They say that having a baby is the most natural thing in the world. But, then again, so is a tsunami. Whether it’s all the hormonal changes, the physical recovery or being responsible for a tiny being who refuses to sleep, the whole experience can be overwhelming. Around one in five mothers struggle with their mental health.

Fortunately, in the last 20 years, attitudes towards maternal mental health have changed significantly. I often meet older women who look back at their times as new mothers and realise that they were struggling with their mental health, but it had gone undetected. In those days, mothers who became emotionally unwell were largely seen as the ones who couldn’t cope. It was shameful. There was little awareness and publicly funded specialist support was scarce.

Things really started to change in 2011 when the Maternal Mental Health Alliance was founded. It later commissioned a study by the LSE. Although the report’s findings were unsurprising, the figures brought the economic reality into focus. The study calculated that maternal mental ill health cost the UK over £8 billion annually: that’s a staggering £10,000 per birth.

They found that, over time the cumulative effect of struggling mothers in the perinatal period spiralled as the babies grew up and other family members required further mental health support or help from Social Care.

Perinatal services started to be seen as essential not only for mothers but as early interventions for so many children’s healthy development and their futures. It’s a shame that mothers’ mental ill health on its own couldn’t be enough of a concern to warrant adequate specialist services, but funding always needs to be justified I suppose.

The good news is that because reports have turned stories into numbers, the government has pledged increased funds to perinatal mental health provision and many more mothers are now being supported.

Public attitudes have changed too. Postnatal depression has had media exposure with celebrity mums such as Adele, Drew Barrymore and Gwyneth Paltrow going public with their difficult postnatal experiences.

The Jewish community has followed suit with charities such as Menucha set up to support postnatal women and Mother to Mother offering communal support after babies are born. Today people tend to more deeply appreciate quite how vulnerable mothers are during the perinatal period. But although this increased awareness has seen waves of acceptance and compassion ripple through communities, the complexity of maternal mental health often gets overlooked.

Most people (myself included until some time ago) picture postnatal depression as mums sitting and crying at the kitchen table while their baby screams in the background. They see it as a situation that can be resolved simply by a trip to the GP and a course of tablets. Plus because of hormonal changes and sleeplessness, all mothers become overwhelmed and cry.

People are unsure about when “baby blues” develops into something more worrying.
I recently moved jobs to work as a family therapist for a community perinatal mental health team, so I see the complexity and variety of maternal mental health difficulties.

Maternal mental ill health can, of course, present as excessive crying, low mood and feeling inadequate as a mother. But it can also look like so many other things, such as feeling overly anxious about the baby, or feeling panicky, having repetitive thoughts or increased irritability. It can look like recurrent flashbacks and a struggle with birth trauma.

The bond between mother and baby is a key part of maternal mental health too, even before the baby is born. How a mum feels towards their baby, how connected or distant, whether she feels that the baby likes her or not could all reflect the mother’s wellbeing and whether she can see her relationship with her baby in perspective.

At the extreme end, a mother might feel that her baby hates her or she might want to either harm her baby or smother it, anxious that services might take it away. Other members of the family react in different ways to the birth of a baby too, and recent awareness has highlighted postnatal depressive symptoms being experienced by fathers too.

Perinatal mental health services provide therapy not only to help mums with their well-being but with their early bonding with their baby as well as support with other key family relationships during this difficult time. Maternal mental health is nuanced and intricate. It affects every family differently.

Mothers’ lives are in the balance. Their children’s future lives are too. We are lucky enough to live in a place where services are available to support mothers’ mental health. Let’s reach out whenever they are needed.

menucha.info
mtom.org.uk