Understanding Maternal Mental Health

Maternity is often considered as a period of growth and transition. While most communities emphasise the physical care required for both the mother and the child, the mental health of the mother is easily neglected. Motherhood is often encased within the context of the mother, the caregivers, the society and community. All these social systems can independently influence the mental health of a mother as she goes through the process of maternity, both before and after the birth of the child. This, when combined with the individual biological and psychological predispositions of the woman, can lead to many concerns through the prenatal and postnatal period. While it is necessary to highlight the potential concerns that a mother could go through, the importance of encouraging general positive mental health, and qualities like resilience, hope and optimism in a woman as she goes through this period of transition, must be recognised.

While maternal mental health is a concern lifelong, the mental health of women during and following pregnancy is especially critical. These times are riddled with physiological changes in the body, and socioculturally embedded lifestyle changes. This can, in turn, exacerbate pre-existing mental health difficulties or contribute to the onset of new problems. Some studies report the prevalence of perinatal depression to be as high as 22% in the first trimester, and perinatal anxiety to be around 7% (Lewis, Austin, & Galbally, 2016). In addition to depression and anxiety, there are various other mental health concerns that women have before and following pregnancy including concerns with body image, erratic moods, and so on. Mental health concerns are also critical to consider in the case of complicated pregnancies, and premature births. Along a similar vein, complications such as miscarriages and abortions elicit the reaction of grief and bereavement - similar to what is experienced when a loved one passes away. Such experiences can also have an adverse impact on mental health, as has been recorded by vast amounts of research literature (Toffol, Koponen, & Partonen, 2013).

With the birth of the child, catering to all the developmental needs of the child can be taxing for the mother, placing heavy strain on her mental health. This situation is further complicated if the child has certain special needs - this may range from having children with neurodevelopmental conditions, childhood physical and mental illnesses, terminal conditions, and visible differences. In such cases, maternity is compounded by caregiver strain, stress, and burden. On the other end, motherhood can also be complicated by a mother’s own physical or mental illness - which a mother may have to balance along with parental responsibilities.

Another critical period for maternal mental health is during the menopausal stage, which most often coincides with the ‘empty nest’, wherein the children leave home. In many cases, this period is marked by what has been called the émpty nest syndrome’, which is characterized by intense feelings of loneliness, emptiness, and lack of purpose. This period too, involves certain consequential physiological changes, and the long-term mental health outcomes of this period is also very crucial.

Closely related to motherhood but not often discussed in its context is the phenomenon of infertility, which again, has critical consequences on mental health. One study reported that women who experience infertility are highly prone to certain mental health disorders like dysthymia (a long-standing form of depression) and anxiety (Klemetti et al., 2010). These experiences also deserve attention from a mental health perspective, and must be given due attention.

The lifelong journey of motherhood across the lifespan is complex, and meanders through numerous ups and downs. Each of the many milestones and events that occur along this journey can bear adverse consequences on mental health, and need to be spoken about and advocated for.

References:

1. Klemetti, R., Raitanen, J., Sihvo, S., Saarni, S., & Koponen, P. (2010). Infertility, mental disorders and well‐being–a nationwide survey. Acta obstetricia et gynecologica Scandinavica, 89(5), 677-682.

2. Lewis, A. J., Austin, E., & Galbally, M. (2016). Prenatal maternal mental health and fetal growth restriction: a systematic review. Journal of Developmental Origins of Health and Disease, 7(04), 416–428. doi:10.1017/s2040174416000076

3. Toffol, E., Koponen, P., & Partonen, T. (2013). Miscarriage and mental health: Results of two population-based studies. Psychiatry Research, 205(1-2), 151–158. doi:10.1016/j.psychres.2012.08.029