Pregnancy is a time of change and uncertainty. We plan for birth and we plan for baby but we’re not in complete control of either outcome. What we know with certainty is that one in five women will experience perinatal anxiety and depression.

That’s not to say that planning for birth and baby isn’t important – it is.

Even a plan that may change helps women feel less anxious and more in control over their birth experience. In fact, it’s imperative when we consider the appalling statistic that one in three mothers experience a birth as traumatic.

So, when the odds are stacked against us, both in terms of our mental health and the birth experience, postpartum mental health should be integral to every woman’s birth plan.

Picture this: You’re about to have a baby and all that’s left to do is check off the “to-do” list.

Hospital bag? Check.

Maternity leave approval. Check.

Home-cooked meals in the freezer. Check.

Mental health support plan. Wait … what?

Yes. Why not plan ahead? Postnatal mental health is something I talk about with all pregnant women in my clinical practice. However, there are many more women who have perinatal mental health risk factors who don’t have access to psychological support during pregnancy.

And what are those risk factors?

Well, there’s a lot of them, I’m afraid. Being a woman who is pregnant is one of them. Women are more vulnerable to mental illness in the perinatal period (conception to 12 months postpartum) than at any other time in their lives. Hormones are thought to play a role in it but perinatal mental illness is much more than just a “hormonal imbalance”.

Those at particular risk are women who have symptoms of anxiety or depression in pregnancy, a history of anxiety or depression, a family history of mental health concerns, a history of trauma, grief and loss (including pregnancy loss), and a lack of practical, social, and emotional support.

So, if one out of five pregnant women will meet the criteria for a perinatal mental illness at some point in their early motherhood journey, why isn’t mental health planning a normal part of preparing for parenthood? Especially when we know a “wait and see” approach can be detrimental to both mother and baby.

Why is early intervention so important?

On top of affecting women, antenatal anxiety and depression can affect the developing foetus while postnatal anxiety or depression can affect the mother-infant relationship. Babies are very sensitive and in tune with their primary caregivers. Early support for mum can mean better outcomes for babies.

So, if you’re expecting a baby, how can you prepare yourself for the postnatal period?

Well, you know yourself best. What happens when you’re tired or stressed? Do you feel anxious or irritable? Do you sleep a lot or not enough? Do you worry about things or do your emotions feel all over the place? Do you tend to pull away from others or seek out company? When overwhelmed we tend to follow similar behaviour patterns. So these are your early warning signs.

Consider your practical support. Who will be there to clean the house, do the laundry and cook meals? Surround yourself with people who will take care of the “house” stuff so that you can recover from the birth and bond with your baby. And if you don’t have practical support but are able to pay for it, a postpartum doula can be hired to support you after the birth of your baby.

Identify your emotional supports (these may be different to the people you turn to for practical help). Are you likely to reach out to them if you’re feeling overwhelmed? If not, arrange for them to check in with you.

If a friend says, “reach out if you need anything,” say to them: “I probably won’t do that. It would be best if you check in with me.” Let your partner or other emotional supports know what you’ll need from them when you’re feeling overwhelmed.

If you don’t have a trusted person to confide in, know that you aren’t alone.

There are perinatal support services available in person and via telehealth across Australia. Talking to a professional can help you emotionally prepare for birth and parenthood, work through grief and loss, prepare for maternity leave or help you reflect on relationship or communication patterns that you may want to change when you become a parent.

Parenting brings many challenges but if we plan for what can be planned and access support early, we can minimise the stress on families. Let’s make mental health a normal part of the conversation when planning for a baby.

• Lauren Keegan is a registered psychologist with extensive perinatal experience, a mother and a writer

In Australia you can reach the PANDA national helpline on 1300 726 306 Monday to Saturday