What hides under the Glow – A Look into Maternal Mental Health

Our mothers go through a life-altering experience during pregnancy. It is not just after giving birth that the changes occur, they begin immediately in the form of hormonal changes, physical changes, as well as mental and emotional changes. Unfortunately, there is a widespread lack of awareness when it comes to the psychological changes a mother goes through, and how they are to be dealt with. According to The World Health Organization (WHO), maternal mental health is defined as “a state of well-being in which a mother realises her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her community”. A low mental health can cause the mother to pay less attention to her and the child, which results in a faulty mother-child relationship and may even give rise to emotional stress and more in the child. So, if adequate attention is not given to the mental health of a mother, it influences both the mother and the child. The recent COVID-19 pandemic caused maternal mental health and care to be pushed back further, with apprehensions about catching the virus, mothers lacked social support, suffered economically and experienced high anxiety levels. Postnatal depression is a commonly known disorder, however there are many more we might not be aware of. There are generally three types- perinatal which ranges from pregnancy to a year after childbirth, antenatal which arises during pregnancy and postnatal which occurs during the first year after birth. Examples of common disorders faced during these periods are perinatal anxiety (some symptoms include: restlessness, panicky, irritability, etc.), perinatal depression (some symptoms include: diminished interest, fatigue, tiredness, etc.) Borderline Personality Disorder (some symptoms include: taking risks, impulsive behaviour, unstable relations, obvious signs of unusual behaviour, etc.) Eating disorders are also common along with changes in taste, frequent nausea and lowered appetite occur during and after pregnancy In India, women are more affected by mental health issues than men, and the population is vast. However, the care available and provided are low compared to the amount of people in need of them. In rural India, women are more exposed to stressors which relate to their economic status. Poverty can cause mental illnesses and also hinder parents from providing their child with quality care and support. Infants belonging to low economic backgrounds suffer malnutrition and a generally low rate of development, and the contributing factor is the poor mental health of the parents. Women’s issues already face a setback in the disadvantaged regions, so the lack of awareness about the mental issues paired with cultural beliefs brings about maladaptive behaviour. A study conducted in rural India (Bhushan, N.L., Krupp, K., Jaykrishna, P. et al., 2020) found that pregnant women who are more frequently visited by community health workers were less likely to report anxiety during pregnancy. Experts have looked into the current policies of India regarding maternal mental health, and they noticed that our country lacks exclusive policies. With the COVID-19 pandemic, a clear interruption in routine care for mothers was noticed which caused distress. They have proposed solutions which include strengthening the implementation of the existing National Mental Health Program (NMHP) which fails to include women in the perinatal period and integrating mental health in the ongoing Reproductive, Maternal, Newborn, Child and Adolescent Health Program. At an individual level, women can make use of different ways to lower feelings of anxiety, fear and agitation experienced during and after pregnancy which can be going for a walk, doing yoga, engaging in gardening and different hobbies boost good feelings and mood. Ensuring a balanced and nutritious diet contributes to both physical and mental health. Being in contact with loved ones and having a good network, receiving visits from health workers, etc. provide support to the mother during a time of uncertainty and unfamiliarity and provide them strength. At the same time, online communities and regular meetings with fellow mothers can help in boosting social support. Talking about the struggles and sharing moments of happiness builds relations and helps mothers to come in terms with what they are feeling. The month of May is dedicated to the mental health of mothers. However, it is important for us to recognize the various struggles mothers face during their journey of becoming a supportive and caring parent to their child throughout the year. People boast about how blissful motherhood and pregnancy is, glossing over the feelings of guilt, fear and anxiety that arise. This makes it hard for mothers to express how they truly feel, as they fear judgement. Treating mothers with gentleness and kindness during a testing time like this, and allowing them to not be okay and reminding them to not wait for help are some ways we can help. The role of information and education is extremely crucial, as it helps mothe

rs prepare and deal with issues that might come their way, more effectively. Maternal mental health disorders can happen to anyone, anytime. It is time we work towards a more supportive and loving environment for mothers who are trying their best every day.

References

1. Bhushan NL, Krupp K, Jaykrishna P, Ravi K, Khan A, Shidhaye R, et al. The association between social support through contacts with Accredited Social Health Activists (ASHAs) and antenatal anxiety among women in Mysore, India: a cross-sectional study. Soc. Psychiatry Psychiatr. Epidemiol. (2020) https://link.springer.com/article/10.1007/s00127-020-01854-4

2. Brand, Sarah R. Brennan, Patricia. Impact of Antenatal and Postpartum Maternal Mental Illness: How are the Children?. Clinical Obstetrics and Gynecology, September 2009. https://journals.lww.com/clinicalobgyn/Abstract/2009/09000/Impact_of_Antenatal_and_ Postpartum_Maternal_Mental.17.aspx

3. Davenport MH, Meyer S, Meah VL, Strynadka MC, Khurana R. Moms are not OK: COVID-19 and maternal mental health. Front. Glob. Womens Health. (2020) https://www.frontiersin.org/articles/10.3389/fgwh.2020.00001/full?fbclid=IwAR1Dxl4

4. I.J. Rowlands, H. Teede, J. Lucke, A.J. Dobson, G.D. Mishra, Young women's psychological distress after a diagnosis of polycystic ovary syndrome or endometriosis, Human Reproduction, Volume 31, Issue 9, September 2016. https://academic.oup.com/humrep/article/31/9/2072/2914000

5. Patrice L Engle, Maternal mental health: program and policy implications, The American Journal of Clinical Nutrition, Volume 89, Issue 3, March 2009 https://academic.oup.com/ajcn/article/89/3/963S/4596820

Written by Kavya Kapoor (1st year)

Reviewed by: Jaya Kumari ( Content Team Coordinator | Editor-in-chief )

Akshita Tanwar (Associate Editor)