At the appointment of psychiatrist Dr Zsuzsa Bodor, she mainly focuses on maternity patients, who are struggling with difficulties during the period of the childbirth, expectant mothers and patients preparing to have children.

It is a very complex period, that requires a complete mental and physical reorganisation, certainly on the part of women. Fortunately, this period can be considered a normative crisis, that is the process takes place in order as the participants adapt, undergoing a series of psychological and interpersonal changes. But the situation is not always so simple. Sometimes it is the specific difficulties of the perinatal period, sometimes it is the individual current or specific difficulties of the woman or family planning to have a child that causes this rearrangement to get blocked and some symptoms to appear.

In the following, we take into account the non-exhaustive list of difficulties most commonly encountered in our practice, in perinatal chronological order.

Difficulties related to conception

• If the wanted baby does not arrive...

after initial sadness and despair, the couple embark on a difficult and painful journey until they accept the fact of childlessness. Alternatively, they may apply assisted reproductive procedures, which also involve physical and emotional strain, often during a painful process that requires serious decisions.

• If you conceive an unintended foetus...

or not at the right time, not the right sex, not from the right person. There can be many reasons why pregnancy is difficult to accept or rejected outright and abortion is chosen, which can be both a relieving and a stressful decision.

• If the mother has a mental illness...

and is taking medication because, for example, she has a history of obsessive-compulsive disorder, depression, panic disorder, schizophrenia, or changes in her mental state due to changes during pregnancy. In these cases, it is important to review the medication and/or choose the one that is least stressful for the foetus.

Pregnancy and strains of childbirth

• Anxiety and depression during pregnancy

For mothers, it can be very surprising and shocking to experience anxiety or persistent negative moods and bad feelings during pregnancy, or even to perceive intrusive traumatic memories. It is also often difficult to communicate these difficulties and problems, because these feelings are not what are expected socially, and it is difficult to act against the expectations. It is not uncommon, however, that some individual or transgenerational trauma 'wake up' because of the effects associated with pregnancy and childbirth, the experience of which can be a great test for the mother. Metaphorically, it's like dumping the contents of every drawer of your soul into the middle of a room. But it also gives an opportunity for sorting and tidying up.

• Loss during pregnancy

Although the chances of foetal loss decrease as the weeks of pregnancy progress, it can happen at any time that pregnancy ends in a loss. Perinatal grief has special characteristics, such as it is often much less validated by society and the personal environment, experienced by unexpected and often ambivalent feelings. However, coping with the loss is also crucial from the point of view of the mental health of the mother and the family

• Premature birth

The crisis associated with premature birth is also stressful for the family, the normal postpartum period is quite different and difficult, because of which maternal anxiety can be higher and the sense of competence can be lower.

• Birth trauma

During childbirth, unfortunately, the mother may be affected in ways that may open the door to reliving previous traumas or to suffering new traumatic effects. In many cases, these can be difficult to deal with because of societal countervailing pressures that want to see women as happy and healthy if 'both child and mother are healthy'. Processing this birth trauma helps to avoid postnatal depression and to achieve the development of maternal competence and reflectivity as soon as possible.

Psychological disorders in the postpartum period

• Postpartum depression

In the first 1-2 weeks after childbirth, 75-80% of women naturally experience depression and unexpected negative moods. This 'baby blues', which is completely normal feeling, passes spontaneously. However, if the depressed mood persists for a month or more, or new symptoms appear (intruding bad thoughts about self-esteem or about the baby, inactivity, persistent sleep disturbances, aggressive thoughts about the baby, persistent feelings of hopelessness, suicidal thoughts), there is a possibility of the development of postpartum depression. Postpartum depression is a 'benign' condition, often resolving spontaneously after 6-12 months. However, subjectively it means great suffering and makes it difficult to develop maternal competence and a reflective mother-child relationship, so it is definitely worth seeking help.

• Postpartum psychosis

It is a condition that develops in 2% of births, which is associated with a loss of maternal reality control and requires medication, most often hospital treatment.

• Birth of a sick child

If the child is born with an unforeseen illness, the family and the mother are faced with the task of accepting reality and embracing the born child instead of the desired one. In many cases, it means experiencing and assisting a series of medical interventions that come with it.

During the perinatal events described here, it is worth seeking professional help if the symptoms and the problem are beyond the mother/family's coping capacity or cause great suffering. When the symptoms become of an extent of severity incompatible with daily life or if the trend is not in the right direction, it is also worth consulting a psychologist or psychiatrist.