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Perinatal Mental Health - A Progressive Challenge

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Perinatal mental health (PMH) issues are mental health problems that occur in mothers during or in the first year after pregnancy.

Medically reviewed by

Dr. Vishal Anilkumar Gandhi

Published At May 22, 2023
Reviewed AtMay 2, 2024

Introduction

The first 1001 days after conception are a critical time for babies. It can also be a tough time for parents, especially for the mother’s mental health. Tiredness and stress are part of the job, but most mothers, have to deal with more serious challenges. One in five women is known to experience a perinatal mental health problem during their pregnancy and in the first year after the birth of the baby. All kinds of factors can contribute to it. Low mood and anxiety are common mental health difficulties. But it is important that they are fully assessed.

What Is Perinatal Mental Health?

The period of time, which includes pregnancy and one year after giving birth, is called the perinatal period. Most women struggle with their mental health during this period. The most common conditions are depression and anxiety. Depression and anxiety are different from normal sadness and worries. Normal sadness and worries disappear over time, but depression and anxiety last longer and impact day-to-day life and a sense of well-being.

How to Determine if a Woman Is Struggling During the Perinatal Period?

The following general symptoms can be looked for:

  • A feeling of depression.

  • Not enjoying regular activities.

  • Sleeping more or less than usual.

  • Eating more or less than usual.

  • Constant tiredness.

  • Low self-esteem.

  • Trouble concentrating.

  • Feelings of guilt.

  • A feeling of being anxious or nervous.

  • Overthinking.

  • Bodily changes like nausea, dizziness, and trembling.

  • In severe cases, suicidal thoughts.

How to Differentiate Between the Usual Depression and the One Triggered During the Perinatal Period?

During pregnancy and postpartum (period after delivery), figuring out if a mother has depression or anxiety becomes complicated. Symptoms of mental illness can show themselves in particular ways that are different from usual. Not all mothers will have the same symptoms, but the following can be checked to differentiate:

  • Being overly anxious about the health of the baby.

  • Sometimes the mother is not even able to sleep even when the baby is sleeping.

  • Some mothers can also feel uninterested in their babies.

  • Feelings of worthlessness.

  • Mothers can also have thoughts about if they are actually fit to be a mother.

  • Unwanted and upsetting thoughts about the baby.

  • Flooding of traumatic memories.

  • More irritable than usual.

  • A feeling of going someplace else or leaving the baby.

Cultural and lifestyle differences can influence the symptoms, meaning different people can experience symptoms in different ways. If someone has several of these symptoms and they happen for most of the day (almost every day), then they might have depression or anxiety. These are very common conditions to experience during the perinatal period, and no matter the situation, the mother should not feel at fault.

What Should Be Done to Improve Mental Health During the Perinatal Period?

The following steps can be adopted to ensure the better mental health of the mother during their perinatal period:

  1. It is important that the red flags are not missed to ensure that the mothers receive the care they need. Healthcare professionals and midwives play an important role in spotting the red flags early and can help the family get the right support as soon as possible.

  2. Women with pre-existing mental health problems may be aware that they have a high risk and ask for support; however, they may still not know where to seek help or they might feel that there are barriers to getting help. If someone with existing mental health is thinking about pregnancy or is already pregnant, lots of support is already available including, preconception advice, psychological therapists, parent-infant bonding, and medication advice. It is important that they do not stop any medication without advice from a medical professional or a perinatal specialist.

  3. For other women, the clues are much more subtle. Anxiety or intrusive thoughts can go under the radar, especially if there are feelings of shame, guilt, or fear of the consequences. If someone has any concerns a perinatal specialist mental health community team is always on hand for advice and support.

  4. For some, there are no early signs at all. A situation can go from normal to very serious and dangerous very quickly. Postpartum psychosis is a medical emergency and it is critical for a mother and the baby. An assessment should be done as soon as possible.

What Is the Role of Perinatal Mental Health Services?

When a mother or a birthing person experiences a perinatal mental health difficulty, the whole family can get affected. The perinatal mental health services support mothers as well as other important people around them. It can be a stressful and isolating experience for partners and other family members when a loved one is unwell. They may need to care for the mother and children in the family, along with juggling day-to-day responsibilities. The perinatal mental health services involve partners and other family members and support them to care for the mother and better understand the mother’s mental health needs. They provide information and guidance throughout the time the mother is receiving care, signpost family members to support for practical difficulties, and involve them in the care plan made with the mother.

The families might deal with changes to their relationship, so family-focused interventions and supporting relationships with the baby are also provided by these professionals. Partners and other family members may have their own mental health needs, and there can be barriers to seeking and accepting help. Recognizing these difficulties and signposting them to sources of support can be really valuable in helping the whole family feel supported.

It is not only other adults who may need support, other children in the family can also be affected and easily forgotten. They might not fully understand what is happening or might not be able to tell their parents how they feel about the situation, in this case, also, mental health service providers can support or guide them to tackle the situation. When a mother and a baby are well supported, they are more likely to have positive mental health relationships and health outcomes. So in this time of huge transition, by being family-focused, perinatal mental health services are in a unique position to enable all family members to thrive.

Conclusion

With the right care at the right time, mothers can have the best chance of being well and enjoying family life with their babies. If a mother is having any mental health problems, then they should consult a healthcare professional or talk to a midwife. It may be hard, but it is important to bring the issues forward and get the appropriate treatment. The good mental health of the mother will also improve the well-being of the baby and the family.

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Dr. Vishal Anilkumar Gandhi
Dr. Vishal Anilkumar Gandhi

Psychiatry

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