After a baby arrives, most of the questions are about the baby. How are they feeding? Are they sleeping? Are they gaining weight? Far fewer people ask the mother how she's actually going, and when they do, the expected answer is "tired but good".
For a lot of new mums, the honest answer is more complicated. You might love your baby deeply and still feel anxious, flat, overwhelmed, or like you've lost track of who you are. Perinatal anxiety and depression are common, affecting up to 1 in 5 expecting and new mums in Australia, and many more women go through a hard adjustment that never gets a name.
This is where a mental health occupational therapist can help. Not by asking you to talk your way through it alone, but by helping you find your feet in the day-to-day reality of life with a baby.
Why Early Motherhood Can Feel So Hard
Becoming a mother is one of the biggest transitions a person goes through. There's a word for it, matrescence, which describes the physical, emotional, social and identity shifts that come with becoming a mother. It's often compared to adolescence, and for good reason.
At the same time, almost everything that used to keep you steady changes overnight. Sleep is broken. Routines disappear. Work, exercise, friendships and time alone can drop away all at once. In OT, we call this occupational imbalance: when daily life fills up with caring for others, and the things that used to refill you quietly fall off the list.
Add the mental load of a newborn, the physical recovery from birth, and in some cases a birth that didn't go the way you hoped, and it's no surprise many mums feel stretched far past what they expected.
What Is a Mental Health Occupational Therapist?
A mental health occupational therapist is an allied health professional who helps people manage the everyday impact of anxiety, depression, stress, trauma and other mental health challenges. In Australia, OTs can hold a mental health endorsement through Occupational Therapy Australia, which recognises additional training and experience in mental health.
Where a psychologist often focuses on talk-based therapy, a mental health OT takes a practical, function-first approach. The question isn't only "how are you feeling?" It's also "how is this affecting your ability to get through the day, care for yourself and your baby, and do the things that matter to you?"
We cover this in more depth in What Does a Mental Health Occupational Therapist Do?
How a Mental Health OT Supports New Mums
Every mum's experience is different, but these are some of the areas we work on most often during pregnancy and the first years of parenting.
Rest and sleep, within reality. Nobody can promise you eight hours with a newborn. What we can do is look at how rest is shared, how to protect sleep where possible, and how to wind down when your mind won't switch off even when the baby does.
Routines that bend. Rigid schedules rarely survive a baby. We help build a loose daily rhythm that gives your day some shape without adding pressure when things don't go to plan.
Anxiety and intrusive thoughts. Many new mums experience constant worry, a racing mind, or unwanted thoughts about something happening to their baby. These are more common than most people realise, and we work on practical ways to manage them so they take up less space.
Overwhelm, irritability and rage. Feeling touched out, snapping at your partner, or being surprised by how angry you feel is common when the nervous system is running on empty. We look at what's driving it and build regulation strategies that fit into real life with a baby.
The mental load. Who remembers the vaccinations, the nappies, the washing and the family birthdays? We help you see the invisible load clearly and find ways to share it.
Identity and the things that matter. Small, realistic steps back towards the parts of yourself that went missing, whether that's movement, creativity, friendships, or ten minutes of quiet.
Returning to work. Planning the transition back, managing the guilt that often comes with it, and setting up routines that make the juggle more manageable.
Signs It Might Be Time to Reach Out
There's no threshold you need to reach before asking for support. That said, it may be worth talking to someone if you notice:
Feeling anxious, on edge or worried most of the time
Low mood, tearfulness or feeling flat for more than two weeks
Struggling to sleep even when your baby is sleeping
Losing interest in things you used to enjoy
Feeling disconnected from your baby, your partner or yourself
Irritability or anger that feels out of character
Thoughts that frighten you or won't leave you alone
Finding everyday tasks harder and harder to manage
If you ever have thoughts of harming yourself or your baby, or you feel unsafe, please reach out straight away. Call 000 in an emergency, Lifeline on 13 11 14 for 24 hour crisis support, or the PANDA National Perinatal Mental Health Helpline on 1300 726 306.
What Does a Session Look Like?
Sessions start with a conversation about what life looks like for you right now: your days and nights, your support network, your birth and feeding experiences if you want to share them, and what feels hardest. There's no checklist to pass and no right way to be coping.
From there, we set goals together and build a plan that fits your actual life, not an ideal version of it. Strategies are small, practical and designed to be tried at home between sessions. We check in regularly and adjust as your baby grows and your needs change.
Many mums see a mental health OT alongside their GP, child and family health nurse or psychologist, as part of a wider care team.
Can You Access a Mental Health OT Through Medicare?
In many cases, yes. If your GP prepares a Mental Health Treatment Plan, they can refer you to an occupational therapist with mental health endorsement for Medicare-rebated sessions. You start with an initial course of sessions, then your GP reviews your plan before any further sessions can be claimed.
Rebate amounts and session numbers are set by Medicare and do change, so it's worth confirming the current details with your GP. Some private health insurance extras policies also cover occupational therapy.
How Nesting Space Can Help
We're a perinatal, occupational, and family mental health practice based in Freshwater, right in the heart of Sydney's Northern Beaches. Perinatal support is at the core of what we do, from pregnancy through the early years of parenting. Our occupational therapists are endorsed mental health clinicians, which means we can see you under a Medicare Mental Health Treatment Plan as part of a GP-guided pathway.
We're not just clinicians, we're your neighbours, and we know that asking for help when you're meant to be "loving every minute" can feel like a big step. Whether you're pregnant and worried about what's ahead, a few weeks in and not feeling like yourself, or a year down the track and still finding your feet, it's never too early or too late to reach out.
If you'd like something to read in the meantime, our ebook The Postpartum Plan No One Gives You covers the practical side of preparing for life after birth.
Get in touch with our Northern Beaches team, or have a chat to your GP about a referral, and we'll talk you through what support could look like for you.
