Birth Center
Understanding and Supporting Maternal Mental Health
Pregnancy, delivery and the first moments and days of a new baby’s life can be a joyous time. However, it’s also a time of extreme exhaustion, tremendous hormonal fluctuations and monumental adjustment. It can be easy to simply characterize maternal mental health behaviors as par for the course, simply a result of the process. But to do so can dangerously overlook potentially significant conditions, resulting in new moms feeling lost and alone during a time that already brings with it significant life changes. It’s important to understand maternal mental health and support women as they navigate the changes of new motherhood.
Common Maternal Mental Health Conditions
Understanding the common mental health conditions many pregnant women and new mothers face is an essential first step in being able to recognize symptoms and provide the appropriate support.
Perinatal depression refers to depression experienced during pregnancy and after childbirth, the latter of which is most commonly referred to as postpartum depression. Symptoms include feeling extremely sad, becoming indifferent or anxious and changes in energy, sleep and appetite. While serious, perinatal depression is treatable.- Perinatal anxiety disorders, also known as perinatal mood and anxiety disorders or PMAD, can include a variety of mental health conditions during pregnancy or within the first year after childbirth (postpartum). These disorders can include generalized anxiety disorder (GAD), social anxiety, panic and postpartum OCD.
- Postpartum psychosis is very rare and can become very serious. It occurs in the time shortly after childbirth and is characterized by a sudden onset of symptoms that can include delusions, erratic thinking, hallucinations and rapid mood changes. Early intervention and treatment are essential to the patient’s long-term wellbeing.
- Postpartum PTSD is, as the name suggests, post-traumatic stress experienced after childbirth if the mother’s pregnancy, labor or delivery were traumatic or distressing.
- Adjustment disorders occur when a new mother experiences sadness, anxiety, irritability, changes in sleep or difficulty bonding with her baby after childbirth.
Risk Factors and Early Signs
Supporting pregnant and new mothers through the mental and emotional highs and lows of new motherhood includes addressing any risk factors or changes in maternal mental health. Pregnant women should talk with their healthcare providers about any pre-existing mental health conditions. Additional contributing factors to maternal health and wellbeing include:
- Previous pregnancy or birth trauma
- Social isolation and lack of support
- Hormonal changes
- Sleep deprivation
- Warning signs that require attention, such as changes in sleep or diet, heightened anxiety, hallucinations or thoughts of self harm
Impact on Mother, Baby and Family
A woman’s mental health plays a big and important role in her ability to care for her new baby, herself and her family. While the short-lived mental effects of childbirth, including fatigue, stress and baby blues occur in the first few weeks, longer lasting maternal mental health disorders can impact ability to function and maintain family relationships.
Significant changes to a new mother’s mental health can hinder her ability to bond with her baby. According to the National Institutes of Health, postpartum depression can lead to anger and a protective style of coping, passivity, withdrawal, dysregulated attention and lower cognitive performance in infants. Left untreated, maternal mental health disorders can bleed into family life, affecting partner relationships and family dynamics and ultimately, long-term health.
Breaking Stigma and Barriers to Care
While the consequences of undiagnosed or untreated maternal mental health are scary, modern day medicine and social norms have ushered in an era when treating these concerns does not come with the disregard or stigma of the past.
In America today, cultural perceptions of motherhood and mental health include the need to listen to women’s concerns and fears as they work their way through pregnancy and new motherhood. Gone are the days of brushing off changes in a mother’s mental health to simple hormonal changes or sleep deprivation. Today, healthcare networks, spouses, partners and family members acknowledge the importance of supporting women through the many stages of pregnancy and motherhood.
Common Maternal Mental Health Myths
As a society, we have shifted our understanding of maternal mental health, disregarding common myths, including:
- Postpartum depression will go away in a month or two. Incorrect – While the initial emotional rollercoaster commonly known as baby blues can resolve in the weeks after childbirth, postpartum depression is a much more serious condition that requires treatment.
- The most common symptom of PPD is crying a lot. False – Symptoms for PPD can range from hopelessness, loss of interest, disengagement, increased anxiety and irritability to thoughts of self harm.
- Maternal mental health issues only arise after the baby is born. Wrong – In fact, almost two-thirds of perinatal mood disorders originate during pregnancy.
And then, of course, there is the pressure society puts on new moms and the pressure they sometimes put on themselves to live up to the impossible “perfect mother” stereotype. It’s worth noting there is no such thing; parenting is incredibly rewarding but also difficult, stressful and unpredictable. Navigating it while also trying to maintain work, family life and personal goals can be challenging. It’s important to allow new families the space and grace to find their footing without imposing outside pressure or judgement.
Some women face barriers to accessing support and treatment for maternal mental health, which is why you should find a healthcare provider who you feel addresses your concerns. Look to local support groups or cost-free services. There are also a variety of mental support lifelines. Refer to the Community and Professional Resources section of this article for more websites and phone numbers.
As a society and as a community, it’s essential to provide pregnant women and new families with unfettered support opportunities to ensure each new parent is receiving the help she or he needs.
Treatment Options and Resources
The good news is, if you’re feeling overwhelmed by the emotions or mental effects of pregnancy or new parenthood, the options and resources are there.
- Therapy approaches
- CBT, or cognitive behavioral therapy, can be an effective therapy for perinatal depression and anxiety.
- IPT, or interpersonal therapy, explores interpersonal problems, improves communication skills and bolsters social support networks.
- Group therapy is also an excellent way to connect with others experiencing similar circumstances while learning new ways to address and cope.
- Medication considerations during pregnancy and breastfeeding
- Many medications that help treat maternal mental health are safe to use while you’re pregnant or breastfeeding, however, it’s imperative to consult with your healthcare provider before you take anything.
- Alternative interventions
- If you want to try approaches that help reduce the effects of anxiety and depression without medication, you can turn to mindfulness practices such as meditation or prenatal yoga, pregnancy and post-pregnancy safe exercise and support groups.
- When and how to seek professional help
- It’s never too early to talk to a professional if you feel you’re experiencing mental health disorders associated with pregnancy or new parenthood. Feelings of anxiety, sadness, hopelessness, depression or other thoughts that interfere with your ability to function or care for your child should be addressed. There is no specific timeline for the fluctuations of maternal mental health; pay attention to your mind and body, consult your partner or physician, and don’t hesitate to talk to someone if you feel you need help.
Self-Care Practices for Mothers
They say it takes a village to raise a baby, but sometimes, it can feel like there aren’t enough extra sets of hands in the entire town to make it through an entire day of new parenting. Establishing time for self care for a new mom right off the bat is an important tenet to maintaining mental wellbeing. This allows moms to get the rest, reflection and personal time they need to be the best parent they can be in the challenging first months of a baby’s life.
Important self care practices include:
- Build realistic expectations – Don’t try to overdo it or ask too much of yourself. This will most likely result in disappointment.
- Create moments of rest – Sleeping when your baby sleeps is an age-old adage, but for good reason. And if you can’t nap when baby is resting, try to create pockets of time throughout the day that provide respite and reprieve, such as short naps, baths or a cup of tea.
- Nutrition and physical movement – Eating a well-balanced diet during and after pregnancy helps provide the nutrients your mind and body need. Mild exercise is also important to boosting both physical and mental health. Talk with your healthcare provider about the best way to approach exercise during and after pregnancy to avoid injury.
- Developing support networks – While new motherhood can feel lonely, it’s important to remember you’re never alone. Turn to other new parents and groups for support. Your local labor and delivery ward, lactation consultant or pediatrician’s office are great places to start.
- Setting boundaries – Establishing boundaries with family, friends, your partner and work is essential to maintaining mental health before and after baby arrives.
Support Strategies for Partners, Family and Friends
Often, a new parent’s first line of defense against overwhelming mental health symptoms is a partner, friend or family member. If you fall into this support category, pay close attention to changes in mood, diet, an inability or disinterest in bonding with baby or other other feelings of depression or anxiety that deserve immediate attention. Don’t be afraid to talk to your partner about how they’re feeling.
Other steps partners can take to support new mothers include establishing practical support measures, such as offering to care for a baby while mom catches up on sleep, cleaning the house, taking care of baby’s bath time or assisting in other ways that don’t always require mom. It’s also important to create space and time for recovery. Pregnancy and childbirth can take a toll on a woman’s body. Make sure to listen and be respectful of boundaries that allow for healing and physical and mental wellbeing.
Alternatively, caregivers and supporters also need to tend to their own mental health. Establishing this new world order can be tricky and take a little bit of time, but it’s important to acknowledge, as a family, that you will all get there while being respectful and supportive of personal needs.
Conclusion
Acknowledging that mental health is just as important as physical health as you navigate your pregnancy and post-pregnancy journey is an important step in personal nourishment. While bringing a child into the world is universal, every woman’s experience is different. The support is there if you need it.
If you are experiencing a mental health crisis postpartum, please reach out to a local provider for care. The behavioral health experts at Aspen Valley Health are ready to help.
