Maternal Mental Health Issues: Causes & Management

By Ryan Sultán, MD

Perinatal mental health refers to a woman’s mental health during pregnancy and the first year after birth. This includes mental illness existing before pregnancy, as well as illnesses that develop for the first time or are greatly exacerbated in the perinatal period. The theme of Maternal Mental Health Awareness Week 2023 is ‘Together in a changing world’. 

According to WHO “Worldwide about 10% of pregnant women and 13% of women who have just given birth experience a mental disorder, primarily depression. In developing countries, this is even higher, i.e. 15.6% during pregnancy and 19.8% after childbirth. In severe cases, mothers’ suffering might be so severe that they may even commit suicide.”

Check out the possible causes, symptoms & treatment options for managing Maternal Mental Health issues,

Why Do Maternal Mental Health Issues Happen During Pregnancy and After Birth?

Maternal mental health problems like depression, anxiety, and postpartum psychosis can occur during pregnancy and after childbirth. It’s a mix of several changes happening at once.

First, there are hormonal changes. When a woman is pregnant and after she gives birth, her hormone levels change a lot. The hormones estrogen and progesterone, which help regulate mood, rise during pregnancy and then drop quickly after childbirth. This rapid change can lead to mood swings and depression.

Second, there are a lot of life changes happening. Pregnancy and having a baby can be stressful and bring up feelings of worry or doubt. Issues like lack of social support, problems in the relationship with the baby’s other parent, or a history of mental health problems can make these feelings worse.

Third, physical changes and lack of sleep can contribute to mental health problems. Pregnancy and childbirth can be uncomfortable and exhausting, which can make mental health problems more likely. Plus, new mothers often don’t get enough sleep, which can make these problems even worse.

Identifying Symptoms of Poor Maternal Mental Health

It can be tricky to identify maternal mental health problems because some of the symptoms can seem like normal parts of pregnancy or having a newborn. But there are some signs to look out for.

For depression, you might see,

• persistent sadness
• a lack of interest in things they usually enjoy
• trouble sleeping or sleeping too much
• a lack of energy
• feelings of worthlessness or guilt
• difficulty concentrating
• thoughts about death or suicide.

Let’s consider a scenario. Say a new mom finds herself crying a lot, feeling disconnected from her baby, and no longer interested in her favorite activities. She might also be tired all the time, even when she’s had enough sleep, and may have thoughts of hurting herself or her baby. These could be signs of depression.

Anxiety can show up as constant worry, restlessness, irritability, muscle tension, and trouble sleeping. For instance, a pregnant woman might worry non-stop about her baby’s health, so much that it interferes with her daily life. She might also have physical symptoms like a racing heart or shortness of breath.

Postpartum psychosis is rare, but it can happen in the first two weeks after childbirth. Symptoms include confusion, obsessive thoughts about the baby, hallucinations, paranoia, and attempts to harm oneself or the baby. A mother with postpartum psychosis might start hearing voices telling her to harm her baby, or she might believe her baby is in danger when it’s not. This is a medical emergency and needs immediate help.

Managing Maternal Mental Health Issues

There are several things mothers and their loved ones can do to manage maternal mental health issues and promote a healthy pregnancy and childbirth:

1. Regular Check-ups: Regular prenatal and postnatal check-ups can help catch any signs of mental health issues early on.
2. Open Communication: Encourage open conversations about mental health. If a mother-to-be or new mom is feeling off, she should feel comfortable talking about it with her healthcare provider, partner, or family.
3. Therapy: Certain types of therapy, like cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT), can be very effective for treating maternal mental health disorders.
4. Medication: In some cases, medication might be necessary. But it’s important to discuss this with a healthcare provider to understand the benefits and any potential risks.
5. Support Networks: Joining support groups can provide reassurance and practical advice. It can also help reduce feelings of isolation.
6. Self-care: Taking care of oneself is key. This includes eating healthy, getting regular exercise, getting enough sleep, and practicing relaxation techniques like mindfulness or yoga.

About the Author: Ryan Sultan, MD is a Board-Certified Mental Health Physician, an expert on Perinatal Depression, a Clinical Director of Integrative Psych, and a Research Professor at Columbia University. 

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