Maternal mental health

What is maternal mental health?

 

Maternal mental health refers to the emotional and psychological wellbeing of a woman during pregnancy, childbirth, and the postpartum period. It includes a range of mental health conditions that can develop due to the hormonal, physical, and emotional changes associated with pregnancy and motherhood.

 

Maternal mental health issues are very common, and research indicates that up to 1 in 5 women experience mental health difficulties during pregnancy or after childbirth. While some emotional responses - such as mood swings - are common, they typically resolve on their own. Maternal mental health conditions are severe or persistent mental health difficulties that require medical intervention.

 

 

What are common maternal mental health conditions?

 

Several mental health conditions can arise or be exacerbated during and after pregnancy. These conditions vary in severity, and some may require immediate treatment to safeguard both the mother and the baby.

 

Perinatal depression

 

Perinatal depression refers to depression that occurs during pregnancy (called antenatal depression) or after childbirth (called postnatal or postpartum depression). It’s one of the most common maternal mental health conditions.

 

Signs may include:

persistent sadness, hopelessness, or feeling empty fatigue, low energy, or difficulty sleeping difficulty bonding with the baby feelings of guilt, shame, or worthlessness thoughts of self-harm or harm towards the baby

 

Postpartum anxiety

 

Postpartum anxiety often manifests as intense worry or fear, usually about the baby’s health, safety, or development.

 

Signs may include:

persistent worry or a sense of dread irritability, restlessness, or nervousness racing thoughts or difficulty concentrating rapid heartbeat, nausea, or muscle tension over-protectiveness or fear of leaving the baby

 

Postpartum obsessive-compulsive disorder (OCD)

 

Postpartum OCD is marked by intrusive, obsessive thoughts that can be distressing or frightening, typically related to the safety of the baby. Mothers may fear causing harm to the baby, even if they have no intention of doing so. This condition is often accompanied by compulsive behaviours meant to ease anxiety.

 

Signs may include:

persistent or intrusive thoughts about harm coming to the baby compulsive behaviours like repeatedly checking on the baby high levels of anxiety and fear related to thoughts

 

Postpartum psychosis

 

Postpartum psychosis is a rare but serious maternal mental health condition. It usually develops within the first two weeks after childbirth and involves a break from reality, often including hallucinations, delusions, or irrational behaviour. Postpartum psychosis is considered a medical emergency that requires immediate medical intervention.

 

Signs may include:

hallucinations (seeing or hearing things that aren't actually present) delusions or irrational beliefs extreme confusion or disorientation rapid mood swings thoughts of self-harm or harm towards the baby

 

Can maternal mental health conditions affect the baby?

 

Yes, maternal mental health conditions can impact the baby’s wellbeing and development. When left untreated, maternal mental health conditions can disrupt the mother’s ability to care for and bond with her baby. Research suggests that children of mothers with untreated maternal mental health conditions are at higher risk of emotional, behavioural, and developmental difficulties.

 

How are maternal mental health conditions managed?

 

There are several effective treatment options for managing maternal mental health conditions, which vary depending on the severity of the symptoms and the mother’s health needs.

 

Therapy

 

Psychotherapy, like cognitive behavioural therapy (CBT) and interpersonal therapy, is the first line of treatment. CBT can help to identify and change negative thought patterns, while interpersonal therapy focuses on improving relationship skills and managing life changes associated with motherhood.

 

Support groups

 

Support groups, both in-person and online, provide invaluable emotional support for mothers experiencing mental health challenges. Speaking with other mothers who have faced similar struggles can reduce feelings of isolation and help mothers feel more understood.

 

Medication

 

In cases where symptoms are severe or not manageable with therapy alone, medication may be prescribed. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), are commonly prescribed and can help alleviate symptoms of depression and anxiety. 

 

Is it safe to take medication while pregnant or breastfeeding?

 

Several medications, including some SSRIs, have been deemed safe for use during pregnancy and breastfeeding, though each patient case is unique and requires a careful risk-benefit assessment. 

 

Mothers should always consult with a specialist before starting, stopping, or adjusting any medication during pregnancy or breastfeeding, as sudden changes can lead to withdrawal symptoms or a worsening of mental health. In some cases, alternative medication or a personalised dosage may be required.

 

Can maternal mental health conditions recur with future pregnancies?

 

Yes, women who have experienced maternal mental health conditions are at a higher risk of recurrence in subsequent pregnancies. If a woman has a history of perinatal depression, anxiety, or other mental health issues, a specialist can help to develop a comprehensive care plan to monitor symptoms closely and intervene early, providing tailored support to reduce risks and ensure both the mother’s and the baby’s wellbeing.