Mental Health of Mothers
Mental Health of Mothers links directly to the health and development of their infants. Preventing and treating perinatal mental illness (from conception to one year after delivery) affects both mother and offspring. Substantial research undertaken in high income countries shows that around 1 in 10 pregnant women and 1 in 13 women who have recently given birth, experience a mental health illness: primarily depression and anxiety (WHO, 2018). Depressive illness is by far the most common complication of maternity. In low and middle countries, the incidence of maternal mental illness is even higher: 15.6% of women during pregnancy and nearly 20% of women after childbirth have been found to experience some form of mental health disorder (WHO, 2018). Mothers who are affected cannot function properly and as a result, their children’s growth and development may be negatively affected. In serious cases, mothers may even commit suicide. Suicide accounts for one in seven perinatal deaths. Psychosis is much less common but may also lead to suicide and also injury of the infant.
Depression causes enormous suffering and a reduced response to the child’s needs. Evidence indicates that treating depression in mothers leads to improved growth and cognitive development of the newborn and reduces the likelihood of diarrhoea and malnutrition among them. Globally, maternal mental health problems are considered as a major public health challenge. Some academic and public health institutions in low and middle-income countries have already initiated low cost interventions with the involvement of non-specialized or community health providers. Impact has been demonstrated not only on mothers but also on growth and development of children (WHO, 218).
Who is at risk? Any woman can develop mental disorders during the perinatal period – during pregnancy and in the first year after delivery. Contributing factors include poor emotional and practical support from one’s partner and/or one’s own mother; exposure to domestic, sexual and gender-based violence; exposure to childhood emotional adversity; having belligerent in-laws; having an unintended/unwanted pregnancy; poverty; conflict situations; natural disasters; and a previous history of mental health illness, all of which increase the risk of a woman developing a mental illness during the perinatal period.
Effects of maternal mental disorders on infants after birth:
- Mental illnesses have serious consequences for women, their infants and their families and suicide contributes to maternal deaths in LMIC countries (WHO, 2010);
- Women with mental health illnesses are often stigmatized and are less likely to participate in prenatal, perinatal, or postnatal care (Fisher et al, 2010);
- Infants are dependent on their mothers for breastfeeding, physical care, comfort and social interaction. If a mother is unable to respond to her baby’s needs due to her poor mental health, her baby’s development is compromised;
- Maternal mental health problems are not only detrimental to the woman’s health; they are also linked to reduced sensitivity and responsiveness in caregiving, and to higher rates of behavioural problems in young children;
- Research shows that offspring whose mothers suffered from perinatal depression are likely to suffer themselves in due course. Poor attachment counts as an adverse childhood experience, which can affect health in later life, e.g. coronary heart disease and Type II diabetes (Barker et al, 2001);
- In low and middle-income countries, the negative effects of maternal mental disorders have been linked directly to low birth weight and undernutrition during the first year of life; stunting; diarrhoeal diseases; infectious illnesses; hospital admissions and reduced completion of immunization schedules among infants (Fisher et al, 2011);
- Very young infants can be affected by and are highly sensitive to the environment and the quality of care given to them. Prolonged or severe mental illness hampers the mother-infant attachment, breastfeeding and infant care (WHO, 2018).
What we need to do Maternal mental health should be integrated into general health care including women’s health, maternal and child health care (WHO, 2018).