Components of Maternal Mental Health
From the moment a woman contemplates having a baby, she enters an unfamiliar world full of excitement, fear, vulnerability, and expectations about the future. From a young age, many women dream of having a baby and often do not consider the potential challenges that may come with family building.
Maternal Mental Health is a term which includes a range of disorders, symptoms and challenges that can occur during pregnancy through the first year after a woman gives birth.
Some of the conditions can include:
depression
anxiety disorders
post traumatic stress disorder
bipolar disorders
If left untreated, these conditions can have long-term negative effects on not only the mother, but the child and entire family unit as well. It is important to consider your potential risk factors prior to getting pregnant for optimal physical and emotional health.
There are different aspects of Maternal Mental Health and various times during the perinatal period (the time of conception through the first year after birth) mental health challenges or symptoms may occur. Staying informed and knowing any potential risk factors you may have ahead of time allows you and your partner to plan ahead and ensure you have the support you need in place.
Components of Maternal Mental Health:
Preconception
Having a baby can be one of the most exciting times in a woman's life. However, often couples do not consider challenges that may present during this time. Taking some time before trying to conceive to assess a woman’s physical and emotional health is a proactive approach to family planning. Identifying potential medical and/ or mental health concerns gives women and couples an opportunity to plan ahead for optimal self care and to have appropriate support in place.
The following are some risk factors that may put women at higher risk of maternal mental health issues:
Previous history of mental health issues
History of trauma or abuse
Marital issues
Recent major life event/ loss
Infertility
Complications during pregnancy, birth or postpartum
If you have any of the above risk factors, we recommend meeting with a mental health professional that specializes in Maternal Mental Health to provide appropriate screening and planning prior to getting pregnant. It is important to inform the members of your medical team as well of any significant history or risk factors as well so they can provide the best care to you throughout your family building journey.
Pregnancy
We typically consider pregnancy as an exciting and joyful time for women. Most of us dream about getting pregnant and think of shopping for cute baby clothes and setting up a nursery. However, up to 20% of women suffer from depression or anxiety during pregnancy. Some women have been treated in the past for anxiety or depression, but others will experience these symptoms for the first time. It is common to confuse these new feelings as part of pregnancy or JUST HORMONES, and it often goes untreated as a result.
Warning signs of anxiety and depression during pregnancy:
Feeling sad
Having racing thoughts you can’t seem to “turn off”
Feeling angry or irritable with those around you
Feeling hopeless about the future
Struggling to get out of bed or not being able to sleep at all
Having scary or intrusive thoughts
Feeling disconnected from your partner
Isolating yourself from family & friends
Not feeling like “yourself” and not enjoying the things that you used to love
Having physical symptoms like and not knowing if they are related to your pregnancy
Although the above feelings can be normal, it is important to talk to a professional if you are struggling or not feeling like yourself. The sooner you can identify a potential issue during pregnancy, you can start to develop a plan of action and self-care. It is also necessary to consider your needs for after you give birth and start postpartum planning.
Postpartum Depression & Anxiety
Although It is normal to have difficulty adjusting to motherhood, approximately 15-20% of new moms will experience more significant symptoms of depression or anxiety. Although women that have struggled with these symptoms previous to having a baby are at a higher risk,
anyone can experience postpartum depression and/ or anxiety. Many women often don’t even realize they are experiencing depression or anxiety, and often think these feelings are normal. Symptoms can present within the first couple of months after having a baby, however, postpartum depression and anxiety symptoms can occur anytime up to one year after childbirth.
It’s important to understand the signs and symptoms of maternal mental health disorders prior to giving birth to help identify if you need support from a mental health professional.
Symptoms of postpartum depression and anxiety include:
Low mood, sadness, tearfulness
Agitation or anxiety
Difficulty concentrating
Feelings of guilt, shame, or hopelessness
Possible thoughts of harming the baby or yourself
Constantly worrying
Feeling that something bad will happen
Disturbances in sleep or appetite
Physical symptoms like nausea, dizziness, heart palpitations
Birth Trauma
Some women experience events during pregnancy or childbirth that are experienced as traumatic. This experience can lead to developing symptoms of PTSD (Post-Traumatic Stress Disorder). While trauma can be physical, it is often emotional and psychological. Birth trauma is not just about what happened during labor and the birth. It can also refer to how you, as the mother, are left feeling afterwards. Often women describe feelings of loss of control, not feeling heard or listened to and a loss of dignity.
Some experiences that can lead to birth trauma can include induction, emergency c-section, lengthy and or very painful labor, high levels of medical intervention, previous trauma, NICU stay and stillbirth.
Common Symptoms of Birth Trauma:
Re-experiencing the traumatic event (flashbacks, nightmares, or intrusive memories)
Feeling a state of hyper-vigilance (constantly on alert, irritable, jumpy)
Worrying that something might happen to your baby
Feelings of sadness, crying, loss of interest, lack of motivation
Lack of appetite
Sleep disturbance
Infertility
Most women dream of getting pregnant and having a baby. We hope when we are ready to start trying, pregnancy comes easily. When this doesn’t happen, it can feel frustrating, scary and overwhelming. You can feel like a failure or somehow, your body isn’t working the way it is supposed to. It can all feel like TOO MUCH.
Infertility is defined as the inability for a couple to conceive after one year. It is estimated that 10-15% of couples struggle with infertility. The number of couples seeking infertility treatment has increased dramatically due to the development of new and more successful treatment options for infertility, increasing awareness of infertility treatment , and couples waiting until later in life to start families. The stress related to infertility can often lead to depression, anxiety, anger, marital issues, sexual dysfunction and social isolation.
Couples often feel a sense of loss as a result of infertility. It is normal to feel frustrated and sometimes take those feelings out on each other.
Common feelings during infertility:
Feeling guilt and shame
Not wanting to be around your friends with kids or that are pregnant
Not having hope for the future
Feeling angry or irritable
Struggling to get out of bed or not being able to sleep at all
Feeling disconnected from your partner
Isolating yourself from family & friends
Not feeling like “yourself” and not enjoying the things that you used to love
Struggling to manage your emotions
Frustrated with physical and emotional symptoms related to your treatments
Perinatal Loss
The loss of a child is an unimaginable time of grief for women, couples, and families. In the US, 10-15% of known pregnancies end in miscarriage and 1% of all pregnancies end in stillbirth (March of Dimes). Whether it is a miscarriage, stillbirth, or the death of an infant, it is a time of emotional upheaval. It is very common for individuals to experience symptoms of anxiety and depression following this kind of loss, leaving one feeling lost and afraid. Coupled with tremendous loss, women also experience the hormonal fluctuations associated with childbirth.
Recognizing that everyone grieves differently, it is important to consider what kind of support you might need during this time. Individual or group therapy can provide a supportive place to help assist you through this difficult time. Couples can also benefit from counseling together, as it is common to experience grief in different ways and stages.
Relationship Support
It is common for couples to struggle during the family building process. Most couples assume when they make the decision to start a family it will be easy and do not anticipate the roadblocks we discussed above.
Some of the issues couples struggle with include:
Communication Issues
Role Adjustment
Sex & Intimacy
Grief & Loss
Substance Abuse
Parenting and family issues
It is important for couples to have the right support in place to help communicate their feelings and needs as they transition through this often overwhelming time.
The Maternal Mental Health Program at Passages provides women and families a supportive space to address their specific needs from pre-conception through the postpartum period. Our clinicians offer education, support, counseling and wellness services to facilitate your family building journey. We work with women and families to identify their unique individual needs to create a comprehensive plan for optimal health and wellness.
