Maternal Mental Health

1 in 10 women develops a mental illness during pregnancy or within the first year after giving birth. With suicide being the leading cause of death for pregnant women and new mothers. So why is maternal mental health such a taboo subject?

Many people have heard about postnatal depression. Depression which can occur after giving birth. However, not many people are aware of antenatal depression, which occurs during pregnancy. Many people are also unaware that there are other forms of mental health conditions that can occur during and after childbirth, such as, perinatal anxiety, OCD, PTSD or psychosis.

Some Terminology:

Perinatal means around birth, this covers the entire pregnancy and up to one year after giving birth.

Postnatal or Postpartum means after birth.

Antenatal or Prenatal means before birth.

Some Numbers and Figures (England each year):

1,380 women experience postpartum psychosis. This is a severe, yet rare, mental illness that typically affects women within a couple of weeks of giving birth. Postpartum psychosis has symptoms such as delusions, hallucinations, paranoia and confusion. Around 2 cases in every 1000 maternities.

1,380 women experience chronic serious mental illness after giving birth. These are longstanding mental illnesses such as schizophrenia or bipolar disorder. There are more likely to develop, recur or deteriorate in the perinatal period.
Around 2 cases in every 1000 maternities.

20,640 women experience severe depressive illness during or after pregnancy. This is the most serious form of depression, where symptoms are severe and persistent. With the symptoms being so intense, they are likely to have a negative impact on the women’s ability to function ‘normally’.
Around 30 cases in every 1000 maternities.

20,640 women experience post-traumatic stress disorder (PTSD) during or after pregnancy. This is more likely to occur if the woman has experienced a stressful pregnancy and/or birth. PTSD is an anxiety disorder. The symptoms are, flashbacks, reoccurring nightmares and intrusive recollections.
Around 30 cases in every 1000 maternities. 

86,020 women experience mild to moderate depressive illness and anxiety states during or after pregnancy. This comes with symptoms such as persistent sadness, fatigue, loss of interest and enjoyment in activities. It often co-occurs with anxiety, which may be experienced as distress, worrying, panic or obsessive thoughts.
Around 100-150 cases in every 1000 maternities.

154,830 women experience adjustment disorders and distress. These can occur when women are finding it hard to adjust or cope with an event such as pregnancy and becoming a parent. Women experiencing such disorders are likely to show a distress reaction which lasts longer than you would typically expect. However, this does not significantly impair their day-to-day functioning.
Around 150-300 cases in every 1000 maternities. 

As you can see, there are various mental health conditions that can affect pregnant women and new mothers. But they are not commonly spoken about.

Many women tend to underplay their feelings when discussing mental health, especially during and after pregnancy. This is often due to the fear of being branded as a bad parent. Although this is hardly the case! There are many forms of help and support available for people experiencing mental health problems, including new parents.

Developing a maternal mental health condition does not make you a bad parent, it shows that you are human, you have emotions and you are struggling to cope with the challenges and changes that come with being a new parent… and that is completely okay! You are not alone, you should not feel guilty for admitting you need help, there are thousands of women who know exactly what you are going through.

Causes: 

There is no definitive cause for the development of maternal mental health problems, although there are various risk factors that may play a role:

  • If you have experienced mental health conditions in the past
  • Biological causes (If a member of your family has experienced mental health conditions at some point in their life.)
  • Lack of support throughout pregnancy and after childbirth
  • Experience of abuse
  • Low self-esteem
  • Stressful living conditions
  • Major life events (maternity leave, moving house, bereavement etc)

Partners and Maternal Mental Health Conditions:

It is not very often that we hear about the partners of the women who have given birth. Is it possible for them to also experience perinatal mental health conditions, even though they are not the ones to have endured pregnancy and childbirth?

Studies show that yes, partners can develop mental health problems during and after pregnancy. Although they cannot be formally diagnosed with perinatal mental health conditions.

One study found that 1 in 5 fathers develop postnatal depression.

Partners can develop mental health conditions for similar reasons to the mothers:

  • Being a young parent without a support network
  • If they have experienced abuse in their childhood
  • If they are struggling to cope with stressful life events
  • If they live in poverty or poor living conditions
  • Struggling with the extra responsibilities that they have as a new parent
  • Financial worries
  • Changes in their relationship
  • Lack of sleep

Baby Blues vs Postnatal Depression:

Many new mothers experience baby blues, a short period of feeling emotional and tearful after giving birth to their baby. This tends to occur within 3-10 days after giving birth and last a few days. It is very normal to feel emotional and overwhelmed when becoming a new parent. Especially as you are faced with new challenges and demands along with a lack of sleep.

With 10-15% of women developing a deeper and longer-term depression, which usually develops within the first 6 weeks after giving birth. It can develop gradually or it can come on suddenly. Either way, if you feel as though you are struggling, remember that it is okay to speak to your GP or health visitor about it. You will NOT be branded as a bad parent, you will be supported.

Treatments:

Treatments will depend on which mental health condition that you have developed. However, they all tend to be treated with a combination of medication and therapies.

Therapies come in many shape and forms. You may receive one to one therapy sessions with a psychiatrist or you may be given the option to take part in group therapy sessions with other parents who are going through something similar themselves. It can be very helpful to talk to others who are feeling the same way as you, sharing experiences and giving one another advice from a personal point of view can be very comforting.

Medications are often in the form of antidepressants, though some mental health conditions may require antipsychotic medications. Your GP will be sure to talk you through all the available treatments and come up with a plan that best suits your needs.

Sources:

Mind Charity – About Maternal Mental Health 
World Health Organisation – Maternal And Child Mental Health
NHS – Perinatal Mental Health
Maternal Mental Health Alliance
Mind Charity – Useful Resources for Maternal Mental Health

 

 

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