Making the World Inclusive for People Suffering from Post-natal Depression

The quality of landscape design can have a huge impact of those suffering from post-natal depression.

After 39 years of having a life on my own, a new chapter of my life called ‘mothering’ started and it completely changed my view of almost everything, including landscape architecture and town planning. When my first baby turned 6 months, I was diagnosed with Postnatal Depression (PND). PND is a depressive illness which affects more than 1 in every 10 women within a year of giving birth, and lasts at least two weeks or longer, but the latest study shows it could appear anytime within 3 years after giving birth.

Research also found that up to 1 in 10 new fathers suffers from PND. One of the causes for my case was isolation. I was living on a busy road and there wasn’t much interaction with the neighbours. I had moved from Japan and had no family here. During my dark period, a local small playground played a significant role in motivating me to get out of the house and saw me through the hardest times. People did not mind if the baby was crying outdoors and I was also able to meet some new mothers who were also feeling isolated. However, I began to notice that the current forms of landscape design were failing to address the needs of people with PND.

Firstly, I noticed various issues at a small scale. I joined a local support group based in a brand new housing development that had many small to medium-sized parks which we used for outdoor meetups. They were equipped with attractive natural play equipment, but had no fencing. Most of us were there to let the babies and pre-schoolers play and enjoy some adult conversation or have some ‘me’ time. But the no-fencing concept did not allow us to do so. Some off-theshelf equipment was also not thought through, such as slides which were inaccessible for toddlers, requiring adults to lift them up all the time.

These might be negligible problems for most people, but for someone like me, it felt like the whole world was hostile towards me and my baby at that time. Secondly, I also found problems at a larger scale – town planning. When I had my second child, I moved to a different town in the same county and had a very different experience there.

1. The Baby Bereavement Garden at Broomfield Hospital in Chelmsford, Essex,.

The first town (Town A) I lived in was a relatively new town, mostly developed by a scheme initiated by a local authority in the 1970s. It has an extensive residential area with public services and businesses. However, all services and functions necessary for new parents, including GP surgeries, play areas and children’s centres, were distant from the town centre and rather dispersed. The road I was living on also lacked any footpath connectivity, even though it was in a rural area. It was impossible to go for a walk from the house with the pram even for half a mile. Those town arrangements made my feeling of isolation even worse.

During my dark period, a local small playground played a significant role in motivating me to get out of the house and saw me through the hardest times.

The second town (Town B) I moved to was a typical historic town, where the residential areas sprawled around the churches and the high street. In this town, almost every function listed above was located in or close to the high street, and within a walkable distance of each other. The most notable difference was that I was supported by many elderly people. I used to go to three different baby groups run by the churches in the high street, which were all helped by elderly volunteers. Meeting and talking to them as experienced parents helped me incredibly to get through the hard times. This was not observed in Town A, but in Town B, its accessibility enabled interaction of people and a strong sense of community was developed. Although I was totally new to the area, I felt more supported and welcomed by the community, and did not suffer from PND for the second time.

In fact, the issues raised above overlap with other issues we are currently facing, such as development of sustainable communities and better connectivity. A thoughtful design and planning with a new viewpoint to be inclusive to people who are suffering from PND may change the world to a better place for everybody. These considerations may include: better town planning to achieve accessible towns such as walkable and buggyfriendly layout; place making to facilitate an interaction between new parents and elderly people; and green social prescribing. Park design will also benefit from the therapeutic landscape design providing a sense of security and restorative places for new parents, as well as thoughtful design on play equipment and rest areas to meet their needs.

Last but not least, to new parents who are currently suffering, you are not alone and please do not suffer on your own. Please seek help and ‘accept help when someone offers it to you.’

These were the most helpful words I was given by my health visitor when I was in the darkest place.

2. The Baby Bereavement Garden at Broomfield Hospital in Chelmsford, Essex,.

Baby Bereavement Garden

On 10th October 2022, the Baby Bereavement Garden at Broomfield Hospital in Chelmsford, Essex, for which I contributed to its design, was formally opened by the Bereavement Midwife Team as part of Baby Loss Awareness Week 2022.

About 5 years ago when I had my first son, I went to a baby group held in Chelmsford Library and met a lady with her baby there. We started talking about our birth experience and she said she had a baby in Basildon Hospital although she lived in Chelmsford. I asked her why, then she told me that she lost her first baby at Broomfield the day after the baby was born and she never wanted to go back as it was too painful. I was so shocked and urged to create a place where she could come back to Broomfield and remember her baby.

Not long after that, a bereavement midwife, Lyndsy at Broomfield contacted my husband Richard, grounds and gardens manager at the hospital, to ask whether there was any location to put a baby bereavement garden, and I said ‘yes! I will design it!’.

The design concept of this garden is ‘butterfly garden’. This garden area is not specific to any religion or background. The image of the butterfly is open to interpretation - it can be a symbol of spirit, soul, angel, or perhaps ‘friends’ of lost babies. In the biodiverse environment on the edge of the ancient woodland, wildlife friendly planting will encourage various habitats including butterflies and benefit to the existing ecology of the natural heritage of Broomfield Hospital.

A short journey to the quiet seating area was created so the families have a contemplative walk. Semi-permeable fencing was provided as a screen so that people have respect for others in the garden. A gate leading to the woodland at the end of the journey is, again, open to interpretation - some may see it as a place where the baby’s spirit flies through the gate to the beautiful woodland.

Tamae Isomura

Tamae Isomura

Tamae Isomura is a Chartered Landscape Architect who has been delivering therapeutic landscape for vulnerable people at hospitals and care homes throughout her career.