Mental health in Belgium: When postpartum struggles go beyond the ‘baby blues’

Postpartum depression is an often debilitating condition. Despite affecting up to one in four mothers, it hasn’t been extensively studied in Belgium, according to Sciensano’s latest Women’s Health report. Helen Lyons talks to the Brussels Childbirth Trust and a woman who battled postpartum anxiety. 

New parents are often warned that the first months can be difficult: disrupted sleep schedules, new routines, physical exhaustion… Given the upheaval that comes with welcoming a newborn, it’s no surprise that parents can experience symptoms of depression and anxiety. 

But for many parents in Belgium, those symptoms become more than the “baby blues” that generally resolve themselves without intervention. 

Méabh is one of them. After weeks of battling postpartum anxiety on her own, she can remember the exact moment she realised she needed professional help.

“I was waiting at the bus stop at Merode,” she recalls. “My five-month-old daughter looked up at me and smiled this big, lovely baby smile, and my brain’s immediate first thought was: don’t smile back, don’t get attached, because you know she’s going to die.” 

Méabh is from Ireland and lives in Brussels with her Italian husband. Their daughter was born during the pandemic, arriving prematurely and going home with her parents only to later be readmitted to hospital for further care. But months later, when all was well, Méabh found herself unable to get through a day without debilitating worries about her baby’s health and safety.

“By this point she was thriving, hitting milestones, there were no residual health effects at all. And I started having these just incredible intrusive thoughts about her health and her life,” says Méabh.

“I was constantly disaster-planning. If I was pushing the stroller on the sidewalk, I would see a car and have a vision of it coming up onto the sidewalk and hitting the stroller. I remember being on a bus and having a panic attack thinking there was Covid in the air onboard. Or I’d be home and think: what if I shower while my partner isn’t here and I slip and no one can take care of the baby till he’s home?” 

Like many migrant families in Belgium, Méabh and her husband faced the additional hurdle of navigating the new territory of parenthood without family help. 

“Many of us who come to Brussels do so without parents or extended family, so we’re basically on our own, starting a family without any of the resources we’re familiar with in our own country,” explains Sandra Drechsel from the Brussels Childbirth Trust (BCT).

Founded in 1978, BCT is a volunteer organisation that supports expectant parents and families in English.

“It’s easier to learn about postnatal things, or prepare for a birth, if you speak a language that you’re comfortable with,” says Drechsel. “So even if many of us might be able to get the information in French or Dutch, it’s just easier to be yourself and be confident if you speak the language well.”

And the need for such information, especially around postpartum mental disorders, is great. 

“Postpartum depression is a long-lasting issue that has been largely undealt with and unspoken about. After giving birth, women feel left alone while experiencing physical and emotional changes without knowing what will come next,” Sciensano writes in its most recent Women’s Health Report, published in 2024. It estimates the prevalence of postpartum depression at between 10 and 27%.

Belgium’s public health institute notes that postpartum and prenatal depression can also affect fathers. It cites a meta-analysis of 47 studies that found the prevalence of prenatal and postpartum depression in fathers to be 9.8% and 8.7% respectively. 

“Parents who adopt a child can also develop depression after the child’s arrival,” the report states. “Although they do not experience the same physical changes that a birthmother does, the emotional and mental stress that comes with the arrival of a new child can have a serious impact on mental health.”

Impact varies

There are a number of mental disorders related to postpartum life: depression, anxiety, eating disorders, drug and alcohol use disorders and even postpartum psychosis, which can lead to thoughts of wanting to harm the newborn.  

Kind en Gezin, the Flemish child and family support agency, describes postpartum psychosis as an exceptional “psychiatric emergency that usually requires immediate admission due to the danger to both mother and child”. It affects 1-2 women out of every 1,000 who give birth and typically develops within one week after childbirth, the agency says.

Postpartum depression is more widespread, Dr Sarah Przednowek writes in an article for the BCT. She is a psychiatrist and psychotherapist with a certificate in transdisciplinary perinatal care from UCLouvain.

Postpartum depression is a major depressive episode that starts either during pregnancy or during the first four weeks after delivery. While “within the first year after birth” is commonly considered the timeframe for such disorders, up to 50% of them start during pregnancy itself. 

The symptoms are more or less the same as in major depressive disorder in general: depressed mood, diminished interest or pleasure in almost all activities, changes to appetite, insomnia or hypersomnia and suicidal ideation or recurrent thoughts of death.

“It’s different from the very common ‘baby blues’, which last for a few days to maximum two weeks after delivery,” Przednowek says, “even though baby blues can actually slightly increase the risk of developing postpartum depression.”

Another frequent symptom is “an inappropriate amount of guilt, often correlated to the fear of not being a ‘good mother’ or not doing things the right way”, Przednowek writes. “Something that is also quite common would be guilt around not feeling an instant connection with the baby. Perinatal depression can also make it very difficult for the mother to feel any sort of interest in taking care of her baby, which can also lead to a lot of guilt.”

The postpartum anxiety that Méabh experienced often manifests itself in the form of hyper-fixating on potential disaster scenarios, feeling on edge and being unable to stop or control worrying. Such disorders are under-recognised throughout pregnancy and postpartum, with symptoms often dismissed as being ‘typical’ of new mothers. 

“Nobody had spoken to me about postpartum anxiety,” Méabh says. “I’ve since met women who’ve experienced postpartum psychosis or postpartum schizophrenia. Some of them had previous mental health struggles, some of them did not. I think in the culture we live in, so much attention is focused on postpartum depression, which is good — I’m glad that there’s a discussion on that. But when it comes to these other disorders, it all sort of gets lumped together and there isn’t a differentiation made between them. With postpartum anxiety, there’s the additional challenge of everyone telling you that ‘it’s normal for new mums to worry’, which means you don’t seek help until it becomes truly debilitating.”

Resources include home support

Belgium offers a range of support for postpartum care, from pre- and postnatal physiologists to subsidised “helpers” who come to the home to cook, do light cleaning and care for the baby for a few hours so parents can rest.

Parents can draw on support in French from the Office de la naissance et de l'enfance (ONE) or La Ligue des familles and in Dutch from Kind en Gezin. English speakers often turn to BCT.

What made the difference for Méabh was the immense support she found from her healthcare providers. “Friends from other countries sometimes describe their experiences as feeling like vessels: while you’re pregnant, everyone cares about how you’re doing. But then you have the baby, and all the focus is on the baby. Here in Belgium there’s already a higher level of care. There’s a sense of: how are you doing as a person, first and foremost? The culture is very much that you aren’t ‘just’ a parent.”

There is, of course, room to improve. Both Méabh and Drechsel point to Belgium’s unimpressive paternity leave policies, which lag behind those of other European countries, and Sciensano notes in its Women’s Health Report that postpartum depression is “poorly studied” in Belgium. 

One reason is perhaps that the issue has yet to fully shed some of its cultural shackles. Méabh recalls being in the hospital and overhearing a new father on the phone to a relative, lamenting that his partner was “really struggling”, while he thought “her maternal instinct would have kicked in”. 

She says: “We have this idea that women have this ‘maternal instinct’ like a button: you just push it and you’re automatically the least selfish, most selfless person with endless amounts of love and energy. There’s this expectation that you’ll just automatically transform.”

Drechsel is glad to see postnatal care increasingly becoming a point of focus, including at BCT. 

“That’s something we’ve been working on more in the past few years: postnatal care that’s much more targeted than what we did before,” she says. “We’d concentrated on prenatal care, but providing postnatal info is just as important.” 

But the BCT, as Drechsel puts it, isn’t “just about information, it’s about creating a social network”—something especially critical when it comes to postpartum mental disorders.

“The support that you get from other parents is just as important because it often helps knowing that other people have been in the same situation,” she says. “It’s easy to sort of fall into a hole, to feel like you’re the only person in the world who feels like you do, when we know it’s not the case. Talking to other people or reading about their experiences shows you that in fact you’re not alone… It really does take a village.” 

The BCT organises activities, events, classes, playgroups and get-togethers as part of a support network for new families. For parents struggling with something beyond the baby blues, Drechsel says community is key and urges people to contact them.

“It can be intimidating to be in a situation like that and feel all alone, but there are other people out there who would be more than happy to help — either because they’re aware of how hard it is or because they’ve been there themselves, or know someone who has.”

When struggling with postpartum mental health issues, Drechsel emphasises that there’s no need for an elaborate plan or solution right away.

“Even if it’s hard, just take that one step of reaching out,” she says. “That’s the most important step — the first one.”

Brussels Childbirth Trust BCT Volunteer-run English-language support, resources and activities for families
Kind en Gezin Public agency for babies and young children in Brussels and Flanders (NL)
ONE Public agency for babies and young children in Brussels and Wallonia (Fr)
La Ligue des familles Supports families in Brussels and Wallonia (Fr)

If you’re contemplating suicide and need to talk, help is available. For support in English, call the 02 648 40 14 helpline or go to www.chsbelgium.org. For support in French, contact Un pass dans l'impasse via 081.777.150 and www.un-pass.be. For support in Dutch, contact the Suicide Helpline on 1813 or visit www.zelfmoord1813.be.

For more information on addiction treatment and mental health services in Belgium: Mental health care in Belgium: National survey plus where to get help and support | The Bulletin

Photos: ©Laiabalartt|Dreamstime.com; ©Brussels Childbirth Trust activities; ©CréSam

The production of this feature was supported by a grant from the Local Innovative Media In Europe Network (LIMENet), co-funded by the European Union.