TW: Perinatal Mental Health, Postpartum Psychosis, Depression, Anxiety, Suicide.
This week is Perinatal Mental Health Awareness Week – and while there’s much work that needs to be done in talking more openly about this topic and getting rid of stigma, it seems, what’s most needed, is a massive increase in resources and funding in our healthcare sector. Alice Hampson takes a deep dive into what’s happening out there…
UPDATE: This story was originally published on May 8 2025. In the year since, the cogs of change are turning – albeit, very slowly. In the story below we spoke to Kristy Maguire, a Kiwi mum who went through a hellish experience during postpartum, which was made all the more traumatising when she was severely let down by the mental health system. Last year, the select committee heard submissions for a bill that will see reforms to the Mental Health Act to make much needed changes to the support and care offered to women – and men – suffering from perinatal mental health issues. Kristy bravely made a submission, which we’ve embedded below. The bill is before the house and is awaiting it’s second reading.
Kristy has received feedback that her submission moved the committee to add in a clause in their list of recommended changes to not separate mums from babies unless absolutely necessary. Mental Health Minister Matt Doocey says the select committee have made their recommendations, last year telling the Herald “They’ve read the submissions – there’s some quite sad and tragic stories where mothers and babies have been separated and you really have to question whether that is the right thing, because what we want to do is make sure they stay together as much as possible,” he says. “They’ve made some recommendations about how mother and baby can stay together and I support that.” We will be sure to return to this story when the bill is next before Parliament.
Amy Castle, the General Manager of PADA (Perinatal Anxiety & Depression Aotearoa) says: “With the Mental Health Amendment Bill progressing, our hope is that it moves us meaningfully closer to a system that is more compassionate, rights-based, and responsive, not just for individuals, but for the wider whānau around them. For those experiencing severe perinatal mental health challenges, including postpartum psychosis, the stakes are incredibly high. We need a system that can respond early, safely, and in a way that upholds dignity while also recognising the unique needs of both parent and baby.”
Kristy Maguire knew that something was wrong – very wrong.
Things had slowly, but surely, been building for some time. But now they felt so severe that she reached for the phone to call 111 for help.
Her pregnancy had been fairly normal up until the later stages, when she started feeling off and very swollen. Her midwife wasn’t concerned, but then at 38 weeks she was sent to hospital. She was diagnosed with preeclampsia – a serious medical condition that causes high blood pressure and can lead to serious or fatal consequences for mother and pēpi – and it was decided she needed to have her baby immediately. Over the next five days an induction was attempted using multiple methods, until she finally delivered her baby by c-section. She was exhausted. And tragically, things only went very downhill for Kristy from there.
It’s well documented that having a difficult pregnancy or experiencing birth trauma can greatly increase your chances of developing a mental health condition postpartum.
Kristy’s midwife records show that from around 35 weeks she was showing ‘normal’ signs of antenatal depression.
“I was feeling very low and disconnected, had little to no energy, struggled to focus and do the basics,” she says. “I was worrying about my mood. I didn’t feel excited for what was to come and I was worried it would continue into postpartum depression and I would struggle being a mum.”
After a series of very serious physical health issues after giving birth, Kristy felt her mental health decline also. Twice, she turned up to the emergency department for help – the second time she called 111 herself. She felt her blood pressure spiking again (unfortunately her blood pressure issues did not resolve after giving birth), but she knew that mentally, things weren’t right. She was having wild thoughts, was paranoid and terrified. “It was like being trapped in a nightmare you can’t wake up from,” she says.
Kristy was again sent home. But three days later she was back in hospital with her baby for what she thought was a routine follow-up appointment. Instead, she was informed that she had been sectioned under the Mental Health Act. Her baby was taken away from her and she was admitted to a mixed gender psychiatric unit.
She was suffering from postpartum psychosis. At just four weeks postpartum, still recovering from a c-section, she was without her baby, in a psychiatric unit that was not built for the unique challenges that face a new mum.
“It was a scary place,” she says. “It was rundown, poorly staffed and it felt like a prison. I was harassed by other male patients. The fact I was four weeks postpartum and recovering from a c-section was not a consideration by any means. I was given cabbage leaves to put down my bra to stop my milk production. By the time I was sectioned, the medication I had been prescribed following my first visit to the ED had actually started to improve my symptoms so I was hyper aware of the situation and the fact I was now under a legal process.”
Kristy’s tale is on one quite extreme end of the scale, but she is unfortunately far from being alone in her experiences.
It is estimated that 12 to 18% of New Zealand mothers and 10% of fathers will develop depression, anxiety or other mental health issues during the perinatal period (that’s the timeframe from pregnancy through to the first year postpartum).
This week is Perinatal Mental Health Awareness Week – a week that aims to spark conversations, improve connection, plus bring awareness and understanding to this topic.
It’s incredibly important we have these conversations, because despite how common perinatal mental health issues are, there’s sadly still stigma and shame attached to them.
Bringing awareness and opening up these conversations around perinatal mental health is a terrific idea and much-needed, but… the more I’ve delved into this topic, the more I’ve also felt a sense of rage.
Because the more I’ve dug in, the more I have found and heard about failings within our healthcare system when it comes to looking after pregnant people and new parents.
There are so many wonderful healthcare workers out there and we are so thankful for their service and empathy and resilience. But this is yet another area of the healthcare sector that is woefully under resourced.
The Stats
The numbers around this topic are astounding. Take this completely hideous statistic for example:
Currently, the leading cause of maternal deaths in NZ is suicide.
Te Tāhū Hauora – the Health Quality and Safety Commission – released a review in 2021 based on statistics gathered from 2006-2017 and discovered that a staggering 45% of all maternal deaths were due to suicide.
Wāhine Māori are 3.35 times more likely to die by suicide during this time.
This also appears to be quite a distinctly New Zealand issue. The reported rate of maternal suicide here is five times higher per capita than that of the UK.
And I’m sorry, just when you thought this couldn’t get any more grim, this stat could just be the tip of the iceberg.
See, these maternal death statistics in NZ cover the time from the start of pregnancy through to 42 days after giving birth or terminating a pregnancy. Over in the UK and the US they track a much longer timeframe than that, because their statistics show that sadly, the most critical time for new mothers taking their own lives is between nine and 12 months after birth. We simply don’t have a record of that number here in NZ. We’re not even entirely sure how big this problem is.
Sadly, the first time I heard the statistic that suicide is the leading cause of maternal deaths in NZ, I was four-months postpartum, and while I was saddened by this stat, I also wasn’t the least bit surprised. In researching this article I’ve now heard the stories of dozens of women and when I’ve told them that stat, their reaction is exactly the same: unfortunately, not a shred of surprise.
Because sadly, it seems that one of the most dangerous things you can do for your mental health as a woman in NZ is to have a baby.
Around one in five new mums will experience mental health issues perinatally.
But, despite it being a fairly common thing to happen, it can be extremely difficult to ask for help, or sometimes even difficult to see that you are struggling during that time period. There’s the stigma and shame attached to it but there’s also so many blurred lines. Everyone knows the newborn period can be challenging, so it’s very easy to think something along the lines of, ‘Maybe this is just what you’re supposed to feel?’ ‘I’m probably just sleep-deprived!’
I remember about a month into postpartum having a range of texts coming in from friends or old colleagues who’d given birth around the same time. We were all trying to gauge as to whether it was normal to feel the way we were feeling. “Ummm, any chance you’re also crying hysterically for a few hours every day?!?’ one text I received read. (Unfortunately this was during the pandemic – we don’t have stats here, but in Canada they saw a massive increase in perinatal mental health issues. The number of women affected ballooned to a staggering 72% of all perinatal women.)
Sadly, it seems that one of the most dangerous things you can do for your mental health as a woman in NZ is to have a baby.
In 2022 a large survey by Mother’s Helpers was released, which found some serious gaps in education, screening/assessment and funded therapeutic treatment. It found that 54% of respondents had never been given information about antenatal (the time during pregnancy) depression and anxiety, and 13% never received information about postpartum depression and anxiety (PPDA). Postpartum, 36% were never even assessed for PPDA, leading to delays in diagnosis and treatments.
Asking for help can be so hard, but unfortunately for those who do seek help, or whose mental distress is picked up by a midwife, GP or Plunket – getting help, is also no easy task.
“More Likely To Get a Response From Santa Claus…”
I spoke to a GP – on the condition of anonymity – who described our current system for new mothers experiencing PPDA as “woeful”.
When a new mother is experiencing mental distress in NZ, their GP, midwife or psychologist/psychotherapist will refer them to Maternal Mental Health (MMH) for assistance and support. But the GP I spoke to said that MMH, “is desperately and frustratingly under-resourced”.
“I have more faith that I will yield results from sending a wish list to Santa Claus than I do from sending a referral to MMH currently,” he says.
It’s something that has been echoed by the women I have spoken to for this story. I spoke to four women about being referred to MMH – none of those four women were able to access their services. Two were told that MMH was “extremely busy” and they “weren’t severe enough” to be seen. The two others were specifically told that because they “weren’t suicidal” they didn’t meet the criteria to be seen. [Note: The Ministry of Health and Te Whatu Ora were contacted for this story and their response is at the end of this article]
Ella* (who has asked to remain anonymous, not because she feels any shame about sharing her experiences, but because she kept her PNA from her mother who was fighting cancer at the time and she doesn’t want to cause her any further distress) says her postnatal anxiety was severe.
“I wasn’t sleeping – at all,” she says. “I was in a terrible state and it was so distressing for my husband too.”
“I remember when we went to see my GP and she did the little quiz about PNA and my score was terrible – the GP said it appeared to be severe, which is what she told MMH. There were one or two questions she asked me about whether I ever had thoughts of harming myself – I can’t remember if suicide was spoken of directly – but I said no. My husband was in the room with me and my baby was in my arms. I had many thoughts of ending my life, but I couldn’t say that in front of my baby, husband or out loud to anyone. I felt so ashamed and guilty of those nagging thoughts. Then, I got that feedback that MMH couldn’t assist because I wasn’t suicidal.”
“I have more faith that I will yield results from sending my wish list to Santa Claus than I do from sending a referral to MMH currently” – An NZ GP.
Ella says she regrets not speaking up at the time – although she has grace for herself and the terrifying situation she was in at the time – as she and her husband then looked privately for mental health support, at quite a considerable cost.
“We’d just had a baby, so money was tight,” she says. “But my husband called around and managed to find a psychologist who specialised in postpartum and clocked how desperate my husband was. She immediately made time for me and I started seeing her weekly, plus I had meds from my GP and thankfully, my husband was able to take a month off work to look after me – although it was unpaid. This put severe stress on our finances, but although it has really set us back, it was still possible. I think about other people who do not have that privilege. How do you get through that alone?”
Joy Reid experienced mild postpartum depression and her experiences postpartum spurred her to start the charity One Mother to Another.
She says NZ “does offer some support systems for new mothers, such as midwives, Plunket and parenting resources. These are invaluable for many families during the early days if the parent has access to them.”
“However,” she says, “there are big gaps, especially for mothers who experience complications, postpartum mental health challenges, or don’t have a strong support network. The system is very stretched, and navigating it can be overwhelming for those already in crisis.”
Time For Change
Amy Castle, the General Manager at Perinatal Anxiety & Depression Aotearoa (PADA) says the perinatal mental health sector is “significantly under-resourced”.
“While care models and commitments are often referenced in policy documents, there appears to be a political assumption that mentioning services equates to delivering them,” she says. “In practice, this is rarely the case.
“More often, parents are encouraged to seek support that either does not exist in their region or is inaccessible due to long waitlists and service constraints. Assistance is frequently conditional – offered only when, and if, resources become available. This leads to a harmful cycle of unmet expectations, delayed interventions and increased distress for whanau.”
Amy says under-resourcing also impacts the frontline workforce because – in an absence of reliable services to refer to – health professionals may hesitate to screen for perinatal mental health issues. “This is not a failure of individual practitioners, but a reflection of systemic inadequacy,” she says. “It places workers in ethically complex situations, forcing them to navigate needs beyond their professional scope without the necessary infrastructure to support safe, effective care.”
There are many areas of concern that PADA – and the health professionals I spoke to for this piece – have identified as needing greater resourcing and funding. Just one of those is an increase in Mother-Baby Units (MBUs).
“While care models and commitments are often referenced in policy documents, there appears to be a political assumption that mentioning services equates to delivering them,” says Amy Castle, GM of PADA. “In practice, this is rarely the case.”
MBUs are specialised units that allow babies to stay with their birthing parents, while they are treated for perinatal mental health issues. Many pieces of research conclude that it is vital for emotional recovery and bonding to keep the mother and child together. “Separation can cause immense distress and harm to both parent and infant, and we must prioritise keeping families intact wherever possible,” says Amy Castle.
International guidelines recommend establishing one specialist MBU for approximately every 15,000 births per year. Given that NZ has around 60,000 births annually, this translates to a recommendation of four MBUs nationwide.
So how many of these units do we have in NZ?
Just two – one in Auckland and one in Christchurch.
Kristy Maguire – who we met at the beginning of this story – unfortunately knows just how it feels to not have access to a MBU. Living in Tauranga, she – and her desperate family – didn’t know such units existed and it was never discussed as an option for her. Instead, she spent a week without her new baby, desperately trying to work out how to get herself out of the involuntary section that saw her held in a mixed gender psychiatric unit, that didn’t specalise in postpartum care.
“I know if my family could have got me to a MBU where both my needs as a postpartum woman, new mum, and person suffering with a mental illness could have been addressed with a holistic approach to my care – they would have,” says Kristy.
Kristy says the experience only exacerbated her mental health issues, which have had long-lasting impacts. And, not only was it a traumatic time for her, but for her family.
“It was terribly traumatic for everyone who was in the thick of it with me,” she says. “No one knew what to do and felt so lost, trying to care for me as well as a newborn baby. My partner was absolutely not okay, and although I asked MMH, he was offered no support services. The way he describes it as he felt completely helpless. We still struggle with the aftermath.”
“I know that it’s not what my family wanted for me but they desperately wanted me to get the right care, unfortunately due to the way the system is, it was either a medical focus, or a psychiatric focus, and there was no specific option for postpartum women with mental illness. My family explained it as ‘an impossible situation’ and I know they were all so gutted about it.”
Kristy says that her experience was traumatic – but she did find some help after linking up with the team at Mama Maia who referred and funded six sessions with maternity mental health practitioner Sarah Horne, who runs a support agency called Anchor Me Postpartum in the Bay of Plenty. “She visited me in my home, and was so amazing and I would recommend her to anyone struggling postpartum,” says Kristy.
After her own experiences navigating the system, Kristy now does a lot of advocacy work in this area – she’s also started a petition to improve perinatal mental health services, which you can sign here.
A Response From Te Whatu Ora
I sent a list of questions to The Ministry of Health and Te Whatu Ora after speaking to women who had experienced perinatal mental health issues, a GP, a psychologist and an expert at PADA (Perinatal Anxiety and Depression Aotearoa). I asked for comment on the following issues:
- The difficulty experienced in accessing help from MMH. Is there a threshold that new mothers experiencing postnatal anxiety and/or depression must reach in order to be seen?
- The number of Mother and Baby Units (MBU) in NZ. International guidelines recommend establishing one specialist MBU for approximately every 15,000 births per year. Given that NZ has around 60,000 births annually, this translates to a recommendation of four MBUs nationwide – twice the number NZ currently has. Is this adequate? Are there any plans to bring our MBUS to the standard of international guidelines?
- The terrible statistic of suicide being the leading cause of maternal death in NZ (45%). We also have a gap in knowledge, with the number of women who die by suicide in the time between 42 days and 12 months after birth being unknown (despite international reports showing rates of suicide spiking between 9 and 12 months postpartum). Does the Ministry of Health have any comment on these statistics and what is being done to address this?
I received the following response from Health New Zealand | Te Whatu Ora Director – Specialist Mental Health and Addiction Karla Bergquist:
“Being pregnant and becoming a new mother are life changing events. There are many reasons why women struggle during pregnancy and in early parenthood, and stress can affect people in different ways. We want to assure women and their whānau that support is available for those who need it.
A Ministry of Health stock take of maternal mental health services of district health board services took place in 2021. Work is ongoing to address the findings of this stocktake.
Women who are pregnant or have a baby under one and are experiencing moderate to severe mental health issues may be referred to specialist maternal mental health services within Health NZ or to a range of other services available through primary and community care.
In addition to the 9-specialist mother and baby inpatient beds across the country dedicated to new mothers experiencing significant challenges with their mental health, Health NZ also has specialist community Maternal Mental Health Services available in all parts of the country.
The teams work with women before and after their baby is born and alongside their partners and family. The services provide:
- specialist assessments
- treatment and planning
- individualised support and therapy
- medication reviews and advice
- information about community support services.
Where there isn’t a specialist maternal mental health service in the local area or region, women can be seen by their local community mental health team with advice and support from the specialist regional team. These teams are also available to provide advice to GPs and lead maternity carers.
For those that require admission to hospital for their maternal mental health needs there will always be consideration of what other community-based options are available and what care can be configured should there be no inpatient maternal mental health beds available. This would include the option of admission to a general acute bed or a women’s health setting until a maternal mental health bed is available, depending on need.
Previous Budgets invested $10.1 million over four years for infant and maternal mental health services. This has funded a mix of additional clinical and non-clinical FTES for community-based specialist infant and maternal mental health teams, as well as packages of care to provide more intensive home-based support to whānau with higher needs.
Women, or whānau and friends, who are concerned about perinatal mental health are encouraged to contact their GP, lead maternity carer, or other health professionals caring for pregnant women or new mothers as soon as possible.
For more information on perinatal mental health, people can visit Perinatal Anxiety & Depression Aotearoa at www.pada.nz”
WHERE TO GO FOR HELP
If you, or someone you know is experiencing distress, PADA is a great place to turn to for support at www.pada.nz.
If you are currently pregnant, Amy Castle from PADA has this great advice about getting prepared before your pēpi arrives. This is obviously not because everyone will experience mental health issues – nor is this meant to alarm anyone – but if it does happen, creating a plan beforehand will make things easier.
Here’s what she recommends:
Navigating the early days of parenthood can be overwhelming, and it can sometimes be difficult for others to know how to help once distress is already happening.
One of the most important things we encourage is setting up support systems before the baby arrives — whether during pregnancy or even earlier if possible.
By creating these pathways in advance, it becomes much easier for family, friends, and support networks to step in quickly and meaningfully if challenges arise.
It’s important to remember that every person’s needs are different. What helps one new parent may not help another.
The key is connection — taking time to truly meet someone where they are, beyond just surface-level check-ins.
Support might look like:
- Preparing meals so parents can rest
- Helping with baby care or household tasks
- Simply sitting quietly with someone so they feel less alone — without needing to say anything at all
At its heart, support is about showing up, listening, and offering care in ways that feel safe and respectful for the parent. Setting up these connections early can make all the difference.
MORE RESOURCES:
- PlunketLine – call 0800 933 922 or text 1737 (24/7)
- Mother’s Helpers 0800 002 717
- Perinatal Anxiety and Depression Aotearoa (PADA) (+64) 04 461 6318
- Post Natal Distress Support Network Trust: 09 8464978 (great Auckland area only)
- 1737, Need to talk? Free call or text 1737 any time for support from a trained counsellor
- Anxiety New Zealand – 0800 ANXIETY (0800 269 4389)
- APP – Action on Postpartum Psychosis – The charity for mums and families affected by postpartum psychosis
And please, don’t forget to sign Kristy’s petition here.
If you’d like to share your experiences, please email me at alice@capsulenz.com
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