Maternal Mental Health

Historically, the phrase ‘Cinderella service’ was applied to mental health, because it received less emphasis and consequently less funding than physical health treatment services. This was exacerbated by a consistent lack of empathy, from both the medical fraternity and the general population, for those who suffered. What also went unrecognised by all but those who work in the discipline, was that untreated mental health problems inevitably impact physical health and longevity, with the consequential personal, social, and economic costs.

Fortunately, things have changed and are continuing to change. There is an increased understanding and acceptance of mental illness by the general population as well as targeted and on-going improvements in the delivery of services by the NHS. People in public life are becoming more open to discussing their own mental health and as a result, inspiring others to do the same. Most significantly, this change is encouraging everyone to consider their mental health and wellbeing and to do something about it, if the need arises. This is important, because the need will arise at some time in our lives, for approximately 25% of us.

What is Mental Health?

Everyone has mental health. Good mental health is essential to our emotional, psychological, and social well-being; effecting how we think, feel and act. The condition of our mental health will determine how we handle stress, relate to others, make choices and live our lives. Our mental health is like many instances of physical health, often invisible to others, but everyone has it and like our physical health, needs to be taken care of.

Research indicates that one in four people will experience mental health issues during their lives. It is estimated that every year in Europe, 83 million people suffer a problem with their mental health.

Good mental health means we can effortlessly think, feel and react; in order to live our life the way we need and want to. However, for those of us who are experiencing a period of poor mental health, our ability to cope with normal life can become difficult, or even impossible.

The causes

The exact cause of most mental illnesses is still not known but a combination of physical, psychological and environmental factors are thought to play a role. It is likely that for many people it will be as a result of a complicated combination of factors.

Some mental illnesses such as bipolar disorder can run in families, which suggest (although not proven) that there could be a genetic link. Experts believe many mental illnesses are linked to abnormalities in several genes that predispose people to problems, but don’t on their own directly cause them. The theory is that a person can inherit a susceptibility to a condition but may not go on to develop it.

What is accepted is that difficult life events have the potential for triggering a period of poor mental health.

Pregnancy and Mental Health

An area that is not readily considered by many is the instance of poor mental health during pregnancy. While we are aware of the emotional and mental health problems that can occur after the baby is born, often we don’t realise that pregnancy itself, also increases the likelihood of developing mental health conditions.

Pregnancy, a time when a woman believes she should feel proud, joyful, excited and thrilled. A time when those around you shower you with good wishes and make you feel special. It is a time for dreaming about a new life and planning for the baby’s future. However, for all the positivity, pregnancy is not an easy ride. Pregnancy is complex and challenging and there will be times when every mother will find it difficult. For a number of mothers (between 10% and 20%), pregnancy can become very hard.

One in five mothers suffer from depression, anxiety or in some cases psychosis during pregnancy, or in the first year after childbirth. After cardiovascular disease, suicide is the most common cause of maternal death. Mental health problems don’t just affect the health of mothers they can also have longstanding effects on a child’s emotional, social and cognitive development. The cost of poor perinatal mental health is estimated at £8.1 billion for each annual birth cohort, or almost £10,000 per birth per year.

The Causes

Inevitably pregnancy creates a huge upheaval in a woman’s body, with changing emotions one of the most common side effects. The constant shifting of emotions can be difficult to deal with, not just personally but for those around you; especially if you were not known for being very emotional before. The roller coaster of emotions can be difficult for you to understand, let alone explain to others how you are feeling and why.

Heightened and volatile emotions during pregnancy are to be expected and are a normal part of the process. Not least because of hormonal changes. During pregnancy, women experience a significant increase in the production of hormones, such as progesterone and oestrogen. This increase can have an impact on your emotions and your brain’s ability to monitor those emotions. Generally, this should not be a cause of concern.

It is not unusual for pregnancy to bring on additional stress. You may find yourself worried about the future, your finances, housing, support and employment. Some women have more difficult or ‘at risk’ pregnancies than others. Discomfort is normal from time to time – from morning sickness to body aches but for some, symptoms can become more challenging or intense, especially if exacerbated by pre-existing conditions. Feelings of being less physically attractive, fatigue or an inability to concentrate, any of these things can impact both mental and physical health, adding to stress and potentially impacting your normal emotions.

Whether from discomfort or stress difficulty sleeping is common when pregnant. Lack of sleep impacts our resilience and has a profound impact on our physical and emotional state.

Let’s not get carried away, all of the above are quite common, so we need to be careful not to feel inadequate or guilty about what is normal. We must simply be aware of them and respond in a healthy, positive way. However, if you feel like your emotions are becoming out of control, or you are experiencing severe anxiety and/ or depression, or are having suicidal thoughts, then you must contact your GP or midwife – as you may need more help.

Getting Help

Just because pregnancy is a normal, natural function of life, does not mean that it will always run smoothly. Many pregnancies have both physical and mental complications and whilst we largely accept the physical, many mothers feel that having mental health issues is a failing or a sign of weakness. It is not unusual for women who have experienced ante and/ or post natal mental illness, to feel guilty or embarrassed about their feelings.

You might be apprehensive about asking for help because you fear that you will be considered an ‘unfit’ mother or ‘not normal’. Just remember, health professionals have seen this all before, many times. They are not there to judge, they are there to help.

If you experience any of the following symptoms*, speak to your GP or midwife immediately:

• You feel low, depressed or anxious often or most of the time and this has been going on for more than two weeks

• Your anxiety is making you feel physically ill with a fast heartbeat, fast breathing, sweating, feeling faint, feeling sick and diarrhoea

• You have panic attacks

• You have unpleasant thoughts that keep coming back and you can’t control them

• You find yourself repeating actions – like washing, checking, counting – to feel better

• You are afraid of giving birth, that you don’t want to go through with it

• You feel like you can’t cope

*Taken from Tommy’s Pregnancy Hub

For additional information try the following organisations:

NHS – Mental health and pregnancy

Mind for better mental health