WARNING: This story may be distressing for some readers
The leading cause of death among pregnant women and new mums in New Zealand is suicide, according to a report released by the Helen Clark Foundation at the end of April.
Foxton mum of five Krystine Nation isn't shocked by this information at all, having had severe post-natal depression (PND) herself in 2019.
"I wasn't able to get any help for it and I nearly lost my life to it," Krystine said, "which is why I chose the topic of maternal mental health for the final year of my degree in health promotion [in 2021]."
Some of you may know Krystine through her "warts and all" mummy blog on social media – The Real Life Wife.
With over 160,000 followers, the number of in-box messages Krystine receives from depressed and desperate women who are unable to source help just confirms to her how badly the health system is letting mums down.
"My mother-in-law believes [her generation of mothers] had so much more support than mums do now ... I have a whole list in my head of reasons why it is so much harder now for mums."
Previous generations of mothers appeared to have more frequent visits from health professionals (primarily Plunket nurses); while modern primary carers (midwives) seem to have difficulty bypassing the public health system and referring struggling mums to outside support.
"Our midwives are the ones who get to know us … can see when there are changes or when things aren't right," said Krystine, "but the most they can do is refer us on [to a GP]."
Regarding her own battle with PND, Krystine knew there was something off with herself, having had three children before Ryley, and went to her GP, only to be told she had the "baby blues".
Three months later - having lost 30kg, feeling like someone else was talking in her head and in the process of planning her own death - she was finally diagnosed with PND by the local DHB mental health crisis team.
However, when referred to the Horowhenua mental health services by the crisis team, Krystine was advised by letter that the service didn't have the resources available to support her.
"As there was no mental health service available to me [when I had PND] the next best thing they could do, because I'd lost so much weight, was send me to an eating disorder psychologist," Krystine said.
Krystine believes every single region needs specific maternal mental health systems in place – somewhere mums can go directly and they don't need to wait for the help they need.
She also thinks that as a society we need to normalise mums asking for help more because there seems to be so much shame around not being able to cope or feelings are labelled as just being hormonal.
When Maddox was born in late 2020, Krystine recognised the signs of PND kicking off again and sought help from Well Child Tamariki Ora, who she had moved to for post-natal care.
Krystine said Tamariki Ora basically saved her life by bringing in the right support people at the right time, including a psychologist for her and a behaviour therapist to help with older son Ryley's sleep issues.
Another reason Krystine believes mums are struggling more these days is "because no one shows up any more."
Before social media and phones became the main method of keeping in touch, people would usually make an effort to pop in to see the new parents and would pick up the phone to chat rather than just send messages.
"Without that [face-to-face contact] I can sit here in a corner crying and tell you I'm doing absolutely great, my baby's amazing and you think I'm okay."
Starting her family over again with the birth of Carter eight years after having her daughters, Krystine noticed that all the baby rules seemed to have changed.
She felt there was almost too much advice in the social media world and most of it was contradictory and shared in such a way that made everyone else's life look perfect.
In 2018, Krystine started up her own imperfect mummy blog, sharing her journey through motherhood, in her own sweary mum style.
Krystine gets inbox messages from mums seeking justification for the way they feel because, "you don't know what you don't know" and "often when you're unwell you don't actually recognise that yourself."
Krystine decided to set up Facebook group Early Days Support for parents in their early days or months of having a baby to provide online support in any and all ways.
She also asked for people who were in a mental and emotional position to be able to safely give support to those who needed it to join as well and was overwhelmed by the response.
"Even just providing one place for all the different links to the different types of support out there [is important]," said Krystine, "because when you're in a bad head space … you don't know where to look."
Krystine believes the mental and physical health of our children, "our future", depends on the mums so absolutely everything has to start with them.
This also means connecting with dads, because if you can teach them to identify when their partners might be struggling, that could be the first step for getting mum the help and support she needs.
If you would like to talk to someone, try one of the following services as a first step:
1737, Need to talk? – Free call or text 1737 to talk to a trained counsellor
Lifeline – 0800 543 354 or (09) 5222 999 within Auckland
Suicide Crisis Helpline – 0508 828 865 (0508 TAUTOKO)
Healthline – 0800 611 116