

“When the medical teams would be coming around, I would be talking to them, and they would ignore every word I said….There was never much discussion even from family, but certainly not from any of the medial services, as to how I was , what concerns did I have. I was very much left to feel you have to cope…[This interview] is probably the first time I actually had the opportunity to express it.”

Not all reaction to services, however, was negative. One father stated that the Mother and Baby unit was “a lifesaver”. Another said the MBU staff were “fantastic”.

Guilt

“There is huge amount of guilt that I felt that I had pushed her into going out and things like that…”

“Feeling negative….that I let her down.”

Overwhelmed:

“I still had to work, there was no one who could cover my job, and look after a newborn, not getting much sleep, my wife is potentially on suicide watch, and being watched 24/7…There wasn’t really time to stop and think how I am feeling because there was no choice but to deal with everything.”

Meanwhile, some fathers reported positive outcomes from the whole experience.

More empathy: “I think I am far more aware of how [the mother], or how I perceive her to be feeling, so even without her saying anything I will find myself second-guessing how I think she is feeling.”

More involved in the care of the baby: “The Mother and Baby Unit taught me how to look after a little one.”

Better relationship with mother afterwards: “We are both very supportive of each other….when one seems exhausted and drained then we give each other a break….We are more sympathetic than before.”

Holford N, Channon S, Heron J & Jones I (2018), The impact of postpartum psychosis on partners, BMC Pregnancy and Childbirth 18

Photo: Kristin Kokkersvold. Creative Commons.