Pulse ·
New mothers get contradictory advice — and it's quietly costing them
A 2024 review of five Australian antenatal care guidelines found poor performance across all six quality domains, including development rigour and clinical applicability. In practice, this produces conflicting guidance from midwives, nurses, and lactation consultants — sometimes contradicting each other within hours of birth.
Postnatal depression and anxiety affect one in five women and one in ten men. Most PND develops after six weeks, yet systematic postnatal screening commonly ends before that window. The gap between when screening stops and when symptoms peak is where many parents fall through.
What just happened
ABC News reported this week on what many new mothers have experienced but rarely seen named plainly: the advice they receive in the first days after birth is often contradictory, and the damage from that contradiction is real.
The case that anchors the piece is Maddy Barrett, a first-time mother who received conflicting guidance from nurses, lactation consultants, and midwives within hours of giving birth. She left hospital without a feeding plan or ongoing support. Her daughter subsequently lost weight from insufficient breastfeeding. Barrett was placed on a triple-feeding protocol — breastfeeding, pumping, and formula — without the underlying problem having been identified. That problem, a severe tongue-tie, was eventually diagnosed. It should have been found earlier.
Her experience is not unusual. A 2024 review in the Journal of Midwifery examined five Australian antenatal care guidelines across six quality domains — scope and purpose, stakeholder involvement, development rigour, clarity, applicability, and editorial independence. All five guidelines scored poorly across all six categories. The guidelines that shape postnatal practice in Australia are not meeting their own quality benchmarks. That is showing up in the variation of advice that reaches patients in the first hours and days after birth.
The both-and
The guideline problem upstream
When clinical guidelines are methodologically weak — limited stakeholder involvement, outdated evidence bases, reviewed only every five years — they produce variation. Practitioners fill that variation with personal experience and opinion. A patient encounters four practitioners over two days and receives four partly incompatible approaches. She has no way to evaluate which, if any, is correct, because she is forty-eight hours postpartum, sleep-deprived, and does not have a reference point for what “normal” looks like.
Dr Nicole Highet of the Centre of Perinatal Excellence (COPE) names what this does to new parents: conflicting advice “undermines their confidence because they have got no reference point as a new parent.” The harm is not only practical — the missed tongue-tie, the insufficient feeding — it is psychological. Each contradictory instruction carries an implicit message that she is the variable. That she is doing it wrong. That she is the problem.
That internal framing — repetitively installed by a system failing to speak clearly — is a documented risk factor for postnatal depression.
The mental health screening gap
Postnatal depression and anxiety affect one in five women and one in ten men. The Gidget Foundation notes that men tend to delay help-seeking until the situation has become acute, while women — despite having more practitioner contact points — are not consistently directed towards appropriate mental health support even when they are clearly struggling.
There is a specific structural problem in how screening is timed. Dr Highet points out that postnatal depression screening occurs before and after birth, but most PND develops after six weeks. The Edinburgh Postnatal Depression Scale is commonly administered around the six-week check — close to when PND is beginning to emerge, not after it has fully declared. For many mothers, the window between the end of systematic screening and the first unambiguous presentation of PND involves weeks of worsening symptoms with no structured care pathway.
PANDA — Perinatal Anxiety and Depression Australia — offers telephone support specifically for this gap: 1300 726 306, available to mothers, fathers, and partners.
What makes this hard to fix quickly
Guidelines reviewed every five years cannot keep pace with the evidence base. That is a systems problem, not an individual practitioner failure. Practitioners working from outdated guidance are doing what they were trained to do — it is the training infrastructure that is lagging.
Dr Erin Seeto of the Gidget Foundation identifies stigma as a parallel problem, amplified by high-profile media coverage of postpartum psychosis. When the public face of postnatal mental illness is its most extreme presentation, people with PND may avoid seeking help — fearing a severe outcome, fearing judgement, or fearing child protective involvement. The severity spectrum, from adjustment difficulty through to PND through to psychosis, is rarely communicated clearly, and that gap costs people treatment they would otherwise accept.
My two cents
If you are in the early weeks postpartum and the advice you are receiving feels contradictory, you are probably not imagining it. The variation in clinical practice is real, it is documented, and it is a systems failure — not a reflection of your ability to understand instructions.
Ask practitioners to explain why they are recommending what they are recommending. “Because that’s what we do here” is not a clinical rationale. If breastfeeding is not working and you have been given three different techniques by three different people, ask specifically for a sustained, dedicated assessment by one clinician — not another brief visit between two other patients.
If your mood has been consistently low, you have lost interest in things that used to matter, or you are having thoughts that frighten you, speak to your GP. Postnatal depression is treatable. Getting assessed is not a declaration of failure — it is the intelligent response to a system that is not reliably finding the people who need support.
Verdict: yes — the gaps in Australia’s postnatal care system are documented and directly relevant to new mothers navigating the first weeks home.
Sources cited
- Mother feared ‘failing’ baby after months of inconsistent advice postpartum — ABC News, 6 September 2026. https://www.abc.net.au/news/2026-09-06/postpartum-mums-failed-by-inconsistent-advice-from-practioners/107070346
- Centre of Perinatal Excellence (COPE) — perinatal mental health. https://www.cope.org.au/
- Gidget Foundation Australia — perinatal emotional health. https://gidgetfoundation.org.au/
- PANDA — Perinatal Anxiety and Depression Australia. https://panda.org.au/
Frequently asked questions
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I'm getting contradictory advice from hospital staff — who should I listen to?
Contradictory advice often reflects genuine variation in clinical opinion, which is itself a sign that the guidelines underpinning practice are inconsistent. Where possible, ask practitioners to explain the reasoning behind their recommendations rather than just accepting the advice. If you are struggling with feeding or another postnatal concern and advice feels irreconcilable, ask specifically for a dedicated referral to a midwife or lactation consultant who can conduct a full, sustained assessment — rather than another brief bedside visit. Your sense that something is not adding up is valid information.
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How do I know if what I'm experiencing is postnatal depression versus normal new-parent exhaustion?
Normal new-parent exhaustion tends to improve with rest and support. Postnatal depression involves persistent low mood, tearfulness, loss of interest in things that usually matter, difficulty bonding with the baby, and sometimes intrusive thoughts — and it does not lift with sleep. If these symptoms have persisted for two weeks or more, it is appropriate to speak with your GP rather than waiting it out. PANDA (1300 726 306) offers free telephone support for perinatal anxiety and depression, for both mothers and fathers.