Recently there has been a lot of attention in the media focused on women’s postnatal mental health. Good mental health is hard to establish and maintain today without children, let alone throwing a newborn baby into the mix along with all the sleepless nights, stress and anxiety that go hand in hand with your new bundle of joy.
The saddest statistic is in relation to maternal deaths by suicide which are the leading cause of direct maternal deaths within a year of childbirth, says a report from researchers at the University of Oxford. A new report has revealed that only 7% of women with mental health problems during pregnancy and after childbirth receive the specialist treatment they need. The study by the Royal College of Obstetricians and Gynaecologists (RCOG) said: “Sometimes women were told that they were just experiencing ‘baby blues’ and to wait and see whether they would feel better… The study found that 81% of women said they experienced at least one episode of a mental health problem during or after pregnancy. Only 19% were referred for any form of help. The National Institute for Health and Care Excellence (NICE) states depression and anxiety are the most common mental health problems during pregnancy, with around 12% of women experiencing depression, and 13% experiencing anxiety at some point, and some women experience both.
There is a lovely African proverb: ‘It takes a village to raise a child.’ African culture recognise that parenting is a shared responsibility – a communal affair – not just the concern of parents or grandparents, but of the extended family as well, uncles, aunts, cousins, neighbours and friends can all be involved and play a part. But how many of us really have that sort of support around us?
With data to support this surely evidence suggests that mental health is of paramount importance during and after pregnancy, and ought to be treated as seriously as any physical concerns by medical professionals? All too often we hear or read about someone’s real life experience with pregnancy or postnatal mental health issues that could so easily be our own. We feel relieved grateful it didn’t happen to us, but what if it did? Becoming a mother is a time of heightened emotions. For many women the dominant emotions are positive ones, but some pregnant women and new mothers experience temporary feelings of low mood including unhappiness, loneliness, and anxiety. For some, these feelings may be severe enough to be a clinically diagnosable mental condition.
Impact on mothers
As well as the specific distress caused by experiencing the symptoms of a mental health problem (discussed below), a woman may have feelings of:
- anger, frustration, and loss at the absence of hoped-for happiness and fulfilment
- shame and stigma
These feelings and worries about consequences such as involvement of social services, may also make a woman reluctant to give honest answers to a health professional’s questions about her mood leading to inaccurate treatment of symptoms. It’s so fraught with fear to admit to anxiety about something we also believe we’re supposed to know how to do yet parenting is hard!
Impact on children according to the report
- Significant anxiety in pregnancy like this can reduce blood flow to the fetus and affect birthweight and future hypertension
- Depression can undermine a mother’s ability to interact with her baby responsively, so that the baby can be less likely to form a secure attachment
- Children (especially boys) of mothers who have been postnatally depressed are at an increased risk of cognitive delay and behavioral problems by school age
- Moderate to severe depression in mothers and fathers increases children’s risk of experiencing depression themselves, particularly in early adulthood.
This infographic shows some of the myths and facts around maternal mental health.
It is of course normal to experience some mood changes – the ‘baby blues.’ This is commonly a brief period of low mood, anxiety and tearfulness with symptoms peaking on the fifth day after birth (Stein 1980). Most new mothers (up to 85%) experience the baby blues (NICE 2006) but with support and reassurance the mood should normally pass spontaneously. If the symptoms have not resolved by 10-14 days after birth, women would benefit from being assessed for postnatal depression according to the Institute (NICE 2006). You can experience any kind of mental health problems during and after pregnancy, but it’s very hard if you feel desperate for any length of time, and these emotions can lead to a deepening sense of isolation.
It’s also important to remember that not all mothers who develop mental health difficulties do so in the early weeks after giving birth. Around 12% of women become depressed during pregnancy, rather than afterwards, and a 2014 study showed that mothers are more likely to suffer from depression when their child is four years old than in the immediate postnatal period – so we mustn’t stop looking out for each other once the first year has passed.
So, what help is available?
Managing stress and parenthood is difficult enough without also battling a mental health condition. By being aware and informed about these and knowing what to look for, you can be best placed to seek help early. The faster you seek help the faster you can recover and get on top of things – so they don’t get on top of you.
Thankfully Perinatal Mental Illnesses are very treatable and only temporary, so you can and will recover with proper professional help. Your first points of contact should be your GP and Health Visitor, they have seen mums in the same position as you and have helped them through it. Your GP may recommend some medication and will also be able to offer alternative methods of recovery.
Other useful sites include:
Remember: to be a good parent you first need to be good to yourself so don’t be afraid to speak up about how you feel. If you are worried about how you are feeling, talk to someone, your partner, GP, midwife, health visitor and friends – there is support out there. You are not alone.