Mental Health Care During Pregnancy

Mental Health Awareness Month

By Constance Ndeleko

Mental Health Awareness Month is a time to recognize issues surrounding mental health worldwide. Today we will identify mental health during pregnancies.

Pregnancy is often a very happy and exciting time. But not every woman feels this way. Some may have mixed, or even negative, feelings about being pregnant. For teenage mothers this could be a shocker with mixed emotion that could tamper with their coping mechanism due to the new changes and uncertainties.

Pregnant and breastfeeding women are facing numerous life changes that make them particularly vulnerable to mental health disorders.

A large multinational study on perinatal mental health conducted before the COVID‐19 era showed that between 4% and 8% of women have moderate‐to‐very severe depressive symptoms during pregnancy and in the postnatal period.

In the context of the COVID‐19 pandemic, maternal distress might be compounded by concerns and fears regarding the risk of infection or hospitalization due to COVID‐19, especially as perinatal morbidity and mortality associated with COVID‐19 have been described.

Generally, many things can affect how a woman feels in pregnancy. These include physical symptoms (e.g. morning sickness), the support you have (or don’t have), and stressful events in your life. Stress over being pregnant, changes in your body during the pregnancy, and everyday worries can take a toll.

Some women could suffer different mental health issues during their pregnancies depending on their environment and circumstances they are facing. Research indicates that, as many as 1 in 5 women have mental health problems in pregnancy or after birth. Depression and anxiety are the most common mental health problems in pregnancy. These affect about 10 to 15 out of every 100 pregnant women.

Some pregnant women may have other mental health issues, such as:

Virtually all women can develop mental disorders during pregnancy and in the first year after delivery, but poverty, migration, extreme stress, exposure to violence (domestic, sexual and gender-based), emergency and conflict situations, natural disasters, and low social support generally increase risks for specific disorders. (WHO)

In addition, pregnancy itself can be stressful. As well as dealing with hormonal and physical changes, you may feel stressed about things such as antenatal tests, particularly if you’ve had a bad experience before, such as a miscarriage.

Very young infants can be affected by and are highly sensitive to the environment and the quality of care, and are likely to be affected by mothers with mental disorders as well. Prolonged or severe mental illness hampers the mother-infant attachment, breastfeeding and infant care.

Impact of a Mother’s mental health illness on children

In severe cases mothers’ suffering from mental might be so severe that they may even commit suicide. In addition, the affected mothers cannot function properly. As a result, the children’s growth and development may be negatively affected as well.

Maternal mental health significantly influences Maternal–fetal attachment (MFA), and infant–caregiver bonding begins fairly early in pregnancy. Maternal depression in the postnatal period interferes with infant growth and failure to thrive.

The perinatal period, which includes both antenatal and postnatal phases, is very significant both for the mother as well as for her child. Infants of depressed mothers often shows lower birth weight (LBW; than infants of no depressed mothers.

A recent study showed that poverty and maternal depression independently and collectively decreased cognitive and emotional wellbeing in children.

Psychological distress and mental illness, including depression and anxiety, influence a child’s emotional, cognitive, and behavior development in addition to impacting birth outcomes and physical growth.

Trait anxiety in mothers predicted difficult infant temperament, such as clinging behavior, frequent crying and irritability, independent of comorbid depression, sociodemographic and obstetric risk factors.

Maternal depressive symptoms, anxiety, and stress have been associated with adverse pregnancy, fetal, and (long‐term) infant outcomes. It is critical that mental health disorders are detected and addressed in clinical practice.

It is perceived stress during pregnancy was a predictor of lower levels of restless/disruptive temperament, more total behavioral problems and more externalizing behavioral problems in 2-year-olds.

Increased maternal morbidity and mortality with increased risk of maternal suicide and impaired parenting capability can badly affect the physical, emotional, social, and cognitive development of their children

Suicide is an important cause of death among pregnant and post- partum women. Psychosis is much less common but may also lead to suicide and in some cases even harming the newborn. Depression causes enormous suffering and disability and reduced response to child’s need. Evidence indicates that treating the depression of mothers leads to improved growth and development of the newborn and reduces the likelihood of diarrhea and malnutrition among them. (WHO)

Sociocultural factors, such as preference for a male child, domestic violence and a lack of social support further accentuates a woman’s risk for psychopathology in our culture and merits

Interventions to mitigate their mental health problems and to promote preventive behaviors are highly warranted. The potential impact of the COVID‐19 pandemic on mental health should not be neglected, especially in vulnerable populations

It’s important to treat mental health concerns during pregnancy. Mothers who are depressed, anxious, or have another issue might not get the medical care they need. They might not take care of themselves, or they may use drugs and alcohol during the pregnancy. All of these things can harm a growing baby.

Early detection and effective interventions where necessary are important to prevent devastating consequences for women themselves, their children, and families. This also reduces the burden of maternal mental health problems for the individual, family, and the entire society.

If you have a mental health issue, talk with your doctor so you can get the help you need during and after your pregnancy.

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