Perinatal Mental Health: What Every Australian Mother Deserves to Know

A guide from Safe Refuge Counselling, a private women’s counselling practice based in Mount Barker, South Australia, with online appointments available across Australia. Safe Refuge is not an emergency, psychiatric, or domestic-violence service.

Content note. This guide discusses perinatal anxiety and depression, intrusive thoughts, birth trauma, pregnancy loss, and urgent mental health concerns in general, non-graphic terms. If you or your baby may be in immediate danger, call 000 or attend an emergency department. PANDA provides perinatal support and referral guidance on 1300 726 306, and Lifeline provides 24-hour crisis support on 13 11 14.

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Start here: which kind of support fits?

You do not need to choose a perfect label before asking for help. Perinatal counselling is a broad starting point for concerns during pregnancy and after birth, including anxiety, low mood, loss, isolation, identity, relationships, and adjustment to motherhood. Birth trauma counselling places more focus on a frightening, overwhelming, or disempowering birth or medical experience and how it is affecting you now. The two areas can overlap.

For a shorter introduction focused on worry after birth, read Postnatal anxiety: the signs new mothers miss. This guide is general information, not diagnosis, emergency care, or individual medical advice.

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1. Who this guide is for

This guide is for women during pregnancy and after birth, and for partners, family members, and friends trying to understand how to help. Perinatal experiences do not always fit one neat category. Worry may sit beside sleep disruption, grief, a difficult birth, changes in identity, relationship strain, or isolation.

The guide uses careful plain language and points to current Australian organisations for clinical guidance and service navigation. The Centre of Perinatal Excellence (COPE) publishes the National Perinatal Mental Health Guideline and public information about perinatal mental health conditions. PANDA provides support, information, and referral guidance for expecting and new parents.

A counsellor cannot diagnose a mental health condition, prescribe medication, or provide emergency psychiatric care. A GP, maternal and child health nurse, psychologist, psychiatrist, or specialist perinatal service may need to be involved depending on what is happening.

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2. Experiences worth talking about

It is reasonable to ask for help when distress is affecting sleep, daily functioning, relationships, caring for yourself or your baby, or your sense of safety. You do not need to decide for yourself whether the experience meets a diagnostic threshold.

Persistent worry or anxiety

Worry can become difficult to carry when it is hard to control, takes up much of the day, continues when there is no immediate problem to solve, or leads to repeated checking and avoidance. Experiences can include:

• Racing thoughts or repeated “what if” questions.
• Feeling permanently alert or unable to settle.
• Physical anxiety sensations such as a racing heart, nausea, or tightness.
• Repeated checking or reassurance seeking.
• Avoiding leaving the house, sleeping, driving, feeding, or accepting help because something feels unsafe.

COPE’s postnatal anxiety information explains common signs and when to seek professional support.

Low mood and loss of interest

Persistent sadness, numbness, hopelessness, guilt, loss of interest, or difficulty functioning deserve attention. These experiences can have more than one cause, including physical health factors, sleep deprivation, grief, and mental health conditions. A GP or other qualified practitioner can assess the wider picture and discuss appropriate care.

Intrusive thoughts and repetitive behaviours

Intrusive thoughts are unwanted thoughts or mental images that can feel disturbing and inconsistent with what a person wants or values. Some parents also find themselves checking, washing, seeking reassurance, or avoiding particular situations in an attempt to reduce distress.

An unwanted thought is not automatically the same as an intention or plan. However, only a qualified practitioner who speaks with you can assess what a thought means in its full context. That assessment may consider how the thought feels to you, whether there is any wish or intention to act, whether you feel in control, whether you are hearing commands or losing touch with reality, and whether you can keep yourself and your baby safe.

Please tell a GP, maternal and child health nurse, psychologist, psychiatrist, or specialist perinatal service promptly if intrusive thoughts are frequent, distressing, leading to compulsive behaviour or avoidance, or making it hard to care for yourself or your baby. You deserve a careful assessment without having to work out the diagnosis alone.

Patterns suggestive of obsessive-compulsive disorder need assessment by a practitioner with appropriate OCD and perinatal expertise. Safe Refuge can offer general counselling support within scope, but it does not provide diagnostic assessment, psychiatric care, or specialist OCD treatment.

Postpartum psychosis and urgent assessment

Postpartum psychosis is a psychiatric emergency. Warning signs can include marked confusion, unusual beliefs, hearing or seeing things other people do not, very little sleep alongside major changes in behaviour or energy, or being unable to keep yourself or your baby safe. COPE provides postpartum psychosis guidance.

If these signs may be present, seek urgent medical assessment. Call 000 when there is immediate danger or attend an emergency department. Do not wait for a routine counselling appointment.

Birth trauma and pregnancy loss

A birth or medical experience can remain distressing even when other people describe the outcome as positive. You may notice unwanted memories, avoidance of reminders, fear around medical settings, grief, anger, or difficulty making sense of what happened. COPE’s birth trauma information describes possible effects and care considerations.

Pregnancy loss, stillbirth, and infant loss can involve grief, trauma, physical recovery, and changes in relationships or identity. Red Nose Grief and Loss provides specialist Australian bereavement support on 1300 308 307.

Identity, adjustment, and loneliness

Motherhood can change routines, relationships, work, identity, and connection with other people. Ambivalence, grief for a previous way of life, or loneliness do not by themselves establish a mental health diagnosis. They can still be important reasons to seek support.

If emotional changes are persistent, intense, or affecting everyday life, discuss them with a GP, maternal and child health nurse, PANDA, or another qualified practitioner rather than assuming they are “just part of motherhood.”

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3. Screening is a starting point, not a diagnosis

The Edinburgh Postnatal Depression Scale (EPDS) is a screening questionnaire used in Australian perinatal care. It can help start a conversation about how someone has been feeling, but it does not diagnose a condition by itself.

Do not use an online score or a number remembered from a previous appointment to assess your own safety or decide that support is unnecessary. Screening results should be interpreted by a qualified practitioner who can consider your answers, current circumstances, culture, language, physical health, and any immediate safety concerns.

If a screening conversation did not capture what is happening, it is reasonable to raise the concern again with your GP, midwife, maternal and child health nurse, or another practitioner. Tell them directly if you are worried about your safety, your baby’s safety, intrusive thoughts, unusual experiences, or a rapid change in how you are functioning.

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4. Finding support in Australia

The right entry point depends on urgency, symptoms, location, cost, and the type of assessment or support required.

• GP or other eligible medical practitioner. Can assess physical and mental health, discuss medication, make referrals, and help coordinate care.
• Maternal and child health service. State and territory services provide postnatal checks, early identification, information, and referral. Names and eligibility differ by location.
• Specialist perinatal mental health service. May be appropriate when symptoms are complex, severe, rapidly changing, or require psychiatric assessment.
• Psychologist or psychiatrist. Can provide assessment or specialist treatment within their professional scope. Confirm referral, fee, rebate, and availability before booking.
• Registered counsellor. Can provide counselling within training and scope. Ask about registration, relevant experience, fees, referral arrangements, and what happens if another level of care is needed.
• Peer and helpline support. PANDA, Lifeline, Red Nose, and other specialist services can provide information, support, and navigation.

Use Healthdirect’s service finder or Medicare Mental Health to look for current services near you. Availability and eligibility change, so confirm details with the service itself.

Medicare and Safe Refuge

The Australian Government’s Better Access initiative has its own eligibility, referral, provider, and claiming rules. Eligible people can claim Medicare benefits for up to 10 individual mental health treatment services per calendar year.

Safe Refuge is a separate private counselling service. Safe Refuge sessions are not Medicare-rebatable, and no GP referral or Mental Health Treatment Plan is required to contact or book Safe Refuge. See the current fees and Medicare information.

Counselling should not replace medical assessment, medication advice, emergency care, or specialist treatment when those are needed. Safe Refuge will discuss referral or shared-care options when a concern sits outside its scope.

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5. How partners, family, and friends can help

Support does not require having the perfect words. Useful starting points include:

• Listen without minimising, debating, or rushing to solve the problem.
• Ask what kind of help would be useful rather than assuming.
• Offer specific practical help, such as a meal, transport, or time to attend an appointment.
• Help contact a GP, PANDA, or another service if making the first call feels difficult.
• Take statements about suicide, safety, unusual beliefs, hearing or seeing things, or major behavioural change seriously.
• Call 000 when there is immediate danger.

Partners and other parents can also experience significant distress. They can contact PANDA, a GP, or another appropriate service for support in their own right.

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6. Australian resources

• PANDA: perinatal mental health support, information, and referral guidance; 1300 726 306. Check the website for current hours.
• COPE: National Perinatal Mental Health Guideline and public information about perinatal mental health conditions.
• Healthdirect: Australian health information and service finder.
• Medicare Mental Health: government service navigation and information about Medicare Mental Health Centres.
• Gidget Foundation Australia: specialist perinatal programs; check current locations, eligibility, and referral requirements.
• Red Nose Grief and Loss: pregnancy and infant loss support; 1300 308 307.
• Australian Breastfeeding Association: breastfeeding information and helpline; 1800 686 268.
• Australasian Birth Trauma Association: birth-trauma information and peer support.
• 13YARN: culturally safe crisis support for Aboriginal and Torres Strait Islander people; 13 92 76, 24 hours.
• 1800RESPECT: domestic, family, and sexual violence counselling, information, and support; 1800 737 732, 24 hours.
• Lifeline: crisis support; 13 11 14, 24 hours.

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7. About Safe Refuge Counselling

Safe Refuge Counselling is a private counselling practice for women, based in Mount Barker and available online across Australia when remote counselling is suitable. Aana Carpenter is an ACA Registered Counsellor, Level 1. Safe Refuge is not a crisis, medical, psychiatric, family-violence, or pregnancy-options service.

Counselling can make room for anxiety, low mood, adjustment to motherhood, loss, isolation, identity, relationships, or a difficult birth within Aana’s training and scope. It can also sit alongside care from a GP, psychologist, psychiatrist, maternal and child health service, or specialist perinatal provider.

Read about perinatal counselling, birth trauma counselling, or current fees and Medicare arrangements. A free discovery call can help you ask questions about fit; it is not an urgent-support line.

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If you need support now

• If you or your baby may be in immediate danger, call 000 or attend an emergency department.
• PANDA: 1300 726 306. Check PANDA for current hours.
• Lifeline: 13 11 14, 24 hours.
• 13YARN: 13 92 76, 24 hours for Aboriginal and Torres Strait Islander people.
• 1800RESPECT: 1800 737 732, 24 hours for domestic, family, or sexual violence support.

You do not need to work out the right diagnosis or service alone. A GP, maternal and child health service, PANDA, Healthdirect, or Medicare Mental Health can help identify an appropriate next step.