By Katherine Allen, University of Minnesota Extension’s Children, Youth & Family Consortium (CYFC)
Maternal mental health during pregnancy, childbirth, and infancy is an important predictor of child development, yet it is massively understudied, underreported, and undertreated. Across the world, mental illness associated with pregnancy and childbirth is a primary complication for women. Depression is the most common mental illness among soon-to-be mothers and new mothers, with over 10 percent of pregnant women and over 13 percent of women who just gave birth experiencing depression (see this World Health Organization site for more information). Other conditions affecting the health of both mother and child include anxiety disorders, eating disorders, and psychotic disorders.
Only recently have many public health organizations and the medical community as a whole started to recognize that perinatal maternal mental illness and mental health can have an effect on both mother and fetus. Thanks to the efforts of many public health organizations, there is increasing recognition of the widespread nature and effects of postpartum depression. Organizations like Maternal Mental Health Now, the Association of Maternal & Child Health Programs, and the Maternal Health Task Force all work to raise awareness about maternal health and mental health, and often focus on the effects of postpartum depression, such as chronic mental illness, struggles with parent-child bonding, and emotional, developmental, and cognitive delays in infants and children. Perinatal mental illness — especially depression — has been linked to low birth weight, preterm delivery, and also postpartum mental illness and suicide. To learn more about the effects of perinatal and postpartum mental illness, please visit any of the sites linked above.
Barriers Remain
In the majority of countries, many real and perceived barriers remain for pregnant women or new mothers in need of services. Research has shown that many women do not actively seek help for perinatal or postpartum depression because they do not know where to go or because assistance is not available to them (Dennis & Chung-Lee, 2006; Goodman, 2009). Furthermore, cultural stigmas around mental illness prevent many women from getting treatment for depression or other psychological disorders, along with fear that disclosing mental illness will lead to having their children taken away.
Women also shy away from seeking perinatal, including antenatal, mental health treatment due to minimization of their feelings by health care professionals or because of fear of medication. Pregnant women or women who are breastfeeding might discontinue medications or refuse prescribed medications because of concern about possible effects of those medications on their child, which can often lead to decreased mental health. The stark lack of research related to psychiatric medications for pregnant or breastfeeding women and their children leave women unsure and unwilling to seek help.
More Research Needed
More time and research must be devoted to mental health during and after pregnancy in order to fully understand its impact on mother and child — sometimes for many years to come. As public health organizations and community advocates work to reduce the stigma and increase knowledge, and as more treatment options become available, we can move into a future where access to mental health support is abundant, and seeking care is easy and commonplace for pregnant women and new mothers.
For More Information
See these resources to learn more:
Thinking Healthy: A manual for psychological management of perinatal depression
A resource for community health workers to help reduce prenatal depression.
Postpartum Support International
Connects mothers, family members, and professionals with a network of support; also includes various tools to help with postpartum mental health.
Minnesota Department of Health: Maternal Wellbeing Innovation Lab
A Minnesota-based project to improve access to mental health resources for new mothers.
Postnatal Depression: A Survival Guide for Dads
Learn how postnatal depression affects fathers and what to do about it.
References
Dennis, C., & Chung-Lee, L. (2006). Postpartum depression help-seeking barriers and maternal treatment preferences: A qualitative systematic review. Birth Issues in Perinatal Care, 33(4), 323-331. http://www.onlinelibrary.
Goodman, J. H. (2009). Women’s attitudes, preferences, and perceived barriers to treatment for perinatal depression. Birth Issues in Perinatal Care, 36 (1), 60-69. http://www.
Katherine Allen is a former public health intern for the Children, Youth & Family Consortium (CYFC)–a part of the University of Minnesota Extension Center for Family Development. She is currently a senior at Haverford College, studying Biology and Sociology.
The staff at the HRSA-funded Center for Leadership Education in Maternal and Child Public Health would like to thank Katherine and CYFC staff members for their permission to repost this article.