Motherhood and Mental Health
Perinatal Mood and Anxiety Disorders (PMADS) are the leading complication associated with childbirth, with a prevalence of 1 in 5 moms.
In Africa, our healthcare systems are overloaded, and then there is the stigma. This translates to the majority of moms who are experiencing PMADS grinding their teeth, hoping the symptoms will disappear.
You are not alone (the stats are there), we are here to provide you with support and resources to guide you back to wellness.
Screening for PMADs
The first step to knowing how well you are doing psychologically and emotionally along this journey is to get screened. All you need to do is to dedicate 10 minutes to answering a few questions, feedback will be sent directly to your mailbox.
This service is completely free of charge!
Education and Information
Becoming a mother has been associated with feelings of elation, falling in love, or an instantaneous bond-forming. There is actually a range of emotions a mother might feel, all real, all valid and not bad.
We advise all moms-to-be and new moms to screen for PMADS to be aware of their emotional and psychological health and provide support and help where required
Why is Perinatal Mental Health Important?
Like all other spheres of health, to be able to take care of yourself, and your baby you need to be well. PMADS are associated with an increased risk of obstetric complications and suicide. Children of mothers with untreated PMADS are also at risk of developing emotional and cognitive problems.
Risk Factors
- previous experience of mental health problems
- biological causes
- lack of support
- difficult childhood experiences
- experience of abuse
- low self-esteem
- stressful living conditions
- major life events
Perinatal Depression
Moms may have difficulty identifying symptoms of perinatal depression because some of the key indicators are largely expected as normal behavioral changes after childbirth, such as lack of interest in activities you once enjoyed or getting less sleep. Symptoms of Perinatal depression might look like:
- During pregnancy or within a year of childbirth
- Persistent sense of sadness, feelings of hopelessness and emptiness
- Lack of interest or motivation for anything
- Continued struggle to sleep, even when baby is well-cared for
- Notable change in eating habits
- Disinterest in caring for self or child/ children
- Detachment from child and other loved ones
- Suicidal thoughts
Perinatal Anxiety
There are different types of anxiety disorders. In some cases, an anxiety disorder may be pre-existing condition prior to pregnancy, or birth. Anxious and fearful thoughts are a natural human response to feeling threatened. Having another vulnerable human who you love fearlessly can be a trigger for perinatal anxiety.
Symptoms may include:
• Looming sense of danger/ unease
• Periods of sudden elevated heart rate/ breathing
• Headaches and dizziness
• Teeth-grinding
• Hot flushes and sweating
• Sick feeling in the stomach
• Dissociation from self or surroundings
• Ruminating- replaying events, conversations, fixation on a situation.
Perinatal OCD (obsessive compulsive disorder)
Perinatal OCD is particularly difficult to diagnose because it is often characterised by intrusive thoughts, which most moms feel afraid and uncomfortable to disclose. Like anxiety, the risk of developing perinatal OCD is increased by having pre-existing OCD. In the perinatal period it may look like:
- Intrusive thoughts about harming baby, self, sexual thoughts
- Excessive sterlization and cleaning
- Obsessions about baby’s health (medications and vaccinations)
- Repetitively checking on baby.
Perinatal Bipolar Mood Disorder
Bipolar mood disorder can be a pre-existing condition. However, for some, pregnancy and postpartum might be the first time they experience bipolar symptoms. Mood fluctuations are a normal human experience. With bipolar disorder the mood shifts between notable depression and hypo-mania (elevated, beyond normal high mood), each phase lasting up to approximately 4 days. The main difference between Bipolar I and Bipolar II is in the severity of the highs and lows. Other symptoms include;
• Irritability
• Impulsivity (Bipolar I)
• Little need for sleep
• Overconfidence
• Rapid speech
• Trouble concentrating
Birth Trauma and Perinatal PTSD
Birth trauma is associated with distressing symptoms linked to a traumatic birth experience. This can happen during pregnancy due to a previous birth experience as well. Some birthing people will also experience PTSD during the perinatal period which stems from other traumatic experiences, e.g. sexual abuse, and are triggered by pregnancy, birth or postpartum. Symptoms of both or either include:
- Flashbacks and nightmares
- Active avoidance of associations of the traumatic experience (e.g. Hospital, doctor, sometimes the baby)
- Detachment
- Hyper-vigilance, panic attacks
- Exaggerated startle-response
Perinatal Psychosis
In comparison to other PMADs, perinatal psychosis is a rare condition, affecting approximately 2 in 1000 birthing people. The majority of documents occurrences are postpartum, beginning within two weeks postpartum. However perinatal psychosis may also begin during pregnancy. This is a serious, yet treatable condition, requiring immediate medical attention. Any symptoms should not be ignored or expected to clear on their own.
- Break from reality/ hallucinations/ delusion (this may look or sound like stories about the baby being a saviour, or being sent to harm.
- Rapid mood swings
- Paranoia
- Difficulty with communicating
- Loss in inhibitions
The World Health Organization (WHO) defines maternal mental health as “a state of well-being in which a mother realizes 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” (2; p 1195)
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