Family going for a walk in the dusk
Family going for a walk in the dusk

Maternal Mental Health

 

Closer Than You Think

Wherever you are whilst you are reading this, take a minute to have a think about all the women you know who are pregnant.  Or have ever been pregnant, or want to get pregnant.  It might even be You.

There is a good chance at least one of them has had or is in the grips of a maternal mental illness.  You might have been aware of it. But you might not.

Because more than 1 in 10 women develop a mental illness during pregnancy or within the first year of having a baby.

Furthermore, 7 out of 10 of those women will underplay the severity of their illness.  Why?  Because having a baby is supposed to be the best thing ever, right?  So, you don’t have a right to feel guilty about feeling even a teensy weensy bit hacked off at the lack of sleep.  And feeling like a milk machine.  Not to mention the mourning of the passing of your previous identity and independence. Right?  Well, according to the glossy magazines and the adverts it seems to be the case.  We see image after image of happy sleep-fresh parents strolling through leafy parks in their co-ordinated clothes.  And mum back to their pre-baby weight a week after being post-partum and not a hair out of place.

MYTH AND FANTASY

I’m going to call it as it is.  Complete and Utter Rubbish.  It is a myth that is pedaled by people who want us to buy stuff by buying into an unrealistic version of an apparently perfect life. It took me 2 years and a half-marathon to get back to my pre-baby weight.  And I don’t think my hair has been in place for 4 years and counting.  Furthermore, I bet I’m not alone.  And before people tell me I ought to be grateful, I am.  I went through years of misery to have my daughter and there is not a day that goes without me being grateful for her.   That doesn’t mean I lose my right to have other human emotions.

At a deeper and more fundamental level, too many parents worry that going through depression or anxiety means they will be deemed unfit parents, and this can be hugely damaging. It is an incorrect assumption.  One  “which is putting lives at risk and preventing people getting the support they deserve”. So says Carmel Bagness Professional Lead for Midwifery and Women’s Health at the RCN.

The Impact

Traditionally, maternal depression has been considered something which happens once a baby has been born, often mistaken for the so-called “baby blues”. In actual fact, this depression starts for many sufferers during pregnancy and continues throughout and beyond.

Apart from the very real impact on the woman concerned, depression can have an impact on the developing baby.  Research published in the journal JAMA Psychiatry suggests that women who experience depression during pregnancy give their children an increased risk of depression as adults. So, there is no greater reason for women to prioritize their own mental health and seek help during pregnancy.

Perinatal mental illness can have an adverse impact on the interaction between a mother and her baby, affecting the child’s emotional, social and cognitive development. And it can detrimentally affect the woman’s self-esteem and her relationships with people in her professional and personal circle.

A Friend’s Story

(My friend, whom I will call Louise, wanted her story to be shared during this Maternal Mental Health awareness week. 29th April to 5th May 2019.)

I am blessed to call Louise one of my friends; I also coached her in the early days of her days as a self-employed entrepreneur.  She is also a midwife, working for the NHS as a Community Midwife and is universally loved by the women who benefit from her services. For good reason, she loves, and is excellent at, what she does.

Louise and I were pregnant at the same time. We met at the NCT classes we attended together along with several other lovely couples, most of whom we are still in touch with.  It is fascinating how bonds formed during pregnancy remain in tact even when our babies turn into walking, talking, actual people.

So, out of all of us, Louise was the one who seemed to be having the most perfect pregnancy.  Certainly none of the psychological baggage of previous miscarriages that I had.  Or the juggling of another small child and studying for a Registrar promotion of another friend.  Nor the weird pregnancy-related dietary complaints or the ubiquitous bad back.  She looked and sounded bumpiliciously fabulous; planning a home birth with a birthing pool.   I enviously imagined it from my position as a high risk geriatric mother with a scheduled induction to be complete with candles, soothing music, partner gently mopping her brow etc.

REALITY

Then the time came and the babies started arriving.  Louise’s homebirth started off as planned but didn’t end up that way.  She ended up being rushed into hospital towards the end of her labour. Unable to cope with the last stages without pain relief, full of fear for her own safety and that of her baby, and in need of the support of the hospital staff.  Suffice to say it wasn’t the calm, romantic welcome to the world she had hoped for her baby and herself.

Once home Louise set about living the life she thought she wanted and like, many other women, the one she thought she ought to be living.  Out for an evening meal with baby asleep next to her within a few days, shopping and socialising with baby.  I sometimes wonder if the fact she is a Midwife ever weighed heavily on her as a false sense of pressure to be a “perfect” new mum.

After a few weeks, she started to realise something was not quite right, not just the normal baby blues.  Paralyzing fears about her baby’s wellbeing, beating herself up that she was struggling to breastfeed, feelings of failing at being a picture-perfect mum became so overwhelming she went to a very dark place; battling her fears and intrusive thoughts.

With the support of her close family and the Health Visitor team, Louise eventually got the help she needed.  Stopping breastfeeding, going onto medication and taking time out to rest and be kind to herself were key to her recovery.

When pregnant with her second child, Louise felt herself experience feelings of depression once again and immediately sought help.  She took the brave decision to go onto medication to stabilise her emotions. She prioritised self-care and calmly delivered her baby at home in the birthing pool with her support team at her side.

COURAGE AND SUPPORT

Louise is an incredibly courageous woman, who was able to conquer her maternal mental health challenges and come through the other side with the right care and support of those around her. Other women have not been so fortunate and this needs to change.

Three Things That Need To Change

As with all mental health conditions, there are many aspects surrounding maternal mental health that need to change.  And here are the three which are cited in the Report “Every Mother Must Get The Help They Need“.  Written as an analysis of comments left at Lucie Holland’s Change.org petition about the urgent need for better awareness and care for those affected by maternal mental health problems.

  • Break down the social stigma and taboo that surrounds maternal mental health.
  • Provide clear, honest, mandatory information and advice to a key member of the family (new dads, birth partners, significant others etc.), before any woman leaves their place of giving birth.
  • Drive and support change in perinatal mental health.

Corporate Social Responsibility

I urge HR departments across the UK to review their Wellbeing Policies and Engagement Strategies. Aside from the economic benefits of properly caring for your staff, it is your moral responsibility to make sure that pregnant women and those returning to work after maternity leave have the opportunity to receive appropriate support with their mental health needs.

Organisations – large and small – must equip themselves with a referral agreement with organisations like mine, which offer a wide variety of services to meet the needs of every woman in this situation. Even if it is a signposting service, it is something to help a person at a time when they are not thinking straight for themselves.

The economic cost to society of not effectively treating perinatal mental illness far outweighs the cost of providing appropriate services. Read the October 2014 report The Costs of Perinatal Mental Health Problems’ by the London School of Economics and the Centre for Mental Health.

It Is OK Not To Be OK.

Kate Morris-Bates – Founder of InsideOut Wellness Centre – CBT Coach and Therapist. kate@insideoutwellness.healthcare | 07927 895415