Lifting the lid on maternal mental health

The World Maternal Mental Health Awareness campaign, now in its third year, declares ‘without mental health, there’s no health’. A sweeping statement? I don’t think so.  If mums aren’t in a good place mentally, then it’s unlikely they’re going to be able to focus on anything other than getting their family through each day, never mind making sure everyone’s getting their 5-a-day, doing 150 minutes of exercise each week or getting to bed in good time.  The reality is if you’re suffering with a perinatal mental health (PMH) problem, life can become completely overwhelming and it’s likely that your physical health will be affected too as it takes a back seat to your other worries.

So why does maternal mental health matter? Aside from not wishing anyone to have to endure the suffering and often devasting effects a mental health illness brings, mums (and dads) are the foundation of the family and if they begin to struggle, then the whole family begins to struggle and this can have dire consequences on the child’s safety, growth and development.

Besides this, we now know more about how critical the parent-infant relationship is on brain and emotional development in babies during pregnancy (yes, from that early on) and in the early years (1,2) and plays a major part in how that child will grow into an adult and on their future health and wellbeing. Hence why it is crucial then for mums (and dads) to have good mental health in order for them to be able to develop a positive relationship with their baby and enable their family to thrive.

Despite the world knowing this, it makes shocking, but not surprising reading to discover that 7 in 10 mums (3) will hide or downplay their symptoms leaving them suffering in silence.

Why is that?

Unfortunately, still in 2018 there is so much stigma and fear attached to having a perinatal mental health problem. Fear that you will be judged for being a bad mum if you tell anyone how you feel, or worse – you think your baby will be removed from you if anyone knows how you really feel.

Reflecting on my own perinatal experiences (the first year of your baby’s life), I can honestly say I would have been one of the 7 in 10 mums not able to say how hard things were because of fear of being stigmatised or judged for being ‘weak’ – a common reason why most people suffering with a mental illness don’t seek support.

I had similar experiences with all 4 of my children but more recently with my last child, towards the end of the pregnancy I had been running round like a mad woman.  It was Christmas time, we were rushing to get major work in our then house finished before Christmas and I really hadn’t given much thought to this baby due towards the end of January. Well, it was my fourth, it would all be fine and I’d just get on with it. How wrong was I!

She arrived three weeks early, wasn’t gaining weight due to breastfeeding problems (it was incredibly painful too, I cried a lot) and she developed prolonged jaundice. I clearly remember having a ‘meltdown’ at around 8 weeks as it all hit me like a train.

I just hadn’t given any thought to how things would change again or the impact of the sleep deprivation, breastfeeding problems and managing with my other children. I am lucky enough to have a very supportive husband and at the time I was also able to speak with Health Visitor (HV) colleagues, however once the initial trauma subsided, I did suffer with similar ‘low level’ symptoms of anxiety and depression as I had with my other children and carried on without saying anything probably for most of that first year. Eventually the ‘fog’ lifted but may have done so sooner had I talked about it more.

Other critical figures show that worldwide, as many as 1 in 5 women experience some type of perinatal mood and anxiety disorder (PMAD). Statistics vary by country, but this is a worldwide concern. PMADs include postpartum depression, postpartum anxiety, postpartum obsessive compulsive disorder, postpartum bipolar, and postpartum psychosis. A much more complex issue than what it is recognised as currently.

It is also estimated that 20 – 25% of pregnancies end in miscarriage or stillbirth. In addition to grief, many of these women also experience postpartum depression. Giving birth to a premature child, or having a child spend extended time in a Neonatal Intensive Care Unit, can also take a toll on maternal mental health.

PMADs affect the entire family with a growing awareness around support for dads as about 1 in 10 develop depression during this time. It’s also likely to be dads and partners who are first to recognise symptoms in mums so it’s vital that they become aware of what to look out for and know how to get help.

What should you be looking out for?

I’ve always said to mums, we all have bad days, especially if you’ve had a bad night with your baby and it’s ok to have a pyjama day now and then. But it’s when this becomes more frequent and your mood and emotions start to impact on your life and you feel isolated, that’s when you need to speak to somebody. However, some of these symptoms (a list can be found here www.thesmilegroup.org/symptoms-of-postnatal-depression/  (their website is a great resource for help) can be misperceived by mums and some professionals as being a ‘normal’ part of new motherhood, possibly why they decide to keep things to themselves.

If you’re aware you’re struggling, I think the most difficult part is taking the first step to actually getting the words out of your mouth and asking for help.

Who should you say it to?

A friend? Your partner? Your GP? Your HV? What should you say? How should you say it? To help with this, The Smile Group have produced a checklist which you can prepare before your appointment and can help direct your discussion with your GP or HV if you’re finding it difficult to start the conversation.

It can be found here http://www.thesmilegroup.org/help-from-the-professionals/and can be taken along to future appointments.

Although not all mental health problems can be avoided but early intervention is key to the prevention, reduction and escalation of perinatal mental ill-health. So it is essential that parents are given the opportunity during antenatal education to prepare for and learn about the transition to parenthood and the impact the life changing event of having a baby has on your life and mental wellbeing.

With the awareness brought about by campaigns like World Maternal Mental Health Day and the UK Maternal Mental Health Week (taking place this week 30thApril – 6thMay) will start to drive social change with a goal towards improving the quality of care for women experiencing all types of PMADs, and reducing the stigma of maternal mental illness.

The campaign is also encouraging all types of health professionals, friends and relatives of new mums to ask her how she’s really feeling and encourage her to seek help.  With the right support, people do move on and recover from PMH problems and an integrated approach to family mental health allows both parents to move beyond this as a thriving family unit.

Contact information

If you know of a mum who is struggling then please encourage them in the first instance to speak with their GP or HV. I am also available to talk and can be contacted via my Facebook page or Laura@lkparenting.com

Please find below a list of websites guiding you to useful resources and available support.

My next Antenatal Parenting Preparation Workshop is running on Saturday 23rd& 30thJune 2018 – please contact me via email to book a place.

Resources

www.lkparenting.com

https://www.facebook.com/hfhf.iom/  (LK Parenting Facebook Page)

https://www.facebook.com/groups/921920334640315/?source_id=422337074779179 (LK Parent Connections closed Facebook Group)

https://www.facebook.com/PerinatalMHPartnershipUK/

http://www.thesmilegroup.org

https://www.mind.org.uk/information-support/types-of-mental-health-problems/postnatal-depression-and-perinatal-mental-health/#.Wuja2C-ZNp8

https://www.bestbeginnings.org.uk

https://maternalmentalhealthalliance.org

References & for more information:

  1. Bernier, S. Calkins & M. Bell (2016). Longitudinal Associations between the Quality of Mother-Infant Interactions and Brain Development across Infancy. Child Development. 87 (4): 1159-1174

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4939105/

  1. More information can be found at

https://www.1001criticaldays.co.uk

  1. More information can be found at

http://wmmhday.postpartum.net