“I’m fine, I’m just tired — all new mums are”

Pervasive low mood beyond the two-week baby-blues window — anhedonia, guilt ("terrible mother"), sleep/appetite change, and detachment from the baby — is postnatal depression, not normal tiredness, and must not be met with "pull yourself together". The non-negotiable task is an EXPLICIT, sensitive risk assessment covering self-harm/suicide (plan, intent, means), thoughts of harming the baby or frightening intrusive thoughts, and ability to care for the baby — plus screening for red flags of puerperal psychosis (rapid onset, perplexity, mania, psychosis, thoughts of harming the baby), a perinatal psychiatric emergency. The examinable hidden agenda is the terror that disclosure means social services "taking the baby" — which drives the minimisation and the concealment of intrusive thoughts; dismantling it honestly (help is about keeping mother and baby together; seeking help is the protective act) is the hinge. Treat the partner’s concern as the reliable signal, respond to shame/bonding-fear/birth-trauma with warmth, and make a supportive plan (NICE CG192: perinatal pathway, psychological therapy, an antidepressant such as sertraline where indicated after checking the BNF breastfeeding advice, health visitor, partner) with robust risk-based safety-netting and review within 1 week (NICE NG222).