Maternal mental health

Maternal mental health covers pregnancy and the first year post-pregnancy (post-partum). Around 10% of pregnant women and 13% of women who have just given birth experience a diagnosable mental health problem (WHO, 2019). Early intervention and support are essential during this period.

Detailed information on maternal mental health can be founded here.

 

Perinatal mental health

Perinatal mental health conditions can occur during pregnancy and delivery. The prevalence rate of common mental disorders among pregnant women ranges from 1%–37% (Jha, Salve, Goswami, Sagar & Kant, 2018).

Women during pregnancy experience significant hormonal changes and physical changes in their bodies, as well as emotional changes that come with adjusting to the idea of pregnancy and motherhood. On top of that, risk factors, such as poor physical health, unplanned pregnancy, limited social support, or low socioeconomic status, are likely to heighten the risk of developing a perinatal mental health problem for pregnant women.

Common perinatal mental health problems include perinatal anxiety and depression. 54% and 37.1% of women experienced perinatal anxiety and depressive symptoms, respectively, in at least one antenatal assessment in Hong Kong. Perinatal anxiety and depression also increase the risk of postpartum depression (Lee et al., 2007). Some mothers may also experience perinatal obsessive-compulsive disorder (OCD) during their pregnancy. Early intervention is vital to protect the health of both mother and infant.

Some risk factors of developing a perinatal mental health problem include:

  • History of mental health problems
  • Younger mothers
  • Poor physical health
  • Unemployment
  • Limited or no social support
  • Low socioeconomic status
  • Experience stressful life events
  • Poor marital satisfaction
  • Carrying their first child or an unplanned pregnancy
  • History of abuse or neglect

 

Postpartum mental health

After giving birth, it can be common for mothers to experience a period of postpartum blues (also known as “baby blues”) – which include symptoms such as feeling emotional, irritable, tearful and restless. Baby blues usually last from a few days to two weeks. This is extremely common, affecting up to 85% of women (Northwestern Medicine, 2019) and will often resolve on its own.

However, some newborn mothers will experience more persistent difficulties with their mood,  which may indicate that they are experiencing postpartum depression. This usually happens 6 weeks to a year after giving birth. Around 13% of newborn mothers will be affected by postpartum depression worldwide (WHO, 2019). Early intervention and social support from a partner, friends and family have been found to be effective in improving symptoms.

Some symptoms of postpartum depression may include:

  • Feeling down, upset or tearful
  • Feeling restless, agitated or irritable
  • Guilt, worthlessness and feeling down about yourself
  • Feeling empty and numb
  • Isolated and unable to relate to other people
  • Finding no pleasure in life or things you usually enjoy
  • A sense of unreality
  • No self-confidence or self-esteem
  • Hopelessness and despair
  • Hostile or indifferent to your partner
  • Hostile or indifferent to your baby
  • Suicidal feelings

You might find yourself:

  • Losing concentration
  • Finding it hard to sleep, even when you have the chance
  • Having a reduced appetite
  • Lacking interest in sex

Learn more about postpartum depression here.

Postpartum psychosis affects around 1-2 out of 1,000 mothers. The symptoms usually occur within 2 weeks after birth (Postpartum support international).

If you are experiencing postpartum psychosis, it is likely that you may experience a mix of symptoms of psychosis, depression and mania, which may include some of the followings:

  • Excited or elated
  • Severely depressed
  • Rapid mood changes
  • Confused or disoriented
  • Restless
  • Unable to sleep, even when you have the chance
  • Unable to concentrate
  • Delusion – strong beliefs that other people don’t share such as you are being followed, or your thoughts are being read
  • Hallucinations – when you experience things that others around you don’t

Learn more about postpartum psychosis here.

 

Stillbirth and miscarriage

The loss of a child, no matter how early, is never forgotten – this holds true for both parents. For women, the bond you have formed with the baby during pregnancy can make this loss even more difficult to process. Complicated emotions may arise — you may feel helpless, regretful, or even blame yourself. Please remember that it takes time to recover, and it is vital to recognise the impact of the loss.

As a partner, friend or family member, you can support a woman going through the loss of a baby through:

  • The recognition of the enormity of their loss
  • Listening to them, and respecting their feelings and beliefs
  • Providing practical support, such as meals
  • Providing an adequate time and place to grieve

Support from a partner, friends and family is crucial to coping with the experience of losing a child. Seeking professional help when necessary can also be helpful.

 

Parental mental health

  • 32.5% of mothers of children aged 0-12 years old reported reaching at-risk levels of mental health stress; 65% reported feeling stress, of which 73% were working mums with a full-time/part-time job (HKCECS, 2017).
  • 85% of mothers felt worried and frustrated due to the COVID-19 pandemic. Of those, 67% were working moms. Respondents mainly reported worry about the health of their family, children’s education, and financial burden. Friction between parents and children also added to feeling stressed and depressed (HKCTU, 2020). The burden on mothers may be particularly significant, as they are often seen as the primary caregivers to children.
  • Restrictions and school suspension due to COVID have added to the burden for working mums – 68% of working mums felt that working and taking care of their children at the same time have doubled their stress, and almost 60% of them would rather work in the office to ease the stress. (AXA, 2021). The lack of boundaries between work and home lives have taken its toll on the mental health of working mums.

In one study, working mums were found to be 40% more stressed than women without kids (Chandola et al., 2019). The new role and responsibilities that come with caring for a new member of the family, the time taken for these commitments, alongside common workplace stressors, are likely to amplify the stress experienced by working mums. Read more about the common stressors and ways to manage mental health for working mums here.

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