The 1st to the 7th of May is observed as Maternal Mental Health Awareness Week. Today, the 3rd of May is observed as World Maternal Mental Health Awareness Day (WMMHDay). It is a day when we raise public awareness of mental health problems that can occur in pregnant women and mothers, and emphasise the importance of taking care of mental health during pregnancy and the postpartum period. It is celebrated on the first Wednesday in May, just before Mother's Day, and throughout May. This global campaign started in 2016 under the slogan Maternal Mental Health Matters. I am very passionate about this topic, in my role as Associate Professor at the Department of Psychology, Catholic University of Croatia, and the lead of the NGO, Centre for Reproductive Mental Health.
Mental difficulties can happen to anyone
Current research shows that one in five women have mental health problems during pregnancy or up to 12 months after giving birth. The following disorders occur most often:
Although pregnancy is a favourable period for women who have previously struggled with bulimia nervosa, it is a sensitive time for the development of binge eating disorder, which is present in about 5% of pregnant women.
Obsessive-compulsive disorder (OCD) may occur in about 4% of mothers.
Postpartum psychosis may occur in 1 to 2 births per 1,000 in the general population, but it is much more common in women with a diagnosis of bipolar or schizoaffective disorders, or in women with a family history of postpartum psychosis; it requires urgent psychiatric treatment.
Why do we need World Maternal Mental Health Day?
Unfortunately, the awareness of the public, pregnant women, mothers themselves, their close ones, and health professionals about these problems is still too weak. Women do not recognise the symptoms; if they are aware of them, they are afraid to seek help because of the stigmatisation. They think that others will consider them to be bad mothers, or they feel shame and guilt. Also, some women fear taking medication or even losing parental rights. However, there are other obstacles, namely that, unfortunately, the necessary professional help is not equally available everywhere.
Peripartum mental disorders affect maternal well-being and quality of life, the child's development, partners who themselves can suffer from peripartum depression, and the family's overall functioning. All of these impose significant costs on the family and society. For example, estimates in the United Kingdom are that the total lifetime costs of peripartum depression are £75,728 per woman with the condition. However, only one-third of that is due to adverse outcomes in mothers, while two-thirds are related to adverse outcomes in children. That is the reason why it is so important to seek help!
There are effective treatments for peripartum disorders
As the public usually thinks that peripartum depression is related only to childbirth and the early postpartum period and that it will pass by itself, research with long-term follow-up of women shows that this is not quite so.
One study followed about 100 women with peripartum depression for two years and showed that it takes an average of 49 weeks for full recovery, which is almost a year. Of these, about 30% of women recover in the first six months, 60% in 12 months, and 90% in 24 months from the onset of depression. Therefore, it is crucial to seek help as early as possible. What is worrying is that out of 10 women with peripartum depression, only four seek help.
The additional problem is that not all European countries have clinical guidelines for peripartum depression management. Only 11 European countries have such policies, although less than half were rated as of adequate quality by a systematic study. However, experts are currently working on developing evidence-based clinical guidelines for peripartum depression within the framework of the international COST Action Riseup-PPD project dedicated to peripartum depression.
Regarding the treatment for peripartum depression, antidepressants are used for severe depression, and concerning psychotherapies, cognitive-behavioural therapy proved the most effective. In addition, there are other effective treatments, such as repetitive transcranial magnetic stimulation (rTMS), although caution is warranted during pregnancy. Therefore, effective treatment exists, but we should encourage women in need to use them.
What can we do? Get involved!
We must never leave the responsibility of seeking help only to women with perinatal mental health difficulties. Indeed, self-blame, which is one of the symptoms of depression, is precisely one of the reasons why women do not seek help, which is paradoxical. It would be like someone with a broken leg not going to the emergency room because they blame themselves for falling!
Therefore, the role of the family and friends is important, which should be sensitive to the woman's needs, offer their emotional support, help with household chores, and honestly ask the mother, "How are you?" with compassion, genuine care, and without judgment.
Also, as a society, we must ensure the necessary steps: carry out psychoeducation about psychological difficulties during pregnancy and after childbirth for mothers and families as well as for health workers, implement effective preventive programs, conduct screening for mental health problems within the health system, and provide available professional help.
The responsibility for positive change lies in our hands! What can we do?
Sign the petition to include this day in the official UN calendar!
Share World Maternal Mental Health Day infographic.
Use #maternalMHmatters on social media.
Ask a pregnant woman or mother around you, "How are you?" and give her a hand to let her know that she is not alone.