Perinatal mental disorders are common and affect around 20% of women (PHE, 2017). However, this statistic does not account for those women who, due to stigma and shame, remain silent and do not come forward for treatment. These disorders are the leading cause of morbidity in pregnancy and a problem within maternal mortality too (Howard & Khalifeh, 2020). They also account for a significant economic burden, with a cost to the economy of around £6.6 billion per year in the UK (Bauer et al., 2015).
It is any type of mental health challenges from conception through to the post-birth period (at least until the infant is one year old, but it often goes on for many years). It includes fertility issues, artificial reproductive techniques, miscarriage, tokophobia (fear of childbirth), hyperemesis gravidarum (extreme sickness), genetic abnormalities, stillbirth, neonatal loss, postpartum psychosis, birth trauma, anxiety, stress and depression.
It is individual. No woman will necessarily experience the same as another. It impacts the mother, the baby and the family.
Infants born to mothers with mental health challenges have a much greater chance of having poor mental health through their lifetime. It causes difficulties with attachment and the ability to self soothe. It occurs in those valuable first thousand crucial days when the infant’s brain development is most vulnerable to developing difficulties.
Maternal mental health is about identity, vulnerability, control, choice, autonomy, difference, and particularly grief. It is transitional, with women constantly moving from one stage to another, and these transitions can be fraught with difficulties.
Motherhood is also subject to misuse of power, both implicitly and explicitly – within the family, professionally, culturally and within religious practices, which can cause women to feel marginalised and oppressed. The ethical issues are vast, complex and differ with each stage. We are accounting for multiple humans: mother, foetus/infant, father, partner, donor (if needed), siblings and wider family. It can affect adoptive parents and partners too.
Maternal mental health is a specialised area of work which needs specialist training and an understanding of the ethical considerations. Relational psychotherapy works particularly well as the woman is in relationship with her infant even prior to conception.
Psychotherapy can offer a safe space to explore your feelings, YOU CAN LOOK FOR AN ACCREDITED THERAPIST ON THE UKCP WEBSITE
You can also find support by contacting:
In an emergency, call: 999
NHS (England), call: 111
NHS Direct (Wales), call: 0845 46 47
The Samaritans 24 hour helpline, call: 116 123